bluuebunny/crossref_metadata_2025 huggingface dataset:
Country of birth and other factors associated with hepatitis B prevalence in a population with high levels of immigration
Authors: Reekie Joanne , Gidding Heather F. , Kaldor John M. , Liu Bette
Published: April 2013

Background and Aim

While hepatitis B virus (HBV) prevalence is known to vary greatly between countries, systematically collected population‐level prevalence data from some countries is limited. Antenatal HBV screening programs in countries with substantial migrant populations provide the opportunity to systematically examine HBV prevalence in order to inform local and regional HBV estimates.

Methods

A comprehensive register of Australian mothers giving birth from January 2000 to December 2008 was linked to a register of HBV notifications. Age‐standardized prevalence of chronic HBV were calculated overall and by the mother's country of birth. Multiple logistic regression was used to investigate other factors associated with HBV prevalence.

Results

Five hundred twenty‐three thousand six hundred sixty‐five women were included and linked to 3861 HBV notifications. The age‐standardized HBV prevalence was low (0.75%, 95% confidence interval 0.72–0.79). The highest HBV prevalence rates were observed in women born in Cambodia (8.60%), Taiwan (8.10%), Vietnam (7.49%), China (6.80%), and Tonga (6.51%). Among Australia‐born women, those who smoked during pregnancy, were from a more disadvantaged socioeconomic background, and lived in remote areas were more likely to have HBV. There was also a trend suggesting a decrease in the prevalence of HBV over time.

Conclusions

Antenatal screening for HBV can provide systematic population estimates of HBV prevalence in migrants and also identify other high prevalence groups. Longer follow‐up will be required to confirm the small decrease in HBV prevalence observed in this study.
Two‐week schedule of hypofractionated radiotherapy as a local salvage treatment for small hepatocellular carcinoma
Authors: Park Jin‐hong , Yoon Sang Min , Lim Young‐Suk , Kim So Yeon , Shim Ju Hyun , Kim Kang Mo , Lee Han Chu , Cho Byungchul , Park Geumju , Kim Jong Hoon
Published: April 2013

Background and Aim

In cases of small hepatocellular carcinoma (HCC) where established curative treatment cannot be applied, stereotactic body radiotherapy (SBRT) has been used as a non‐invasive alternative treatment modality. However, short‐course SBRT may not be safe if the tumor is located around a critical normal organ. Therefore, we applied hypofractionated radiotherapy for these tumors and evaluated outcomes of this treatment.

Methods

Between December 2008 and August 2011, 26 patients (28 lesions) with HCC were treated with hypofractionated radiotherapy. Inclusion criteria were HCC not suitable for surgery or other local ablative therapy, a tumor size < 6 cm, adequate hepatic function, an HCC located within 2 cm of a critical organ, and no evidence of vascular invasion. A dose of 4–5 Gy per fraction was given, with a total dose of 40–50 Gy over 2 weeks.

Results

The overall response rate was 67.9%, with seven complete responses (25.0%) and 12 partial responses (42.9%) at 3 months after radiotherapy. The overall survival rates at 1 and 2 years were 88.5% and 67.2%, respectively. The local control rate at 2 years was 87.6%. The Intrahepatic recurrence‐free and distant failure‐free survival rates at 2 years were 36.5% and 68.2%, respectively. Grade ≥ 3 hepatic toxicity was observed in one patient.

Conclusions

Two‐week schedule of hypofractionated radiotherapy for small HCC was feasible with good local control and safety. This fractionation schedule can be used as an alternative treatment option for HCC located close to a critical normal organ if short‐course SBRT is not feasible.
Association Between Sedating Medications and Delirium in Older Inpatients
Authors: Rothberg Michael B. , Herzig Shoshana J. , Pekow Penelope S. , Avrunin Jill , Lagu Tara , Lindenauer Peter K.
Published: April 2013

Objectives

To examine the association between Beers criteria sedative medications and delirium in a large cohort of hospitalized elderly adults with common medical conditions.

Design

Retrospective cohort and nested case–control studies.

Setting

374 U.S. hospitals.

Participants

All individuals aged 65 and older admitted to the hospital between September 2003 and June 2005 with one of six principal diagnoses (acute myocardial infarction, chronic obstructive pulmonary disease, community‐acquired pneumonia, congestive heart failure, ischemic stroke, urinary tract infection).

Measurements

Primary outcome was presumed hospital‐acquired delirium, defined as initiation of an antipsychotic medication or restraints on hospital Day 3 or later. Logistic and proportional hazards regression were used to model the associations between sedative exposure and delirium.

Results

The dataset contained 225,028 participants (median age 82; 58% female). Four percent fit the definition of hospital‐acquired delirium (median onset Day 5). In all, 38,883 (17%) participants received one or more sedative medications. In the cohort study, diphenhydramine (adjusted odds ratio (AOR) = 1.22, 95% confidence interval (CI) = 1.09–1.36) and short‐acting benzodiazepines (AOR = 1.18, 95% CI = 1.03–1.34) were associated with greater risk of subsequent delirium. In the nested case–control study, diphenhydramine, short‐ and long‐acting benzodiazepines and promethazine were associated with delirium. Amitriptyline and muscle relaxants were not associated with delirium in either study. Confounding by indication could not be excluded for drugs that are sometimes used improperly to treat delirium.

