bluuebunny/crossref_metadata_2025 huggingface dataset:
Effects of hydrological regulation and anthropogenic pollutants on Dongting Lake in the Yangtze floodplain
Authors: Chen Xu , McGowan Suzanne , Xu Lei , Zeng Linghan , Yang Xiangdong
Published: April 2015

Dongting Lake, a wetland of international importance under the Ramsar Convention, is the hydrological lynchpin of the Yangtze floodplain. It is subjected to eutrophication and heavy metal pollution, but little is known of recent rapid degradation of its aquatic environment and potential causes. Here, we use sedimentary records of particle size, elements and pigments, combined with historical hydrological and limnological data, to assess aquatic environmental changes since ca 1960. Coarse particles in the sediments increased after 2003, while concentrations of K, Li, Al and Mg declined. These changes are probably linked to strong erosion of the downstream riverbed and declining supply of ion‐rich material from the upper Yangtze reaches after the Three Gorges Dam (TGD) began to operate. Furthermore, enrichment of sedimentary heavy metals and total phosphorus since the 1990s can be attributed to the influx of anthropogenic pollutants. Biotic responses are manifested in higher concentrations of fossil algal pigments, especially those from chlorophytes and siliceous algae after the TGD impoundment. Multivariate analysis revealed that changes in fossil pigments were significantly correlated with total phosphorus and Pb and three indicators for hydrological conditions (i.e. coarse particles, water exchange ratio and sediment discharge), indicating that influx of anthropogenic pollutants and hydrological regulation by the TGD are main drivers of algal community change. Our results provide reference conditions for restoration of Dongting Lake and highlight the importance of hydrological connection with the mainstream and pollution control for continuing efforts to restore Dongting Lake, as well as other similar floodplain lakes worldwide. Copyright © 2015 John Wiley & Sons, Ltd.
Burn severity alters peatland moss water availability: implications for post‐fire recovery
Authors: Lukenbach M. C. , Devito K. J. , Kettridge N. , Petrone R. M. , Waddington J. M.
Published: April 2015

Wildfire is the largest disturbance affecting northern peatlands; however, little is known about how burn severity (organic soil depth of burn) alters post‐fire hydrological conditions that control the recovery of keystone peatland mosses (i.e. Sphagnum). For this reason, we assessed the impact of burn severity on moss water availability by measuring soil tension (Ψ) and surface volumetric moisture content (θ) in burned and unburned portions of a peatland complex 2 years after fire. We found that both high and low burn severity decreased post‐fire water availability by altering peat hydrophysical properties (moisture retention and water repellency). Locations covered by Sphagnum fuscum prior to fire exhibited a decreasing post‐fire water availability with an increasing burn severity. In contrast, the lowest water availability (Ψ > 400 cm, θ < 0·02) was observed in feather mosses that underwent low burn severity (residual branches identifiable). Deep burning (>0·20 m) in peatland margins and burn depths >0·05 m in the middle of the peatland exhibited the highest water availability (Ψ < 60 cm). Locations with low surface θ and high Ψ, notably feather mosses undergoing low burn severity, exhibited minimal moss recolonization. Such areas dominate post‐fire surface cover (~40%) within late successional (mature) peatlands or peatlands located in dry hydrological settings. We argue that such environments are under‐represented in conceptual models of post‐fire recovery. A new conceptual model is proposed in which (1) deep burning is counterbalanced by rapid recolonization and (2) pre‐fire species interact with burn severity to produce substantial lags in post‐fire moss recovery. Copyright © 2015 John Wiley & Sons, Ltd.
Heterodimer‐specific TLR2 stimulation results in divergent functional outcomes in B‐cell precursor acute lymphoblastic leukemia
Authors: Rolf Nina , Kariminia Amina , Ivison Sabine , Reid Gregor S. , Schultz Kirk R.
Published: April 2015

