bluuebunny/crossref_metadata_2025 huggingface dataset:
Birth Outcomes Associated with Receipt of Group Prenatal Care Among Low‐Income Hispanic Women
Authors: Tandon S. Darius , Colon Lucinda , Vega Patricia , Murphy Jeanne , Alonso Alina
Published: September 2012

Introduction: Although Hispanic women in the United States have preterm birth and low‐birth‐weight rates comparable to non‐Hispanic white women, their rates fall short of 2010 Healthy People goals, with variability found across states. This study examined the effectiveness of the CenteringPregnancy group prenatal care model in reducing preterm birth and low‐birth‐weight rates for Hispanic women.

Methods: Pregnant Hispanic women at less than or equal to 20 weeks, gestation initiating prenatal care between January 2008 to July 2009 at 2 Palm Beach County, Florida, public health clinics selected either group or traditional prenatal care. Data on neonatal birth weight and gestational age were obtained through abstraction of Palm Beach County Health Department medical records. Records were abstracted for 97% of CenteringPregnancy (n = 150) and 94% of traditional care (n = 66) participants.

Results: A statistically significant difference was found in the percentage of women giving birth to preterm neonates (5% group prenatal care vs 13% traditional care; P= .04). There were no statistically significant differences in the percentage of women having a low‐birth‐weight neonate when group and traditional care participants were compared.

Discussion: The CenteringPregnancy model holds promise for improving the birth outcomes of Hispanic women. Future research should be conducted with larger sample sizes to replicate study findings using experimental designs and incorporating formal cost‐effectiveness analyses.
Effect of Heating Schedule on Fabrication of Ti3SiC2‐based Composites from Ti–SiC Powder Mixture
Authors: Istomin Pavel V. , Nadutkin Alexander V. , Grass Vladislav E.
Published: September 2012

We herein describe a set of experiments used to study the effect of heating schedule on phase formation during the fabrication of Ti3SiC2‐based materials from Ti–SiC powder mixtures by means of pressureless sintering. We found that combustion was initiated at a temperature of about 1330°C, which resulted in the formation of Ti‐rich eutectic melt followed by crystallization of Ti3SiC2. It was shown that when preannealing was performed at 1150°C, no further combustive process could occur, and an intermediate, nonequilibrium phase composition, consisting of Ti5Si3Cx, TiC, and SiC remained until the end of the heat treatment. We herein discuss the mechanistic interpretation of this behavior.
Titania Nanoparticle Suspension for Fabrication of Micrometer Feature Arrays via a Template‐Assisted Approach
Authors: Liang Yongxuan , Lu Kathy
Published: September 2012

In this study, TiO2 nanoparticle suspensions are guided by templated molds to fabricate micrometer feature patterns and arrays. The effects of PEG with different molecular weights on suspension flowability and surface wettability between the PDMS molds and the TiO2 suspensions on pattern formation are investigated. PEG 400 is the most desirable dispersant. The suspensions have the best wetting on the mold surface with 3 wt% TX‐100 addition. Micrometer feature arrays with feature sizes ranging from 750 nm to 1.5 μm are obtained. Fundamental understanding, regarding suspension flowability, wetting, and the ability to make different feature sizes and shapes, is discussed.
G4 motifs in human genes
Authors: Maizels Nancy
Published: September 2012

The G4 motif, G≥3NxG≥3NxG≥3NxG≥3, is enriched in some genomic regions and depleted in others. This motif confers the ability to form an unusual four‐stranded DNA structure, G4 DNA. G4 DNA is associated with genomic instability, which may explain depletion of G4 motifs from some genes and genomic regions. Conversely, G4 motifs are enriched downstream of transcription start sites, where they correlate with pausing. The uneven distribution of G4 motifs in the genome strongly suggests that mechanisms of selection act not only on one‐dimensional genomic sequence, but also on structures formed by genomic DNA. The biological roles of G4 structures illustrate that, to understand genome function, it is important to consider the dynamic structural potential implicit in the G4 motif.
The genome: an isochore ensemble and its evolution
Authors: Bernardi Giorgio
Published: September 2012

The genomes of eukaryotes are mosaics of isochores. These are long DNA stretches that are fairly homogeneous in base composition and that belong to a small number of families characterized by different ratios of GC to AT and different short‐sequence patterns (i.e., different DNA structures that interact with different proteins). This genome organization led to two discoveries: (1) the genomic code, which refers to two correlations, that of the composition of coding and contiguous noncoding sequences, and that of coding sequences and the structural properties of the encoded proteins; and (2) the genome phenotypes, which correspond to the patterns of isochore families in the genomes. These patterns indicate that genome evolution may proceed either according to a conservative mode or to a transitional (isochore shifting) mode, apparently depending upon whether the environment is constant or shifting. According to the neoselectionist theory, natural selection is responsible for both modes.
Preaching about the converted: how meiotic gene conversion influences genomic diversity
Authors: Cole Francesca , Keeney Scott , Jasin Maria
Published: September 2012

