bluuebunny/crossref_metadata_2025 huggingface dataset:
Using social media for knowledge translation, promotion of evidence‐based medicine and high‐quality information on health
Authors: Puljak Livia
Published: September 2015

Knowledge translation activities may be targeted toward all participants in healthcare practices, including patients, consumers, and policy makers. Hereby, use of social media, namely, social network Facebook, as a tool for knowledge translation, promotion of evidence‐based medicine, and high‐quality information on health is described. In March 2013, a Facebook page of the Croatian Cochrane Branch was created and its main contents are translated plain language summaries of the systematic reviews produced by The Cochrane Collaboration. Since the page was created, it has gained 1441 followers, mostly from Croatia and neighboring countries with similar language. Most of the page followers are women aged 25 to 44 and the most popular content is related to pregnancy, childbirth, and breastfeeding. Page followers are lay persons, health professionals, and journalists, who further disseminate the page content. In summary, social media enables multiple possibilities to engage with target audience and to disseminate the evidence‐based medicine content.
Identification and description of controlled clinical trials published in Physiotherapy journals in Spain
Authors: Turrillas Maitane , Sitjà‐Rabert Mercè , Pardo Hector , Vilaró Casamitjana Jordi , Fort‐Vanmeerhaeghe Azahara , Morral Fernández Antonio , Cebrià i Iranzo Maria Àngels , Bonfill Cosp Xavier
Published: September 2015

Rationale and objectives

The quantity and quality of research in physiotherapy has increased exponentially during the past decades. However, retrieving publications associated with this field of research is difficult. The aim of this study is to identify and describe controlled clinical trials (CCT) published in Spanish physiotherapy journals using electronic and handsearching strategies.

Method

Observational study through which we identified eligible journals in order to retrieve CCTs using electronic and handsearching strategies, as proposed by the Cochrane Collaboration. A descriptive analysis of the main characteristics of these CCTs was completed.

Results

Seventy‐eight CCTs were identified in 10 eligible journals, none of which were indexed in the major databases. 16.7% of the identified studies were multicentric. Traumatology and orthopaedics was the most studied field (33.3%) followed by neurology (15.4%). The most researched health problems were back pain (17.24%) fibromyalgia, arthrosis and stroke (6.8% each). Measured outcomes varied greatly, including pain control, functional mobility and quality of life. Most CCTs (64.1%) had a high risk of bias.

Conclusions

The number of CCTs published in Spanish physiotherapy journals is limited. Handsearching these journals is essential, since none is indexed in major databases. In general, the identified CCTs carry a high risk of bias.
Response of sex ratio to timing of breeding in the small cyprinid Gnathopogon caerulescens
Authors: Fujioka Y. , Kikko T. , Saegusa J. , Usuki T. , Ohtsuka T.
Published: September 2015

The influence of hatching date on the sex ratio of wild Gnathopogon caerulescens was examined. Cohorts reared from eggs collected in the early and middle parts of the spawning season showed almost balanced sex ratios, with female bias in some cohorts. Cohorts born later in the season mostly displayed male bias, and the mean proportion of males later in the season was significantly higher than in early‐ and mid‐season cohorts. These results indicate that the sex ratio of G. caerulescens changes with the time of breeding, increasing along with the ambient water temperature of the lake.
Pretreatment for substance‐abusing people with intellectual disabilities: intervening on autonomous motivation for treatment entry
Authors: Frielink N. , Schuengel C. , Kroon A. , Embregts P. J. C. M.
Published: September 2015

Background

Despite a lack of consensus regarding prevalence rates of substance abuse, people with intellectual disabilities (ID) on average use substances slightly less often than their non‐disabled peers. However, their use of substances is more often problematic. Avoidance of treatment is a crucial problem among substance‐abusing people with ID. This study tested a motivational intervention to facilitate autonomous motivation (i.e. wanting to change substance abuse because of a sense of free choice and volition) for engaging with a subsequent addiction treatment.

Method

A multiple‐case experimental design (N = 6) was conducted to measure day‐to‐day motivation to change substance abuse among individuals with mild ID (N = 3) and borderline level of intellectual functioning (N = 3) in the Netherlands. The participants (five men, one woman) lived in the community (except one, he lived in a residential facility) and abused cannabis, alcohol or hashish. During the intervention phase, the 10‐session treatment programme ‘Beat the kick’ was delivered by an experienced psychologist, based on motivational interviewing techniques adapted for people with mild to borderline ID. Participants completed an adaptive self‐reported inventory based on self‐determination theory (SDT) two to three times a week during baseline, intervention and 1‐month follow‐up.

Results

The results of five of the six participants (one dropped out) showed that the type of motivation changed from more controlled types of motivation (i.e. external motivation and introjected motivation) at baseline to more autonomous types of motivation after completion of the intervention. In addition, the participants reported a significant increase in overall need satisfaction and autonomy satisfaction and a significant decrease of overall need frustration.