Conclusion

An association was found between several Beers criteria sedative medications and delirium in hospitalized medical patients. Given the prevalence of these medications and the morbidity associated with delirium, further investigation into the appropriateness of such prescribing is warranted.
Input‐Output‐based Life Cycle Inventory
Authors: Müller Bodo , Schebek Liselotte
Published: April 2013

An input‐output‐based life cycle inventory (IO‐based LCI) is grounded on economic environmental input‐output analysis (IO analysis). It is a fast and low‐budget method for generating LCI data sets, and is used to close data gaps in life cycle assessment (LCA). Due to the fact that its methodological basis differs from that of process‐based inventory, its application in LCA is a matter of controversy. We developed a German IO‐based approach to derive IO‐based LCI data sets that is based on the German IO accounts and on the German environmental accounts, which provide data for the sector‐specific direct emissions of seven airborne compounds. The method to calculate German IO‐based LCI data sets for building products is explained in detail. The appropriateness of employing IO‐based LCI for German buildings is analyzed by using process‐based LCI data from the Swiss Ecoinvent database to validate the calculated IO‐based LCI data.

The extent of the deviations between process‐based LCI and IO‐based LCI varies considerably for the airborne emissions we investigated. We carried out a systematic evaluation of the possible reasons for this deviation. This analysis shows that the sector‐specific effects (aggregation of sectors) and the quality of primary data for emissions from national inventory reporting (NIR) are the main reasons for the deviations. As a rule, IO‐based LCI data sets seem to underestimate specific emissions while overestimating sector‐specific aspects.
Response of Rice to Insect Elicitors and the Role of OsJAR1 in Wound and Herbivory‐Induced JA‐Ile Accumulation
Authors: Fukumoto Kaori , Alamgir Kabir Md , Yamashita Yuko , Mori Izumi C. , Matsuura Hideyuki , Galis Ivan
Published: April 2013

Plants produce jasmonic acid (JA) and its amino acid conjugate, jasmonoyl‐L‐isoleucine (JA‐Ile) as major defense signals in response to wounding and herbivory. In rice (Oryza sativa), JA and JA‐Ile rapidly increased after mechanical damage, and this increase was further amplified when the wounds were treated with oral secretions from generalist herbivore larvae, lawn armyworms (Spodoptera mauritia), revealing for the first time active perception mechanisms of herbivore‐associated elicitor(s) in rice. In the rice genome, two OsJAR genes can conjugate JA and Ile and form JA‐Ile in vitro; however, their function in herbivory‐induced accumulation of JA‐Ile has not been investigated. By functional characterization of TOS17 retrotransposon‐tagged Osjar1 plants and their response to simulated herbivory, we show that OsJAR1 is essential for JA‐Ile production in herbivore‐attacked, field‐grown plants. In addition, OsJAR1 was required for normal seed development in rice under field conditions. Our results suggest that OsJAR1 possesses at least two major functions in rice defense and development that cannot be complemented by the additional OsJAR2 gene function, although this gene previously showed overlapping enzyme activity in vitro.
Changes in blood parameters in rhesus monkeys (Macaca mulatta) during the first trimester of gestation
Authors: Ibáñez‐Contreras Alejandra , Hernández‐Godínez Braulio , Reyes‐Pantoja Sergio A. , Jiménez‐García Andrea , Solís‐Chavéz Salvador A. , Suarez‐Gutiérrez Rodrigo , Gálvan‐Montaño Alfonso
Published: April 2013

Background

Regarding the good practice in the laboratory work, it is essential to have a broad spectrum of biochemical and hematological references in pregnant females to determine the health status of the colony.

Objective

To establish reference values to reveal changes in hematology and blood chemistry in pregnant rhesus monkeys (Macaca mulatta) in their first trimester of pregnancy.

Methods

Twenty‐eight females in reproductive stage were used, divided into two groups: 14 pregnant macaques in their first trimester and 14 non‐pregnant used as the control group. Blood samples were collected for the hematological test and blood chemistry.

Results

The results showed significant difference in the blood chemistry for the following parameters: glucose, total bilirubin, and total protein. The hematological evaluation revealed significant difference in leukocytes and neutrophils.

Conclusions

These findings offer a reference range and provide a basis for improvement in techniques and refinement of clinical processes in these specimens.
Anatomical Variations in the Posterior Part of the Circle of Willis and Vascular Pathology in Bilateral Thalamic Infarction
Authors: Förster Alex , Nölte Ingo , Wenz Holger , Al‐Zghloul Mansour , Kerl Hans U. , Brockmann Marc A. , Groden Christoph
Published: April 2013

BACKGROUND AND PURPOSE

Bilateral paramedian thalamic infarction is a rare subtype of stroke the etiology of which still remains undetermined in many patients.

METHODS

From a computed tomography (CT)/magnetic resonance imaging report database, we identified and analyzed 48 patients with bilateral paramedian thalamic infarction on diffusion‐weighted imaging. Vascular pathologies were noted on CT angiography (CTA)/magnetic resonance angiography (MRA) and the P1 segments of the posterior cerebral artery (PCA) described as normal, hypoplastic, or absent.

RESULTS

Vascular imaging revealed top of the basilar artery (BA) occlusion in 6 (12.5%), BA occlusion in 4 (8.3%), BA stenosis in 1 (2.1%), and BA hypoplasia in 3 (6.3%), PCA occlusion in 4 (8.3%), and PCA stenosis in 4 (8.3%) patients. In 18 (37.5%) patients, one or both P1 segments of the PCA were hypoplastic or absent. Patients with hypoplastic/absent P1 segments were more likely to have exclusively bilateral paramedian thalamic lesions (P < .001). An embolic source could be identified in 25 (55.6%) patients; there were no significant differences between both groups.

