bluuebunny/crossref_metadata_2025 huggingface dataset:
Histomorphometric evaluation of maxillary molar roots and surrounding periodontium following molar intrusion in rats
Authors: Choi Y. J. , Kim K. H. , Lee K. J. , Chung C. J. , Park Y. C.
Published: October 2014

Structured Abstract

Objectives

To investigate periodontal tissue changes during and after molar intrusion in rats.

Setting and Sample population

The Department of Orthodontics at Yonsei University. Thirty 12‐week‐old male rats were assigned to 1 control and 5 experimental groups (n = 5 each).

Materials and Methods

In the experimental groups, two maxillary molars were intruded for 2 weeks; the control group underwent the same procedures without the intrusion force. After 2 weeks of intrusion, rats in one of the experimental groups and in the control group were killed. In the other four experimental groups, the new molar positions were either retained or not retained with an occlusal bite block for 1 or 2 weeks prior to euthanization. Histomorphometric analysis was performed for sulcus depth, osteoclast number per unit alveolar bone length, and root resorption area per unit root surface length.

Results

Sulcus depth increased during intrusion (P < 0.05), but decreased after 2 weeks of retention (P < 0.05). The number of osteoclasts increased during intrusion (P < 0.05), but subsequently decreased regardless of the retention regime (P < 0.05). Root resorption area increased after molar intrusion, irrespective of the retention regimen, relative to that of the control group (P < 0.05) and was the greatest after 2 weeks of retention.

Conclusion

These results indicated that root resorption occurred during and after molar intrusion and that the surrounding periodontium remodeled accordingly as tooth positions were altered, regardless of retention regime.
Α technique for atraumatic root extraction, immediate implant placement and loading in maxillary aesthetic zone
Authors: Tsirlis A.T. , Eliades A.N. , Georgopoulou‐Karanikola T.G. , Vasiloudi M.I.
Published: October 2014

The study aims to report a technique for the extraction of an anterior maxillary root with simultaneous immediate implant placement and immediate loading with provisional non‐functional restoration. Due to a root fracture of a maxillary lateral incisor (#22), a semilunar flap was utilised to create a bony window in the apical area of the tooth and gently extract the remaining portion of the root through the alveolar socket. This technique is recommended in cases of immediate implant placement in fresh extraction sites where coronal bony bridge is intact. Then an implant was placed and the apical bony defect was repaired with guided bone regeneration. The loading of the implant with a temporary implant restoration within 24 h was applied without functional occlusal contacts. The placement of the permanent restoration was scheduled for 6 months later. After 1 year, a clinical and radiographic examination showed a normal peri‐implant bone level and a successful aesthetic effect. Furthermore, after four years the patient was examined and the implant is still showing good functional and aesthetic outcome. The preservation of the coronal bony anatomy, periosteum and soft tissues during the immediate implant placement is a major contributing factor to a desired aesthetic effect, which is enhanced with the option of immediate non‐functional loading. The described surgical approach preserves the advantages of immediate implant placement in fresh extraction sites in the maxillary aesthetic zone without intrasulcular incision and mucoperiosteal flap elevation while minimising the bony injuries during the extraction of the tooth.
Two‐step transplantation for primary hyperoxaluria: A winning strategy to prevent progression of systemic oxalosis in early onset renal insufficiency cases
Authors: Sasaki Kengo , Sakamoto Seisuke , Uchida Hajime , Shigeta Takanobu , Matsunami Masatoshi , Kanazawa Hiroyuki , Fukuda Akinari , Nakazawa Atsuko , Sato Mai , Ito Shuichi , Horikawa Reiko , Yokoi Tadashi , Azuma Noriyuki , Kasahara Mureo
Published: October 2014

Several transplant strategies for PH1 have been proposed, and LT is performed to correct the metabolic defects. The patients with PH1 often suffer from ESRD and require simultaneous LKT, which leads to a long wait due to the shortage of suitable organ donors. Five patients with PH1 underwent LDLT at our institute. Three of the five patients were under dialysis before LDLT, while the other two patients were categorized as CKD stage 3. An isolated LDLT was successfully performed in all but our first case, who had complicated postoperative courses and consequently died due to sepsis after retransplantation. The renal function of the patients with CKD stage 3 was preserved after LDLT. On the other hand, our second case with ESRD underwent successful LDKT six months after LDLT, and our infant case is waiting for the subsequent KT without any post‐LDLT complications after the early establishment of PD. In conclusion, a two‐step transplant strategy may be needed as a life‐saving option for patients with PH1 and may be possible even in small infants with systemic oxalosis. While waiting for a subsequent KT, an early resumption of PD should be considered from the perspective of the long‐term requirement of RRT.
Lifesaving liver transplantation for multi‐organ failure caused by Bacillus cereus food poisoning
Authors: Tschiedel Eva , Rath Peter‐Michael , Steinmann Jörg , Becker Heinz , Dietrich Rudolf , Paul Andreas , Felderhoff‐Müser Ursula , Dohna‐Schwake Christian
Published: October 2014