Reports of spontaneous acute lymphoblastic leukemia (ALL) remissions following severe bacterial infections suggest that bacterial components may trigger elimination of ALL. To date, TLR2, which recognizes a broad range of bacterial pathogens through TLR1 or TLR6 heterodimerization, has not been fully evaluated for direct effects on ALL. Studies investigating TLR2 signaling in other tumor cell types utilizing single ligands have yielded contradictory results, and comparative, heterodimer‐specific analyses of TLR2 stimulation are lacking. In this study, we report that two well‐characterized heterodimer‐specific TLR2 ligands, Pam3CSK4 (TLR2/1), and Pam2CSK4 (TLR2/6), induce ALL cell lines and primary ALL samples to upregulate CD40 expression. However, only Pam3CSK4 triggers Caspase‐8‐mediated apoptosis and sensitizes cells to vincristine‐mediated cytotoxicity. Consistent with this result, stimulation of ALL cells through TLR2/1 or TLR2/6 activates Mal, p38 and the NF‐κB and PI3K signaling pathways with divergent kinetics that may underlie their distinct downstream effects. Our results reveal a novel branching in downstream responses to heterodimer‐specific TLR2 stimulation in ALL cells and emphasize the need for comparative studies to determine differential biological effects observed in specific tumor cells. Based on our results, TLR2/1 ligand Pam3CSK4 possesses potential for generating anti‐ALL activity through its direct effects on leukemic blasts.
Pemphigus is associated with KIR3DL2 expression levels and provides evidence that KIR3DL2 may bind HLA‐A3 and A11 in vivo
Authors: Augusto Danillo G. , O'Connor Geraldine M. , Lobo‐Alves Sara C. , Bass Sara , Martin Maureen P. , Carrington Mary , McVicar Daniel W. , Petzl‐Erler Maria Luiza
Published: April 2015

Although HLA‐A3 and A11 have been reported to be ligands for KIR3DL2, evidence for any in vivo relevance of this interaction is still missing. To explore the functional importance of KIR3DL2 allelic variation, we analyzed the autoimmune disease pemphigus foliaceus, previously associated (lower risk) with activating KIR genes. KIR3DL2*001 was increased in patients (odds ratio (OR) = 2.04; p = 0.007). The risk was higher for the presence of both KIR3DL2*001 and HLA‐A3 or A11 (OR = 3.76, p = 0.013), providing the first evidence that HLA‐A3 and A11 may interact with KIR3DL2 in vivo. The nonsynonymous single nucleotide polymorphism 1190T (rs3745902) was associated with protection (OR = 0.52, p = 0.018). This SNP results in a threonine‐to‐methionine substitution. Individuals who have methionine in this position exhibit a lower percentage of KIR3DL2‐positive natural killer (NK) cells and also lower intensity of KIR3DL2 on expressing natural killer cells; additionally, we show that the expression of KIR3DL2 is independent of other killer cell immunoglobulin‐like receptors. Pemphigus foliaceus is a very unique complex disease strongly associated with immune‐related genes. It is the only autoimmune disease known to be endemic, showing a strong correlation with environmental factors. Our data demonstrate that this relatively unknown autoimmune disease may facilitate understanding of the molecular mechanisms of KIR3DL2 ligand recognition.
Rehydrogenation of Aminoboranes to Amine–Boranes Using H2O: Reaction Scope and Mechanism
Authors: Leitao Erin M. , Manners Ian
Published: April 2015

Water has been successfully employed as a reagent with which to rehydrogenate aminoboranes (e.g., iPr2N=BH2, 2,2,6,6‐Me4C5H6N=BH2, and also transient Me2N=BH2 derived from 1/2[Me2N‐BH2]2) to amine–boranes (e.g., iPr2NH·BH3, 2,2,6,6‐Me4C5H6NH·BH3, Me2NH·BH3) in approximately 30 % yield. The conversion to amine–boranes from the corresponding aminoboranes using this method represents an example of a metal‐free, single‐step route for the hydrogenation of the B=N bond. Deuterium labeling studies indicated that the protic hydrogen (N–H) on the rehydrogenated amine–borane was derived from H2O, whereas the third hydridic hydrogen (B–H) on the amine–borane was generated from the formation of a postulated hydride‐bridged intermediate H2B(μ‐H)(μ‐NR2)B(OH)H (R2 = Me2, iPr2, 2,2,6,6‐Me4C5H6), which requires a second equivalent of the starting aminoborane, thus explaining the low yield. Formation of insoluble borates (BxOyHz) provides a driving force for the reaction. Significantly, the yield can be increased by adding a sacrificial source of BH3 (e.g., to ca. 53 % for BH3·THF) or by adding a separate source of H– (e.g., to ca. 95 % for LiBH4) to complement the H+ (from H2O) in a more atom‐efficient reaction.
Sub‐ppt Level Detection of Mercury(II) Based on Anodic Stripping Voltammetry with Prestripping Step at an In Situ Formed Bismuth Film Modified Glassy Carbon Electrode
Authors: Wu Shao‐Hua , Zheng Zhao‐Yan , Zhang Ji‐Fang , Song Zi‐Wang , Fang Lei , Sun Jian‐Jun
Published: April 2015