CONCLUSIONS

Vascular imaging is useful to determine underlying vascular pathologies and may support the diagnosis of small vessel disease in those patients with isolated bilateral paramedian thalamic infarction, hypoplastic/absent P1 segment of the PCA, and lack of vascular pathology.
Space weathered rims found on the surfaces of the Itokawa dust particles
Authors: Noguchi Takaaki , Kimura Makoto , Hashimoto Takahito , Konno Mitsuru , Nakamura Tomoki , Zolensky Michael E. , Okazaki Ryuji , Tanaka Masahiko , Tsuchiyama Akira , Nakato Aiko , Ogami Toshinori , Ishida Hatsumi , Sagae Ryosuke , Tsujimoto Shinichi , Matsumoto Toru , Matsuno Junya , Fujimura Akio , Abe Masanao , Yada Toru , Mukai Toshifumi , Ueno Munetaka , Okada Tatsuaki , Shirai Kei , Ishibashi Yukihiro
Published: April 2013

On the basis of observations using Cs‐corrected STEM, we identified three types of surface modification probably formed by space weathering on the surfaces of Itokawa particles. They are (1) redeposition rims (2–3 nm), (2) composite rims (30–60 nm), and (3) composite vesicular rims (60–80 nm). These rims are characterized by a combination of three zones. Zone I occupies the outermost part of the surface modification, which contains elements that are not included in the unchanged substrate minerals, suggesting that this zone is composed of sputter deposits and/or impact vapor deposits originating from the surrounding minerals. Redeposition rims are composed only of Zone I and directly attaches to the unchanged minerals (Zone III). Zone I of composite and composite vesicular rims often contains nanophase (Fe,Mg)S. The composite rims and the composite vesicular rims have a two‐layered structure: a combination of Zone I and Zone II, below which Zone III exists. Zone II is the partially amorphized zone. Zone II of ferromagnesian silicates contains abundant nanophase Fe. Radiation‐induced segregation and in situ reduction are the most plausible mechanisms to form nanophase Fe in Zone II. Their lattice fringes indicate that they contain metallic iron, which probably causes the reddening of the reflectance spectra of Itokawa. Zone II of the composite vesicular rims contains vesicles. The vesicles in Zone II were probably formed by segregation of solar wind He implanted in this zone. The textures strongly suggest that solar wind irradiation damage and implantation are the major causes of surface modification and space weathering on Itokawa.
Resonant behavior of comet Halley and the Orionid stream
Authors: Sekhar A. , Asher D. J.
Published: April 2013

Comet 1P/Halley has the unique distinction of having a very comprehensive set of observational records for almost every perihelion passage from 240 B.C. This has helped to constrain theoretical models pertaining to its orbital evolution. Many previous works have shown the active role of mean motion resonances (MMR) in the evolution of various meteoroid streams. Here, we look at how various resonances, especially the 1:6 and 2:13 MMR with Jupiter, affect comet 1P/Halley and thereby enhance the chances of meteoroid particles getting trapped in resonance, leading to meteor outbursts in some particular years. Comet Halley itself librated in the 2:13 resonance from 240 B.C. to 1700 A.D. and in the 1:6 resonance from 1404 B.C. to 690 B.C., while stream particles can survive for time scales of the order of 10,000 yr and 1,000 yr in the 1:6 and 2:13 resonances, respectively. This determines the long‐term dynamical evolution and stream structure, influencing the occurrence of Orionid outbursts. Specifically, we are able to correlate the occurrence of enhanced meteor phenomena seen between 1436–1440, 1933–1938, and 2006–2010 with the 1:6 resonance and meteor outbursts in 1916 and 1993 with the 2:13 resonance. Ancient as well as modern observational records agree with these theoretical simulations to a very good degree.
Schwann cell involvement in the peripheral neuropathy of spinocerebellar ataxia type 3
Authors: Suga Noriaki , Katsuno Masahisa , Koike Haruki , Banno Haruhiko , Suzuki Keisuke , Hashizume Atsushi , Mano Tomoo , Iijima Masahiro , Kawagashira Yuichi , Hirayama Masaaki , Nakamura Tomohiko , Watanabe Hirohisa , Tanaka Fumiaki , Sobue Gen
Published: April 2013

Aims

Spinocerebellar ataxia type 3 (SCA3) is an inherited spinocerebellar ataxia caused by the expansion of trinucleotide CAG repeats in the gene encoding ataxin‐3. The clinical manifestations of SCA3 include peripheral neuropathy, which is an important cause of disability in a subset of patients. Although the loss of neurones in the dorsal root ganglion (DRG) has been postulated to be the cause of this neuropathy, the precise mechanism remains to be elucidated.

Methods

To clarify the clinicopathological characteristics of SCA3‐associated peripheral neuropathy, we performed nerve conduction studies and histopathological analyses. Nerve conduction studies were carried out in 18 SCA3 patients. Immunohistochemical analyses of the anterior and posterior roots of the spinal cord and peripheral nerves were performed in five SCA3 patients. We also employed immunohistochemistry and immunoelectron microscopy analyses with an anti‐polyglutamine antibody.

