bluuebunny/crossref_metadata_2025 huggingface dataset:
Challenges to accurate susceptibility testing and interpretation of quinolone resistance in Enterobacteriaceae: results of a Spanish multicentre study
Authors: Rodriguez-Martinez José-Manuel , Machuca Jesús , Calvo Jorge , Diaz-de-Alba Paula , Rodríguez-Mirones Cristina , Gimeno Concha , Martinez-Martinez Luis , Pascual Álvaro
Published: March 2015

Objectives

The objective of this study was to evaluate the proficiency of Spanish laboratories with respect to accurate susceptibility testing and the detection and interpretation of quinolone resistance phenotypes in Enterobacteriaceae.

Methods

Thirteen strains of Enterobacteriaceae were sent to 62 participating centres throughout Spain; strains harboured GyrA/ParC modifications, reduced permeability and/or plasmid-mediated quinolone resistance genes. The centres were requested to evaluate nalidixic acid and five quinolones, provide raw/interpreted clinical categories and to detect/infer resistance mechanisms. Consensus results from reference centres were used to assign minor, major and very major errors (mEs, MEs and VMEs, respectively).

Results

Susceptibility testing in the participating centres was frequently performed using the MicroScan WalkAway, Vitek 2 and Wider systems (48%, 30% and 8%, respectively). CLSI/EUCAST breakpoints were used in 71%/29% of the determinations. The percentage of VMEs for all quinolones was well below 2%. Only ofloxacin and moxifloxacin showed higher values for raw VMEs (6.6%), which decreased to 0% and 2.9%, respectively, in the interpreted VMEs. These errors were particularly associated with the CC-03 strain [qnrS2 + aac(6′)-Ib-cr]. For MEs, percentages were always <10%, except in the case of ofloxacin and nalidixic acid. There was a significantly higher percentage of all types of errors for strains whose MICs were at the border of clinical breakpoints.

Conclusions

The use of different breakpoints and methods, the complexity of mutation-driven and transferable resistance mechanisms and the absence of specific tests for detecting low-level resistance lead to high variability and represent a challenge to accuracy in susceptibility testing, particularly in strains with MICs on the border of clinical breakpoints.
Nocardia puris brain abscess in an immunocompromised woman
Authors: Smith Lindsay M. , Galvin Shannon R.
Published: March 2015

Introduction:

Nocardia puris is a rare cause of infection worldwide, with very few published cases. Here we report the first case to our knowledge of brain abscess caused by N. puris.

Case presentation:

Our patient, currently undergoing treatment with rituximab for non‐Hodgkin lymphoma, presented with a 2 week history of worsening headache and nuchal rigidity. Magnetic resonance imaging of the brain revealed a ring‐enhancing mass in the right temporal lobe. The abscess was surgically resected and the causative organism was identified as N. puris by culture and then 16S PCR of the rRNA gene. Our patient was successfully treated with a combination of imipenem and trimethoprim–sulfamethoxazole (15 mg kg−1 day−1) for 3 months, followed by 9 months of monotherapy with trimethoprim–sulfamethoxazole.

Conclusion:

Treatment of nocardiosis remains challenging, with each species having a unique antimicrobial susceptibility profile. Our patient was successfully treated with a combination of imipenem and trimethoprim–sulfamethoxazole, followed by monotherapy with trimethoprim–sulfamethoxazole.
Galactomannan antigen and Aspergillus antibody responses in a transplant recipient with multiple invasive fungal infections
Authors: Dupont D. , Geffriaud T. , Boibieux A. , Rimmele T. , Picot S. , Persat F.
Published: March 2015

Introduction:

We report Aspergillus antigen and antibody responses in a case of multiple invasive fungal diseases.

Case presentation:

The patient, a double‐lung transplant recipient, had candidaemia and invasive pulmonary aspergillosis with cerebral involvement. The follow‐up of the serum Aspergillus galactomannan antigen by ELISA showed a level increase that correlated with the patient’s aggravation. It was retrospectively completed by kinetics analysis using different anti‐Aspergillus antibody assays (ELISA and Western blotting).

Conclusion:

A balance between the Aspergillus antigen and anti‐Aspergillus antibodies was shown using different anti‐Aspergillus antibody assays. The results of these two antibody techniques appeared rather congruent.
N—H...S and C—H...S hydrogen bonds in two tetraalkylammonium dithiobiurea(1–) inclusion compounds
Authors: Guo Hao , Wu Jinfeng
Published: March 2015

