bluuebunny/crossref_metadata_2025 huggingface dataset:
Influence of selected soil properties, soil management practices and socio‐economic variables on relative weed density in a hand hoe‐based conservation agriculture system
Authors: Mavunganidze Z. , Madakadze I. C. , Nyamangara J. , Mafongoya P.
Published: August 2016

Weeds are problematic to the smallholder farmers, who practise conservation agriculture (CA) in sub‐Saharan Africa, owing to an apparent lack of appropriate weed management strategies. We investigated weed dynamics under the planting basin (PB) system (hand hoe‐based CA) to assist the design of appropriate weed management options. On‐farm experiments were conducted under semi‐arid conditions in Zimbabwe to determine the effects of 11 selected soil properties, four socio‐economic variables and two soil management practices on relative weed density. Weed counts were made according to species at 3, 6 and 9 weeks after crop emergence. Multivariate ordination techniques and a quadratic model, developed with partial least squares, showed that Richardia scabra increased with sand content in the soil. Density of R. scabra and Melinis repens also increased with topsoil potassium content. When ranked according to importance, relative weed density was most dependent on sand content followed by topsoil potassium, nitrate, clay and silt content, and training related to crop production. Soil physico‐chemical properties, therefore, had greater influence on relative weed density than socio‐economic variables and soil management practices. We concluded that variability in weed density under the PB system was not necessarily determined by tillage alone, but was also a consequence of soil properties and to a lesser extent of socio‐economic variables and soil management practices. Understanding soil properties and management practices, which determine weed variability, helps in the design of general weed management recommendations that can be used by smallholders, most of whom do not have access to field‐specific advice.
Human cytomegalovirus prevalence and distribution of glycoprotein B, O genotypes among hospitalized children with respiratory infections in West China, 2009–2014
Authors: Chen Jia‐Yi , Zheng Tian‐Li , Zhou Tao , Hu Peng‐Wei , Huang Meng‐Jiao , Xu Xin , Pei Xiao‐Fang
Published: August 2016

Objectives

Human cytomegalovirus (HCMV) is an important pathogen causing morbidity and mortality in children. HCMV prevalence in children with respiratory infections has not been investigated in West China. Previous studies have suggested that glycoproteins genotypes may be associated with different clinical presentations, but the associations were controversial. The aim of this study was to determine the prevalence of HCMV infection in children with respiratory infections, the distributions of gB, gO genotypes among these isolates and their potential predictive roles for the development of symptoms in children.

Methods

A total of 1709 respiratory specimens were obtained from hospitalised children with respiratory symptoms from 2009 to 2014 for the confirmation of HCMV infection. Glycoprotein B,O genotyping was carried out by multiplex nested PCR and sequencing.

Results

The overall infection rate was 10.8%, and dominant genotypes were gB1 (74.2%) and gO1 (37.1%). Clinical characteristics differed between infants and children >1 year of age. Infants infected with HCMV had a higher frequency of fever (P < 0.001), cough (P < 0.001), rhinorrhea (P < 0.001), expectoration (P = 0.001) and diarrhoea (P = 0.005). Children <1 year age infected with gB1 had a higher rate of cough (P = 0.0192).

Conclusions

Infants infected with HCMV had a severe clinical outcome. gB1 may negatively associate with clinical presentations and quality of life in these children. The prevalence of HCMV infection and genotype distribution emphasises the importance of HCMV screening, vaccination and control for transmission.
Política y redes sociales en Argentina. El caso de los candidatos presidenciales de 2011 en Twitter
Authors: Slimovich Ana
Published: August 2016

Las transformaciones de los medios masivos y el surgimiento de nuevos medios han generado nuevas prácticas sociales. El objeto de estudio de este trabajo es la digitalización del discurso político. Para ello, utilizaremos herramientas de la socio-semiótica, de la teoría política y de la teoría de la mediatización y la convergencia. El corpus está formado por las cuentas de Twitter de los candidatos a la presidencia de las elecciones Argentina 2011. Apuntamos a detallar los modos de inserción del discurso político en las redes sociales. Sostenemos, como hipótesis, que los usos de las redes sociales por parte de los políticos están enmarcados en los acontecimientos políticos y, a la vez, implican lógicas de diferentes medios. A estos usos los denominamos estrategias mediáticas. Tomando en cuenta las herramientas de Twitter, la interrelación con los medios masivos y el mundo de la política, concluiremos con la emergencia de cuatro tipos de estrategia.
Technical Note: Unified imaging and robotic couch quality assurance
Authors: Cook Molly C. , Roper Justin , Elder Eric S. , Schreibmann Eduard
Published: August 2016

Purpose:

To introduce a simplified quality assurance (QA) procedure that integrates tests for the linac's imaging components and the robotic couch. Current QA procedures for evaluating the alignment of the imaging system and linac require careful positioning of a phantom at isocenter before image acquisition and analysis. A complementary procedure for the robotic couch requires an initial displacement of the phantom and then evaluates the accuracy of repositioning the phantom at isocenter. We propose a two‐in‐one procedure that introduces a custom software module and incorporates both checks into one motion for increased efficiency.

Methods:

The phantom was manually set with random translational and rotational shifts, imaged with the in‐room imaging system, and then registered to the isocenter using a custom software module. The software measured positioning accuracy by comparing the location of the repositioned phantom with a CAD model of the phantom at isocenter, which is physically verified using the MV port graticule. Repeatability of the custom software was tested by an assessment of internal marker location extraction on a series of scans taken over differing kV and CBCT acquisition parameters.