Conclusions

The implementation of SDT and motivational interviewing principles in the treatment programme ‘Beat the kick’ reliably changed the type of motivation. In addition, the experimental effects provide initial proof of the use and applicability of SDT among people with ID.
Nanowire‐based structures for infrared to ultraviolet emitters studied by cathodoluminescence
Authors: GUSTAFSSON ANDERS
Published: September 2015

Nanowires are structures with features on the nanoscale, and it is therefore essential to study their properties on that scale. We present optical data from a variety of nanowire‐based structures using cathodoluminescence imaging and spectroscopy. One important feature of nanowires is the stacking sequence of the crystal, either zincblede, wurtzite or a mix of the two. We show that this has an impact on the optical properties. In radial quantum wells, the thickness can be controlled on a monolayer level, in the case of flat side facets of the nanowires. With rough side facets, the quantum well collapses into quantum dots, as revealed by cathodoluminescence imaging. In order to extend the emission wavelength of light‐emitting diodes into the ultraviolet or to cover the whole visible range, we use nanowire‐seeded truncated pyramids as bases for these devices, based on either GaInN (visible) and AlGaN (ultraviolet).
Evaluation of hepatitis B virus transmission and antiviral therapy among hepatitis B surface antigen‐positive pregnant women
Authors: Tekin Koruk Suda , Batirel Ayse , Kose Sukran , Cetin Akhan Sila , Aygen Bilgehan , Tulek Necla , Hatipoglu Çigdem , Bulut Cemal , Yıldız Orhan , Sacligil Cahide , Sirmatel Fatma , Altunok Elif
Published: September 2015

Aim

The aim of the present study was to assess the potential risk of hepatitis B virus (HBV) vertical transmission among Turkish parturient women and to evaluate the efficacy and safety of antiviral agents.

Material and Methods

Data were collected retrospectively from 114 HBV‐infected pregnant women and their infants in eight health institutions in Turkey.

Results

The baseline characteristics of the women were: mean age, 28.3 ± 5.2 years; alanine aminotransferase, 57.4 ± 139.0 U/L; aspartate aminotransferase, 56.6 ± 150.0 U/L; and HBV DNA, 8.3 × 107 ± 2.6 × 108 copies/mL. Family history of HBV infection was detected in 53.5% (n = 61). In total, 60 (52.6%) pregnant women received tenofovir (60.0%), lamivudine (33.3%) or telbivudine (6.7%) therapy at the median gestational age of 22.2 ± 8.5 (1–36) weeks. All infants were vaccinated and hepatitis B immune globulin was administered, with 81 of them (71.1%) available for follow‐up. After completion of HBV vaccination course, 71 (87.7%) infants had protective anti‐HBs levels, three (3.7%) were hepatitis B surface antigen‐positive, and seven (8.6%) were hepatitis B surface antigen‐negative with nonprotective anti‐HBs levels. Five of the infants had low gestational birthweight but no other birth defects were observed.

Conclusion

According to our results, viral load may not be the only effecting factor for transmission of HBV to children of infected mothers. Pregnant women with high viral load should be followed‐up closely during pregnancy. They should begin to take tenofovir or telbivudine, which are category B drugs for pregnancy, at the beginning of the third trimester at the latest. We need new treatment strategies; and close follow‐up of mothers and children is another important issue.
Developmental Outcomes of School Attachment Among Students of Mexican Origin
Authors: Castro‐Schilo Laura , Ferrer Emilio , Hernández Maciel M. , Conger Rand D.
Published: September 2015

We used a longitudinal community study of 674 grade school children (Grades 5, 6, 7, and 8; 337 males, 337 females) of Mexican origin to examine outcomes of school attachment. Attachment to school is important in this population given the high level of school dropout rates of Mexican‐origin students. Results indicated that, on average, school attachment from fifth to sixth grade remains stable, but declines from sixth to eighth grade. Boys had lower levels of school attachment at fifth grade but followed similar patterns of change as girls did. Attachment to teachers, peer competence, school aspirations and expectations, and substance‐use cognitions emerged as longitudinal outcomes of level or changes in school attachment. Gender moderated associations of school attachment.
Development and validation of a stability indicating isocratic HPLC method for gemcitabine with application to drug release from poly lactic-co-glycolic acid nanoparticles and enzymatic degradation studies
Authors: Chen Guanyu , Svirskis Darren , Wen Jingyuan
Published: September 2015

Objectives

Previously reported HPLC methods for gemcitabine determination are time-consuming with complicated mobile phases and gradient elution. Thus, a sensitive and stability-indicating isocratic HPLC method, which provides simple, fast and precise measurements, was developed. This method was applied to study the digestive enzymatic degradation of gemcitabine, for the first time, and the protection afforded following incorporation into poly lactic-co-glycolic acid (PLGA) nanoparticles.

Methods

An analytical HPLC method was developed with an optimized combination of operating conditions. Forced degradation and application of the method to in-vitro drug release studies were conducted. Finally, gemcitabine-loaded nanoparticles were exposed to the digestive enzymes pepsin, trypsin and α-chymotrypsin, and the resulting degradation evaluated.

Key findings

The analytical method was linear between 1 and 100 μg/ml, with excellent accuracy of 99.91–101.77% and precision of 1.71 or lower, with a 0.014 μg/ml limit of detection (LOD) and a 0.043 μg/ml limit of quantification (LOQ). Following exposure of gemcitabine to stressors, the drug was relatively stable in strong acid (1 N HCl), base (1 N NaOH) and as an aqueous solution exposed to light over 7 days, with less than 10% degradation. However, gemcitabine was more susceptible to degradation at 70°C and oxidative conditions (3% v/v H2O2) with greater than 10% degradation noted after 7 days. In-vitro drug release studies demonstrated a sustained drug release profile from PLGA nanoparticles, which also improved the resistance of gemcitabine to enzymatic degradation.