Two inclusion compounds of dithiobiurea and tetrapropylammonium and tetrabutylammonium are characterized and reported, namely tetrapropylammonium carbamothioyl(carbamothioylamino)azanide, C12H28N+·C2H5N4S2−, (1), and tetrabutylammonium carbamothioyl(carbamothioylamino)azanide, C16H36N+·C2H5N4S2−, (2). The results show that in (1), the dithiobiurea anion forms a dimerviaN—H...N hydrogen bonds and the dimers are connected into wide hydrogen-bonded ribbons. The guest tetrapropylammonium cation changes its character to become the host molecule, generating pseudo-channels containing the aforementioned ribbons by C—H...S contacts, yielding the three-dimensional network structure. In comparison, in (2), the dithiobiurea anions are linkedviaN—H...S interactions, producing one-dimensional chains which pack to generate two-dimensional hydrogen-bonded layers. These layers accommodate the guest tetrabutylammonium cations, resulting in a sandwich-like layer structure with host–guest C—H...S contacts.
Unexpected proline coordination in the copper chain polymer [Cu(μ-Cl)2(μ-DL-proline-κ2O:O′)]1∞
Authors: Lamberts Kevin , Şerb Mihaela-Diana , Englert Ulli
Published: March 2015

Incatena-poly[copper(II)-di-μ-chlorido-μ-proline-κ2O:O′], [CuCl2(C5H9NO2)]n, two symmetry-independent metal cations adopt distorted octahedral coordination, typical ford9Jahn–Teller systems. Each chloride bridge is involved in both a short and a very long interaction with a CuIIcentre. The centrosymmetric crystal structure contains homochiral chains of opposite handedness which extend along the shortest lattice parameter (i.e. a). TheO:O′-bridging coordination mode of proline, although a common motif for such complexes in general, is remarkable for CuII; the vast majority of amino acid derivatives of this cation are characterized byN,O-chelation.
Inversion twinning in a second polymorph of the hydrochloride salt of the recreational drug ethylone
Authors: Cameron T. Stanley , Grossert J. Stuart , Maheux Chad R. , Alarcon Idralyn Q. , Copeland Catherine R. , Linden Anthony
Published: March 2015

A second polymorph of the hydrochloride salt of the recreational drug ethylone, C12H16NO3+·Cl−, is reported [systematic name: (±)-2-ethylammonio-1-(3,4-methylenedioxyphenyl)propane-1-one chloride]. This polymorph, denoted form (A), appears in crystallizations performed above 308 K. The originally reported form (B) [Woodet al.(2015).Acta Cryst. C71, 32–38] crystallizes preferentially at room temperature. The conformations of the cations in the two forms differ by a 180° rotation about the C—C bond linking the side chain to the aromatic ring. Hydrogen bonding links the cations and anions in both forms into similar extended chains in which any one chain contains only a single enantiomer of the chiral cation, but the packing of the ions is different. In form (A), the aromatic rings of adjacent chains interleave, but pack equally well if neighbouring chains contain the same or opposite enantiomorph of the cation. The consequence of this is then near perfect inversion twinning in the structure. In form (B), neighbouring chains are always inverted, leading to a centrosymmetric space group. The question as to why the polymorphs crystallize at slightly different temperatures has been examined by density functional theory (DFT) and lattice energy calculations and a consideration of packing compactness. The free energy (ΔG) of the crystal lattice for polymorph (A) lies some 52 kJ mol−1above that of polymorph (B).
Cost estimation for electric light and power elements during building design
Authors: Aibinu Ajibade A. , Dassanayake Dharma , Chan Toong-Khuan , Thangaraj Ram
Published: March 2015

Purpose

– The study reported in this paper proposed the use of artificial neural networks (ANN) as viable alternative to regression for predicting the cost of building services elements at the early stage of design. The purpose of this paper is to develop, test and validate ANN models for predicting the costs of electrical services components.

Design/Methodology/Approach

– The research is based on data mining of over 200 building projects in the office of a medium size electrical contractor. Of the over 200 projects examined, 71 usable data were found and used for the ANN modeling. Regression models were also explored using IBM Statistical Package for Social Sciences Statistics Software 21, for the purpose of comparison with the ANN models.

Findings

– The findings show that the cost forecasting models based on ANN algorithm are more viable alternative to regression models for predicting the costs of light wiring, power wiring and cable pathways. The ANN prediction errors achieved are 6.4, 4.5 and 4.5 per cent for the three models developed whereas the regression models were insignificant. They did not fit any of the known regression distributions.

Practical implications

– The validated ANN models were converted to a desktop application (user interface) package – “Intelligent Estimator.” The application is important because it can be used by construction professionals to reliably and quickly forecast the costs of power wiring, light wiring and cable pathways using building variables that are readily available or measurable during design stage, i.e. fully enclosed covered area, unenclosed covered area, internal perimeter length and number of floors.

Originality/value

– Previous studies have concluded that the methods of estimating the budget for building structure and fabric work are inappropriate for use with mechanical and electrical services. Thus, this study is unique because it applied the ANN modeling technique, for the first time, to cost modeling of electrical services components for building using real world data. The analysis shows that ANN is a better alternative to regression models for predicting cost of services elements because the relationship between cost and the cost drivers are non-linear and distribution types are unknown.
Urban management, destination management and urban destination management: a comparative review with issues and examples from New Zealand
Authors: Pearce Douglas G.
Published: March 2015

Purpose

– The purpose of this paper is to first outline the central thrust of two currently non-convergent but intrinsically related streams of research – urban management and destination management – and explore the links between them. Both require an approach which coordinates and integrates multiple actors and functions in dynamic settings.