Results:

The proposed method was able to correctly position the phantom at isocenter within acceptable 1 mm and 1° SRS tolerances, verified by both physical inspection and the custom software. Residual errors for mechanical accuracy were 0.26 mm vertically, 0.21 mm longitudinally, 0.55 mm laterally, 0.21° in pitch, 0.1° in roll, and 0.67° in yaw. The software module was shown to be robust across various scan acquisition parameters, detecting markers within 0.15 mm translationally in kV acquisitions and within 0.5 mm translationally and 0.3° rotationally across CBCT acquisitions with significant variations in voxel size. Agreement with vendor registration methods was well within 0.5 mm; differences were not statistically significant.

Conclusions:

As compared to the current two‐step approach, the proposed QA procedure streamlines the workflow, accounts for rotational errors in imaging alignment, and simulates a broad range of variations in setup errors seen in clinical practice.
Estimating scatter in cone beam CT with striped ratio grids: A preliminary investigation
Authors: Hsieh Scott
Published: August 2016

Purpose:

To propose a new method for estimating scatter in x‐ray imaging. Conventional antiscatter grids reject scatter at an efficiency that is constant or slowly varying over the surface of the grid. A striped ratio antiscatter grid, composed of stripes that alternate between high and low grid ratio, could be used instead. Such a striped ratio grid would reduce scatter‐to‐primary ratio as a conventional grid would, but more importantly, the signal discontinuities at the boundaries of stripes can be used to estimate local scatter content.

Methods:

Signal discontinuities provide information on scatter, but are contaminated by variation in primary radiation. A nonlinear image processing algorithm is used to estimate the scatter content in the presence of primary variation. We emulated a striped ratio grid by imaging phantoms with two sequential CT scans, one with and one without a conventional grid. These two scans are processed together to mimic a striped ratio grid. This represents a best case limit of the striped ratio grid, in that the extent of grid ratio modulation is very high and the scatter contrast is maximized.

Results:

In a uniform cylinder, the striped ratio grid virtually eliminates cupping. Artifacts from scatter are improved in an anthropomorphic phantom. Some banding artifacts are induced by the striped ratio grid.

Conclusions:

Striped ratio grids could be a simple and effective evolution of conventional antiscatter grids. Construction and validation of a physical prototype remains an important future step.
Free vibration of layered magnetoelectroelastic spheres
Authors: Heyliger P. R. , Pan E.
Published: August 2016

A discrete-layer model is presented and applied to the free vibration of layered anisotropic spheres with coupling among the elastic, electric, and magnetic fields. Through-thickness approximations in the radial direction are pre-integrated and combined with independent approximations in the azimuthal and circumferential directions to provide estimates of the natural frequencies for a variety of representative geometries. Results are in excellent agreement with existing analytical studies and additional results are presented for higher-order spheroidal modes. Predictions of the level of influence of magnetoelectric coupling are also given.
Draft Genome Sequence of
Micromonospora
sp
.
Strain HK10, Isolated from Kaziranga National Park, India
Authors: Talukdar Madhumita , Das Dhrubajyoti , Borah Chiranjeeta , Deka Boruah Hari Prasanna , Bora Tarun Chandra , Singh Anil Kumar
Published: August 2016

We report the 6.92-Mbp genome sequence of
Micromonospora
sp. HK10, isolated from soil samples collected from Kaziranga National Park, Assam, India. The full genome of strain
Micromonospora
sp
.
strain HK10 consists of 6,911,179 bp with 73.39% GC content, 6,196 protein-coding genes, and 86 RNAs.
Genome Sequence of
Gordonia
Phage BetterKatz
Authors: Pope Welkin H. , Berryman Emily N. , Forrest Kaitlyn M. , McHale Lilliana , Wertz Anthony T. , Zhuang Zenas , Kasturiarachi Naomi S. , Pressimone Catherine A. , Schiebel Johnathon G. , Furbee Emily C. , Grubb Sarah R. , Warner Marcie H. , Montgomery Matthew T. , Garlena Rebecca A. , Russell Daniel A. , Jacobs-Sera Deborah , Hatfull Graham F.
Published: August 2016

BetterKatz is a bacteriophage isolated from a soil sample collected in Pittsburgh, Pennsylvania using the host
Gordonia terrae
3612. BetterKatz's genome is 50,636 bp long and contains 75 predicted protein-coding genes, 35 of which have been assigned putative functions. BetterKatz is not closely related to other sequenced
Gordonia
phages.
Genome Sequences of
Gordonia
Phages Bowser and Schwabeltier
Authors: Montgomery Matthew T. , Pope Welkin H. , Arnold Zachary M. , Basina Aleksandra , Iyer Ankitha M. , Stoner Ty H. , Kasturiarachi Naomi S. , Pressimone Catherine A. , Schiebel Johnathon G. , Furbee Emily C. , Grubb Sarah R. , Warner Marcie H. , Garlena Rebecca A. , Russell Daniel A. , Jacobs-Sera Deborah , Hatfull Graham F.
Published: August 2016

Gordonia
phages Bowser and Schwabeltier are newly isolated phages infecting
Gordonia terrae
3612. Bowser and Schwabeltier have similar siphoviral morphologies and their genomes are related to each other, but not to other phages. Their lysis cassettes are atypically situated among virion tail genes, and Bowser encodes two tyrosine integrases.
Genome Sequences of
Gordonia
Phages Hotorobo, Woes, and Monty
Authors: Pope Welkin H. , Davis Jameson P. , O'shea Sirinya , Pfeiffer Anastasia C. , Rich Alexandra N. , Xue Jason C. , Shedlock Kathleen A. , Stanton Ann-Catherine J. , Furbee Emily C. , Grubb Sarah R. , Warner Marcie H. , Montgomery Matthew T. , Garlena Rebecca A. , Russell Daniel A. , Jacobs-Sera Deborah , Hatfull Graham F.
Published: August 2016