Bacillus cereus is a spore‐forming, gram‐positive bacterium that causes food poisoning presenting with either emesis or diarrhea. Diarrhea is caused by proteinaceous enterotoxin complexes, mainly hemolysin BL, non‐hemolytic enterotoxin (NHE), and cytotoxin K. In contrast, emesis is caused by the ingestion of the depsipeptide toxin cereulide, which is produced in B. cereus contaminated food, particularly in pasta or rice. In general, the illness is mild and self‐limiting. However, due to cereulide intoxication, nine severe cases with rhabdomyolysis and/or liver failure, five of them lethal, are reported in literature. Here we report the first case of life‐threatening liver failure and severe rhabdomyolysis in this context that could not be survived without emergency hepatectomy and consecutive liver transplantation.
The natural history of dementia
Authors: Kua Ee Heok , Ho Emily , Tan Hong Hee , Tsoi Chris , Thng Christabel , Mahendran Rathi
Published: October 2014

This review summarizes studies on the natural history of dementia with a focus on Alzheimer's disease and vascular dementia. Understanding the course of dementia is important not only for patients, caregivers, and health professionals, but also for health policy‐makers, who have to plan for national resources needed in the management of an increasing number of dementia cases. From the available published data, the life expectancy of elderly people with dementia is shorter than that of non‐demented elderly. Reports on survival after a diagnosis of dementia vary from 3 to 12 years. The wide variation is partly due to the diagnostic criteria used in the studies and the sites where they were conducted (i.e. hospitals, clinics, or homes). There is an apparent difference in survival between Alzheimer's disease patients with onset of illness before 75 years and those after 75 years: the younger patients have a longer life expectancy. However, there are conflicting data on survival (in years) comparing male and female patients and comparing patients of different ethnicities. For vascular dementia, published papers on life expectancy vary between 3 to 5 years. Vascular dementia appears to have a poorer prognosis than Alzheimer's disease. The stages of severity of dementia were compared in a follow‐up of a sample of Alzheimer's disease patients in Singapore, and the mean duration of the mild phase (clinical dementia rating 1) was 5.6 years, the moderate phase (clinical dementia rating 2) was 3.5 years, and the severe phase (clinical dementia rating 3) was 3.2 years. At the various phases of the disease, the demand on health‐care services and economic cost are different.
The reward positivity: From basic research on reward to a biomarker for depression
Authors: Proudfit Greg Hajcak
Published: October 2014

Feedback indicating monetary loss elicits an apparent negative deflection in the event‐related potential (ERP) that has been referred to as the feedback error‐related negativity, medial frontal negativity, feedback‐related negativity, and feedback negativity—all conceptualizations that suggest a negative ERP component that is greater for loss than gain. In the current paper, I review a programmatic line of research indicating that this apparent negativity actually reflects a reward‐related positivity (RewP) that is absent or suppressed following nonreward. I situate the RewP within a broader nomological network of reward processing and individual differences in sensitivity to rewards. Further, I review work linking reductions in the RewP to increased depressive symptoms and risk for depression. Finally, I discuss future directions for research on the RewP.
Religion and the Japanese American Incarceration
Authors: Blankenship Anne M.
Published: October 2014

Abundant scholarship analyzes the United States' incarceration of Japanese Americans during World War II, but the subject of religion in the camps and religious responses to the incarceration has been long overlooked. The government promised freedom of religion in the camps while encouraging Japanese Americans to consolidate worship into one Buddhist, one Catholic, and one Protestant church in each incarceration center. Incarcerees found strength through fellowship and religious faith. Outside of the camps, progressive Christians tried to alleviate the harms caused by the injustice and increase tolerance around the country. The field offers examples of early race relations work within American Protestantism and introduces the ways in which the government prioritized and attempted to enforce freedom of religion within a fabricated and restricted wartime environment. Further examination of these events will complement studies of 20th century liberal Christianity, American Buddhism, religious liberty and the state, the early civil rights movement, religion and World War II, and Asian American theology.
What Roles for Which Stakeholders under Extended Producer Responsibility?
Authors: Kalimo Harri , Lifset Reid , Atasu Atalay , Van Rossem Chris , Van Wassenhove Luk
Published: October 2014

This article analyzes extended producer responsibility (EPR), two decades after the concept emerged. It concentrates on the scope of the producers' responsibility vis‐à‐vis other stakeholders in the context of EPR for waste electronics. It argues that in order for a core aspect of EPR – the creation of design incentives – to function properly the responsibilities need to be shared between the producers and other stakeholders, and that the allocation of responsibilities needs to be both more rigorous and more nuanced than is presently the case. The article structures the discussion on, and presents solutions to, the proper allocation of responsibilities by creating a framework that distinguishes between issues relating to the core premises of EPR, those that are a function of the multilevel system of governance in which EPR is pursued, and those that are of a practical nature, cutting across jurisdictional levels.
Investigation of dyeing behavior of oxidative dye in fine structures of the human hair cuticle by nanoscale secondary ion mass spectrometry
Authors: Kojima T. , Yamada H. , Saito Y. , Nawa T. , Isobe M. , Yamamoto T. , Aoki D. , Matsushita Y. , Fukushima K.
Published: October 2014

Background/purpose

In oxidative coloring, the hair cuticle layers are not only the penetration pathway for active ingredients but also one of the most important dyeing regions. The dyeing mechanism of oxidative dyes in fine structures of the cuticle remains unclear. To investigate the dyeing behavior of oxidative dyes in fine structures of the cuticle, hair cross‐sections were analyzed by nanoscale secondary ion mass spectrometry (NanoSIMS).

Methods

The preparation method of hair cross‐section for NanoSIMS measurement was improved. Improved hair cross‐sections were analyzed using NanoSIMS.