Results

The mean sensory nerve action potentials of the SCA3 patients were half of the normal values. The motor conduction velocities were decreased, and the distal latencies were also significantly prolonged in the nerves studied relative to the those in normal controls. Histopathological analyses detected axonal sprouting and myelin thinning in all cases. Ataxin‐3 aggregates were found in the cytoplasm of Schwann cells in all of the SCA3 patients examined but not in control subjects.

Conclusions

In addition to the previously reported neuronopathy, the results of the present study indicate that Schwann cells are involved in the formation of the pathogenic intracytoplasmic ataxin‐3 protein aggregates in patients with SCA3‐associated neuropathy.
Immunology of neuromyelitis optica: a T cell–B cell collaboration
Authors: Mitsdoerffer Meike , Kuchroo Vijay , Korn Thomas
Published: April 2013

Neuromyelitis optica (NMO) is a debilitating autoimmune inflammatory disease of the central nervous system (CNS) that is distinct from multiple sclerosis (MS). The discovery of NMO‐immunoglobulin G (IgG) in the serum of NMO—but not MS—patients was a breakthrough in defining diagnostic criteria for NMO. NMO‐IgG is an antibody directed against the astrocytic water channel protein aquaporin‐4 (AQP4). While there is evidence that NMO‐IgG is also involved in mediating tissue damage in the CNS, many aspects of the pathogenic cascade in NMO remain to be determined. It is clear that antigen‐specific T cells contribute to the generation of NMO‐IgG in the peripheral immune compartment, as well as to the development of NMO lesions in the CNS. T helper 17 (Th17) cells, equipped both in providing B cell help and inducing tissue inflammation, may be involved in NMO development and pathogenesis. Here, we review immunologic aspects of NMO, placing recent findings in the biology of T–B cell cooperation into perspective with autoimmunity of the CNS.
Neonatal clinical pharmacology
Authors: Allegaert Karel , van de Velde Marc , van den Anker John
Published: April 2013

Effective and safe drug administration in neonates should be based on integrated knowledge on the evolving physiological characteristics of the infant who will receive the drug and the pharmacokinetics (PK) and pharmacodynamics (PD) of a given drug. Consequently, clinical pharmacology in neonates is as dynamic and diverse as the neonates we admit to our units while covariates explaining the variability are at least as relevant as median estimates. The unique setting of neonatal clinical pharmacology will be highlighted based on the hazards of simple extrapolation of maturational drug clearance when only based on ‘adult’ metabolism (propofol, paracetamol). Second, maturational trends are not at the same pace for all maturational processes. This will be illustrated based on the differences between hepatic and renal maturation (tramadol, morphine, midazolam). Finally, pharmacogenetics should be tailored to neonates, not just mirror adult concepts. Because of this diversity, clinical research in the field of neonatal clinical pharmacology is urgently needed and facilitated through PK/PD modeling. In addition, irrespective of already available data to guide pharmacotherapy, pharmacovigilance is needed to recognize specific side effects. Consequently, pediatric anesthesiologists should consider to contribute to improved pharmacotherapy through clinical trial design and collaboration, as well as reporting on adverse effects of specific drugs.
The clonal dependence of turion formation in the duckweed Spirodela polyrhiza—an ecogeographical approach
Authors: Kuehdorf Katja , Jetschke Gottfried , Ballani Ludwig , Appenroth Klaus‐J.
Published: April 2013

Formation of turions, the vegetative perennation organs, plays an important role in the survival strategy of Spirodela polyrhiza (L.) Schleiden. Turion formation [quantified as number of turions formed per frond; specific turion yield (SY)] was investigated in 27 clones collected from a wide geographical range. The Pearson correlation was tested with (1) duration of growing season (monthly average temperature of ≥10°C), (2) relative growth rate of the fronds, (3) longitude and latitude, and (4) several climatic parameters, in all possible single and multiple regressions. All single coefficients of determination were below 0.10. The highest correlation (R2 = 0.61; adjusted for the number of explaining variables 0.54) was found in a multiple linear regression with the following five parameters: average temperatures over the year and during the growing season, duration of the growing season and precipitation over the year and during the growth period. All these parameters were shown to have significant contributions. This equation was used successfully to predict the SY of five newly isolated clones. Finally, on the basis of all 32 clones the following conclusions were drawn: The mean annual temperature has the highest impact. It is suggested that lower temperatures decrease the survival rate of turions and that adaptation refers to increasing SY. The different levels of SY in the clones (ranging from SY = 0.22 to 5.9) were detected even after several years of in vitro cultivation. It is therefore assumed that these adaptations to the climatic conditions are genetically determined.
Developmental Kinetics of Pig Embryos by Parthenogenetic Activation or by Handmade Cloning
Authors: Li J , Li R , Liu Y , Villemoes K , Purup S , Callesen H
Published: April 2013