Design/methodology/approach

– The paper then analyses empirical examples from three New Zealand cities to illustrate relationships between destination management and urban management in practice.

Findings

– These cases show that without being labelled as such, quite a lot of activity takes place which reflects dimensions of both destination management and urban management, especially in terms of integration and coordination. This raises questions of just what constitutes destination management, a series of discrete ad hoc actions or some broader vision and framework.

Originality/value

– Empirical evidence from the three New Zealand cities shows that, with the exception of Dunedin, destination management is not a term or a concept that is explicitly used there. Nevertheless, without being labelled as such, in practice there is quite a lot of activity taking place which reflects dimensions of both destination management and urban management, especially in terms of integration and coordination.
Building trust and cohesion in virtual teams: the developmental approach
Authors: Lu Luo
Published: March 2015

Purpose

– Using the developmental process of interpersonal relationships as a metaphor, the purpose of this paper is to examine the mediating effects of trust and cohesion on the links between psychosocial factors and work outcomes among Chinese employees.

Design/methodology/approach

– A three-wave survey method was used to collect data from 388 full-time employees working in virtual teams in diverse industries in Taiwan.

Findings

– Structural equation modeling confirmed that trust and cohesion were two key psychological mechanisms linking up team psychosocial factors (i.e. psychological similarity, shared activities) and work outcomes (i.e. job satisfaction, team performance).

Practical implications

– This study examined virtual teams, which are increasingly prevalent in cloud computing applications, from a largely overlooked social psychological perspective. The results clearly demonstrated that the development and functioning of work teams is similar to the formation and functioning of social relationships. Thus, psychology in general, social psychology in particular, should have a lot to contribute to the better understanding of the rich dynamism of work teams, virtual and face-to-face.

Originality/value

– This is the first study testing a comprehensive model of the process of attraction-identification-trust-performance in the virtual team context with a non-western sample. The unique individual-level analysis underlining the human factors complements more often taken approach of organization- and/or team-level analysis of virtuality tackling structural and strategic issues.
Leveraging apps for research and learning: a survey of Canadian academic libraries
Authors: Canuel Robin , Crichton Chad
Published: March 2015

Purpose

– The purpose of this paper is to assess the response of Canadian academic libraries to the rapid proliferation of mobile application (apps), many of which are useful for research, teaching, and learning.

Design/methodology/approach

– A survey was conducted to identify existing initiatives that address the use of mobile apps to facilitate research, teaching, and learning at the libraries of the 97 member institutions of the Association of Universities and Colleges of Canada (AUCC). Based on this survey, this paper describes how apps are promoted, curated, organized, and described by today’s academic libraries. A review of the literature places this survey in its broader context.

Findings

– In total, 37 per cent of AUCC member libraries include links to mobile apps in their web site. Larger, research-intensive universities, tend to leverage apps more frequently than smaller institutions. Examples of how academic libraries are promoting apps provide insight into how academic librarians are responding to the proliferation of mobile technology.

Practical implications

– The results of this survey highlight trends with regard to this emerging service opportunity, help to establish current best practices in the response of academic libraries to the emergence of mobile apps, and identify areas for potential future development.

Originality/value

– This is the first study of its kind to explore and describe how third-party apps are used and promoted within an academic library context.
Psychiatric disorders and labour force activity
Authors: Jonsdottir Annika , Waghorn Geoffrey
Published: March 2015

Purpose

– The purpose of this paper is to explore and review the range and quality of international epidemiological and observational studies reporting impacts of psychiatric disorders on labour force activity. This information is needed to explore the relative priority of different diagnostic groups for more intensive forms of vocational rehabilitation.

Design/methodology/approach

– The authors provide an overview of the current literature. A systematic review of papers measuring labour force variables and psychiatric disorders across a range of countries is conducted. These results are compared to OECD background unemployment rates during the same period. The results for each diagnostic category included are aggregated and compared to the other diagnostic categories.

Findings

– The proportions of people employed decreased with the more severe disorder categories, indicating that severe psychiatric illnesses are contributing to employment struggles for people with these illnesses, across countries.

Research limitations/implications

– This review is exploratory and shows that there is little consistency in reporting of labour force variables. Future research should endeavour to utilise internationally agreed definitions of labour force activity.

Practical implications

– This conclusion is relevant to matching community residents with psychiatric disorders to the more intensive and costly forms of vocational rehabilitation.

Originality/value

– To our knowledge, no previous review has examined diagnostic categories of psychiatric disorders by labour force activity internationally while taking into account background unemployment. This review found an employment gradient related to severity of diagnostic category that will be of interest to clinicians and policy makers.
A nuanced view on supply chain integration: a coordinative and collaborative approach to operational and sustainability performance improvement
Authors: Wiengarten Frank , Longoni Annachiara
Published: March 2015

Purpose

– This paper aims to report the results of an empirical study examining the operational, environmental and social sustainability performance impact of supply chain integration (SCI) width and depth in the form of coordinative and collaborative SCI.