Results

The cuticle layer thickness of the hair cross‐section could be widened. It was confirmed that 12C− ions were more strongly detected from endocuticle than from other fine structures of cuticle. The NanoSIMS 12C− image and hue saturation intensity (HSI) D−/1H− ratio image of the hair, dyed with deuterium‐labeled oxidative dye, indicated that the endocuticle had a higher D−/1H− ratio than the other fine structures of the cuticle. It was substantiated that more colored chromophores were fixated in the endocuticle than in other fine structures of the cuticle.

Conclusion

The dyeing behavior of oxidative dyes in fine structures of hair cuticle was substantiated by NanoSIMS analysis using the improved hair cross‐section preparation method.
Second‐order analysis of anisotropic spatiotemporal point process data
Authors: Comas C. , Rodriguez‐Cortes F. J. , Mateu J.
Published: October 2014

Second‐order orientation methods provide a natural tool for the analysis of spatial point process data. In this paper, we extend to the spatiotemporal setting the spatial point pair orientation distribution function. The new space–time orientation distribution function is used to detect space–time anisotropic configurations. An edge‐corrected estimator is defined and illustrated through a simulation study. We apply the resulting estimator to data on the spatiotemporal distribution of fire ignition events caused by humans in a square area of 30 × 30 km2 for 4 years. Our results confirm that our approach is able to detect directional components at distinct spatiotemporal scales. © 2014 The Authors. Statistica Neerlandica © 2014 VVS.
A saddlepoint approximation to the distribution of the sum of independent non‐identically beta random variables
Authors: Nadarajah Saralees , Jiang Xiao , Chu Jeffrey
Published: October 2014

The exact distribution of the sum of more than two independent beta random variables has not been known. Even in terms of approximations, only the normal approximation is known for the sum. Motivated by Murakami [Statistica Neerlandica, 2014, doi:10.1111/stan.12032], we derive here a saddlepoint approximation for the distribution of sum. An extensive simulation study shows that it always performs better than the normal approximation.
Correlation of ABH blood group antigens secretion with Helicobacter pylori infection in Pakistani patients
Authors: Ansari Shazia Akbar , Khan Adnan , Khan Taseer Ahmed , Raza Yasir , Syed Sofia Ali , Akhtar Syed Shakeel , Kazmi Shahana Urooj
Published: October 2014

Objectives

A and B blood group antigens are fucosylated carbohydrate present on human erythrocytes and body secretions. Their presence in body secretions depends on the expression of a dominant allele of secretor gene FUT2 and is correlated with susceptibility to various infectious and non‐infectious diseases. We investigated the correlation of blood group and ABH antigen secretion with Helicobacter pylori infection and gastroduodenal symptoms and analysed the distribution of babA gene among ABH secretors and non‐secretors.

Methods

Two hundred and ninety patients who underwent gastroduodenal endoscopy during 2011 to 2012 participated. Gastric biopsy, saliva and blood samples were obtained from every patient. Gastric biopsies were subjected to rapid urease test and PCR for the detection of H. pylori and babA gene. Blood grouping and ABH antigens secretions were determined by Lewis blood group phenotyping and haemagglutination inhibition test.

Results

50.34% of patients were ABH antigen secretors and 45.51% non‐secretors. Distribution analysis of blood group revealed that 40 blood group B, 67 blood group A 20 blood group O and 19 blood group AB patients secreted ABH antigens in saliva. Fifty‐six blood group O, 19 blood group B, 32 blood group A and 17 blood group AB patients were non‐secretors. Gastroduodenal complaints were common among non‐secretors. Sixty‐two percent of patients with a combination of duodenal ulcer and gastro‐oesophageal reflux and 54% of patients with gastritis were non‐secretors. Of 290 samples, 31.02% were positive for H. pylori. Thirty percent of these tested positive for babA gene; the majority belonged to non‐secretor blood group O.

Conclusions

Our results suggest that the infection of H. pylori is correlated with ABO blood groups and blood group antigens secretion in body fluids.
Shimmy of an Aircraft Main Landing Gear With Geometric Coupling and Mechanical Freeplay
Authors: Howcroft C. , Lowenberg M. , Neild S. , Krauskopf B. , Coetzee E.
Published: October 2014

The self-sustained oscillation of aircraft landing gear is an inherently nonlinear and dynamically complex phenomenon. Although such oscillations are ultimately driven from the interaction between the tires and the ground, other effects, such as mechanical freeplay, and geometric nonlinearity, may influence stability and add to the complexity of observed behavior. This paper presents a bifurcation study of an aircraft main landing gear (MLG), which includes both mechanical freeplay and significant geometric coupling, the latter achieved via consideration of a typical side-stay orientation. These aspects combine to produce complex oscillatory behavior within the operating regime of the landing gear, including longitudinal and quasi-periodic shimmy. Moreover, asymmetric forces arising from the geometric orientation produce bifurcation results that are extremely sensitive to the properties at the freeplay/contact boundary. However, this sensitivity is confined to the small amplitude dynamics of the system. This affects the interpretation of the bifurcation results; in particular bifurcations from high amplitude behavior are found to form boundaries of greater confidence between the regions of different behavior given uncertainty in the freeplay characteristics.
On the Fluidic Response of Structures in Hypervelocity
Impacts
Authors: Thurber Andrew , Bayandor Javid
Published: October 2014