Meiotic crossover (CO) recombination involves a reciprocal exchange between homologous chromosomes. COs are often associated with gene conversion at the exchange site where genetic information is unidirectionally transferred from one chromosome to the other. COs and independent assortment of homologous chromosomes contribute significantly to the promotion of genomic diversity. What has not been appreciated is the contribution of another product of meiotic recombination, noncrossovers (NCOs), which result in gene conversion without exchange of flanking markers. Here, we review our comprehensive analysis of recombination at a highly polymorphic mouse hotspot. We found that NCOs make up ∼90% of recombination events. Preferential recombination initiation on one chromosome allowed us to estimate the contribution of CO and NCO gene conversion to transmission distortion, a deviation from Mendelian inheritance in the population. While NCO gene conversion tracts are shorter, and thus have a more punctate effect, their higher frequency translates into an approximately two‐fold greater contribution than COs to gene conversion–based allelic shuffling and transmission distortion. We discuss the potential impact of mammalian NCO characteristics on evolution and genomic diversity.
Creative deaminases, self‐inflicted damage, and genome evolution
Authors: Conticello Silvestro G.
Published: September 2012

Organisms minimize genetic damage through complex pathways of DNA repair. Yet a gene family—the AID/APOBECs—has evolved in vertebrates with the sole purpose of producing targeted damage in DNA/RNA molecules through cytosine deamination. They likely originated from deaminases involved in A>I editing in tRNAs. AID, the archetypal AID/APOBEC, is the trigger of the somatic diversification processes of the antibody genes. Its homologs may have been associated with the immune system even before the evolution of the antibody genes. The APOBEC3s, arising from duplication of AID, are involved in the restriction of exogenous/endogenous threats such as retroviruses and mobile elements. Another family member, APOBEC1, has (re)acquired the ability to target RNA while maintaining its ability to act on DNA. The AID/APOBECs have shaped the evolution of vertebrate genomes, but their ability to mutate nucleic acids is a double‐edged sword: AID is a key player in lymphoproliferative diseases by triggering mutations and chromosomal translocations in B cells, and there is increasing evidence suggesting that other AID/APOBECs could be involved in cancer development as well.
Factors affecting farmers’ adoption of integrated rice–fish farming systems in the Mekong delta, Vietnam
Authors: Bosma Roel H. , Nhan Dang K. , Udo Henk M. J. , Kaymak Uzay
Published: September 2012

This study investigated the determinants of the adoption of improved rice–fish farming systems in the Mekong delta to support policy making, agricultural land‐use planning and extension of integrated rice–fish farming. Recently these systems have been referred to as adaptations to climate change, while traditional rice–fish systems have often been abandoned. In 2006, we carried out surveys among 94 farmers either practising rice monoculture or having an improved rice–fish system. We analysed data among others with binary logistic regression and simulated adoption by using fuzzy logic. Per capita and per hectare incomes of households practising rice–fish systems were nearly double, while their farm size was 1.3 times larger than that of the rice monoculture farms. Households with larger homesteads, i.e. neighbouring irrigated fields and ponds, better access to financial capital and more know‐how of rice and fish culture and their integration, were more likely to adopt rice–fish systems. Previously identified drivers and factors for adoption, such as an appropriate agro‐ecological context and the farmer’s education and training level, were confirmed. Promoting rice–fish systems needs participatory extension and research approaches for sustainable agriculture strategies such as integrated pest management (IPM) in which farmers, trainers and researchers optimize technologies in constantly changing contexts.
Distributing Who Gets What and Why: Four Normative Approaches to Global Health
Authors: Brown Garrett Wallace
Published: September 2012

When surveying policy documents on global health one is often struck by a general lack of theorizing about why we have moral duties to promote equitable global health initiatives and in regards to what prioritized values should represent the satisfaction of these moral duties. Although there is general agreement that current inequalities in global health provision exist, and agreement that some form of response is necessary, there is little consensus about what should be done to rectify this situation. The purpose of this article is to explore four normative arguments about why we might have global health responsibilities and to examine their relationship with distributive principles for the alleviation of global health inequalities. Through this examination it will be argued that current theorizing about global health rests on opposing ontological perspectives about what global health should prioritize and that these presuppositions result in distinctively antagonistic normative demands about how we should distribute, who gets what and why.

Policy Implications

 Creating a more equitable distribution of global health requires policy makers to seriously rethink the key presuppositions, assumption and biases that underpin and perpetuate the inequalities involved with current global health policy.

 In rethinking global health policy – and if we believe reaching some level of health equity to be a morally important endeavor – then greater commitments to the distributive and deliberative properties of cosmopolitan developmental partnerships will be required.

 To this end, global health equity will require cosmopolitan commitments to individual health beyond state and civilizational boundaries, a renewed focus on the social determinants of health, key reforms to unjust global economic practices, and the reformation of global decision making toward more inclusive and deliberative governance formations.
Ecological Populations of Bacteria Act as Socially Cohesive Units of Antibiotic Production and Resistance
Authors: Cordero Otto X. , Wildschutte Hans , Kirkup Benjamin , Proehl Sarah , Ngo Lynn , Hussain Fatima , Le Roux Frederique , Mincer Tracy , Polz Martin F.
Published: September 2012

Toxic Neighborhood

Bacterial populations are often considered to be driven by gene-centric, selfish dynamics. Superficially, antibiotic production fits this picture as individuals can gain most benefit by inhibiting or killing close relatives with high niche overlap. Contrary to that notion,

Cordero
et al.