Contents

The developmental kinetics of pig embryos produced by parthenogenetic activation without (PAZF) or with (PAZI) zona pellucida or by handmade cloning (HMC) was compared by time‐lapse videography. After cumulus cell removal, the matured oocytes were either left zona intact (PAZI) or were made zona free by pronase digestion (PAZF) before they were activated (PA). Other matured oocytes were used for HMC based on foetal fibroblast cells. On Day 0 (day of PA or reconstruction), the embryos were cultured for 7 days in vitro in our time‐lapse system. Pictures were taken every 30 min, and afterwards, each cell cycle was identified for each embryo to be analysed. Results showed that the PA embryos (both PAZF and PAZI) had shorter first cell cycle compared with HMC (17.4. 17.8 vs 23.6 h), but had a longer time length from four cell to morula stages (57.9, 53.8 vs 44.9 h). However, at the second cell cycle, PAZF embryos needed shorter time, while PAZI embryos had similar time length as HMC embryos, and both were longer than PAZF (23.4, 24.8 vs 14.6 h). Both PAZF and PAZI embryos used similar time to reach the blastocyst stage, and this was later than HMC embryos. In addition, when all of these embryos were grouped into viable (developed to blastocysts) and non‐viable (not developed to blastocysts), the only difference in the time length was observed on the first cell cycle (18.6 vs 24.5 h), but not on the later cell cycles. In conclusion, our results not only give detailed information regarding the time schedule of in vitro‐handled pig embryos, but also indicate that the first cell cycle could be used as a selecting marker for embryo viability. However, to evaluate the effect of the produced techniques, the whole time schedule of the pre‐implantation developmental kinetics should be observed.
INCOME DISPARITY AND CORRELATION IN JAPAN
Authors: Tamesue Kazuki , Tsutsumi Morito , Yamagata Yoshiki
Published: April 2013

With the collapse of the bubble economy in the early 1990s, economic disparities have arisen both among the people and in the different regions of Japan. Advancements in spatial analysis have led to the development of strong tools to explicitly consider spatial dependence and heterogeneity; however, no significant research has been carried out using such tools for analyzing the economic disparity at the municipal level in Japan. The objective of this study is to analyze the regional income disparities in Japan during the period known as the “lost decade.” The data used in this research are annual data collected at the municipality level during 1998–2007. Exploratory spatial data analysis and local indicators of spatial association have been used to classify municipalities into categories and to identify local spatial clustering and spatial outliers leading to income disparity in Japan, respectively.
Human platelet‐specific antigen frequencies in Indonesian population
Authors: Asmarinah  , Dharma R. , Ritchie N. K. , Rahayu S. , Putricahya E. , Santoso S.
Published: April 2013

Background

Alloantibodies against human platelet antigens (HPAs) are responsible for the development of alloimmune thrombocytopenia including platelet transfusion refractoriness (PTR) and neonatal alloimmune thrombocytopenia (NAIT). Therefore, transfusion of HPA‐compatible platelets is of importance for the management of these diseases.

Aim

Determination of the allele frequency of the major HPA systems for Indonesian blood donors and the development of the first HPA‐typed donor registry in Indonesia.

Methods

DNA derived from 500 Indonesian healthy blood donors was genotyped for HPA‐1 to HPA‐6 and HPA‐15 alleles by the use of polymerase chain reaction sequence‐specific primer method.

Results

The gene frequencies of the rare allelic variants HPA‐1b, ‐2b, ‐3b, ‐4b, ‐5b, ‐6b and ‐15b were 0·023, 0·060, 0·493, 0·052, 0·032, 0·044 and 0·049, respectively. However, donors homozygous for the HPA‐1b, ‐2b and ‐6b were not found in this cohort, indicating that the risks of alloimmunisation caused by incompatibility of these three HPA systems are extremely low. In contrast, alloimmunisation against HPA‐3, ‐4, ‐5 and ‐15 systems is anticipated.

Conclusion

The development of an HPA‐genotyped registry for donors homozygous for HPA‐1b, ‐2b and ‐6b is desired for the optimum management of PTR patients and children with NAIT.
A molecular technique for the detection and differentiation of Demodex mites on cats
Authors: Frank Linda A. , Kania Stephen A. , Chung Karianne , Brahmbhatt Rupal
Published: April 2013

Background

Demodex gatoi causes a pruritic dermatitis in cats. Diagnosis requires the demonstration of mites using superficial skin scrapings or faecal flotation, which can be insensitive.

Hypothesis/Objectives

The goal of this study was to develop a molecular method to diagnose D. gatoi infection in cats and distinguish these mites from Demodex cati.

Animals

Fifty‐three shelter cats, 11 cats from a closed research colony and 12 privately owned cats were used.

Methods

Demodex gatoi and D. cati were obtained from scrapings of cat skin. The 16S rRNA DNA was amplified by PCR, sequenced and compared with available Demodex sequences. Hair and skin samples were also collected for microscopic examination and DNA isolation.

Results

DNA sequences were obtained from D. gatoi and D. cati. qPCR with D. gatoi specific primers and probe amplified DNA isolated from D. gatoi and not D. cati. Conversely, D. cati qPCR primers and probe amplified D. cati DNA and not D. gatoi.

Five of the shelter cats were positive for D. gatoi. Two of these cats were pruritic, and the other three were in contact with these cats. Only one cat was positive for D. gatoi on skin scraping but was negative for D. gatoi or D. cati DNA.