In a hypervelocity impact (HVI) event, the shock pressures exceed the strength of common aerospace materials, and brief shock-induced temperature rises cause melting and vaporization of most structural bodies. Under these extreme conditions, the failure and deformation of solids can resemble fluid flow. By using meshless Lagrangian models in an explicit computational framework, this work identifies analogous fluidic interactions and further quantifies the role of shear and inertial forces in HVIs.
Multilayer MoS2 transistors enabled by a facile dry-transfer technique and thermal annealing
Authors: Yang Rui , Zheng Xuqian , Wang Zenghui , Miller Christopher J. , Feng Philip X.-L.
Published: October 2014

Molybdenum disulfide (MoS2) two-dimensional nanostructures have been actively explored for ultrasmall transistors beyond graphene. The current prevailing methods for producing MoS2 devices involve multiple wet chemistry steps, which not only are time consuming, but may also unfavorably affect material quality and impair device performance through the chemical processes. Here, the authors report the first dry-transferred pristine MoS2 field-effect transistors (FETs) without any post-transfer lithographical and chemical processes, by using a facile, completely dry transfer technique with high throughput and high precision in alignment. The authors also show that the device performance can be greatly boosted by thermal annealing. Combining the dry-transfer technique with thermal annealing, the authors achieve MoS2 FETs with mobility up to 76 cm2/(V s) and on/off ratios exceeding 107. The authors further show how continued annealing cycles improve the MoS2 devices' conductance, mobility, on/off ratio, transconductance, threshold voltage, and contact quality.
The effects of wood variability on the free vibration of an acoustic guitar top plate
Authors: Shepherd Micah R. , Hambric Stephen A. , Wess Dennis B.
Published: October 2014

A finite element model of a bare top plate with braces and a bridge plate was created using orthotropic material properties. The natural variation of the wood properties including dependence on moisture content was also determined. The simulated modes were then compared to experimentally obtained modes from top plate prototypes. Uncertainty analysis was also performed to determine the statistical bound of natural variability between wood samples. The natural frequencies of the model fall within the computed error bound. These results reinforce the importance of obtaining accurate material properties for acoustic guitar modeling.
Origin of shear thickening in semidilute wormlike micellar solutions and evidence of elastic turbulence
Authors: Marín-Santibáñez Benjamín M. , Pérez-González José , Rodríguez-González Francisco
Published: October 2014

The origin of shear thickening in an equimolar semidilute wormlike micellar solution of cetylpyridinium chloride and sodium salicylate was investigated in this work by using Couette rheometry, flow visualization, and capillary Rheo-particle image velocimetry. The use of the combined methods allowed the discovery of gradient shear banding flow occurring from a critical shear stress and consisting of two main bands, one isotropic (transparent) of high viscosity and one structured (turbid) of low viscosity. Mechanical rheometry indicated macroscopic shear thinning behavior in the shear banding regime. However, local velocimetry showed that the turbid band increased its viscosity along with the shear stress, even though barely reached the value of the viscosity of the isotropic phase. This shear band is the precursor of shear induced structures that subsequently give rise to the average increase in viscosity or apparent shear thickening of the solution. Further increase in the shear stress promoted the growing of the turbid band across the flow region and led to destabilization of the shear banding flow independently of the type of rheometer used, as well as to vorticity banding in Couette flow. At last, vorticity banding disappeared and the flow developed elastic turbulence with chaotic dynamics.
Draft Genome Sequence of a Multidrug-Resistant New Zealand Isolate of Mycobacterium tuberculosis Lineage 3
Authors: Mac Aogáin Micheál , Johari Bushra M. , Bower James E. , O'Toole Ronan F.
Published: October 2014

Multidrug resistance constitutes a threat worldwide to the management of tuberculosis (TB). We report the draft whole-genome sequence of a lineage 3 (East-African Indian) isolate of
Mycobacterium tuberculosis
which presented as multidrug resistant in New Zealand, and describe a number of single-nucleotide polymorphisms in genes relating to drug resistance.
Complete Genome Sequence of Escherichia coli BW25113
Authors: Grenier Frédéric , Matteau Dominick , Baby Vincent , Rodrigue Sébastien
Published: October 2014

Escherichia coli
BW25113 is the parent strain of the Keio collection comprising nearly 4,000 single-gene deletion mutants. We report the complete 4,631,469-bp genome sequence of this strain and the key variations from the type strain
E. coli
MG1655.
Complete Genome Sequences of Virulent Mycoplasma capricolum subsp.
capripneumoniae
Strains F38 and ILRI181
Authors: Falquet Laurent , Liljander Anne , Schieck Elise , Gluecks Ilona , Frey Joachim , Jores Joerg
Published: October 2014

Contagious caprine pleuropneumonia (CCPP) caused by
Mycoplasma capricolum
subsp.
capripneumoniae
is a severe epidemic affecting mainly domestic
Caprinae
species but also affects wild
Caprinae
species.
M. capricolum
subsp.
capripneumoniae
belongs to the “
Mycoplasma mycoides
cluster.” The disease features prominently in East Africa, in particular Kenya, Tanzania, and Ethiopia. CCPP also endangers wildlife and thus affects not only basic nutritional resources of large populations but also expensively built-up game resorts in affected countries. Here, we report the complete sequences of two
M. capricolum
subsp.
capripneumoniae
strains: the type strain F38 and strain ILRI181 isolated druing a recent outbreak in Kenya. Both genomes have a G+C content of 24% with sizes of 1,016,760 bp and 1,017,183 bp for strains F38 and ILRI181, respectively.
Draft Genome Sequence of Halotolerant Polycyclic Aromatic Hydrocarbon-Degrading Pseudomonas bauzanensis Strain W13Z2
Authors: Wang Xinxin , Jin Decai , Zhou Lisha , Wu Liang , Qi Lin , Li Chen , An Wei , Chen Yu
Published: October 2014