Design/methodology/approach

– A questionnaire was sent to operations managers located in India. The data collection effort was part of the International Manufacturing Strategy Survey. Following the approaches by Frohlich and Westbrook (2001) and Schoenherr and Swink (2012), cluster analysis and analysis of covariance methods were conducted.

Findings

– This study supports previous studies proposing that wider SCI including customers and suppliers positively impact on performance. The authors also shed light on previous contradictory results, illustrating that different level of SCI depth (i.e. coordinative and collaborative practices) lead to different operational and sustainability performance outcomes. Thus, challenging the view of the general SCI-performance improvement hypothesis.

Originality/value

– Although research on SCI has advanced over the past years, there is still controversy about the SCI–performance relationship. Through considering SCI depth in terms of coordinative and collaborative practices, the authors provide a more nuanced view on its potential performance benefits. Therefore, this paper will be beneficial for supply chain managers considering SCI and future supply chain management research.
Can self-advocacy impact upon culture?
Authors: Greig Rob
Published: March 2015

Purpose

– The purpose of this paper is to provide a commentary on the preceding article “Changing organisational culture: another role for self-advocacy”.

Design/methodology/approach

– The paper suggests that self-advocacy has the potential to be a significant influence on organisational culture, but questions whether self-advocacy's current funding regime and limited focus on outcomes makes this possible.

Research limitations/implications

– This issue is identified as one where further research would be beneficial.

Practical implications

– If organisations are to use self-advocacy as a route of cultural change, it is suggested that attention will need to be given to issues of independent funding, management change objectives and whole system change.

Originality/value

– If evidence were generated to support the belief that self-advocacy can impact on organisational culture, the consequences for how society and services behave towards people with learning disabilities could be significant.
Commentary on “The use of cognitive behaviour therapy to treat depression in people with learning disabilities: a systematic review”
Authors: Langdon Peter E.
Published: March 2015

Purpose

– The purpose of this paper is to provide a commentary on “The use of cognitive-behaviour therapy to treat depression in people with learning disabilities: a systematic review”.

Design/methodology/approach

– Drawing on the literature, as well as both clinical and research experience, some reasons are outlined for the lack of attention given to psychological therapies to treat depression amongst people with intellectual disabilities (IDs).

Findings

– More research is needed, but existing evidence is promising regarding the effectiveness of adapted cognitive-behaviour therapy for depression amongst people with IDs.

Originality/value

– The commentary draws attention to the scope for developing a range of effective cognitive, behavioural and cognitive-behavioural treatments.
Performance and profile: a twofold bank profitability riddle
Authors: Divini Aikaterini , Schiniotakis Nikos
Published: March 2015

Purpose

– The purpose of this research is to examine whether a relation between employees’ profile and bank branch profitability holds in the Greek banking sector. Employees’ profile may include education, training, work experience, age and place of origin/living. In addition, it is examined whether high employee performance is related to profitable bank branches.

Design/methodology/approach

– The case of a Greek cooperative bank is selected with a network of 49 branches and a sample of 258 bank branch employees. Secondary data are collected from the bank’s human resources department database and electronic archives in reference to the year 2011. The methodology used in the research includes descriptive analysis, discriminant analysis and binominal logistic regression analysis.

Findings

– There are specific employees’ profile features relating to efficient performance that affect bank branch profitability. The findings highlight the importance of recruiting in accordance to a bank’s skills requirements and the significant role of alternative training programs, motivation and performance evaluation systems in augmenting a bank’s overall profitability.

Originality/value

– This research is the first attempt to combine and connect particular employee characteristics with efficient performance. It is also the first time that this particular bank, sample and data are examined and analyzed to serve the purpose of this research.
Being open matters: the antecedents and consequences of cross-understanding in teams
Authors: Meslec Nicoleta , Graff Daniel
Published: March 2015

Purpose

– The aim of the current paper is to explore the role of cross-understanding as a mediator between openness to cognitive experience and reflective communication cognitions on the one hand and team performance on the other hand using the input-mediator-output-input (IMOI) model as a framework (Ilgenet al., 2005).

Design/methodology/approach

– The sample consisted of 156 participants organized in 37 student teams. Two mediation models were estimated while using a nonparametric resampling procedure of bootstrapping developed by Hayes (2012).

Findings

– Cross-understanding positively mediates the relation between openness to cognitive diversity and team performance and the relation between reflective communication cognition and team performance. Reflective communication cognition has a direct and negative relation to team performance. Additionally, the percentage of women within groups positively relates to group performance.

Research limitations/implications

– Future research could explore the validity of this model in other organizational settings and while using different indicators for team performance.

Practical implications

– Practitioners should encourage an open climate toward knowledge diversity and different perspectives within teams, as this might create the optimal conditions for cross-understanding to emerge. Team members should also be encouraged to learn not only about the knowledge of other team members but also about their beliefs, preferences and things they are sensitive to, as this awareness is beneficial for the overall team performance.