Hotorobo, Woes, and Monty are newly isolated bacteriophages of
Gordonia terrae
3612. The three phages are related, and their genomes are similarly sized (76,972 bp, 73,752 bp, and 75,680 bp for Hotorobo, Woes, and Monty, respectively) and organized. They have extremely long tails and among the longest tape measure protein genes described to date.
Genome Sequences of
Gordonia
Phages BaxterFox, Kita, Nymphadora, and Yeezy
Authors: Pope Welkin H. , Bandla Sharanya , Colbert Alexandra K. , Eichinger Fiona G. , Gamburg Michelle B. , Horiates Stavroula G. , Jamison Jerrica M. , Julian Dana R. , Moore Whitney A. , Murthy Pranav , Powell Meghan C. , Smith Sydney V. , Mezghani Nadia , Milliken Katherine A. , Thompson Paige K. , Toner Chelsea L. , Ulbrich Megan C. , Furbee Emily C. , Grubb Sarah R. , Warner Marcie H. , Montgomery Matthew T. , Garlena Rebecca A. , Russell Daniel A. , Jacobs-Sera Deborah , Hatfull Graham F.
Published: August 2016

Gordonia
phages BaxterFox, Kita, Nymphadora, and Yeezy are newly characterized phages of
Gordonia terrae
, isolated from soil samples in Pittsburgh, Pennsylvania. These phages have genome lengths between 50,346 and 53,717 bp, and encode on average 84 predicted proteins. All have G+C content of 66.6%.
Whole-Genome Sequence of
Corynebacterium auriscanis
Strain CIP 106629 Isolated from a Dog with Bilateral Otitis from the United Kingdom
Authors: Tiwari Sandeep , Jamal Syed Babar , Oliveira Leticia Castro , Clermont Dominique , Bizet Chantal , Mariano Diego , de Carvalho Paulo Vinicius Sanches Daltro , Souza Flavia , Pereira Felipe Luiz , de Castro Soares Siomar , Guimarães Luis C. , Dorella Fernanda , Carvalho Alex , Leal Carlos , Barh Debmalya , Figueiredo Henrique , Hassan Syed Shah , Azevedo Vasco , Silva Artur
Published: August 2016

In this work, we describe a set of features of
Corynebacterium auriscanis
CIP 106629 and details of the draft genome sequence and annotation. The genome comprises a 2.5-Mbp-long single circular genome with 1,797 protein-coding genes, 5 rRNA, 50 tRNA, and 403 pseudogenes, with a G+C content of 58.50%.
Complete Genome Sequence of
Gluconacetobacter hansenii
Strain NQ5 (ATCC 53582), an Efficient Producer of Bacterial Cellulose
Authors: Pfeffer Sarah , Mehta Kalpa , Brown R. Malcolm
Published: August 2016

This study reports the release of the complete nucleotide sequence of
Gluconacetobacter hansenii
strain NQ5 (ATCC 53582). This strain was isolated by R. Malcolm Brown, Jr. in a sugar mill in North Queensland, Australia, and is an efficient producer of bacterial cellulose. The elucidation of the genome will contribute to the study of the molecular mechanisms necessary for cellulose biosynthesis.
Complete Genome Sequence of the Cyanobacterium
Anabaena
sp. 33047
Authors: Pfeffer Sarah , Brown R. Malcolm
Published: August 2016

This study presents the complete nucleotide sequence of
Anabaena
sp. ATCC 33047 (
Anabaena
CA), a filamentous, nitrogen-fixing marine cyanobacterium, which under salt stress conditions accumulates sucrose internally. The elucidation of the genome will contribute to the understanding of cyanobacterial diversity.
Draft Genome Sequences of Two Magnetotactic Bacteria,
Magnetospirillum moscoviense
BB-1 and
Magnetospirillum marisnigri
SP-1
Authors: Koziaeva Veronika V. , Dziuba Marina V. , Ivanov Timophey M. , Kuznetsov Boris B. , Skryabin Konstantin G. , Grouzdev Denis S.
Published: August 2016

We report here the draft genome sequences of two recently isolated magnetotactic species,
Magnetospirillum moscoviense
BB-1 and
Magnetospirillum marisnigri
SP-1. The genome of
M. moscoviense
BB-1 has 4,164,497 bp, 65.2% G+C content, and comprises 207 contigs. The genome of
M. marisnigri
SP-1 consists of 131 contigs and has a length of 4,619,819 bp and 64.7% G+C content.
Draft Genome Sequences of
Escherichia coli
Isolates from Wounded Military Personnel
Authors: Arivett Brock A. , Ream Dave C. , Fiester Steven E. , Kidane Destaalem , Actis Luis A.
Published: August 2016

Members of the
Escherichia coli
bacterial family have been grouped as ESKAPE (
Enterococcus faecium
,
Staphylococcus aureus
,
Klebsiella pneumoniae
,
Acinetobacter baumannii
,
Pseudomonas aeruginosa
, and
Enterobacter
species) pathogens because of their extensive drug resistance phenotypes and increasing threat to human health. The genomes of six extended-spectrum β-lactamase (ESBL)-producing
E. coli
strains isolated from wounded military personnel were sequenced and annotated.
Draft Genome Sequences of
Pseudomonas aeruginosa
Isolates from Wounded Military Personnel
Authors: Arivett Brock A. , Ream Dave C. , Fiester Steven E. , Kidane Destaalem , Actis Luis A.
Published: August 2016

Pseudomonas aeruginosa
, a Gram-negative bacterium that causes severe hospital-acquired infections, is grouped as an ESKAPE (
Enterococcus faecium, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa
, and
Enterobacter
species) pathogen because of its extensive drug resistance phenotypes and effects on human health worldwide. Five multidrug resistant
P. aeruginosa
strains isolated from wounded military personnel were sequenced and annotated in this work.
Safety Recommendations for Moxa Use Based on the Concentration of Noxious Substances Produced during Commercial Indirect Moxibustion
Authors: Kwon O Sang , Cho Seong Jin , Choi Kwang-Ho , Yeon Sun Hee , Kang Suk-Yun , Kim Jae-hyo , Ahn Seong-Hun , Ryu Yeonhee
Published: August 2016

Background

Moxibustion therapy has been used historically for thousands of years and there are many clinical trials supporting its efficacy and effectiveness for various conditions. Moxa smoke has been a major reason for avoiding moxibustion due to its smell and potential risks to the human body.