Conclusion

Results from this study show D. gatoi and D. cati to be distinct species. A novel qPCR test for the identification and differentiation of D. gatoi and D. cati was developed. Once optimized, this test could provide a valuable technique for the diagnosis of D. gatoi infection.
Po‐Poster ‐ 23: The geometrical accuracy of 3D reconstructions from orthogonal views using distortion corrected image intensifier images
Authors: Diamond K , Farrell T
Published: April 2013

Three‐dimensional source localization in brachytherapy is integral to the treatment planning process. Many high dose rate (HDR) brachytherapy facilities employ a mobile C‐arm to accomplish this task. Digital images captured directly from an image intensifier are distorted and must be dewarped prior to their use in treatment planning. This preliminary study examines the accuracy of 3D reconstructions of a known object using digital images that have had the distortion removed using a simple mathematical model. Orthogonal images of a known test object were acquired and corrected, and were then used to reconstruct the object. The cumulative uncertainty in the reconstructed location of fiducial marks on the object over 18 cm length orientation was 1.2 mm, compared to 1.0 mm over a 16 cm length using CR film. Potential improvements to image processing methods employed in this study are also discussed.
Po‐Poster ‐ 31: An improved derivation of the Joiner expressions for determining a simple independent method to derive fully isoeffective schedules following a change in dose per fraction
Authors: Elmehdi H , Pistorius S
Published: April 2013

In the paper written by Joiner (IJROBP 2004; 58(3): 871–875), entitled A simple α/β‐independent method to derive fully isoeffective effective schedules following a change in dose per fraction, the author derived two mathematical expressions by which dosimetric errors in delivering the prescribed dose per fraction in a treatment can be corrected for. In doing so, the author made an invalid assumption in which he assumed α/β is zero for both early and late effects. Even though this assumption is wrong, the author arrived “mistakenly” at the right solution. In this presentation, we use first principles to derive these two expressions and the limits at which they cannot be applied, both from radiobiological and mathematical point of views. We also explain the inherent α/β‐independence of the expressions. Acknowledgment: The authors would like to acknowledge the financial support of CancerCare Manitoba Foundation.
Po‐Poster ‐ 32: Optimization of an x‐ray diffraction experiment via numerical calculations
Authors: Wang Y , Leclair R , Boileau M , Zhao P
Published: April 2013

In our lab, a research program focused on identifying breast cancer by measuring the x‐ray scatter signals is under development. In an attempt to help us determine how the misalignment of the experimental setup and the fluorescence escaping affect our measured results in our particular experimental conditions, we have developed a set of simulation programs written in C++ object‐oriented language. We use a 5 mm diameter 5 mm thick water target as our sample and a cadmium zinc telluride detector. We have simulated the scattering in the sample, incorporated misalignments in our system and studied the effects of K‐fluorescence escape from our detector. We simulate monoenergetic beams with energies of 15 keV, 25 keV, and 35 keV. We also consider a 50 kV x‐ray spectrum. The angles studied range from 5° to 16° . The misalignments are that the beams on either the target or the detector are offset by (0.5mm, 0.5mm) or (−0.5mm, −0.5mm) from the center, or the detector angle has an offset of ±0.2 degrees. We find small percent differences ranging from −1.65% to 4.91% for aligned versus misaligned geometries. We anticipate that we can align our system to obtain good results. The K‐fluorescence escape probability varies as a function of the incoming photon energy and the depth of interaction in the detector. The highest escape probability of 11% occurs for a photon energy of about 33 keV. The escaping is essentially from the top surface of our detector and we may need to take this effect into account.
Po‐Poster ‐ 36: Using the internet for real‐time medical physics education
Authors: Woo M , Ng K
Published: April 2013

This presentation is an update on the Remote Real‐Time Learning Project (http://www.neteinfach.com/rrtl/index.htm). The goal of the project is to promote the use of Internet to provide classroom style real‐time interactive education in Medical Physics. This project was started 3 years ago as a collaboration between the Department of Medical Physics at the Toronto‐Sunnybrook Regional Cancer Centre in Canada and the Department of Radiology at the University of Malaya in Malaysia. A class of Medical Physics graduate students at the University of Malaya attended lectures provided by lecturers in Toronto, using the Internet as the main tool of communication. As part of the study, the different methods that can be used to provide real‐time interactive remote education were explored, and various topics including traditional classroom lectures as well as hands‐on workshops were also delivered. Based on our experience, a reasonably stable methodology has been established. This methodology allows a fairly smooth set‐up and conduction of the lectures, at an insignificant cost, while offering flexible convenience to the lecturers as well as the students, despite the widely different time zones. The current plan is to expand the process to allow students at multiple sites of the world to attend the online lectures at the same time. Our project welcomes the participation of both lecturers and students who are interested in taking advantage of the advance of the Internet to promote greater accessibility of quality education in the field.
Medical Imaging: The vision for new medical advances
Authors: Bronskill M
Published: April 2013

Medical imaging uses various types of electromagnetic radiation to produce images which reveal exquisite detail about the structures and functions of the human body. As medical imaging evolves, it takes on new roles beyond the detection and assessment of disease. Advances in medical imaging are stimulating medical scientists to develop new devices and techniques which characterize and treat diseases. This is often achieved by incorporating imaging in new roles for guiding, delivering, monitoring and assessing interventional procedures, frequently in real time during the procedure. This presentation will illustrate how this medical imaging “vision” is stimulating new advances in cardiology, tumour detection and biopsy, cancer treatment, and assessment and treatment of diseases of the brain.
Sci‐YIS Fri ‐ 01: A protocol for the validation of non‐linear image registration systems
Authors: Rivest R , Riauka T , Murtha A , Fallone B
Published: April 2013