(p.
1228
; see the Perspective by

Morlon

) show that bacteria in the wild form social units in which antibiotic production and resistance leads to cooperation within, and antagonism between, populations. A combination of high-throughput interaction screening, molecular genetics, and genomics revealed that antibiotics are produced by only a few members of each population, while all other members are resistant. In the past, lack of knowledge of the ecological structure of microbial populations has led to interpretations of antibiotic production and resistance as being largely driven by short-lived, cyclic invasions of populations by antibiotic-producing resistant bacteria. This work shows that structured, socially cohesive bacterial populations exist in the wild and form organizational patterns similar to those of animal and plant populations.
Microbial Cooperative Warfare
Authors: Morlon Hélène
Published: September 2012

Analysis of microbial interactions in the wild shows that microbes cooperate to resist competition.
Type I Interferon Induction during Influenza Virus Infection Increases Susceptibility to Secondary Streptococcus pneumoniae Infection by Negative Regulation of γδ T Cells
Authors: Li Wenjing , Moltedo Bruno , Moran Thomas M.
Published: September 2012

The majority of deaths following influenza virus infection result from secondary bacterial superinfection, most commonly caused by
Streptococcus pneumoniae
. Several models have been proposed to explain how primary respiratory viral infections exacerbate secondary bacterial disease, but the mechanistic explanations have been contradictory. In this study, mice were infected with
S. pneumoniae
at different days after primary influenza A (X31) virus infection. Our findings show that the induction of type I interferons (IFNs) during a primary nonlethal influenza virus infection is sufficient to promote a deadly
S. pneumoniae
secondary infection. Moreover, mice deficient in type I interferon receptor (IFNAR knockout [KO] mice) effectively cleared the secondary bacterial infection from their lungs, increased the recruitment of neutrophils, and demonstrated an enhanced innate expression of interleukin-17 (IL-17) relative to wild-type (WT) mice. Lung γδ T cells were responsible for almost all IL-17 production, and their function is compromised during secondary
S. pneumoniae
infection of WT but not IFNAR KO mice. Adoptive transfer of γδ T cells from IFNAR KO mice reduced the susceptibility to secondary
S. pneumoniae
infection in the lung of WT mice. Altogether, our study highlights the importance of type I interferon as a key master regulator that is exploited by opportunistic pathogens such as
S. pneumoniae
. Our findings may be utilized to design effective preventive and therapeutic strategies that may be beneficial for coinfected patients during influenza epidemics.
A comparison of individual versus community influences on youth smoking behaviours: a cross-sectional observational study
Authors: Adachi-Mejia Anna M , Carlos Heather A , Berke Ethan M , Tanski Susanne E , Sargent James D
Published: September 2012

Objectives

To compare individual with community risk factors for adolescent smoking.

Design

A cross-sectional observational study with multivariate analysis.

Setting

National telephone survey.

Participants

3646 US adolescents aged 13–18 years in 2007 recruited through a random digit-dial survey.

Outcome measures

Ever tried smoking and, among experimental smokers, smoking intensity (based on smoking in past 30 days).

Results

One-third of participants (35.6%, N=1297) had tried smoking. After controlling for individual risk factors, neither tobacco outlet density nor proximity were associated with tried smoking or smoking intensity. Associations with trying smoking included age (adjusted OR (AOR)=1.23, 95% CI 1.16 to 1.31), lower socioeconomic status (AOR=0.82, 95% CI 0.74 to 0.91), sibling smoking (AOR=2.13, 95% CI 1.75 to 2.59), friend smoking (AOR=2.60, 95% CI 2.19 to 3.10 for some and AOR=7.01, 95% CI 5.05 to 9.74 for most), movie smoking exposure (AOR=2.66, 95% CI 1.95 to 3.63), team sports participation (AOR=0.69, 95% CI 0.54 to 0.89) and sensation seeking (AOR=7.72, 95% CI 5.26 to 11.34). Among experimental smokers, age (AOR=1.32, 95% CI 1.21 to 1.44), minority status (AOR=0.48, 95% CI 0.30 to 0.79 for Black; AOR=0.46, 95% CI 0.31 to 0.69 for Hispanic; AOR=0.53, 95% CI 0.43 to 0.85 for mixed race/other), friend smoking (AOR=3.37, 95% CI 2.37 to 4.81 for some; AOR=20.27, 95% CI 13.22 to 31.08 for most), team sports participation (AOR=0.38, 95% CI 0.26 to 0.55) and sensation seeking (AOR=6.57, 95% CI 3.71 to 11.64) were associated with smoking intensity.

Conclusions

The study suggests that interventions and policies to prevent and reduce youth smoking should focus on individual risk factors for smoking, including supporting participation in team sports, minimising exposure to movie smoking, addressing the social influence of friend smoking and addressing experience seeking among high sensation-seekers.
Factors influencing the length of hospital stay among patients resident in Blackpool admitted with COPD: a cross-sectional study
Authors: Agboado Gabriel , Peters Jonathan , Donkin Lynn
Published: September 2012

Objectives

To identify the differential effects of patient, health service, temporal and geographic factors on length of stay (LOS) for chronic obstructive pulmonary disease (COPD)-related admissions.