Methods

10 units of commercial indirect moxa (CIM) from six manufacturers (A–F) were burnt in a 2.5×2.5×2.5 m chamber without ventilation, and concentrations of carbon oxides (CO and CO2), nitrogen oxides (NOx), and volatile organic compounds (VOCs) from the indoor air samples were measured.

Results

For brands A, B, C, D, E, and F, respectively, relative to baseline values, we observed an increase in CO (from 0.002 to 0.007, 0.006, 0.005, 0.006, 0.005, and 0.006 parts per billion (ppb)), NOx (from 0.009 to 0.051, 0.025, 0.015, 0.050, 0.019, and 0.020 ppb), and total VOCs (TVOC; from 48.06 to 288.83, 227.93, 140.82, 223.22, 260.15, and 161.35 μg/m3), while the concentration of CO2 was not elevated. Each CIM brand demonstrated different VOC emission characteristics, which could be divided into three groups. On average, we estimated that 20 units of CIM or 2.41 g moxa floss would need to be combusted in order to exceed the safe levels set by Korean environmental law. This limit is likely to be greater in the case of a larger room or use of ventilation.

Conclusions

Despite increased CO/NOx/VOC concentrations, overall levels remained within safe limits. These findings may help clinicians to maintain safe moxibustion treatment conditions to help keep both patients and clinicians safe from the pollutants generated by moxa combustion.
Solitaire stentectomy: ‘deploy and engage’ and ‘loop and snare’ techniques
Authors: Parthasarathy Rajsrinivas , Gupta Vipul , Goel Gaurav , Mahajan Anshu
Published: August 2016

Solitaire FR stent-based mechanical thrombectomy provides clinical benefit in selected patients with acute ischaemic stroke due to large vessel occlusion. A dreaded device complication that is associated with poor technical and clinical outcome is stent detachment. Retrieval of the detached stent can be technically challenging and has been attempted with variable success. The key benefit of this strategy is the lack of need to administer fibrinolytic/antiplatelet agents that can potentially be catastrophic in the setting of acute stroke. Therefore, retrieval may be preferred to other strategies (balloon angioplasty, lytic/glycoprotein 2b/3a inhibitors administration) to address detached stent. We report two patients in whom the detached stent was retrieved using alternative techniques—‘deploy and engage’ and ‘loop and snare’—as snare retrieval failed.
Post-streptococcal reactive arthritis: where are we now
Authors: Pathak Himanshu , Marshall Tarnya
Published: August 2016

A 35-year-old man presented with polyarthritis and constitutional symptoms, and a recent history of multiple tick bites and skin rash on trekking holiday. He did not respond to oral doxycycline and cephalexine for presumed Lyme's disease. Further investigation confirmed strongly positive streptococcal serology. There was absence of clinical or echocardiography evidence of heart involvement and immunological screening for inflammatory arthritis was negative. In the absence of other major Jones criteria for acute rheumatic fever, besides polyarthritis and the serological evidence of a recent streptococcal infection, a diagnosis of post-streptococcal reactive arthritis (PSRA) was also made. He responded well to penicillin therapy and has been started on oral penicillin prophylaxis as per available guidance. As streptococcal infections in the adult population are increasingly reported, it is a timely opportunity to revisit PSRA, and develop comprehensive treatment and antibiotic prophylaxis guidelines.
Successful treatment of recurrent renal stones with Cinacalcet in a patient with primary hyperparathyroidism
Authors: Chauhan Priyesh , Gittoes Neil J , Geberhiwot Tarekegn
Published: August 2016

A man aged 72 years with long-standing primary hyperparathyroidism (HPT), a background of recurrent bilateral renal stones and failed parathyroid surgery is described. During the 27 months preceding treatment, episodes of renal colic became increasingly frequent and he required multiple surgical interventions. Given the lack of medical therapies to definitively treat his symptoms, he was started on a trial of the calcimimetic, Cinacalcet. Cinacalcet has previously been shown to reduce hypercalcaemia in patients with primary HPT. Despite this, there is a paucity of evidence to suggest that its use is associated with a long-term reduction in urinary calcium excretion and renal stone recurrence. In our case, within 4 months of starting treatment, serum and urinary calcium had normalised and parathyroid hormone concentrations were within reference ranges. To date, over a 50-month treatment period, there has been a complete cessation in stone formation, and no further urological intervention has been required.
Trends in diabetes in pregnancy in Sweden 1998–2012
Authors: Fadl Helena E , Simmons David
Published: August 2016

Objective

Diabetes in pregnancy has been shown to increase in parallel with the increasing prevalence of obesity. In this national population-based study, we analyzed the trends for gestational diabetes mellitus (GDM), type 1 diabetes in pregnancy, and type 2 diabetes in pregnancy in Sweden between 1998 and 2012.