Originality/value

– This paper contributes to the team cognition literature by bringing empirical support for a relatively less investigated concept: cross-understanding. The paper establishes its relation to team performance and two of its potential antecedents – openness to cognitive diversity and reflective communication cognition.
A case for agent-based models in organizational behavior and team research
Authors: Secchi Davide
Published: March 2015

Purpose

– This paper aims at introducing agent-based models (ABMs) and reviews some of their features in an attempt to show why they can be useful for organizational behavior research.

Design/methodology/approach

– The use of simulations has increased substantially in the past ten to fifteen years, but management seems to hold back to the agent-based “revolution”. The paper first describes the ABMs, and then discusses some of the issues that usually prevent management scholars from using simulations.

Findings

– This paper indicates how an agent-based approach can help overcome the hesitations surrounding computer simulations because (a) it makes it relatively easy to model emergent and complex social phenomena, and (b) simulation is made easier by user-friendly software platforms that connect it to the existing research methods.

Originality/value

– This article describes ABMs in a way that may be attractive to organization scholars, and it depicts the frontiers of a more flexible computational and mathematical approach to organizations, management and teams.
Detailed monitoring of a small but recovering population reveals sublethal effects of disease and unexpected interactions with supplemental feeding
Authors: Tollington Simon , Greenwood Andrew , Jones Carl G. , Hoeck Paquita , Chowrimootoo Aurélie , Smith Donal , Richards Heather , Tatayah Vikash , Groombridge Jim J.
Published: March 2015

Infectious diseases are widely recognized to have substantial impact on wildlife populations. These impacts are sometimes exacerbated in small endangered populations, and therefore, the success of conservation reintroductions to aid the recovery of such species can be seriously threatened by outbreaks of infectious disease. Intensive management strategies associated with conservation reintroductions can further compound these negative effects in such populations.

Exploring the sublethal effects of disease outbreaks among natural populations is challenging and requires longitudinal, individual life‐history data on patterns of reproductive success and other indicators of individual fitness.

Long‐term monitoring data concerning detailed reproductive information of the reintroduced Mauritius parakeet (Psittacula echo) population collected before, during and after a disease outbreak was investigated.

Deleterious effects of an outbreak of beak and feather disease virus (BFDV) were revealed on hatch success, but these effects were remarkably short‐lived and disproportionately associated with breeding pairs which took supplemental food. IndividualBFDVinfection status was not predicted by any genetic, environmental or conservation management factors and was not associated with any of our measures of immune function, perhaps suggesting immunological impairment. Experimental immunostimulation using thePHA(phytohaemagglutinin assay) challenge technique did, however, provoke a significant cellular immune response.

We illustrate the resilience of this bottlenecked and once critically endangered, island‐endemic species to an epidemic outbreak ofBFDVand highlight the value of systematic monitoring in revealing inconspicuous but nonetheless substantial ecological interactions. Our study demonstrates that the emergence of such an infectious disease in a population ordinarily associated with increased susceptibility does not necessarily lead to deleterious impacts on population growth and that negative effects on reproductive fitness can be short‐lived.
Do Experiences with Medicare Managed Care Vary According to the Proportion of Same‐Race/Ethnicity/Language Individuals Enrolled in One's Contract?
Authors: Price Rebecca Anhang , Haviland Amelia M. , Hambarsoomian Katrin , Dembosky Jacob W. , Gaillot Sarah , Weech‐Maldonado Robert , Williams Malcolm V. , Elliott Marc N.
Published: March 2015

Objective

To examine whether care experiences and immunization for racial/ethnic/language minority Medicare beneficiaries vary with the proportion of same‐group beneficiaries in Medicare Advantage (MA) contracts.

Data Sources/Study Setting

Exactly 492,495 Medicare beneficiaries responding to the 2008–2009 MA Consumer Assessment of Healthcare Providers and Systems (CAHPS) Survey.

Data Collection/Extraction Methods

Mixed‐effect regression models predicted eight CAHPS patient experience measures from self‐reported race/ethnicity/language preference at individual and contract levels, beneficiary‐level case‐mix adjustors, along with contract and geographic random effects.

Principal Findings

As a contract's proportion of a given minority group increased, overall and non‐Hispanic, white patient experiences were poorer on average; for the minority group in question, however, high‐minority plans may score as well as low‐minority plans. Spanish‐preferring Hispanic beneficiaries also experience smaller disparities relative to non‐Hispanic whites in plans with higher Spanish‐preferring proportions.