Pseudomonas bauzanensis
W13Z2 is a halotolerant polycyclic aromatic hydrocarbon (PAH)-degrading bacterium isolated from petroleum-contaminated drill cuttings in the Bohai Sea. Here, we report the 8.6-Mb draft genome sequence of this strain, which will provide insights into the diversity of
Pseudomonas
and the mechanism of PAHs degradation in drill cuttings.
Draft Genome Sequences of 10 Strains of the Genus
Exiguobacterium
Authors: Vishnivetskaya Tatiana A. , Chauhan Archana , Layton Alice C. , Pfiffner Susan M. , Huntemann Marcel , Copeland Alex , Chen Amy , Kyrpides Nikos C. , Markowitz Victor M. , Palaniappan Krishna , Ivanova Natalia , Mikhailova Natalia , Ovchinnikova Galina , Andersen Evan W. , Pati Amrita , Stamatis Dimitrios , Reddy T. B. K. , Shapiro Nicole , Nordberg Henrik P. , Cantor Michael N. , Hua X. Susan , Woyke Tanja
Published: October 2014

High-quality draft genome sequences were determined for 10
Exiguobacterium
strains in order to provide insight into their evolutionary strategies for speciation and environmental adaptation. The selected genomes include psychrotrophic and thermophilic species from a range of habitats, which will allow for a comparison of metabolic pathways and stress response genes.
Draft Genome Sequence of Buttiauxella agrestis, Isolated from Surface Water
Authors: Jothikumar Narayanan , Kahler Amy , Strockbine Nancy , Gladney Lori , Hill Vincent R.
Published: October 2014

MI agar is routinely used for quantifying
Escherichia coli
in drinking water. A suspect
E. coli
colony isolated from a water sample was identified as
Buttiauxella agrestis
. The whole genome sequence of
B. agrestis
was determined to understand the genetic basis for its phenotypic resemblance to
E. coli
on MI agar.
Whole-Genome Sequence of Mycobacterium kyorinense
Authors: Ohtsuka Kouki , Ohnishi Hiroaki , Nozaki Eriko , Pais Ramos Jesus , Tortoli Enrico , Yonetani Shota , Matsushima Satsuki , Tateishi Yoshitaka , Matsumoto Sohkichi , Watanabe Takashi
Published: October 2014

We report here the first draft genome sequence of
Mycobacterium kyorinense
, which was described in 2009 and exhibits significant pathogenicity to humans.
Investigation into the Effects of Using Two Or Four Acupuncture Needles with Bidirectional Rotation on Experimentally-Induced Contact Heat Pain in Healthy Subjects
Authors: Paley Carole A , Johnson Mark I
Published: October 2014

Objectives

There is growing evidence from experimental studies that the acupuncture dose or technique influences the speed of onset of hypoalgesia. The aim of this study was to investigate the effects of acupuncture using two or four needles on experimental contact thermal pain in healthy volunteers.

Methods

Forty two participants were randomised into three groups: four-needle group (LI4, LI11, LI10, TE5), two-needle group (verum at LI4, LI11 and mock at LI10, TE5) and mock acupuncture group (LI4, LI11, LI10, TE5). Each participant rated pain intensity (visual analogue scale, VAS) to a series of noxious stimuli administered to the forearm 2°C above the heat pain threshold during needling and immediately after removal of the needles.

Results

Experimentally-induced heat pain intensity (VAS) during and after the intervention was lower than pre-intervention but there were no statistically significant differences in this change between groups. There were no statistically significant differences between groups in the time taken for pain intensity to decrease by 33% from pre-intervention. However, a 33% decrease in pain intensity within 3 min of needle insertion was observed for 13 participants (92.9%) in the four-needle group compared with 66.7% of participants in the two-needle group and 57.1% in the mock acupuncture group. There was less variance in VAS in the four-needle group, suggesting more consistency in hypoalgesic response when using more needles.

Conclusions

There is tentative evidence that four needles may be superior to two needles in generating rapid onset hypoalgesia. The findings suggest that further investigation is warranted.
Quantifying care coordination using natural language processing and domain-specific ontology
Authors: Popejoy Lori L , Khalilia Mohammed A , Popescu Mihail , Galambos Colleen , Lyons Vanessa , Rantz Marilyn , Hicks Lanis , Stetzer Frank
Published: October 2014

Objective This research identifies specific care coordination activities used by Aging in Place (AIP) nurse care coordinators and home healthcare (HHC) nurses when coordinating care for older community-dwelling adults and suggests a method to quantify care coordination.

Methods A care coordination ontology was built based on activities extracted from 11 038 notes labeled with the Omaha Case management category. From the parsed narrative notes of every patient, we mapped the extracted activities to the ontology, from which we computed problem profiles and quantified care coordination for all patients.