Conclusion

These results demonstrate the utility and effectiveness of this simple isocratic HPLC method in evaluating the overall performance of a gemcitabine-loaded formulation.
Seasonal differences in the effects of oscillatory and uni‐directional flow on the growth and nitrate‐uptake rates of juvenile Laminaria digitata (Phaeophyceae)
Authors: Kregting Louise T. , Hepburn Christopher D. , Savidge Graham
Published: September 2015

The influence of oscillatory versus unidirectional flow on the growth and nitrate‐uptake rates of juvenile kelp, Laminaria digitata, was determined seasonally in experimental treatments that simulated as closely as possible natural environmental conditions. In winter, regardless of flow condition (oscillatory and unidirectional) or water velocity, no influence of water motion was observed on the growth rate of L. digitata. In summer, when ambient nitrate concentrations were low, increased water motion enhanced macroalgal growth, which is assumed to be related to an increase in the rate of supply of nutrients to the blade surface. Nitrate‐uptake rates were significantly influenced by water motion and season. Lowest nitrate‐uptake rates were observed for velocities <5 cm · s−1 and nitrate‐uptake rates increased by 20%–50% under oscillatory motion compared to unidirectional flow at the same average speed. These data further suggested that the diffusion boundary layer played a significant role in influencing nitrate‐uptake rates. However, while increased nitrate‐uptake in oscillatory flow was clear, this was not reflected in growth rates and further work is required to understand the disconnection of nitrate‐uptake and growth by L. digitata in oscillatory flow. The data obtained support those from related field‐based studies, which suggest that in summer, when insufficient nitrogen is available in the water to saturate metabolic demand, the growth rate of kelps will be influenced by water motion restricting mass transfer of nitrogen.
Different strategies of energy storage in cultured and freshly isolated Symbiodinium sp.
Authors: Wang Li‐Hsueh , Chen Hung‐Kai , Jhu Chu‐Sian , Cheng Jing‐O. , Fang Lee‐Shing , Chen Chii‐Shiarng
Published: September 2015

The endosymbiotic relationship between cnidarians and Symbiodinium is critical for the survival of coral reefs. In this study, we developed a protocol to rapidly and freshly separate Symbiodinium from corals and sea anemones. Furthermore, we compared these freshly‐isolated Symbiodinium with cultured Symbiodinium to investigate host and Symbiodinium interaction. Clade B Symbiodinium had higher starch content and lower lipid content than those of clades C and D in both freshly isolated and cultured forms. Clade C had the highest lipid content, particularly when associated with corals. Moreover, the coral‐associated Symbiodinium had higher protein content than did cultured and sea anemone‐associated Symbiodinium. Regarding fatty acid composition, cultured Symbiodinium and clades B, C, and D shared similar patterns, whereas sea anemone‐associated Symbiodinium had a distinct pattern compared coral‐associated Symbiodinium. Specifically, the levels of monounsaturated fatty acids were lower than those of the saturated fatty acids, and the level of polyunsaturated fatty acids (PUFAs) were the highest in all examined Symbiodinium. Furthermore, PUFAs levels were higher in coral‐associated Symbiodinium than in cultured Symbiodinium. These results altogether indicated that different Symbiodinium clades used different energy storage strategies, which might be modified by hosts.
Analysis of Job Satisfaction: The Case ofJapanese Private Companies
Authors: Hasegawa Hikaru , Ueda Kazuhiro
Published: September 2015

The scope of economic theory expands if we consider that working provides people with both pecuniary compensation for its disutility and job satisfaction. This study empirically analyzes the job satisfaction of employees inJapanese private companies using a multivariate ordered probit model. In particular, we examine the effects of a big economic shock, such as theLehman shock, on job satisfaction, as well as the effects of differences in gender and employment status. We estimate the model using aBayesian analysis and a multivariate ordered probit model using theMarkov chainMonteCarlo method. We show that non‐pecuniary aspects of jobs play an important role in job satisfaction.
How much is enough? An investigation of the relationship between haemodialysis adequacy and quality of life of elderly patients
Authors: Zimbudzi Edward , Samlero Reggie , Kerr Peter G , Zoungas Sophia
Published: September 2015

Aim

The average age of patients requiring haemodialysis is on the rise and has resulted in an increase in the number of elderly people receiving dialysis. While haemodialysis is one of the treatment options for this patient group, questions about its effectiveness have been raised. A second question centres on how much haemodialysis is actually needed to maintain quality of life (QoL). This study examined the relationship between dialysis adequacy and the QoL of elderly patients on haemodialysis.

Method

A prospective cohort of 40 haemodialysis patients aged 75 years and above was recruited and studied over 3 months. Quality of life was assessed with the European Quality of Life‐5 Dimensions questionnaire and dialysis adequacy with the urea reduction ratio (URR), and the relationship between the two examined using a simple linear regression model.

Results

The average age of the participants was 79.8 ± (3.9 years; 45% were women, and diabetes was the main cause of kidney disease (42.5%). The mean URR, visual analogue scale, European Quality of Life‐5 Dimensions indices score and Charlson comorbidity index scores were 78.1 ± (5.5)%, 65.4 ± (13.7)%, 0.7 ± (0.27) and 6.3 ± (2.15), respectively. There was no clear relationship between dialysis adequacy and QoL, r = 0.093. Dialysis adequacy did not significantly predict QoL (P = 0.09).

Conclusion

There was no evidence for an association between haemodialysis adequacy and QoL in elderly patients receiving haemodialysis across a URR range of 64.0% to 88.9%. Attempts to improve dialysis adequacy beyond these levels may not be necessary for maintaining the QoL of elderly patients on dialysis.