Design

We used stratified Cox proportional hazard model to evaluate the association between LOS and patient, health service, temporal and geographical factors.

Setting

Patients resident in Blackpool, North West England, admitted to the local hospital with COPD.

Participants

We used the Admitted Patient Care General Episode Commissioning Dataset for the period 1 April 2005–31 March 2010. We analysed records of admission spells among patients resident in Blackpool aged 40 years or older admitted with a primary diagnosis of COPD.

Results

There were 2410 admissions meeting the inclusion criteria over the period. These admissions were attributed to 1172 COPD patients, an average of 2.06 admissions per patient. The median LOS was 6 days (95% CI 6 to 6) while the mean was 9.8 days (95% CI 9.1 to 10.5). Patients were 22% more likely to be discharged earlier in 2009/2010 compared with 2005/2006 (adjusted HR 1.22; p=0.0100). LOS was associated with socioeconomic deprivation with those in the most deprived areas being 35% less likely to be discharged earlier compared with those from the least deprived areas (adjusted HR 0.65; p=0.0010).

Conclusions

LOS among COPD patients have reduced over the period of the study. Age, deprivation, Charlson index, specialty of admission and cause of exacerbations were independently associated with LOS. Though there were no significant associations between LOS and season of admission and distance from hospital, there were significant variations in LOS associated with these variables based on selected patient characteristics.
Development of an economic model to assess the cost-effectiveness of hawthorn extract as an adjunct treatment for heart failure in Australia
Authors: Ford Emily , Adams Jon , Graves Nicholas
Published: September 2012

Objective

An economic model was developed to evaluate the cost-effectiveness of hawthorn extract as an adjunctive treatment for heart failure in Australia.

Methods

A Markov model of chronic heart failure was developed to compare the costs and outcomes of standard treatment and standard treatment with hawthorn extract. Health states were defined by the New York Heart Association (NYHA) classification system and death. For any given cycle, patients could remain in the same NYHA class, experience an improvement or deterioration in NYHA class, be hospitalised or die. Model inputs were derived from the published medical literature, and the output was quality-adjusted life years (QALYs). Probabilistic sensitivity analysis was conducted. The expected value of perfect information (EVPI) and the expected value of partial perfect information (EVPPI) were conducted to establish the value of further research and the ideal target for such research.

Results

Hawthorn extract increased costs by $1866.78 and resulted in a gain of 0.02 QALYs. The incremental cost-effectiveness ratio was $85 160.33 per QALY. The cost-effectiveness acceptability curve indicated that at a threshold of $40 000 the new treatment had a 0.29 probability of being cost-effective. The average incremental net monetary benefit (NMB) was −$1791.64, the average NMB for the standard treatment was $92 067.49, and for hawthorn extract $90 275.84. Additional research is potentially cost-effective if research is not proposed to cost more than $325 million. Utilities form the most important target parameter group for further research.

Conclusions

Hawthorn extract is not currently considered to be cost-effective in as an adjunctive treatment for heart failure in Australia. Further research in the area of utilities is warranted.
Barriers to the uptake of evidence from systematic reviews and meta-analyses: a systematic review of decision makers’ perceptions
Authors: Wallace John , Nwosu Bosah , Clarke Mike
Published: September 2012

Objective

To review the barriers to the uptake of research evidence from systematic reviews by decision makers.

Search strategy

We searched 19 databases covering the full range of publication years, utilised three search engines and also personally contacted investigators. Reference lists of primary studies and related reviews were also consulted.

Selection criteria

Studies were included if they reported on the views and perceptions of decision makers on the uptake of evidence from systematic reviews, meta-analyses and the databases associated with them. All study designs, settings and decision makers were included. One investigator screened titles to identify candidate articles then two reviewers independently assessed the quality and the relevance of retrieved reports.

Data extraction

Two reviewers described the methods of included studies and extracted data that were summarised in tables and then analysed. Using a pre-established taxonomy, the barriers were organised into a framework according to their effect on knowledge, attitudes or behaviour.

Results

Of 1726 articles initially identified, we selected 27 unique published studies describing at least one barrier to the uptake of evidence from systematic reviews. These studies included a total of 25 surveys and 2 qualitative studies. Overall, the majority of participants (n=10 218) were physicians (64%). The most commonly investigated barriers were lack of use (14/25), lack of awareness (12/25), lack of access (11/25), lack of familiarity (7/25), lack of usefulness (7/25), lack of motivation (4/25) and external barriers (5/25).

Conclusions

This systematic review reveals that strategies to improve the uptake of evidence from reviews and meta-analyses will need to overcome a wide variety of obstacles. Our review describes the reasons why knowledge users, especially physicians, do not call on systematic reviews. This study can inform future approaches to enhancing systematic review uptake and also suggests potential avenues for future investigation.
Lung Injury Prevention with Aspirin (LIPS-A): a protocol for a multicentre randomised clinical trial in medical patients at high risk of acute lung injury
Authors: Kor Daryl Jon , Talmor Daniel S , Banner-Goodspeed Valerie M , Carter Rickey E , Hinds Richard , Park Pauline K , Gajic Ognjen , Gong Michelle N
Published: September 2012

Introduction

Acute lung injury (ALI) is a devastating condition that places a heavy burden on public health resources. Although the need for effective ALI prevention strategies is increasingly recognised, no effective preventative strategies exist. The Lung Injury Prevention Study with Aspirin (LIPS-A) aims to test whether aspirin (ASA) could prevent and/or mitigate the development of ALI.