Results We compared two groups of patients: AIP who received enhanced care coordination (n=217) and HHC who received traditional care (n=691) using 128 135 narratives notes. Patients were tracked from the time they were admitted to AIP or HHC until they were discharged. We found that patients in AIP received a higher dose of care coordination than HHC in most Omaha problems, with larger doses being given in AIP than in HHC in all four Omaha categories.

Conclusions ‘Communicate’ and ‘manage’ activities are widely used in care coordination. This confirmed the expert hypothesis that nurse care coordinators spent most of their time communicating about their patients and managing problems. Overall, nurses performed care coordination in both AIP and HHC, but the aggregated dose across Omaha problems and categories is larger in AIP.
Genetic investigations in childhood deafness
Authors: Parker Michael , Bitner-Glindzicz Maria
Published: October 2014

Permanent childhood sensorineural hearing loss, is one of the most common birth defects in developed countries. It is important to identify the aetiology of hearing loss for many reasons, as there may be important health surveillance implications particularly with syndromic causes. Non-syndromic sensorineural hearing loss is a highly heterogeneous genetic condition, meaning that it may be caused by any one of numerous genes, with very few phenotypic distinctions between the different genetic types. This has previously presented significant challenges for genetic testing. However, the introduction of new technologies should enable more comprehensive testing in the future, bringing significant benefits to more affected children and their families.
Tracheobronchitis as an extraintestinal manifestation of ulcerative colitis
Authors: Javia Siddharth , Agrawal Abhinav , Patell Rushad , Jasdanwala Sarfaraz
Published: October 2014

Respiratory involvement is a rare extraintestinal manifestation of ulcerative colitis (UC). It commonly presents as bronchiectasis and rarely as tracheobronchitis. It can occur before or after the presentation of gastrointestinal symptoms. Only rarely does it occur after the patient undergoes colectomy. Diagnosis should be considered in any patient with UC who presents with unexplained upper respiratory symptoms and a negative work up for infectious aetiologies. It responds well to immunosuppressive therapy. We present a case of a 21-year-old woman who underwent colectomy for ulcerative colitis and later presented with new onset severe reversible inflammation of the upper respiratory tract.
The importance of screening for serum free light chains in suspected cases of multiple myeloma and their impact on the kidney
Authors: Talbot B , Wright D , Basnayake K
Published: October 2014

Multiple myeloma (MM) is the second most common haematological malignancy in the UK. We present a case series of three patients with light chain only myeloma who had normal serum protein electrophoretic studies at screening and were diagnosed using serum and urine free light chain assessment. This series reiterates the importance of thorough and robust screening for MM in patients presenting with renal disease. We review the up to date literature and we highlight the need to screen patients for MM with a combination of serum electrophoresis/immunofixation and either urinary or serum free light chain measurement and to maintain a high index of suspicion regardless of the presence or absence of proteinuria. We also discuss the emerging role of the serum free light chain assay.
Listening to patients with cancer: using a literary-based research method to understand patient-focused care
Authors: Begley Amanda , Pritchard-Jones Kathy , Biriotti Maurice , Kydd Anna , Burdsey Tim , Townsley Emma
Published: October 2014

Objective

In spite of considerable attention, patients diagnosed with cancer continue to report poor experiences of care. The root causes of this remain unclear. This exploratory study aimed to investigate new ways of understanding the experience of patients with cancer, using a literary-based research approach.

Design

Interviews were undertaken with four patients diagnosed with high-grade brain cancers at least 6 months from diagnosis and with people (n=5) identified by the patients as important in their care pathway. Interview transcripts were analysed by humanities academics as pieces of literature, where each patient's story was told from more than one person's perspective. The academics then came together in a facilitated workshop to agree major themes within the patient experiences. The themes were presented at a patient and carer event involving 70 participants to test the validity of the insights.

Results

Insights into the key issues for patients with cancer could be grouped into six themes: accountability; identity; life context; time; language; rigour and emotion. Patients often held a different perspective to the traditionally held medical views of what constitutes good care. For example, patients did not see any conflict between a doctor having scientific rigour and portraying emotion.

Conclusions

One key feature of the approach was its comparative nature: patients often held different views from those traditionally held by physicians of what constitutes health and good outcomes. This revealed aspects that may be considered by healthcare professionals when designing improvements. Proposals for further testing are discussed, with a particular emphasis on the need for sensitivity to individual differences in experiences.
Supervised learning events in the Foundation Programme: a UK-wide narrative interview study
Authors: Rees Charlotte E , Cleland Jennifer A , Dennis Ashley , Kelly Narcie , Mattick Karen , Monrouxe Lynn V
Published: October 2014

Objectives

To explore Foundation trainees’ and trainers’ understandings and experiences of supervised learning events (SLEs), compared with workplace-based assessments (WPBAs), and their suggestions for developing SLEs.

Design

A narrative interview study based on 55 individual and 19 group interviews.

Setting

UK-wide study across three sites in England, Scotland and Wales.

Participants

Using maximum-variation sampling, 70 Foundation trainees and 40 trainers were recruited, shared their understandings and experiences of SLEs/WPBAs and made recommendations for future practice.

Methods

Data were analysed using thematic and discourse analysis and narrative analysis of one exemplar personal incident narrative.