An important step in the image guided adaptive radiotherapy (IGAR) process is the registration of medical images. Image registration has been used in clinically for a number of years; however registration systems have been restricted to linear or rigid registration, meaning that they cannot take into account soft tissue or organ motion with respect to rigid bony structures. Among its applications, non‐linear or deformable registration will allow for more accurate delineation of tumours and critical structures by correcting for organ motion and patient miss‐alignment from image study to study. Since deformable registration is still in its infancy, a standard protocol for the validation of these systems does not exist. A comprehensive protocol to assess the accuracy of deformable registration systems over a wide range of clinical and research applications has been developed. The protocol has been applied to the Reveal‐MVS Fusion Workstation from Mirada Solutions Ltd. It consists of a preliminary phantom study designed to assess the registration of images with well‐defined objects that have known positions, sizes, and shapes. In addition, a collection of novel and established metrics are used to determine image registration accuracy for both, real and simulated patient images. Results show that the Reveal‐MVS system is well suited for some applications of non‐linear image registration, but not applicable for others. Results will be used to further refine and improve upon existing non‐linear image registration algorithms.
An investigation of industrial molding compounds for use in 3D ultrasound, MRI, and CT imaging phantoms
Authors: Yunker Bryan E. , Cordes Dietmar , Scherzinger Ann L. , Dodd Gerald D. , Shandas Robin , Feng Yusheng , Hunter Kendall S.
Published: April 2013

Purpose:

This study investigated the ultrasound, MRI, and CT imaging characteristics of several industrial casting and molding compounds as a precursor to the future development of durable and anatomically correct flow phantoms.

Methods:

A set of usability and performance criteria was established for a proposed phantom design capable of supporting liquid flow during imaging. A literature search was conducted to identify the materials and methods previously used in phantom fabrication. A database of human tissue and casting material properties was compiled to facilitate the selection of appropriate materials for testing. Several industrial casting materials were selected, procured, and used to fabricate test samples that were imaged with ultrasound, MRI, and CT.

Results:

Five silicones and one polyurethane were selected for testing. Samples of all materials were successfully fabricated. All imaging modalities were able to discriminate between the materials tested. Ultrasound testing showed that three of the silicones could be imaged to a depth of at least 2.5 cm (1 in.). The RP‐6400 polyurethane exhibited excellent contrast and edge detail for MRI phantoms and appears to be an excellent water reference for CT applications. The 10T and 27T silicones appear to be usable water references for MRI imaging.

Conclusions:

Based on study data and the stated selection criteria, the P‐4 silicone provided sufficient material contrast to water and edge detail for use across all imaging modalities with the benefits of availability, low cost, dimensional stability, nontoxic, nonflammable, durable, cleanable, and optical clarity. The physical and imaging differences of the materials documented in this study may be useful for other applications.
Necrotising pancreatitis presenting as a painful mass in the groin and sepsis
Authors: O'Sullivan K E , Larkin J O , Guiney M , Reynolds J V
Published: April 2013

Acute pancreatitis is typically associated with classical clinical and radiological features. The sensitivity of CT to diagnose acute pancreatitis depends on the severity of the attack and ranges from 77% to 92% with a specificity approaching 100%. Despite the fact this is a common disease, there are myriad clinical presentations of acute pancreatitis. We report herein an especially rare presentation where severe acute necrotising pancreatitis presented with a tender inguinoscrotal swelling with a normal pancreas on CT imaging.
Successful treatment of acute hereditary angioedema attacks with self-administered icatibant in patients with venous access problems
Authors: Wiednig Michaela
Published: April 2013

Hereditary angioedema is a rare and potentially fatal autosomal dominant disorder characterised by unpredictable skin, gastrointestinal tract or respiratory tract oedema. Plasma-derived C1-esterase inhibitors are effective in the prophylaxis or treatment of hereditary angioedema type I and II attacks, but must be administered intravenously. This may be problematic in patients with venous access difficulties. Icatibant, a bradykinin B2-receptor antagonist, is administered subcutaneously. In July 2008 icatibant received approval for healthcare professional-administered treatment of hereditary angioedema attacks in adults. In 2011 it received European Medicines Agency and US Food and Drug Administration licences for patient-administered treatment of hereditary angioedema attacks. Given these approvals, and with the appropriate training, icatibant could provide the opportunity for patients to self-administer treatment. This is one of the first long-term follow-up reports of patients with hereditary angioedema using self-administered icatibant. During follow-up, icatibant remained effective and patient satisfaction was high.
Nevirapine-induced Stevens-Johnson syndrome following HIV postexposure prophylaxis
Authors: Bannaga Ayman , Rahama Omar , Barlow Gavin
Published: April 2013

A 25-year-old Caucasian heterosexual man with a recent history of unprotected sex in Vietnam while on a holiday was prescribed HIV postexposure prophylaxis by a local doctor; nevirapine, stavudine and lamivudine. He was subsequently admitted to a UK hospital with sore throat, bilateral conjunctivitis, genital ulceration and severe widespread maculo-papular rash. Extensive investigations for infective causes were negative and he was subsequently recovered with conservative therapy.
Recurrent case of ibuprofen-induced aseptic meningitis in mixed connective tissue disease
Authors: Karmacharya Paras , Mainali Naba Raj , Aryal Madan Raj , Lloyd Benjamin
Published: April 2013

Although relatively uncommon, the incidence of non-steroidal anti-inflammatory drug-induced aseptic meningitis appears to be increasing among patients with connective tissue disease and also among the healthy population. Ibuprofen is the most common culprit identified. We report a case of a 28-year-old woman with mixed connective tissue disease and recent intake of ibuprofen, presenting with a recurrent episode of ibuprofen-induced aseptic meningitis.
A rare cause of epigastric pain in a middle-aged man
Authors: Nahas Rannie , Pain Thomas , Goulden Peter
Published: April 2013