Key message

Modern therapy should embrace the concept of quality of life and focus more on symptom relief and optimization of self‐management skills to improve the well‐being of the elderly patients with ESKD.
Pulmonary hypertension is an independent predictor of cardiovascular events and mortality in haemodialysis patients
Authors: Reque Javier , Quiroga Borja , Ruiz Caridad , Villaverde Maria Teresa , Vega Almudena , Abad Soraya , Panizo Nayara , López‐Gómez J. Manuel
Published: September 2015

Aim

The evidence about prevalence, associated factors of pulmonary hypertension (PH) and its impact on patient's outcomes is limited.

Methods

We included 211 haemodialysis patients, we estimated the systolic pulmonary artery pressure (SPAP) by 2D Doppler echocardiography defining PH as a SPAP above 35 mmHg, the median follow‐up was 39 (19–56) moths, and the primary endpoints were all cause mortality and cardiovascular events.

Results

We found PH in 91 patients (43.9%). Independent determinants of PH were age, previous cardiovascular disease, the Nt‐pro‐BNP level hs‐TnT, the systolic dysfunction, diastolic dysfunction and left ventricular hypertrophy. Over the follow‐up 94 cardiovascular events occurred, variables associated were: PH, age, history cardiovascular disease, dyslipidaemia, elevated concentration of Nt‐pro‐BNP and hs‐TnT, systolic and diastolic dysfunction, in a multivariate model, the PH maintained its independent association. Mortality data: 88 patients died (41.7%); 35 (29.5%) in the no PH group and 53 (58.5%) in the PH group (P < 0.001). In the Cox survival analysis, we found an association between mortality and age, previous cardiovascular disease, history of peripheral vascular disease, Nt‐pro‐BNP levels. In a multivariate model the PH remains as independent predictor of mortality.

Conclusions

Pulmonary hypertension is a common finding in HD patients and a valuable predictor of mortality and cardiovascular events. Prospective studies are needed to assess the effect of intervention on risk factors in improving patient's outcomes.
U‐shaped relationship between uric acid and residual renal function decline in continuous ambulatory peritoneal dialysis patients
Authors: Hsieh Yao‐Peng , Yang Yu , Chang Chia‐Chu , Kor Chew‐Teng , Wen Yao‐Ko , Chiu Ping‐Fang , Lin Chi‐Chen
Published: September 2015

Aim

There is little information on the relationship between uric acid (UA) and residual renal function (RRF) in continuous ambulatory peritoneal dialysis (CAPD). The aim of this research is to study the influence of UA on RRF decline in CAPD patients.

Methods

A retrospective observational cohort study of 304 patients who started CAPD without anuria between 2001 and 2010 was conducted at a single medical center. The outcomes measured in the study included the rate of RRF decline and anuria. A multiple ordinal logistic regression model with backward elimination was conducted to determine the independent factors of the slope of RRF decline. A Cox proportional hazard model was conducted to determine the independent variables of time to anuria.

Results

The average rate of RRF decline was −0.12 ± 0.22 mL/min per month. Multivariate analysis showed that lower UA group (<0.372 mmol/L), higher UA group (≧0.421 mmol/L), male gender, diabetes mellitus (DM), the use of calcium channel blocker (CCB), and RRF at baseline were linked positively with the rate of RRF decline; on the other hand, independence in dialysate exchanges and BUN were negatively associated with the risk of RRF decline. In addition, male gender, DM, diuretics, and CCB were associated with a higher risk of progression to anuria, whereas 24‐h urine amount at baseline conferred a protective role in the development of anuria.

Conclusions

A U‐shaped relationship was found between UA levels and the rate of RRF decline in patients on CAPD, with a faster decline rate in those of higher and lower UA groups.
A pilot and feasibility study of the plasma and tissue pharmacokinetics of cefazolin in an immature porcine model of pediatric cardiac surgery
Authors: Kilbaugh Todd J. , Himebauch Adam S. , Zaoutis Theoklis , Jobes David , Greeley William J. , Nicolson Susan C. , Zuppa Athena F.
Published: September 2015

Background

Surgical site infection (SSI) prevention for children with congenital heart disease is imperative and methods to assess and evaluate the tissue concentrations of prophylactic antibiotics are important to help maximize these efforts.

Aim

The purposes of this study were to determine the plasma and tissue concentrations with standard of care, perioperative cefazolin dosing in an immature porcine model of pediatric cardiac surgery, and to determine the feasibility of this model.

Methods

Piglets (3–5 days old) underwent either median sternotomy (MS) or cardiopulmonary bypass with deep hypothermic circulatory arrest (CPB + DHCA) and received standard of care prophylactic cefazolin for the procedures. Serial plasma and microdialysis sampling of the skeletal muscle and subcutaneous tissue adjacent to the surgical site was performed. Cefazolin concentrations were measured, noncompartmental pharmacokinetic analyses were performed, and tissue penetration of cefazolin was assessed.

Results

Following the first intravenous dose, maximal cefazolin concentrations in the subcutaneous tissue and skeletal muscle were similar between groups with peak tissue concentrations 15–30 min after administration. After the second cefazolin dose given with the initiation of CPB, total plasma cefazolin concentrations remained relatively constant until the end of DHCA and then decreased while muscle‐ and subcutaneous‐unbound cefazolin concentrations showed a second peak during or after rewarming. For the MS group, 60–67% of the intraoperative time showed subcutaneous and skeletal muscle concentrations of cefazolin >16 μg·ml−1 while this percentage was 78–79% for the CPB + DHCA group. There was less tissue penetration of cefazolin in the group that underwent CBP + DHCA (P = 0.03).