Results

While participants volunteered understandings of SLEs as learning and assessment, they typically volunteered understandings of WPBAs as assessment. Trainers seemed more likely to describe SLEs as assessment and a ‘safety net’ to protect patients than trainees. We identified 333 personal incident narratives in our data (221 SLEs; 72 WPBAs). There was perceived variability in the conduct of SLEs/WPBAs in terms of their initiation, tools used, feedback and finalisation. Numerous factors at individual, interpersonal, cultural and technological levels were thought to facilitate/hinder learning. SLE narratives were more likely to be evaluated positively than WPBA narratives overall and by trainees specifically. Participants made sense of their experiences, emotions, identities and relationships through their narratives. They provided numerous suggestions for improving SLEs at individual, interpersonal, cultural and technological levels.

Conclusions

Our findings provide tentative support for the shift to formative learning with the introduction of SLEs, albeit raising concerns around trainees’ and trainers’ understandings about SLEs. We identify five key educational recommendations from our study. Additional research is now needed to explore further the complexities around SLEs within workplace learning.
Task shifting interventions for cardiovascular risk reduction in low-income and middle-income countries: a systematic review of randomised controlled trials
Authors: Ogedegbe Gbenga , Gyamfi Joyce , Plange-Rhule Jacob , Surkis Alisa , Rosenthal Diana Margot , Airhihenbuwa Collins , Iwelunmor Juliet , Cooper Richard
Published: October 2014

Objective

To evaluate evidence from published randomised controlled trials (RCTs) for the use of task-shifting strategies for cardiovascular disease (CVD) risk reduction in low-income and middle-income countries (LMICs).

Design

Systematic review of RCTs that utilised a task-shifting strategy in the management of CVD in LMICs.

Data Sources

We searched the following databases for relevant RCTs: PubMed from the 1940s, EMBASE from 1974, Global Health from 1910, Ovid Health Star from 1966, Web of Knowledge from 1900, Scopus from 1823, CINAHL from 1937 and RCTs from ClinicalTrials.gov.

Eligibility criteria for selecting studies

We focused on RCTs published in English, but without publication year. We included RCTs in which the intervention used task shifting (non-physician healthcare workers involved in prescribing of medications, treatment and/or medical testing) and non-physician healthcare providers in the management of CV risk factors and diseases (hypertension, diabetes, hyperlipidaemia, stroke, coronary artery disease or heart failure), as well as RCTs that were conducted in LMICs. We excluded studies that are not RCTs.

Results

Of the 2771 articles identified, only three met the predefined criteria. All three trials were conducted in practice-based settings among patients with hypertension (2 studies) and diabetes (1 study), with one study also incorporating home visits. The duration of the studies ranged from 3 to 12 months, and the task-shifting strategies included provision of medication prescriptions by nurses, community health workers and pharmacists and telephone follow-up posthospital discharge. Both hypertension studies reported a significant mean blood pressure reduction (2/1 mm Hg and 30/15 mm Hg), and the diabetes trial reported a reduction in the glycated haemoglobin levels of 1.87%.

Conclusions

There is a dearth of evidence on the implementation of task-shifting strategies to reduce the burden of CVD in LMICs. Effective task-shifting interventions targeted at reducing the global CVD epidemic in LMICs are urgently needed.
Evaluation of Health in Pregnancy grants in Scotland: a protocol for a natural experiment
Authors: Dundas Ruth , Ouédraogo Samiratou , Bond Lyndal , Briggs Andrew H , Chalmers James , Gray Ron , Wood Rachael , Leyland Alastair H
Published: October 2014

Introduction

A substantial proportion of low birth weight is attributable to the mother's cultural and socioeconomic circumstances. Early childhood programmes have been widely developed to improve child outcomes. In the UK, the Health in Pregnancy (HiP) grant, a universal conditional cash transfer of £190, was introduced for women reaching the 25th week of pregnancy with a due date on/or after 6 April 2009 and subsequently withdrawn for women reaching the 25th week of pregnancy on/or after 1 January 2011. The current study focuses on the evaluation of the effectiveness and cost-effectiveness of the HiP grant.

Methods and analysis

The population under study will be all singleton births in Scotland over the periods of January 2004 to March 2009 (preintervention), April 2009 to April 2011 (intervention) and May 2011 to December 2013 (postintervention). Data will be extracted from the Scottish maternity and neonatal database. The analysis period 2004–2013 should yield over 585 000 births. The primary outcome will be birth weight among singleton births. Other secondary outcomes will include gestation at booking, booking before 25 weeks; measures of size and stage; gestational age at delivery; weight-for-dates, term at birth; birth outcomes and maternal smoking. The main statistical method we will use is interrupted time series. Outcomes will be measured on individual births nested within mothers, with mothers themselves clustered within data zones. Multilevel regression models will be used to determine whether the outcomes changed during the period in which the HiP grants was in effect. Subgroup analyses will be conducted for those groups most likely to benefit from the payments.

Ethics and dissemination

Approval for data collection, storage and release for research purpose has been given (6 May 2014, PAC38A/13) by the Privacy Advisory Committee. The results of this study will be disseminated through peer-reviewed publications in journals, national and international conferences.
MediDial cards: a quick win for service improvement
Authors: Davies Mike , Panchal Sonia
Published: October 2014

One of the key roles of a junior doctor is co-ordinating the care of their patients and communicating with different departments or specialties within the hospital. To do this, junior doctors often spend a lot of time on a daily basis contacting the hospital switchboard in order to locate a required bleep/extension/fax number, or trying to navigate an intranet based directory which can be difficult to use. We aimed to improve this task for junior doctors as a pilot project for engaging junior doctors in service improvement.