Conclusions

The tendency for high‐minority contracts to provide less positive patient experiences for others in the contract, but similar or even more positive patient experiences for concentrated minority group beneficiaries, may reflect cultural competency, particularly language services, that partially or fully counterbalance the poorer overall quality of these contracts. For some beneficiaries, experiences may be just as positive in some high‐minority plans with low overall scores as in plans with higher overall scores.
Review article: Emergency department models of care in the context of care quality and cost: A systematic review
Authors: Wylie Kate , Crilly Julia , Toloo Ghasem (Sam) , FitzGerald Gerry , Burke John , Williams Ged , Bell Anthony
Published: March 2015

To identify current ED models of care and their impact on care quality, care effectiveness, and cost. A systematic search of key health databases (Medline, CINAHL, Cochrane, EMbase) was conducted to identify literature on ED models of care. Additionally, a focused review of the contents of 11 international and national emergency medicine, nursing and health economic journals (published between 2010 and 2013) was undertaken with snowball identification of references of the most recent and relevant papers. Articles published between 1998 and 2013 in the English language were included for initial review by three of the authors. Studies in underdeveloped countries and not addressing the objectives of the present study were excluded. Relevant details were extracted from the retrieved literature, and analysed for relevance and impact. The literature was synthesised around the study's main themes. Models described within the literature mainly focused on addressing issues at the input, throughput or output stages of ED care delivery. Models often varied to account for site specific characteristics (e.g. onsite inpatient units) or to suit staffing profiles (e.g. extended scope physiotherapist), ED geographical location (e.g. metropolitan or rural site), and patient demographic profile (e.g. paediatrics, older persons, ethnicity). Only a few studies conducted cost‐effectiveness analysis of service models. Although various models of delivering emergency healthcare exist, further research is required in order to make accurate and reliable assessments of their safety, clinical effectiveness and cost‐effectiveness.
Paracetamol poisoning in adolescents in an Australian setting: Not quite adults
Authors: Graudins Andis
Published: March 2015

Objective

To describe and compare the characteristics of paracetamol poisoning in adolescent and adult patients.

Method

Descriptive retrospective case series of adolescent (12–17 years) and adult (>18 years) patients presenting to a metropolitan hospital network ED, diagnosed with paracetamol poisoning from October 2009 to September 2013.

Results

There were 220 adolescent (median age 16 years, 47% treated with acetylcysteine [NAC]) and 647 adult presentations (median age 27 years, 42% treated with NAC) for paracetamol poisoning in the study period. Adolescent patients were more frequently women (89% vs 76%; odds ratio [OR] 2.4; 95% confidence interval [CI] 1.5–3.8) and ingested similar amounts of paracetamol (18 g) when requiring NAC treatment. Adolescents were more likely to ingest paracetamol as a single agent (53% vs 34%; OR 2.2; 95% CI 1.6–3.0) and less likely to ingest compound paracetamol products than adults (18% vs 29%; OR 0.54; 95% CI 0.36–0.79). Adolescents were less likely to report accidental supratherapeutic ingestion of paracetamol (0.02% vs 10%; OR 0.23; 95% CI 0.09–0.58), or co‐ingestion of prescription medications (25% vs 43%; OR 0.4; 95% CI 0.31–0.62). Adolescents had more frequent histamine release reactions to NAC than adults (17% vs 8%; OR 2.3; 95% CI 1.2–4.5). No cases required liver transplantation or resulted in death.

Conclusion

Adolescents ingested comparable amounts of paracetamol to adults, when presenting with deliberate self‐poisoning. However, there were significant differences in co‐ingested medications and the reason for ingestion of paracetamol. Histamine reactions to NAC were more common in adolescents; however, most were mild. Overall, outcome was favourable in both cohorts.
Hemithoracic radiation therapy after extrapleural pneumonectomy for malignant pleural mesothelioma: Toxicity and outcomes at an Australian institution
Authors: Bece Andrej , Tin Mo Mo , Martin Darren , Lin Robert , McLean Jocelyn , McCaughan Brian
Published: March 2015

Introduction

We aim to report the outcome of patients with malignant pleural mesothelioma who underwent extrapleural pneumonectomy (EPP) and adjuvant hemithoracic radiotherapy with or without chemotherapy at a single Australian institution.

Method

Between July 2004 and March 2013, 53 patients were referred for radiation treatment following EPP, of whom 49 were suitable for adjuvant treatment. Radiation treatment initially involved a 3D conformal, mixed electron/photon technique, delivering 45–50.4 Gy in 25–28 fractions (31 patients) and subsequently a nine‐field intensity‐modulated radiotherapy technique, delivering 50.4–54 Gy in 28–30 fractions (18 patients). Fifty‐five per cent of patients also received pre‐operative chemotherapy. We assessed toxicity, disease‐specific and overall survival in patients who commenced radiation treatment.

Results

Forty‐one patients (84%) completed treatment as prescribed. Six patients stopped prematurely due to toxicity, and two with disease progression. Most patients discontinuing due to toxicity received over 90% of the prescribed dose. Common acute toxicities included nausea, fatigue, anorexia and dermatitis. Severe early toxicities were rare. Late toxicities were uncommon, with the exception of a persistent elevation in liver enzymes in those with right‐sided disease. Neither clinical hepatitis nor radiation pneumonitis was documented. With a median follow up of 18.7 months, median disease‐free and overall survival were 21.6 and 30.5 months, respectively, and 2‐year overall survival was 57.3%.