Methods and analysis

LIPS-A is a multicentre, double-blind, randomised clinical trial testing the hypothesis that the early administration of ASA will result in a reduced incidence of ALI in adult patients at high risk. This investigation will enrol 400 study participants from 14 hospitals across the USA. Conditional logistic regression will be used to test the primary hypothesis that early ASA administration will decrease the incidence of ALI.

Ethics and dissemination

Safety oversight will be under the direction of an independent Data and Safety Monitoring Board (DSMB). Approval of the protocol was obtained from the DSMB prior to enrolling the first study participant. Approval of both the protocol and informed consent documents were also obtained from the institutional review board of each participating institution prior to enrolling study participants at the respective site. In addition to providing important clinical and mechanistic information, this investigation will inform the scientific merit and feasibility of a phase III trial on ASA as an ALI prevention agent. The findings of this investigation, as well as associated ancillary studies, will be disseminated in the form of oral and abstract presentations at major national and international medical specialty meetings. The primary objective and other significant findings will also be presented in manuscript form. All final, published manuscripts resulting from this protocol will be submitted to Pub Med Central in accordance with the National Institute of Health Public Access Policy.
Transmissibility of the 2009 H1N1 pandemic in remote and isolated Canadian communities: a modelling study
Authors: Mostaço-Guidolin Luiz C , Bowman Chris S , Greer Amy L , Fisman David N , Moghadas Seyed M
Published: September 2012

Objectives

During the first wave of the 2009 influenza pH1N1, disease burden was distributed in a geographically heterogeneous fashion. It was particularly high in some remote and isolated Canadian communities when compared with urban centres. We sought to estimate the transmissibility (the basic reproduction number) of pH1N1 strain in some remote and isolated Canadian communities.

Design

A discrete time susceptible-exposed-infected transmission model was fit to infection curves simulated from laboratory-confirmed case counts for pH1N1 on each day. The sampling from Poisson distribution was used to estimate the basic reproduction number, R0, of pH1N1 during the spring wave for five different communities in Manitoba and Nunavut, Canada, where remote and isolated communities experienced a high incidence of infection, and high rates of hospitalisation and intensive care unit admission.

Setting

Remote and isolated communities in Northern Manitoba, Nunavut, and the largest urban centre (Winnipeg) in the province of Manitoba, Canada.

Results

Using published values of the exposed and infectious periods specific to H1N1 infection, corresponding to the average generation time of 2.78 days, we estimated a mean value of 2.26 for R0(95% CI 1.57 to 3.75) in a community located in northern Manitoba. Estimates of R0for other communities in Nunavut varied considerably with higher mean values of 3.91 (95% CI 3.08 to 4.87); 2.03 (95% CI 1.50 to 3.19); and 2.45 (95% CI 1.68 to 3.44). We estimated a lower mean value of 1.57 (95% CI 1.35 to 1.87) for R0in the Winnipeg health region, as the largest urban centre in Manitoba.

Conclusions

Influenza pH1N1 appears to have been far more transmissible in rural and isolated Canadian communities than other large urban areas. The differential severity of the pandemic in these regions may be explained partly by differential transmissibility, and suggests the need for more nuanced, targeted or population-specific control strategies in Canada.
What's in a name generator? Choosing the right name generators for social network surveys in healthcare quality and safety research
Authors: Burt Ronald S , Meltzer David O , Seid Michael , Borgert Amy , Chung Jeanette W , Colletti Richard B , Dellal George , Kahn Stacy A , Kaplan Heather C , Peterson Laura E , Margolis Peter
Published: September 2012

Background

Interest in the use of social network analysis (SNA) in healthcare research has increased, but there has been little methodological research on how to choose the name generators that are often used to collect primary data on the social connection between individuals for SNA.

Objective

We sought to determine a minimum set of name generators sufficient to distinguish the social networks of a target population of physicians active in quality improvement (QI).

Methods

We conducted a pilot survey including 8 name generators in a convenience sample of 25 physicians active in QI to characterize their social networks. We used multidimensional scaling to determine what subset of these name generators was needed to distinguish these social networks.

Results

We found that some physicians maintain a social network organized around a specific colleague who performed multiple roles while others maintained highly differentiated networks. We found that a set of 5 of the 8 name generators we used was needed to distinguish the networks of these physicians.

Conclusions

Beyond methodology for selecting name generators, our findings suggest that QI networks may require 5 or more generators to elicit valid sets of relevant actors and relations in this target population.
The accident and emergency department questionnaire: a measure for patients’ experiences in the accident and emergency department
Authors: Bos Nanne , Sizmur Steve , Graham Chris , van Stel Henk F
Published: September 2012

Background

The National Health Service National Patient Survey Programme systematically gathers patients’ experiences about the care they have recently received. Prioritising quality improvement activities in the accident and emergency (A&E) department requires that survey outcomes are meaningful and reliable. We aimed to determine which method of obtaining summary scores for the A&E department questionnaire optimally combined good interpretability with robust psychometric characteristics.