Conclusions

The cefazolin dosing used in this study achieves plasma and tissue concentrations that should be effective against methicillin‐sensitive Staphylococcus aureus but may not be effective against some gram‐negative pathogens. The timing of the cefazolin administration prior to incision and a second dose given during cardiopulmonary bypass may be important factors for achieving goal tissue concentrations.
Urinary incontinence and other pelvic floor dysfunctions in female athletes in Brazil: A cross‐sectional study
Authors: Almeida M. B. A. , Barra A. A. , Saltiel F. , Silva‐Filho A. L. , Fonseca A. M. R. M. , Figueiredo E. M.
Published: September 2015

The pelvic floor (PF) provides support to all pelvic organs, as well as appropriately closure/opening mechanism of the urethra, vagina, and anus. Therefore, it is likely that female athletes involved in high‐impact and in strong‐effort activities are at risk for the occurrence of urinary incontinence (UI). This study aimed to investigate the occurrence of UI and other PF dysfunctions (PFD) [anal incontinence (AI), symptoms of constipation, dyspareunia, vaginal laxity, and pelvic organ prolapse] in 67 amateur athletes (AT) compared with a group 96 of nonathletes (NAT). An ad hoc survey based on questions from reliable and valid instruments was developed to investigate the occurrence of PFD symptoms. The risk of UI was higher in AT group (odds ratio: 2.90; 95% CI: 1.50–5.61), mostly among artistic gymnastics and trampoline, followed by swimming and judo athletes. Whereas, AT group reported less straining to evacuate (OR: 0.46; 95% CI: 0.22–0.96), manual assistance to defecate (OR: 0.24; 95% CI: 0.05–1.12), and a higher stool frequency (OR: 0.29; 95% CI: 0.13–0.64) than NAT group. The occurrence of loss of gas and sexual symptoms was high for both groups when compared with literature, although with no statistical difference between them. Pelvic organ prolapse was only reported by nonathletes. Athletes are at higher risk to develop UI, loss of gas, and sexual dysfunctions, either practicing high‐impact or strong‐effort activities. Thus, pelvic floor must be considered as an entity and addressed as well. Also, women involved in long‐term high‐impact and strengthening sports should be advised of the impact of such activities on pelvic floor function and offered preventive PFD strategies as well.
The attenuation of correlation coefficients: a statistical literacy issue
Authors: Trafimow David
Published: September 2015

Much of the science reported in the media depends on correlation coefficients. But the size of correlation coefficients depends, in part, on the reliability with which the correlated variables are measured. Understanding this is a statistical literacy issue.
Calibration of EBT2 film using a red‐channel PDD method in combination with a modified three‐channel technique
Authors: Chang Liyun , Ho Sheng‐Yow , Lee Tsair‐Fwu , Yeh Shyh‐An , Ding Hueisch‐Jy , Chen Pang‐Yu
Published: September 2015

Purpose:

Ashland Inc. EBT2 and EBT3 films are widely used in quality assurance for radiation therapy; however, there remains a relatively high degree of uncertainty [B. Hartmann, M. Martisikova, and O. Jakel, “Homogeneity of Gafchromic EBT2 film,” Med. Phys. 37, 1753–1756 (2010)]. Micke et al. (2011) recently improved the spatial homogeneity using all color channels of a flatbed scanner; however, van Hoof et al. (2012) pointed out that the corrected nonuniformity still requires further investigation for larger fields. To reduce the calibration errors and the uncertainty, the authors propose a new red‐channel percentage‐depth‐dose method in combination with a modified three‐channel technique.

Methods:

For the ease of comparison, the EBT2 film image used in the authors’ previous study (2012) was reanalyzed using different approaches. Photon beams of 6‐MV were delivered to two different films at two different beam on times, resulting in the absorption doses of ranging from approximately 30 to 300 cGy at the vertical midline of the film, which was set to be coincident with the central axis of the beam. The film was tightly sandwiched in a 303‐cm3 polystyrene phantom, and the pixel values for red, green, and blue channels were extracted from 234 points on the central axis of the beam and compared with the corresponding depth doses. The film was first calibrated using the multichannel method proposed by Micke et al. (2010), accounting for nonuniformities in the scanner. After eliminating the scanner and dose‐independent nonuniformities, the film was recalibrated via the dose‐dependent optical density of the red channel and fitted to a power function. This calibration was verified via comparisons of the dose profiles extracted from the films, where three were exposed to a 60° physical wedge field and three were exposed to composite fields, and all of which were measured in a water phantom. A correction for optical attenuation was implemented, and treatment plans of intensity modulated radiation therapy and volumetric modulated arc therapy were evaluated.

Results:

The method described here demonstrated improved accuracy with reduced uncertainty. The relative error compared with the measurements of a water phantom was less than 1%, and the overall calibration uncertainty was less than 2%. Verification tests revealed that the results were close to those of the authors’ previous study, and all differences were within 3%, except those with a high‐dose gradient. The gamma pass rates (2%/2 mm) of the treatment plan evaluated using the method described here were greater than 99%, and no obvious stripe patterns were observed in the dose‐difference maps.