Research design and methods

A population-based cohort study using the Swedish national medical birth registry data. The time periods were categorized into 3-year intervals and adjusted for maternal body mass index (BMI), ethnicity, and age in a logistic regression.

Results

Each type of diabetes increased over the studied 15-year period. Type 1 diabetes increased by 33.2% (22.2–45.3) and type 2 diabetes by 111% (62.2–174.4) in the adjusted model. Nordic women had the highest prevalence of type 1 diabetes (0·47%) compared with other ethnic groups. The increase in GDM and, to a lesser extent, type 2 diabetes was explained by country of birth, BMI, and maternal age. The prevalence of GDM in Nordic women (0.7–0.8%) did not increase significantly over the time period.

Conclusions

All types of diabetes in pregnancy increased over the 15-year time period in Sweden. Maternal pre-pregnancy BMI remains the key factor explaining the increase in GDM/type 2 diabetes. How to turn around the growing prevalence of diabetes in pregnancy, with its short-term and long-term health effects on both mother and child, requires population-based interventions that reduce the likelihood of entering pregnancy with a raised BMI.
How effective are brief interventions in reducing alcohol consumption: do the setting, practitioner group and content matter? Findings from a systematic review and metaregression analysis
Authors: Platt Lucy , Melendez-Torres G J , O'Donnell Amy , Bradley Jennifer , Newbury-Birch Dorothy , Kaner Eileen , Ashton Charlotte
Published: August 2016

Background

While the efficacy and effectiveness of brief interventions for alcohol (ABI) have been demonstrated in primary care, there is weaker evidence in other settings and reviews do not consider differences in content. We conducted a systematic review to measure the effect of ABIs on alcohol consumption and how it differs by the setting, practitioner group and content of intervention.

Methods

We searched MEDLINE, EMBASE, PsycINFO; CINAHL, Social Science Citation Index, Cochrane Library and Global Health up to January 2015 for randomised controlled trials that measured effectiveness of ABIs on alcohol consumption. We grouped outcomes into measures of quantity and frequency indices. We used multilevel meta-analysis to estimate pooled effect sizes and tested for the effect of moderators through a multiparameter Wald test. Stratified analysis of a subset of quantity and frequency outcomes was conducted as a sensitivity check.

Results

52 trials were included contributing data on 29 891 individuals. ABIs reduced the quantity of alcohol consumed by 0.15 SDs. While neither the setting nor content appeared to significantly moderate intervention effectiveness, the provider did in some analyses. Interventions delivered by nurses had the most effect in reducing quantity (d=−0.23, 95% CI (−0.33 to −0.13)) but not frequency of alcohol consumption. All content groups had statistically significant mean effects, brief advice was the most effective in reducing quantity consumed (d=−0.20, 95% CI (−0.30 to −0.09)). Effects were maintained in the stratified sensitivity analysis at the first and last assessment time.

Conclusions

ABIs play a small but significant role in reducing alcohol consumption. Findings show the positive role of nurses in delivering interventions. The lack of evidence on the impact of content of intervention reinforces advice that services should select the ABI tool that best suits their needs.
Does pre-pregnancy BMI determine blood pressure during pregnancy? A prospective cohort study
Authors: Savitri Ary I , Zuithoff Peter , Browne Joyce L , Amelia Dwirani , Baharuddin Mohammad , Grobbee Diederick E , Uiterwaal Cuno S P M
Published: August 2016

Objectives

To evaluate if pre-pregnancy body mass index (BMI) determines blood pressure throughout pregnancy and to explore the role of gestational weight gain in this association. In addition, the effects of pre-pregnancy BMI and gestational weight gain on the occurrence of gestational hypertension and pre-eclampsia were investigated.

Design

Prospective cohort study.

Setting

Maternal and child health primary care referral centre, Jakarta, Indonesia.

Population and measurements

2252 pregnant women visiting Budi Kemuliaan Hospital and its branch for regular antenatal care visits from July 2012 to April 2015. Pre-pregnancy BMI (kg/m2) was based on self-reported pre-pregnancy weight and measured height at first visit. Gestational weight gain was calculated as weight at the day of delivery minus the pre-pregnancy weight. Systolic blood pressure (SBP) and diastolic blood pressure (DBP) were measured during pregnancy at every visit. Linear mixed models were used to analyse this relation with repeated blood pressure measures as the outcome and pre-pregnancy BMI as the predictor. When looking at gestational hypertension and pre-eclampsia as outcomes, (multiple) logistic regression was used in the analysis.

Results

Independent of pre-pregnancy BMI, SBP and DBP increased by 0.99 mm Hg/month and 0.46 mm Hg/month, respectively. Higher pre-pregnancy BMI was associated with higher pregnancy SBP (0.25 mm Hg/kg/m2; 95% CI 0.17 to 0.34; p<0.01) and DBP (0.18 mm Hg/kg/m2; 0.13 to 0.24; p<0.01) in adjusted analysis. Every 1 kg/m2higher pre-pregnancy BMI was associated with 6% and 9% higher odds for gestational hypertension (adjusted OR (aOR) 1.06; 95% CI 1.03 to 1.09; p<0.01) and pre-eclampsia (aOR 1.09; 1.04 to 1.14; p<0.01). Accounting for gestational weight gain did not attenuate these associations.

Conclusions

Pre-pregnancy BMI determines the level, but not the change, of blood pressure in pregnancy and is linked to higher odds for gestational hypertension and pre-eclampsia, independent of gestational weight gain.
Primary cervical cancer screening with an HPV mRNA test: a prospective cohort study
Authors: Sørbye Sveinung Wergeland , Fismen Silje , Gutteberg Tore Jarl , Mortensen Elin Synnøve , Skjeldestad Finn Egil
Published: August 2016

Objectives

To assess the performance of a 5-type human papillomavirus (HPV) messenger RNA (mRNA) test in primary screening within the framework of the Norwegian population-based screening programme.