Methods

A&E department questionnaire data from 151 hospital trusts were analysed, covering 49 646 patients. Three methods of grouping and summarising items of the questionnaire were compared: principal components analysis (PCA); Department of Health dimensions; sections according to the patient's journey through the A&E department. The patient-level reliability of summary scores was determined by Cronbach's α coefficients (threshold: α>0.70), construct validity by Pearson's correlation coefficients, and the discriminative capacity by intra-class correlation coefficients (ICCs) and reliability of A&E-level mean scores.

Results

The PCA provided the best score reliability on six clear and interpretable composites: waiting time; doctors and nurses; your care and treatment; hygiene; information before discharge; overall. The discriminative power of the concepts was comparable for the three methods, with ICCs between 0.010 and 0.061. A&E sample sizes were adequate to obtain good to excellent reliability of A&E-level mean scores.

Conclusions

The A&E department questionnaire is a valid and reliable questionnaire to assess patients’ experiences with the A&E. The discriminative power of six summary scores offers a reliable comparison of healthcare performance between A&Es to increase patient centredness and quality of care.
The sea anchor technique: a novel method to aid in stent-assisted embolization of giant cerebral aneurysms
Authors: Edwards Landon , Kota Gopi , Morris Padraig P
Published: September 2012

Endovascular navigation past some large or giant intracranial aneurysms for the purpose of stent deployment can be difficult. Some of these lesions have a morphology which compels the operator to navigate through the aneurysm dome in order to gain distal access, a step which requires straightening of the delivery microcatheter before a stent can be deployed. In most patients this can be achieved by simply retracting the microcatheter and reducing the loop within the aneurysm. However, in certain patients the acute angle formed between aneurysm inflow and outflow tracts as well as the dynamics of tension within the microcatheter act together to prevent this from happening. Instead of retracting and straightening across the aneurysm neck, the microcatheter withdraws leaving the intra-aneurysm loop intact. This challenge can thwart attempts at stent placement and subsequent embolization. The authors describe a simple and safe technique to circumvent this problem, a way of stabilizing the distal tip of the microcatheter which they term the ‘sea anchor’.
Re-screeningChlamydia trachomatispositive subjects: a comparison of practices between an STI clinic, general practitioners and gynaecologists
Authors: Dukers-Muijrers Nicole H T M , van Liere Genevieve A F S , Hoebe Christian J P A
Published: September 2012

Objectives

Re-screening after an initial positive test is a highly effective strategy to identify newChlamydia trachomatispositive cases. Here, we evaluate adherence to international re-screening guidelines and the re-screening positive rates among sexual healthcare providers.

Methods

Passive retrospective cohort data were obtained from our STI clinic (South Limburg, Netherlands) and from the public laboratory that performs the majority ofC trachomatistests (September 2006–September 2010) conducted in the eastern South Limburg area. We assessed trends in re-screening after 3–12 months among young (16–25-year-old) and older women and men and evaluated differences between providers using multivariate regression analyses.

Results

The positive rates inC trachomatisscreening varied from 2–9% depending on the type of provider. At the STI clinic, subsequent re-screening was performed in 33% (382/1144) of patients, and 19% of re-screening cases were positive (74/382). Similar rates were observed for gynaecologists (re-screening 30%, 54/178; re-screening positive rate 15%, 8/51); re-screening rates were lower for general practitioners (23%, 144/625, p<0.01), but the positive rate in re-screening was similar (17%, 25/144). At the STI clinic, the re-screening rate was higher for older females (p<0.01) and older males (p<0.01) than for young females. The re-screening rate for young male patients increased over time (p=0.04). General practitioners re-screened young women more often than young (p<0.01) and older (p<0.01) men.

Conclusions

Positive rates were high for all care providers when re-screening patients. However, re-screening practices are suboptimal and differ between providers, arguing for improved adherence to currentC trachomatiscontrol guidelines.
Repeat genitalChlamydia trachomatistesting rates in young adults in England, 2010
Authors: Woodhall Sarah C , Atkins Janice L , Soldan Kate , Hughes Gwenda , Bone Angie , Gill O Noel
Published: September 2012

Objectives

To explore patterns of repeat chlamydia testing among young people in England and factors associated with testing positive at repeat test.

Methods

We analysed chlamydia testing among 15 to 24-year-olds in England in a single calendar year (2010) using data from the genitourinary medicine clinic activity dataset (GUMCAD) and tests reported through the National Chlamydia Screening Programme (NCSP). Case records were linked using patient clinic numbers (GUMCAD), or by matching date of birth, gender and postcode (NCSP). Individuals could not be linked between datasets. The incidence of repeat testing was estimated using survival analysis. Risk factors for testing positive at repeat test were explored using multivariable logistic regression.

Results

1 235 058 tests in the NCSP dataset and 502 095 in GUMCAD were included. The incidence of repeat testing was 18.4 and 26.1 per 100 person years in the NCSP dataset and GUMCAD respectively. Among NCSP repeat tests, the proportion testing positive was higher in those reporting recent change of sexual partner (adjusted OR males 1.44; females 1.52), and among those with a positive compared to a negative baseline test (adjusted OR males 2.57; females 1.95).