Our multi-disciplinary team, led by junior doctors and with the support of the Trust, produced and implemented lanyard (MediDial) cards containing common and relevant (fax, bleep, and extension) numbers for use by junior doctors. Through the introduction of our MediDial cards we not only reduced the frequency junior doctors needed to contact the switchboard on a daily basis, but also the length of time spent waiting to speak to an operator. The MediDial cards were also found to be time saving and more useful than the previous intranet based database. Since the introduction of the MediDial cards, the project has been rolled out across the Trust and presented at Grand Rounds as an example of junior doctor led service improvement, aiming to encourage trainees to engage with quality improvement projects.
Pharmacovigilance in hospice/palliative care: net effect of gabapentin for neuropathic pain
Authors: Sanderson Christine , Quinn Stephen J , Agar Meera , Chye Richard , Clark Katherine , Doogue Matthew , Fazekas Belinda , Lee Jessica , Lovell Melanie R , Rowett Debra , Spruyt Odette , Currow David C
Published: October 2014

Objective

Hospice/palliative care patients may differ from better studied populations, and data from other populations cannot necessarily be extrapolated into hospice/palliative care clinical practice. Pharmacovigilance studies provide opportunities to understand the harms and benefits of medications in routine practice. Gabapentin, a γ-amino butyric acid analogue antiepileptic drug, is commonly prescribed for neuropathic pain in hospice/palliative care. Most of the evidence however relates to non-malignant, chronic pain syndromes (diabetic neuropathy, postherpetic neuralgia, central pain syndromes, fibromyalgia). The aim of this study was to quantify the immediate and short-term clinical benefits and harms of gabapentin in routine hospice/palliative care practice.

Design

Multisite, prospective, consecutive cohort.

Population

127 patients, 114 of whom had cancer, who started gabapentin for neuropathic pain as part of routine clinical care.

Settings

42 centres from seven countries. Data were collected at three time points—at baseline, at day 7 (and at any time; immediate and short-term harms) and at day 21 (clinical benefits).

Results

At day 21, the average dose of gabapentin for those still using it (n=68) was 653 mg/24 h (range 0–1800 mg) and 54 (42%) reported benefits, of whom 7 (6%) experienced complete pain resolution. Harms were reported in 39/127 (30%) patients at day 7, the most frequent of which were cognitive disturbance, somnolence, nausea and dizziness. Ten patients had their medication ceased due to harms. The presence of significant comorbidities, higher dose and increasing age increased the likelihood of harm.

Conclusions

Overall, 42% of people experienced benefit at a level that resulted in continued use at 21 days.
Inulin contents and tissue distribution in underground storage organs of Asteraceae species from the Brazilian rocky fields
Authors: Joaquim Emanuela de Oliveira , Figueiredo-Ribeiro Rita de Cássia Leone , Hayashi Adriana Hissae , Carvalho Maria Angela Machado de
Published: October 2014

Geophytes are widespread in rocky fields, having evolved to survive adverse environmental conditions mainly because of their underground storage organs and reserve compounds. Among these compounds, carbohydrates have several functions other than as an energy source, including protection against drought and extreme temperatures. In this work, we analyzed the composition and tissue distribution of carbohydrates in the underground organs of four Asteraceae species from a preserved area of rocky fields in the Brazilian Cerrado. Soluble carbohydrates were quantified and analyzed by HPAEC–PAD, and starch was analyzed by an enzymatic assay. All species (Baccharis subdentata DC., Chresta curumbensis (Philipson) H.Rob., Lessingianthus floccosus (Gardner) H.Rob., and Strophopappus glomeratus (Gardner) R.Esteves) store long-chain inulin-type fructans. Among them, C. curumbensis presented the highest amount of soluble carbohydrates, comprising 25% of the reserve organ dry mass. Inulin sphero-crystals were visualized under polarized light, mainly in the vascular cylinder. Buds were found on the underground organs of B. subdentata and C. curumbensis, and secretory structures were identified in S. glomeratus, L. floccosus, and C. curumbensis. The occurrence of buds, secretory structures, and fructans in these organs is probably related to ecophysiological strategies used as defense and survival mechanisms in response to stress conditions, particularly drought and fire, that occur frequently in rocky fields.
Functionalized thienoacridines: synthesis, optoelectronic, and structural properties
Authors: Robertson Sean F. , Leitch Alicea A. , Korobkov Ilia , Soldatov Dmitriy V. , Brusso Jaclyn L.
Published: October 2014

The preparation and characterization of hexylated, brominated, and 5-hexyl-2-thienyl-substituted tetrathienoacridine (TTAc) is described. Comparative electrochemical, optical, computational, and solid-state studies with their thienoanthracene (TTAn) analogs demonstrate that replacement of CH with nitrogen leads to an overall lowering of the frontier molecular energy levels and decrease in the HOMO–LUMO energy gap. While the brominated TTAc and TTAn derivatives are isostructural, as indicated by X-ray diffraction studies, the lower sublimation temperature and thermochromic behaviour exhibited by bromo-TTAc is attributed to an additional dipole−dipole interaction resulting from the dipole moment afforded by carbon/nitrogen substitution in the core aromatic ring. This work represents a fundamental study of heteroatom substitution in 2-D conjugated small molecules and investigates how inclusion of an electron deficient aromatic ring into the molecular framework (i.e., acridine versus anthracene) can influence the physical properties.