Conclusions:

Spatial homogeneity was significantly improved via the calibration method described here. This technique is both convenient and time‐efficient because it does not require cutting the film, and only two exposures are necessary.
Physiological Responses to Indoor Versus Outdoor Training in Postmenopausal Women
Authors: Lacharité-Lemieux Marianne , Dionne Isabelle J.
Published: September 2015

Chronic effects of two different exercise environments on self-chosen intensity and physiological adaptations were examined in postmenopausal women. Twenty-three healthy to overweight (body mass index [BMI] 22–29 kg/m2) postmenopausal women performed three weekly training sessions during 12 weeks and were assigned to either: (1) indoor training or (2) outdoor training. Body composition, metabolic profile, and physical fitness (including Vo2max, maximal strength, and endurance) were assessed pre- and postintervention. Exercise intensity was measured every week during the training. Maximum intensity decreased significantly in time only in outdoor training (p ≤ .05). Body composition and VO2max were significantly improved indoors (p ≤ .05), whereas resting blood pressure and upper body maximal strength and endurance were improved outdoors (p ≤ .05). Indoor training is associated with maintaining intensity over time and slightly higher physiological improvements than outdoor training. However, outdoor training seems promising from a long-term perspective, due to its positive effects on health parameters and exercise adherence.
Clinical Appraisal of Fosfomycin in the Era of Antimicrobial Resistance
Authors: Sastry Sangeeta , Clarke Lloyd G. , Alrowais Hind , Querry Ashley M. , Shutt Kathleen A. , Doi Yohei
Published: September 2015

Fosfomycin is recommended as one of the first-line agents for treatment of urinary tract infections (UTIs) in the latest guidelines endorsed by the Infectious Diseases Society of America (IDSA) and the European Society for Clinical Microbiology and Infectious Diseases (ESCMID). We evaluated the use of fosfomycin among inpatients at a tertiary care hospital between 2009 and 2013. UTI cases were defined using physician diagnosis and the National Healthcare Safety Network (NHSN) surveillance definitions. The number of patients treated with fosfomycin increased from none in 2009 to 391 in 2013. Among 537 patients who received fosfomycin for any indication during this period, UTI was the most common indication (74%), followed by asymptomatic bacteriuria (10%). All except 19 patients received a single dose of fosfomycin.
Escherichia coli
was the most common organism involved (52%). For 119 patients with UTIs, after exclusion of those with negative urine culture results, negative urinalysis results, receipt of additional agents, or indeterminate clinical outcomes, the clinical success rate at 48 h was 74.8%. Of 89 patients who met the criteria for NHSN-defined UTIs, 89.9% had successful outcomes. Recurrent infections occurred in 4.3% of cases, and mild adverse events were observed in 2.0%. All 100 randomly selected extended-spectrum β-lactamase (ESBL)-producing
E. coli
clinical isolates from this period were susceptible to fosfomycin. In conclusion, the use of fosfomycin has increased substantially since implementation of the updated guidelines at this hospital. Fosfomycin was used mainly for the treatment of physician-diagnosed UTIs, and the clinical outcomes were generally favorable. Fosfomycin maintained activity against
E. coli
despite the increased use of the agent.
Deletion of
liaR
Reverses Daptomycin Resistance in Enterococcus faecium Independent of the Genetic Background
Authors: Panesso Diana , Reyes Jinnethe , Gaston Elizabeth P. , Deal Morgan , Londoño Alejandra , Nigo Masayuki , Munita Jose M. , Miller William R. , Shamoo Yousif , Tran Truc T. , Arias Cesar A.
Published: September 2015

We have shown previously that changes in LiaFSR, a three-component regulatory system predicted to orchestrate the cell membrane stress response, are important mediators of daptomycin (DAP) resistance in enterococci. Indeed, deletion of the gene encoding the response regulator LiaR in a clinical strain of
Enterococcus faecalis
reversed DAP resistance (DAP-R) and produced a strain hypersusceptible to antimicrobial peptides. Since LiaFSR is conserved in
Enterococcus faecium
, we investigated the role of LiaR in a variety of clinical
E. faecium
strains representing the most common DAP-R genetic backgrounds. Deletion of
liaR
in DAP-R
E. faecium
R446F (DAP MIC of 16 μg/ml) and R497F (MIC of 24 μg/ml; harboring changes in LiaRS) strains fully reversed resistance (DAP MICs decreasing to 0.25 and 0.094 μg/ml, respectively). Moreover, DAP at concentrations of 13 μg/ml (achieved with human doses of 12 mg/kg body weight) retained bactericidal activity against the mutants. Furthermore, the
liaR
deletion derivatives of these two DAP-R strains exhibited increased binding of boron-dipyrromethene difluoride (BODIPY)-daptomycin, suggesting that high-level DAP-R mediated by LiaR in
E. faecium
involves repulsion of the calcium-DAP complex from the cell surface. In DAP-tolerant strains HOU503F and HOU515F (DAP MICs within the susceptible range but bacteria not killed by DAP concentrations of 5× the MIC), deletion of
liaR
not only markedly decreased the DAP MICs (0.064 and 0.047 μg/ml, respectively) but also restored the bactericidal activity of DAP at concentrations as low as 4 μg/ml (achieved with human doses of 4 mg/kg). Our results suggest that LiaR plays a relevant role in the enterococcal cell membrane adaptive response to antimicrobial peptides independent of the genetic background and emerges as an attractive target to restore the activity of DAP against multidrug-resistant strains.
In Vitro
Susceptibility Profiles of Eight Antifungal Drugs against Clinical and Environmental Strains of Phaeoacremonium
Authors: Badali Hamid , Khodavaisy Sadegh , Fakhim Hamed , de Hoog G. Sybren , Meis Jacques F. , Chowdhary Anuradha
Published: September 2015