A 50-year-old man presents to the emergency department with epigastric pain and is found to have severe hypertension on clinical examination. After admission to hospital, further investigation with CT imaging reveals the patient has an uncomplicated splenic artery dissection. Conservative management is chosen as advised by a vascular surgery team and the patient was subsequently discharged from hospital with warfarin anticoagulation and antihypertensive medicines. This case report aims to build a profile of a patient who may present with splenic artery dissection and details our recommended management plan.
Effectiveness of nurse home-visiting for disadvantaged families: results of a natural experiment
Authors: Sawyer Michael Gifford , Frost Linda , Bowering Kerrie , Lynch John
Published: April 2013

Objective

To evaluate the effects of a postnatal home-visiting programme delivered by community health nurses to socially disadvantaged mothers in South Australia.

Design

The intervention group of 428 mothers lived in metropolitan Adelaide and the comparison group of 239 mothers lived in regional towns where the programme was not yet available. All participating mothers met health service eligibility criteria for enrolment in the home-visiting programme. Participants in both groups were assessed at baseline (mean child age=14.4 weeks SD=2.3), prior to programme enrolment, and again when the children were aged 9, 18 and 24 months.

Setting

State-wide community child health service.

Participants

667 socially disadvantaged mothers enrolled consecutively. 487 mothers (73%) completed the 24-month assessment.

Intervention

Two-year postnatal home-visiting programme based on the Family Partnership Model.

Primary outcome measures

Parent Stress Index (PSI), Kessler Psychological Distress Scale and the Ages and Stages Questionnaire.

Results

Mixed models adjusting for baseline differences were used to compare outcomes in the two groups. The mothers in the home-visiting group reported greater improvement on the PSI subscales assessing a mother's perceptions on the quality of their relationship with their child (1.10, 95% CI 0.06 to 2.14) and satisfaction with their role as parents (0.46, 95% CI −0.15 to 1.07) than mothers in the comparison group. With the exception of childhood sleeping problems, there were no other significant differences in the outcomes across the two groups.

Conclusions

The findings suggest that home-visiting programmes delivered by community health nurses as part of routine clinical practice have the potential to improve maternal–child relationships and help mothers adjust to their role as parents.

Clinical Trial Registration

Australian and New Zealand Clinical Trials Registry ACTRN12608000275369.
A time series approach for evaluating intra-city heat-related mortality
Authors: Hondula David M , Davis Robert E , Rocklöv Joacim , Saha Michael V
Published: April 2013

Extreme heat is a leading cause of weather-related mortality. Most research has considered the aggregate response of the populations of large metropolitan areas, but the focus of heat-related mortality and morbidity investigations is shifting towards a more fine-scale approach in which impacts are measured in smaller units such as postal codes. However, most existing statistical techniques to model the relationship between temperature and mortality cannot be directly applied to the intra-city scale because small sample sizes inhibit proper modelling of seasonality and long-term trends. Here we propose a time series technique based on local-scale mortality observations that can provide more reliable information about vulnerability within metropolitan areas. The method combines a generalised additive model with direct standardisation to account for changing death rates in intra-city zones. We apply the method to a 26-year time series of postal code-referenced mortality data from Philadelphia County, USA, where we find that heat-related mortality is unevenly spatially distributed. Fifteen of 46 postal codes are associated with significantly increased mortality on extreme heat days, most of which are located in the central and western portions of the county. In some cases the local death rate is more than double the county average. Identification of high-risk areas can enable targeted public health intervention and mitigation strategies.
Estimating population size, HIV prevalence and HIV incidence among men who have sex with men: a case example of synthesising multiple empirical data sources and methods in San Francisco
Authors: Raymond H Fisher , Bereknyei Sylvia , Berglas Nancy , Hunter Jennifer , Ojeda Norah , McFarland Willi
Published: April 2013

Objective

The number of persons living with HIV/AIDS, the number of new infections and the number of persons at risk for HIV infection are the foundations of evidence-based prevention, treatment and care planning. However, few jurisdictions have complete and accurate estimates of these indicators. HIV/AIDS case reporting, which includes only persons diagnosed with infection and reported to health departments, does not reflect all HIV/AIDS cases, thus underestimating the true size of the epidemic. Obtaining direct measures of HIV incidence is methodologically challenging. Moreover, no censuses exist for the number of persons at highest risk for infection, including men who have sex with men (MSM).

Method

We present an approach of triangulation that draws upon multiple empirical and overlapping sources of information through different methods to synthesise data-based estimates of the prevalence, incidence and denominator of MSM at risk for infection in San Francisco. We further use existing data to establish plausible upper and lower bounds for each estimate.

Result

We arrived at an overall population size of 66 487 of MSM in San Francisco as of 31 December 2010. The number of MSM living with HIV/AIDS was 15 873, corresponding to an HIV prevalence of 23.9%. We projected 806 new cases in 2010, translating to an incidence rate of 1.59% per year.

Conclusions

While not without limitations, our estimates provide useful information for the purpose of HIV/AIDS prevention and care planning, drawing from diverse sources that may be available in local health jurisdictions. We believe that our approach enhances the credibility of such estimates by mitigating bias from only one source of data or one methodological approach.