Conclusion

Hemithoracic radiotherapy following EPP, although associated with significant early toxicity, is well tolerated. Most patients complete the prescribed treatment, and clinically significant late toxicities are rare.
Initial experience using the rigid forceps technique to remove wall‐embedded IVC filters
Authors: Avery Allan , Stephens Maximilian , Redmond Kendal , Harper John
Published: March 2015

Introduction

Severely tilted and embedded inferior vena cava (IVC) filters remain the most challenging IVC filters to remove. Heavy endothelialisation over the filter hook can prevent engagement with standard snare and cone recovery techniques. The rigid forceps technique offers a way to dissect the endothelial cap and reliably retrieve severely tilted and embedded filters. By developing this technique, failed IVC retrieval rates can be significantly reduced and the optimum safety profile offered by temporary filters can be achieved. We present our initial experience with the rigid forceps technique described by Stavropoulos et al. for removing wall‐embedded IVC filters.

Methods

We retrospectively reviewed the medical imaging and patient records of all patients who underwent a rigid forceps filter removal over a 22‐month period across two tertiary referral institutions.

Results

The rigid forceps technique had a success rate of 85% (11/13) for IVC filter removals. All filters in the series showed evidence of filter tilt and embedding of the filter hook into the IVC wall. Average filter tilt from the Z‐axis was 19 degrees (range 8–56). Filters observed in the case study were either Bard G2X (n = 6) or Cook Celect (n = 7). Average filter dwell time was 421 days (range 47–1053). There were no major complications observed.

Conclusion

The rigid forceps technique can be readily emulated and is a safe and effective technique to remove severely tilted and embedded IVC filters. The development of this technique across both institutions has increased the successful filter removal rate, with perceived benefits to the safety profile of our IVC filter programme.
Usefulness of positron emission tomography‐computed tomography in pre‐operative evaluation of intra‐thoracic esophageal cancer
Authors: Kim Jae Jun , Park Jae Kil , Moon Seok Whan
Published: March 2015

Background

The purpose of the study was to clarify the usefulness of positron emission tomography‐computed tomography (PET‐CT) for pre‐operative evaluation of intra‐thoracic esophageal cancer, especially in terms of regional lymph node status.

Methods

Medical records of 93 consecutive cases from July 2007 to October 2012 were retrospectively reviewed. All patients underwent curative and complete esophagectomies for intra‐thoracic esophageal cancer. We compared pre‐operative maximum standard uptake values (SUVmax) of esophageal tumors and regional lymph nodes (LN) with other variables (chronic obstructive pulmonary disease, history of previous other primary cancer, gender, differentiation, and neoadjuvant therapy). In addition, the SUVmax of tumors and LNs were analyzed with pathologic findings.

Results

There was no significant difference of each tumor and LN SUVmax according to factors including chronic lung disease, age, history of previous other cancer, differentiation, and gender. Pre‐operative evaluations by PET‐CT were not accurate (tumor sensitivity 76.4%, specificity 25%; LN sensitivity 45.2%, specificity 54.8%). Receiver operating characteristic analysis showed that LN metastasis could not be appropriately diagnosed with SUVmax (P = 0.871). There was no difference in SUVmax between pathologically positive and negative LN subgroups. Tumor SUVmax correlated with the progression of esophageal cancer in patients without neoadjuvant therapy (P < 0.001). However, LN SUVmax had no correlation with overall pathologic stage. After neoadjuvant therapy, there were significant decreases in SUVmax in both pathologically positive and negative LN subgroups (P = 0.043, P = 0.008).

Conclusion

 Surgery should not be withheld in N‐stage according to PET‐CT findings and carefully considered in conjunction with other conditions.
FSH regulates fat accumulation and redistribution in aging through the Gαi/Ca2+/CREB pathway
Authors: Liu Xin‐Mei , Chan Hsiao Chang , Ding Guo‐Lian , Cai Jie , Song Yang , Wang Ting‐Ting , Zhang Dan , Chen Hui , Yu Mei Kuen , Wu Yan‐Ting , Qu Fan , Liu Ye , Lu Yong‐Chao , Adashi Eli Y. , Sheng Jian‐Zhong , Huang He‐Feng
Published: March 2015

Increased fat mass and fat redistribution are commonly observed in aging populations worldwide. Although decreased circulating levels of sex hormones, androgens and oestrogens have been observed, the exact mechanism of fat accumulation and redistribution during aging remains obscure. In this study, the receptor of follicle‐stimulating hormone (FSH), a gonadotropin that increases sharply and persistently with aging in both males and females, is functionally expressed in human and mouse fat tissues and adipocytes. Follicle‐stimulating hormone was found to promote lipid biosynthesis and lipid droplet formation; FSH could also alter the secretion of leptin and adiponectin, but not hyperplasia, in vitro and in vivo. The effects of FSH are mediated by FSH receptors coupled to the Gαi protein; as a result, Ca2+ influx is stimulated, cAMP‐response‐element‐binding protein is phosphorylated, and an array of genes involved in lipid biosynthesis is activated. The present findings depict the potential of FSH receptor‐mediated lipodystrophy of adipose tissues in aging. Our results also reveal the mechanism of fat accumulation and redistribution during aging of males and females.
The Australian asset‐pricing debate
Authors: Durand Robert B. , Limkriangkrai Manapon , Chai Daniel
Published: March 2015