In vitro
susceptibilities of a worldwide collection of molecularly identified
Phaeoacremonium
strains (
n
= 43) belonging to seven species and originating from human and environmental sources were determined for eight antifungal drugs. Voriconazole had the lowest geometric mean MIC (0.35 μg/ml), followed by posaconazole (0.37 μg/ml), amphotericin B (0.4 μg/ml), and isavuconazole (1.16 μg/ml). Caspofungin, anidulafungin, fluconazole, and itraconazole had no activity.
Outcomes of Aminopenicillin Therapy for Vancomycin-Resistant Enterococcal Urinary Tract Infections
Authors: Cole Kelli A. , Kenney Rachel M. , Perri Mary Beth , Dumkow Lisa E. , Samuel Linoj P. , Zervos Marcus J. , Davis Susan L.
Published: September 2015

Vancomycin-resistant urinary tract infections are often challenging to treat. This retrospective cohort study compared outcomes between patients treated for vancomycin-resistant enterococcal urinary tract infection with an aminopenicillin and those treated with a non-β-lactam antibiotic. Inpatients treated with an enterococcus-active agent for their first symptomatic vancomycin-resistant enterococcal urinary tract infection between 1 January 2012 and 31 December 2013 were considered for inclusion. Patients with colonization, on hospice, or receiving comfort care only were excluded. The primary endpoint of clinical cure was defined as resolution of clinical symptoms, or symptom improvement to the extent that no additional antibacterial drug therapy was necessary, and lack of microbiologic persistence. Secondary endpoints of 30-day readmission or retreatment and 30-day all-cause mortality were also compared. A total of 316 urinary isolates were screened, and 61 patients with symptomatic urinary tract infection were included. Twenty (35%) of the 57 isolates tested were ampicillin susceptible. Thirty-one patients received an aminopenicillin, and 30 received a non-β-lactam. Rates of clinical cure for aminopenicillin versus non-β-lactam treatment were 26/31 (83.9%) and 22/30 (73.3%) (
P
= 0.315), respectively. Rates of 30-day readmission (6/31, or 19.4%, versus 9/30, or 30%, respectively;
P
= 0.334), 30-day retreatment (4/31, or 12.9%, versus 4/30, 13.3%, respectively;
P
= 0.960), and 30-day all-cause mortality (2/31, or 6.5%, versus 1/30, or 3.3%, respectively;
P
= 0.573) were also not significantly different between groups. Aminopenicillins may be a viable option for treating vancomycin-resistant urinary tract infection regardless of the organism's ampicillin susceptibility. Prospective validation with larger cohorts of patients should be considered.
Activation of Antibiotic Production in Bacillus spp. by Cumulative Drug Resistance Mutations
Authors: Tojo Shigeo , Tanaka Yukinori , Ochi Kozo
Published: September 2015

Bacillus subtilis
strains produce a wide range of antibiotics, including ribosomal and nonribosomal peptide antibiotics, as well as bacilysocin and neotrehalosadiamine. Mutations in
B. subtilis
strain 168 that conferred resistance to drugs such as streptomycin and rifampin resulted in overproduction of the dipeptide antibiotic bacilysin. Cumulative drug resistance mutations, such as mutations in the
mthA
and
rpsL
genes, which confer low- and high-level resistance, respectively, to streptomycin, and mutations in
rpoB
, which confer resistance to rifampin, resulted in cells that overproduced bacilysin. Transcriptional analysis demonstrated that the enhanced transcription of biosynthesis genes was responsible for the overproduction of bacilysin. This approach was effective also in activating the cryptic genes of
Bacillus amyloliquefaciens
, leading to actual production of antibiotic(s).
Biochemical Characterization of VIM-39, a VIM-1-Like Metallo-β-Lactamase Variant from a Multidrug-Resistant Klebsiella pneumoniae Isolate from Greece
Authors: Papagiannitsis Costas C. , Pollini Simona , De Luca Filomena , Rossolini Gian Maria , Docquier Jean-Denis , Hrabák Jaroslav
Published: September 2015

VIM-39, a VIM-1-like metallo-β-lactamase variant (VIM-1 Thr33Ala His224Leu) was identified in a clinical isolate of
Klebsiella pneumoniae
belonging to sequence type 147. VIM-39 hydrolyzed ampicillin, cephalothin, and imipenem more efficiently than did VIM-1 and VIM-26 (a VIM-1 variant with the His224Leu substitution) because of higher turnover rates.
(A)Historical Science
Authors: Casadevall Arturo , Fang Ferric C.
Published: September 2015

In contrast to many other human endeavors, science pays little attention to its history. Fundamental scientific discoveries are often considered to be timeless and independent of how they were made. Science and the history of science are regarded as independent academic disciplines. Although most scientists are aware of great discoveries in their fields and their association with the names of individual scientists, few know the detailed stories behind the discoveries. Indeed, the history of scientific discovery is sometimes recorded only in informal accounts that may be inaccurate or biased for self-serving reasons. Scientific papers are generally written in a formulaic style that bears no relationship to the actual process of discovery. Here we examine why scientists should care more about the history of science. A better understanding of history can illuminate social influences on the scientific process, allow scientists to learn from previous errors, and provide a greater appreciation for the importance of serendipity in scientific discovery. Moreover, history can help to assign credit where it is due and call attention to evolving ethical standards in science. History can make science better.
How do general practitioners manage patients with cancer symptoms? A video-vignette study
Authors: Jiwa Moyez , Meng Xingqiong , O'Shea Carolyn , Magin Parker , Dadich Ann , Pillai Vinita
Published: September 2015

Objectives

Determine how general practitioners (GPs) manage patients with cancer symptoms.