Design

Nationwide register-based cohort study.

Setting

In 2003–2004, general practitioners and gynaecologists recruited 18 852 women for participation in a primary screening study with a 5-type HPV mRNA test.

Participants

After excluding women with a history of abnormal smears and with cervical intraepithelial neoplasia grade 2 (CIN2+) before or until 3 months after screening, 11 220 women aged 25–69 years were eligible for study participation. The Norwegian Cancer Registry completed follow-up of CIN2+ through 31 December 2009.

Interventions

Follow-up according to the algorithm for cytology outcomes in the population-based Norwegian Cervical Cancer Screening Programme.

Main outcome measures

We estimated cumulative incidence of CIN grade 3 or worse (CIN3+) 72 months after the 5-type HPV mRNA test.

Results

3.6% of the women were HPV mRNA-positive at baseline. The overall cumulative rate of CIN3+ was 1.3% (95% CI 1.1% to 1.5%) through 72 months of follow-up, 2.3% for women aged 25–33 years (n=3277) and 0.9% for women aged 34–69 years (n=7943). Cumulative CIN3+ rates by baseline status for HPV mRNA-positive and mRNA-negative women aged 25–33 years were 22.2% (95% CI 14.5% to 29.8%) and 0.9% (95% CI 0.4% to 1.4%), respectively, and 16.6% (95% CI 10.7% to 22.5%) and 0.5% (95% CI 0.4% to 0.7%), respectively, in women aged 34–69 years.

Conclusions

The present cumulative incidence of CIN3+ is similar to rates reported in screening studies via HPV DNA tests. Owing to differences in biological rationale and test characteristics, there is a trade-off between sensitivity and specificity that must be balanced when decisions on HPV tests in primary screening are taken. HPV mRNA testing may be used as primary screening for women aged 25–33 years and 34–69 years.
Improving the diagnostic quality and adequacy of shoulder radiographs in a District General Hospital
Authors: Richards Bethany , Riley James , Saithna Adnan
Published: August 2016

A high rate of suboptimal shoulder radiographs was identified during a service evaluation exercise in our orthopaedic outpatient clinics. Inadequate radiographs require a return to the radiology department for further imaging, a resultant increased workload, delays in the clinic, increased radiation for patients, and inconvenience and decreased patient satisfaction. Furthermore, if a sub-optimal radiograph is accepted there is concern that diagnoses may be missed. The aim of this project was to decrease the rate of suboptimal radiographs by delivering a teaching package directed towards quality improvement.

Evaluation criteria were set for standard orthopaedic shoulder radiographs (Anterior-posterior, axillary, and Velpeau views). Baseline data collection was performed over three, two-week periods and included all patients attending the shoulder clinic. The percentage of x-rays which were deemed adequate was only 19.4% for anterior-posterior views and 57.9% for axillary views.

A comprehensive educational package was delivered to radiographers. This included a formal PowerPoint based teaching session, hands on training with practice using a skeleton, posters with step-by step instructions on how to obtain an adequate image, and PDF aide memoires suitable for viewing on a smartphone. Two subsequent two-week periods of data collection were performed to evaluate the benefit of this intervention.

Delivery of focussed training and provision of easily accessible aide memoires to facilitate improved quality of radiographs resulted in a significant (p<0.05) reduction in the rate of inadequate images. There was also a significant decreases in the rate of return to the radiology department for repeat imaging.
Improving Door to Needle time in Patients for Thrombolysis
Authors: Fernandes Darren , Umasankar Udayaraj
Published: August 2016

Ischaemic stroke can result in approximately 2 million brain neurones being damaged for each minute that it is left untreated. Various trials and studies such as the National Institute of Neurologic Disorders (NINDS) trial, the European Cooperative Acute Stroke Study (ECASS), ECASS II, and the Alteplase Thrombolysis for Acute Noninterventional Therapy in Ischemic Stroke (ATLANTIS) study have clearly demonstrated the beneficial effects of intravenous tissue plasminogen activator (tPA) for treatment of acute stroke.

Therefore to minimise damage and improve clinical outcome, we need to identify patients who present within 4.5 hours of symptom onset and reduce the time taken to adminster a thrombolytic agent. This time is commonly referred to as the ‘door to needle’ (DTN) time.

Our standard, set by the Clinical Commissioning Group (CCG) is to achieve a median time of scanning and thrombolysis within 55 minutes from the time that the patient enters the hospital. The aim of our QIP was to collect data on what the DTN time was during November 2015, December 2015, and January 2016 and to evaluate how this can be improved after each month.

This Quality Improvement Project in the DTN time in patients for thrombolysis has identified areas in the pathway that leads to delays. One major contributing factor is the time for a doctor to come and assess and administer the thrombolytic agent to the patient. Change was implemented by ensuring that the core medical trainee on call is allocated to respond as a priority to all possible thrombolysis calls. This has resulted in a reduction of mean DTN time, from 74 minutes in November to 43 minutes in January. As well as improving patient outcomes, it is proposed that the implementation of change has benefitted the training experience and development of key skills of the core medical trainees.
Bioactive versus bare platinum coils for the endovascular treatment of intracranial aneurysms: systematic review and meta-analysis of randomized clinical trials
Authors: Broeders Joris A , Ahmed Ali Usama , Molyneux Andrew J , Poncyljusz Wojciech , Raymond Jean , White Phillip M , Steinfort Brendan
Published: August 2016

Background

Bioactive coils were introduced in 2002 in an attempt to improve aneurysm healing and durability of angiographic results. Evidence demonstrating superior efficacy to justify the routine use of bioactive coils over bare coils is limited. We compared the periprocedural and clinical outcome after bioactive and bare platinum coiling for intracranial aneurysms.