Utilising a comprehensive data set for Australian firms, we examine a range of competing asset‐pricing models, including the four‐ and five‐factor models where the equity‐risk premium is augmented by size, value, momentum and liquidity premia, and find that none of the models tested appears to adequately explain the cross section of Australian returns. A model accounting for Australia's integration with the US equity market appears to be the best of the competing models we study. Our argument that a model recognising Australia's integration with the USA is supported when we apply the portfolio and factor construction methodology suggested by Brailsford et al. (2012a,b).
Systematic review: noncoeliac gluten sensitivity
Authors: Molina‐Infante J. , Santolaria S. , Sanders D. S. , Fernández‐Bañares F.
Published: March 2015

Background

Noncoeliac gluten sensitivity (NCGS) is a controversial emerging disorder. Despite reported symptoms related to the ingestion of gluten, NCGS remains a diagnosis based on the exclusion of coeliac disease, given the absence of reliable biomarkers.

Aim

To evaluate the prevalence, diagnostic exclusion of coeliac disease and the efficacy of a gluten‐free diet (GFD) for NCGS patients.

Methods

A PubMed search was performed up to December 2014. According to consensus diagnostic criteria, NCGS was defined as self‐reported gluten intolerance, negative coeliac serology and absence of villous atrophy. Studies evaluating the impact of a GFD on patients with irritable bowel syndrome (IBS) were also included.

Results

Prevalence rates of NCGS (0.5–13%) differed widely. Seventeen studies, including 1561 patients (26 children), met the inclusion criteria for NCGS. HLA haplotypes could not be linked to histology [normal or lymphocytic enteritis (LE)] in 1123 NCGS patients. HLADQ2/DQ8 haplotypes were present in 44% of NCGS patients. After advanced diagnostic techniques in 189 NCGS patients combining LE and HLADQ2/DQ8 haplotypes, 39 (20%) were reclassified as coeliac disease. There was a higher than expected family history of coeliac disease and autoimmune disorders in NCGS patients. A GFD resulted in variable results for variable, but significantly improved stool frequency in HLADQ2 positive diarrhoea‐predominant IBS patients.

Conclusions

Prevalence rates for NCGS are extremely variable. A subset of NCGS patients might belong in the so‐called ‘coeliac‐lite’ disease. The benefit of a GFD for NCGS patients is currently controversial. HLADQ2 positive diarrhoea‐type IBS patients might gain symptom improvement from a GFD.
Confirming the structure of negative beliefs about psychosis and bipolar disorder: A confirmatory factor analysis study of the Personal Beliefs about Experience Questionnaire and Personal Beliefs about Illness Questionnaire
Authors: Taylor Peter J. , Pyle Melissa , Schwannauer Matthias , Hutton Paul , Morrison Anthony
Published: March 2015

Objectives

Negative beliefs about psychosis and other mental health difficulties may contribute to depression and distress in individuals with these experiences. The Personal Beliefs about Experience Questionnaire (PBEQ) and Personal Beliefs about Illness Questionnaire (PBIllQ) are two widely used measures of these beliefs. It is currently uncertain how the items on these measures map onto different underlying factors. This study therefore aimed to test the factor structure of these two measures.

Methods

Confirmatory factor analysis (CFA) was used to test three alternative, pre‐specified, factor structures for the PBIllQ and PBEQ in a sample of individuals diagnosed with bipolar disorder (n = 202) and a sample of individuals with experien‐ces of psychosis (n = 362). Associations with depressive symptoms were also examined.

Result

A three‐factor structure was supported for both measures, which included Negative Expectations/Appraisals (NEA), Internal Shame/Defectiveness (ISD) and External Shame (ES) factors. The NEA and ISD subscales also had consistent independent associations with depressive symptoms.

Conclusions

The results suggest that the PBIllQ and PBEQ may capture three distinct sets of negative beliefs in individuals with psychosis or bipolar disorder and that these beliefs may have important consequences for subsequent difficulties in these populations such as depression. Both measures may be helpful in supporting assessment and formulation in clinical practice and in evaluating belief change in intervention trials. However, when used in these settings, the three subscales identified in this study may be the most valid way of calculating scores on these measures.

Practitioner points

Negative personal beliefs about the causes, meaning and consequences of psychosis and bipolar disorder are associated with greater distress and depression. Two related measures, the PBIllQ and PBEQ, have been developed to assess these beliefs.

Our analyses suggest that scores on these questionnaires are best broken down into three subscales which capture perceptions of internal shame or defectiveness, general negative appraisals and perceptions of external shame.

These subscales may capture key underlying sets of negative beliefs within individuals with psychosis or bipolar disorder, which in turn impact upon well‐being, such as being associated with greater depression.

These subscales can be used to aid assessment and formulation within clinical practice but may also provide a valuable means of assessing changes in negative beliefs following interventions.