Conclusions

We observed moderate levels of repeat testing within a year. Considering the frequency of partner change among young people, more could be done to encourage re-testing upon change of sexual partner. Increasing re-testing following a positive test could probably identify unresolved or repeat infections that may otherwise go untreated. Work to establish the optimum approach to repeat testing in England is now warranted.
Genital warts in men: a large population-based cross-sectional survey of Danish men
Authors: Munk Christian , Nielsen Ann , Liaw Kai-Li , Kjaer Susanne Krüger
Published: September 2012

Objectives

To estimate the occurrence of and risk factors associated with genital warts in Danish men

Methods

We conducted a cross-sectional, questionnaire-based study among almost 23 000 men aged 18–45 years, randomly sampled from the general population of Denmark. Data was collected on self-reported clinically diagnosed genital warts, and various lifestyle habits.

Results

Ever having had clinically diagnosed genital warts was reported by 7.9% of the men. The median age at first occurrence was 22 years. Genital warts within the previous 12 months were reported by 0.92% of the men, with a peak of 1.83% among men aged 21–24 years. The likelihood of reporting genital warts was strongly correlated with the lifetime number of sex partners (OR 8.0; 95% CI 6.0 to 10.8 for ≥15 partners vs 1–2 partners). Other factors associated with an increased risk for genital warts included ever having smoked and having had other sexually transmitted infections.

Conclusions

Almost 8% of Danish men aged 18–45 years reported having had a diagnosis of genital warts. The results provide baseline information for developing and monitoring prevention strategies against genital warts, such as vaccination against human papillomavirus types 6 and 11.
Estimating the population size of men who have sex with men: a modified Laska, Meisner and Siegel procedure taking into account internet populations
Authors: Chen Hao , Zhang Yanhui , Tan Hongzhuan , Lin Dan , Chen Mengshi , Chen Niannian , Bao Yugang , Wen Shiwu
Published: September 2012

Objectives

Men who have sex with men (MSM) are an at-risk population for HIV/AIDS.Accurately estimating the size of MSM is important to monitor the HIV/AIDS epidemic and to implement HIV/AIDS prevention in the MSM population. None of the current methods for MSM population size estimation is satisfactory, especially for internet samples. We try to use the modified Laska, Meisner and Siegel (LMS) method to estimate the size of MSM in tangible venues and internet virtual venues.

Methods

Laska, Meisner and Siegel developed an unbiased estimator for the size of a population in a single venue based on a single sample (LMS method). In this study, we modified the LMS method for the estimation of population size of MSM (LMS* procedure). Specially, we integrated the MSM size of traditional tangible venue with internet virtual venue. Currently, the latter is an important source of socialisation for MSM population. To do this, we added a few parameters to the original LMS method. Then we applied the LMS* procedure to estimate the size of MSM in Changsha, the capital city of the Chinese Province of Hunan.

Results

The LMS* procedure handled the complexity of socialisation among MSM population well. According to the LMS* procedure, the total number of MSM was 65 657 (95% CI 57 922 to 73 388), constituting a proportion of 5.43% (95% CI 4.79% to 6.07%) in the sexually active male population (15–64-year-olds) in Changsha.

Conclusions

We conclude that the LMS* procedure is suitable for the estimation of a hard-to-reach population, such as MSM, in tangible venues and internet virtual venues.
Sexual behaviour and less frequent bathing are associated with higher human papillomavirus incidence in a cohort study of uncircumcised Kenyan men
Authors: Backes Danielle M , Snijders Peter J F , Hudgens Michael G , Bailey Robert C , Bogaarts Martijn , Agot Kawango , Agingu Walter , Moses Stephen , Meijer Chris J L M , Smith Jennifer S
Published: September 2012

Objectives

Data on the acquisition of human papillomavirus (HPV) infection in men are limited, especially from developing regions including Africa. The objective of this study was to characterise and determine the risk factors of HPV acquisition among a cohort of uncircumcised men participating in a randomised controlled trial (RCT) of male circumcision in Kisumu, Kenya.

Methods

Penile exfoliated cell specimens were collected at baseline, 6- and 12-month follow-up visits from the glans/coronal sulcus and shaft of men enrolled in the control arm of the RCT between 2002 and 2005. All participants were HIV seronegative, aged 17–24 years at baseline and remained uncircumcised over follow-up. Specimens were tested with GP5+/6+ PCR to detect 44 HPV types. Parametric frailty models were used to assess risk factors of HPV incidence.

Results

The median age of 966 participants was 20 years. The median follow-up time was 12.1 months. The incidence rate (IR) of any HPV infection was 49.3/1000 person-months with HPV16 having the highest IR (10.9/1000 person-months). The strongest risk factors for overall HPV incidence were bathing less frequently than daily (adjusted HR=2.6; 95% CI 1.0 to 6.5) and having ≥2 female sexual partners in the past year (adjusted HR=1.6; 95% CI 1.2 to 2.1).