Methods

MEDLINE, EMBASE, Cochrane Library, and ISI Web of Knowledge Conference Proceedings Citation Index—Science were searched for randomized clinical trials (RCTs) comparing bioactive and bare coils. The methodological quality was evaluated to assess bias risk. Periprocedural outcomes and mid-term outcomes were compared.

Results

Five independent RCTs comparing bioactive (n=1084) and bare coils (n=1084) were identified. Periprocedural outcome was similar for both groups. Bioactive coiling increased the rate of complete aneurysm occlusion (47% vs 40%; RR 1.17 (95% CI 1.05 to 1.31); p=0.006) and reduced the rate of residual aneurysm neck at 10 months compared with bare coiling in the mid-term (26% vs 31%; RR 0.82 (95% CI 0.70 to 0.96); p=0.01). There were no differences in aneurysm recurrence, aneurysm rupture, stroke, neurological death, modified Rankin Scale score and reinterventions. Subgroup analysis for the three RCTs on hydrogel coils demonstrated reduction of residual aneurysms compared with bare coiling (25% vs 34%; RR 0.76 (95% CI 0.58 to 0.99); p=0.04).

Conclusions

Bioactive coils ensure a higher rate of medium-term complete aneurysm occlusion while reducing the rate of residual neck aneurysms compared with bare coiling in the mid-term. Hydrogel coils reduce residual aneurysms compared with bare coils. While there is level 1a evidence to show more complete aneurysm occlusion, longer term follow-up is needed to determine if this translates into clinical significance.
Endovascular treatment of cribriform plate dural arteriovenous fistulas: technical difficulties and complications avoidance
Authors: Robert Thomas , Blanc Raphaël , Smajda Stanislas , Ciccio Gabriele , Redjem Hocine , Bartolini Bruno , Fahed Robert , Piotin Michel
Published: August 2016

Objective

Cribriform plate dural arteriovenous fistula (dAVF) is a rare pathology, for which the treatment of choice used to be neurosurgery. Technological advances in micro-catheters and embolic agents permitted new endovascular alternatives.

Methods

We included all patients treated endovascularly for a cribriform plate dAVF between 2008 and 2013. We retrospectively analysed data focusing on the type of treatment chosen.

Results

Ten patients were treated by endovascular approach, with a need for an additional surgical exclusion of the fistula in two cases. Thirteen embolisation sessions were done. Embolisation of the fistula through an ethmoidal artery was the technique of choice; the catheterism of the ophthalmic artery was impossible in two cases and the embolic agent did not penetrate in four cases. The embolisation through the middle meningeal artery was successful in one case but the tortuosity of this artery prevented good penetration of the embolic agent. Venous approach was successful in all cases but was limited to fistulas with superficial venous drainage.

Conclusions

Endovascular treatment of cribriform plate dAVF is safe and effective. The embolisation through ethmoidal artery is the method of choice. Branches of the middle meningeal artery are tortuous and prevent the penetration of embolic agent. Venous approach is effective but is limited to cases of failure of the arterial approach.
High HbA1c is associated with higher risk of ischaemic stroke in Pakistani population without diabetes
Authors: Nomani Ali Zohair , Nabi Sumaira , Ahmed Shahzad , Iqbal Mansoor , Rajput Haris Majid , Rao Suhail
Published: August 2016

Context

The role of glycated haemoglobin (HbA1c) in the prediction of ischaemic stroke in individuals without diabetes is underestimated.

Aims

We performed a study to analyse the role of HbA1c in the risk prediction of ischaemic stroke in Pakistani population without diabetes. We further studied the difference between HbA1c values of individuals with diabetes and without diabetes with stroke.

Settings and design

Single centre, case–control.

Materials and methods

In phase I, a total of 233 patients without diabetes with ischaemic stroke and 245 as controls were enrolled. Association of HbA1c levels, lipid profiles and blood pressure recordings with ischaemic stroke was analysed. In phase II, comparison was done between diabetics and non-diabetics with stroke.

Statistical analysis

Comparison of the mean variables was performed with Student's t-tests. Logistic regression analysis with ischaemic stroke as the dependent variable was performed for phase I.

Results

In phase I, the ischaemic stroke group had significantly higher HbA1c levels (5.9±2.9% vs 5.5±1.6%) compared with controls (p<0.05). Triglyceride cholesterol, high-density lipoprotein cholesterol, systolic blood pressure, diastolic blood pressure and HbA1c were the significant determinants of stroke (p<0.05). In phase II, mean HbA1c values were significantly higher in the diabetes group (7.6±2.1 vs 6.1±2.3) (p<0.05) but other parameters were not statistically significantly different (p>0.05).