Design

GPs reviewed 24 video-vignettes and case notes on patients with cancer symptoms and indicated whether they would refer the patient and/or prescribe medication, and/or undertake further investigation. According to available guidelines, all cases warranted a referral to a specialist or further investigations.

Setting

Australian primary care sector.

Participants

102 practising GPs participated in this study, including trainees.

Interventions

The research was part of a larger randomised controlled trial testing a referral pro forma; however, this paper reports on management decisions made throughout the study.

Primary and secondary outcome measures

This paper reports on how the participants would manage the patients depicted in each vignette.

Results

In more than one-in-eight cases, the patient was not investigated or referred. Patient management varied significantly by cancer type (p<0.001). For two key reasons, colorectal cancer was the chosen referent category. First, it represents a prevalent type of cancer. Second, in this study, colorectal cancer symptoms were managed in a similar proportion of options—that is, prescription, referral or investigation. Compared with vignettes featuring colorectal cancer participants were less likely to manage breast, bladder, endometrial, and lung cancers with a ‘prescription only’ or ‘referral only’ option. They were less likely to manage prostate cancer with a ‘prescription only’, yet more likely to manage it with a ‘referral with investigation’. With regard to pancreatic and cervical cancers, participants were more likely to manage these with a ‘referral only’ or a ‘referral with investigation’.

Conclusions

Some patients may receive a delayed cancer diagnosis, even when they present with typical cancer symptoms to a GP who can access relevant diagnostic tests.

Trial registration number

ACTRN12611000760976.
Outcome of a new patient pathway for managing B3 breast lesions by vacuum-assisted biopsy: time to change current UK practice?
Authors: Strachan C , Horgan K , Millican-Slater R A , Shaaban A M , Sharma N
Published: September 2015

Aims

B3 lesions of the breast represent a difficult management dilemma. The umbrella term ‘B3’ incorporates lesions with little associated malignancy risk as well as lesions with significant risk of concurrent neoplasia. Diagnosis of B3 lesions in screening populations is largely made on needle core biopsy, which provides little tissue to adequately diagnose pathologically diverse lesions. The advent of vacuum-assisted biopsy (VAB) provides the multidisciplinary team with a more representative pathology sample to direct management.

Methods

In this unit, in 2009, a pathway to guide management of B3 lesions detected on needle core biopsy in screening patients was implemented to assess whether VAB was a safe and viable alternative to surgery in selected cases.

Here we present the 5-year follow-up results of this pathway.

Results

398 patients with B3 lesions were suitable for this pathway, of which 321 went on to have second-line VAB. 24% of these patients subsequently required surgery for malignancy or ongoing concerns, and thus 245 avoided surgery being subsequently referred for 5-year mammographic surveillance or back to screening. Median follow-up was 3 years (IQR 2), and no cancers were detected at the original B3 site during follow-up.

Conclusions

We have demonstrated here that with large volume tissue sampling for indeterminate lesions of the breast surgery can be safely avoided in selected B3 lesions with and without atypia.
Origin of inverted vascular bundles in winged leaves of Scleria plusiophylla (Cyperaceae)
Authors: Hoss Kátia Arenhart , Trevisan Rafael , Rodrigues Ana C.
Published: September 2015

The genus Scleria P.J. Bergius is pantropical, occurs in various habitats such as forests, fields, and wetlands, and is morphologically diverse. Some species have a winged sheath, which remains on the leaf blade and forms the last pair of costae. Anatomical observations of leaf blades of Scleria plusiophylla Steud. revealed the presence of inverted vascular bundles in the region of the wing. During the development of the shoot apical meristem of S. plusiophylla, it was observed that the wing emerges through divisions and enlargement of protoderm cells of the abaxial surface and subsurface cells (ground meristem) of the sheath. The ground meristem, from both sides of the sheath, gives rise to the procambial strands, which have normal differentiation. Subsequently, in the transition region between the sheath and the leaf blade, the growth of the sheath ends and the development of the leaf blade continues with the wings remaining adnate to the blade and initially folded towards the dorsal surface. As the leaf blade develops, the wings gradually unfold. Bulliform cells on the abaxial surface of the epidermis, which marked the beginning of the wing, and inverted vascular bundles intercalated with normal vascular bundles, are also observed. It was concluded that all of the bundles in the wing of the leaf blade have normal development and follow the orientation of development related to the side of the sheath from which they were initially derived, resulting in vascular bundles with different phloem positions.
The role of methoxy substituents in regulating the activity of selenides that serve as spirodioxyselenurane precursors and glutathione peroxidase mimetics
Authors: Press David J. , Back Thomas G.
Published: September 2015

A series of o-(hydroxymethyl)phenyl selenides containing single or multiple methoxy substituents was synthesized, and the rate at which each compound catalyzed the oxidation of benzyl thiol to its disulfide with excess hydrogen peroxide was measured. This assay provided the means for comparing the relative abilities of the selenides to mimic the antioxidant selenoenzyme glutathione peroxidase. The mechanism for catalytic activity involves oxidation of the selenides to their corresponding selenoxides with hydrogen peroxide, cyclization to spirodioxyselenuranes, followed by reduction with two equivalents of thiol to regenerate the original selenide with concomitant disulfide formation. A single p-methoxy group on each aryl moiety afforded the highest catalytic activity, while methoxy groups in the meta position had little effect compared to the unsubstituted selenide, and o-methoxy groups suppressed activity. The installation of multiple methoxy groups on each aryl moiety provided no improvement. These results can be rationalized on the basis of dominating mesomeric and steric effects of the p- and o-substituents, respectively.