Conclusions

HPV IRs were notably high in this cohort of high-risk, uncircumcised men from Kisumu, Kenya, with the number of sexual partners and bathing frequency being the strongest risk factors.
Dog owners' perceptions of breed‐specific dangerous dog legislation in the UK
Authors: Oxley J. A.
Published: September 2012

The aim of this study was to identify both the level and source of knowledge that dog owners in the UK have of the Dangerous Dogs Act 1991. In order to acquire such information a questionnaire was designed and distributed using two main methods over a period of five months. Questionnaires were distributed via three pet‐related online forums and by hand at two locations within five predefined areas in England. In total, 459 responses were received. Of these, 21.4 per cent were unable to name a single type of banned dog and 81.9 per cent of respondents agreed that information on dog legislation was not publicised enough. The knowledge of banned breeds among the dog owners surveyed was low and respondents expressed a desire to see the law relating to dangerous dogs in the UK either changed or improved.
A novel gold nanoparticles‐based assay for rapid detection of Melissococcus plutonius, the causative agent of European foulbrood
Authors: Saleh M. , Soliman H. , Sørum H. , Fauske A. K. , El‐Matbouli M.
Published: September 2012

European foulbrood (EFB) is a severe bacterial brood disease of honey bees (Apis mellifera) caused by Melissococcus plutonius. Diagnosis of EFB in the field is based on visual inspection of brood‐combs and detection of diseased larvae. However, symptoms of EFB may be easily obscured by other diseases or abnormalities in the brood, making definitive diagnosis difficult. Hence, confirmatory laboratory assays, such as PCR and real‐time PCR, are used to verify the presence of M plutonius in suspected colonies. While these methods are accurate and specific, they are time consuming and labour intensive. Herein, we report development of a label‐free colorimetric nanodiagnostic method for direct detection of unamplified M plutonius DNA using unmodified gold nanoparticles. Under appropriate conditions, the DNA probes hybridised with their complementary target sequences in the sample DNA, which resulted in aggregation of the gold nanoparticles and a concomitant red to blue colour change, which was observed visually. The assay could detect as few as 25 copies of the M plutonius cell wall‐associated protease gene within 20 minutes. The assay results were in 100 per cent concordance with real‐time PCR‐positive and PCR‐negative samples. Our study demonstrated that the gold nanoparticles‐based assay is a specific and sensitive tool for rapid detection of M plutonius.
THE LOG CANONICAL THRESHOLD OF HOLOMORPHIC FUNCTIONS
Authors: HAI LE MAU , HIEP PHAM HOANG , HUNG VU VIET
Published: September 2012

In this paper we give the relation between the log canonical threshold c0(f) and the geometry of the zero set {f = 0} of a holomorphic function f. Applying the above relation we give a simple proof for the ascending chain condition in dimension two.
CATEGORIFICATION OF QUANTUM GENERALIZED KAC–MOODY ALGEBRAS AND CRYSTAL BASES
Authors: KANG SEOK-JIN , OH SE-JIN , PARK EUIYONG
Published: September 2012

We construct and investigate the structure of the Khovanov-Lauda–Rouquier algebras R and their cyclotomic quotients Rλ which give a categorification of quantum generalized Kac–Moody algebras. Let U𝔸(𝔤) be the integral form of the quantum generalized Kac–Moody algebra associated with a Borcherds–Cartan matrix A = (aij)i, j ∈ I and let K0(R) be the Grothendieck group of finitely generated projective graded R-modules. We prove that there exists an injective algebra homomorphism [Formula: see text] and that Φ is an isomorphism if aii ≠ 0 for all i ∈ I. Let B(∞) and B(λ) be the crystals of [Formula: see text] and V(λ), respectively, where V(λ) is the irreducible highest weight Uq(𝔤)-module. We denote by 𝔅(∞) and 𝔅(λ) the isomorphism classes of irreducible graded modules over R and Rλ, respectively. If aii ≠ 0 for all i ∈ I, we define the Uq(𝔤)-crystal structures on 𝔅(∞) and 𝔅(λ), and show that there exist crystal isomorphisms 𝔅(∞) ≃ B(∞) and 𝔅(λ) ≃ B(λ). One of the key ingredients of our approach is the perfect basis theory for generalized Kac–Moody algebras.
THE EFFECTS OF THE BEYOND MEAN FIELD CORRECTIONS OF FERMI SUPERFLUID GAS IN A DOUBLE-WELL POTENTIAL
Authors: WANG WEN-YUAN , DUAN WEN-SHAN , LIU JIE
Published: September 2012

By considering the contribution of the higher-order term representing the lowest approximation of beyond mean field corrections, we investigate a superfluid Fermi gas confined in a double-well potential in Bose–Einstein Condensation (BEC) side of the Bardeen–Cooper–Schrieffer (BCS) to BEC crossover. Two limited cases of deep BEC regime and BEC regime of BCS–BEC crossover, corresponding to the two-body scattering length a sc is small enough and large enough, respectively. We derive a simple two-mode model that could depict the dynamics effectively. With making thorough analysis on the two-mode model and its corresponding classical Hamiltonian, we find that the Josephson oscillation or self-trapping phenomenon could emerge at certain parameters. We find three kinds of the phase states: Josephson oscillation (JO), oscillating-phase-type self-trapping (OPTST) and running-phase-type self-trapping (RPTST). The dependence of these three phase states on the dimensionless interaction parameter y = 1/(kFa sc ) and the initial system energy are given in this paper.