Conclusions

Higher HbA1c indicated a significantly increased risk for ischaemic stroke. An HbA1c value above 5.6% (prediabetic range) predicted future risk of stroke and efforts to maintain glucose level within the normal range (≤5.6%) in individuals with high cardiovascular risk are important.
Cellular stress associated with the differentiation of Plasmodium berghei ookinetes
Authors: Duran-Bedolla Josefina , Téllez-Sosa Juan , Valdovinos-Torres Humberto , Pavón Natalia , Buelna-Chontal Mabel , Tello-López Angel T. , Argotte-Ramos Rocio , Rodríguez Mario Henry , Rodríguez María Carmen
Published: August 2016

For malaria transmission, Plasmodium parasites must develop in the mosquito vector. Oxidative stress in the insect midgut, triggered by environmental changes (e.g., pH and temperature), influences the cellular signaling involved in differentiation from gametocytes to mobile ookinetes for the purpose of parasite survival. Oxidative stress activates the homeostatic response to stress characterized by the phosphorylation eIF2α, the attenuation of protein synthesis, and the transcription of genes participating in the unfolded protein response and antioxidant processes, forming a part of an integrated stress response (ISR). We hypothesized that ISR operates during the differentiation of gametocytes to ookinetes to assure Plasmodium survival. Using in-vitro conditions resembling the mosquito midgut conditions, we cultured Plasmodium berghei gametocytes to ookinetes and evaluated the redox balance by detecting reactive oxygen species and superoxide dismutase activity. Additionally, we evaluated the phosphorylation of eIF2α, the attenuation of the global protein synthesis, and the gene expression of cellular stress markers (e.g., endoplasmic reticulum chaperones and antioxidant molecules, measured by reverse-transcription quantitative polymerase chain reaction), finding that these processes were all taking place, probably to improve survival during the differentiation of Plasmodium berghei ookinetes.
Reducing uncertainty and risk through field-based studies
Authors: Bowman M. B. J. , Smyth Helen R.
Published: August 2016

Field-based studies, be they regional or basin-scale fieldwork, or the examination of outcrop analogues, have been an important component of petroleum system studies in the upstream oil and gas industry for many years. Recent technological advances, founded on traditional field methodologies, whether they are in digital outcrop characterization or developments in processing and computational capabilities, have fuelled a resurgence in such fieldwork. These studies enable the building of realistic models that allow the exploration or production geoscientist to navigate effectively from plate-to-play-to-pore. The interrogation of field data and resulting models provide a more informed means of benchmarking the subsurface, as well as a more realistic view of subsurface uncertainty and the management of associated risk in subsurface description and prediction.

This Special Publication records 12 papers given at a conference titled ‘Reducing Subsurface Uncertainty and Risk Through Field-Based Studies’ organized by the Petroleum Group of the Geological Society of London, and held in London from 4 to 6 March 2014. The observations drawn in this introductory paper reflect the authors’ experiences, presentations at the conference and manuscripts within this volume.
Technology Enhanced Learning for Higher Education in Brazil
Authors: de Oliveira Neto José Dutra , de Sousa Gomes Gilvania
Published: August 2016

There is a pressing need to adapt to the students' learning style because old teaching strategies no longer work today. Emerging technologies present new opportunities for transforming teaching and learning. Active methodologies like flipped learning, using technology and collaboration, provides a new instructional model that improves teaching effectiveness and efficiency in higher education.
The aging neuromuscular system and motor performance
Authors: Hunter Sandra K. , Pereira Hugo M. , Keenan Kevin G.
Published: August 2016

Age-related changes in the basic functional unit of the neuromuscular system, the motor unit, and its neural inputs have a profound effect on motor function, especially among the expanding number of old (older than ∼60 yr) and very old (older than ∼80 yr) adults. This review presents evidence that age-related changes in motor unit morphology and properties lead to impaired motor performance that includes 1) reduced maximal strength and power, slower contractile velocity, and increased fatigability; and 2) increased variability during and between motor tasks, including decreased force steadiness and increased variability of contraction velocity and torque over repeat contractions. The age-related increase in variability of motor performance with aging appears to involve reduced and more variable synaptic inputs that drive motor neuron activation, fewer and larger motor units, less stable neuromuscular junctions, lower and more variable motor unit action potential discharge rates, and smaller and slower skeletal muscle fibers that coexpress different myosin heavy chain isoforms in the muscle of older adults. Physical activity may modify motor unit properties and function in old men and women, although the effects on variability of motor performance are largely unknown. Many studies are of cross-sectional design, so there is a tremendous opportunity to perform high-impact and longitudinal studies along the continuum of aging that determine 1) the influence and cause of the increased variability with aging on functional performance tasks, and 2) whether lifestyle factors such as physical exercise can minimize this age-related variability in motor performance in the rapidly expanding numbers of very old adults.
Continuous positive airway pressure treatment does not normalize the prolonged reflex inhibition to inspiratory loading in obstructive sleep apnea
Authors: Murray Nicholas P. S. , McKenzie David K. , Gandevia Simon C. , Butler Jane E.
Published: August 2016

In obstructive sleep apnea (OSA), the short-latency inhibitory reflex (IR) of inspiratory muscles to airway occlusion is prolonged in proportion to the severity of the OSA. The mechanism underlying the prolongation may relate to chronic inspiratory muscle loading due to upper airway obstruction or sensory changes due to chronic OSA-mediated inflammation. Continuous positive airway pressure (CPAP) therapy prevents upper airway obstruction and reverses inflammation. We therefore tested whether CPAP therapy normalized the IR abnormality in OSA. The IR responses of scalene muscles to brief airway occlusion were measured in 37 adult participants with untreated, mostly severe, OSA, of whom 13 were restudied after the initiation of CPAP therapy (usage >4 h/night). Participants received CPAP treatment as standard clinical care, and the mean CPAP usage between initial and subsequent studies was 6.5 h/night (range 4.1-8.8 h/night) for a mean of 19 mo (range 4–41 mo). The duration of the IR in scalene muscles in response to brief (250 ms) inspiratory loading was confirmed to be prolonged in the participants with OSA. The IR was assessed before and after CPAP therapy. CPAP treatment did not normalize the prolonged duration of the IR to airway occlusion (60 ± 21 ms pretreatment vs. 59 ± 18 ms posttreatment, means ± SD) observed in participants with severe OSA. This suggests that the prolongation of IR reflects alterations in the reflex pathway that may be irreversible, or a specific disease trait.