Sensitive and selective detection of Hg2+ in solution is a challenging work. An anodic stripping voltammetry with prestripping step at an in situ formed bismuth film modified glassy carbon electrode was proposed for detection of mercury(II) in solution. This prestripping step was able to decrease the background and improve the signal‐to‐noise ratio and thus enhance the sensitivity. With this method, highly sensitive and selective detection of Hg2+ with a ppt‐level detection limit of 0.5 ng L−1 could be achieved. Moreover, this method provides low interference, rapid and extreme simple and convenience, and hold great promise for in situ Hg2+ determination.
Electrochemical Sensor for the Quantification of Dopamine Using Glassy Carbon Electrodes Modified with Single‐Wall Carbon Nanotubes Covalently Functionalized with Polylysine
Authors: Gutiérrez Alejandro , Gasnier Aurélien , Pedano María L. , Gonzalez‐Dominguez Jose Miguel , Ansón‐Casaos Alejandro , Hernández‐Ferrer Javier , Galicia Laura , Rubianes María D. , Martínez María T. , Rivas Gustavo A.
Published: April 2015

We report a dopamine electrochemical sensor based on the modification of glassy carbon electrodes (GCE) with polylysine‐functionalized single‐wall carbon nanotubes (SWCNT‐PLys). The resulting electrodes (GCE/SWCNT‐PLys) showed a significant improvement in the electrooxidation of dopamine with drastic decrease in the peak potentials separation and important enhancement in the associated currents. Dopamine was detected by differential pulse voltammetry‐adsorptive stripping with medium exchange at nanomolar levels even in the presence of high excess of ascorbic and uric acids. The sensor was successfully used for the quantification of dopamine in urine samples enriched with the neurotransmitter.
Determination of Carbendazim by Adsorptive Stripping Differential Pulse Voltammetry Employing Glassy Carbon Paste Electrode Modified with Graphene and Amberlite XAD 2 Resin
Authors: Khare Ninad G. , Dar Riyaz A. , Srivastava Ashwini K.
Published: April 2015

Graphene nanosheets (GNS) and amberlite XAD‐2 (XAD2) modified glassy carbon paste electrode (GNS‐XAD2‐GCPE) were fabricated for voltammetric determination of Carbendazim (MBC). GNS was synthesized by Hummer’s method and characterized by SEM, EDAX, and XRD techniques. After optimizing the analytical conditions in 0.4 M citrate buffer (pH 4.0), the peak current was found to be linear in the range of 8.36×10−9 to 4.13×10−6 M (r=0.9986) with detection limit of 3.14×10−9 M (S/N=3) by AdSDPV. The method was validated for the determination of MBC in soil, fruit, blood serum, urine, waste and ground water samples with satisfactory recoveries.
Analysis of small interfering RNA by capillary electrophoresis in hydroxyethylcellulose solutions
Authors: Liu Chenchen , Yamaguchi Yoshinori , Zhu Xifang , Li Zhenqing , Ni Yi , Dou Xiaoming
Published: April 2015

The analysis of small interfering RNA (siRNA) is important for gene function studies and drug developments. We employed CE to study the separation of siRNA ladder marker, which were ten double‐stranded RNA (dsRNA) fragments ranged from 20 to 1000 bp, in solutions of hydroxyethylcellulose (HEC) polymer with different concentrations and molecular weights (Mws). Migration mechanism of dsRNA during CE was studied by the mobility and resolution length (RL) plots. We found that the RL depended on not only the concentration of HEC, but also the Mw of HEC. For instance, RL of small dsRNA fragment was more influenced by concentration of high Mw HEC than large dsRNA fragment and RL of large dsRNA fragment was more influenced by concentration of low Mw HEC than small dsRNA fragment. In addition, we found electrophoretic evidence that the structure of dsRNA was more compact than dsDNA with the same length. In practice, we succeeded to separate the glyceraldehyde 3‐phosphate dehydrogenase siRNA in the mixture of the siRNA ladder marker within 4 min.
Detection of polycyclic aromatic hydrocarbons (PAHs) in raw menhaden fish oil using fluorescence spectroscopy: Method development
Authors: Pena Edwin A. , Ridley Lauren M. , Murphy Wyatt R. , Sowa John R. , Bentivegna Carolyn S.
Published: April 2015

Raw menhaden fish oil was developed for biomonitoring polycyclic aromatic hydrocarbons (PAHs) using fluorescence spectroscopy. Menhaden (Genus Brevoortia) were collected in 2010 and/or 2011 from Delaware Bay, New Jersey, USA; James River, Virginia, USA; Vermillion Bay, Louisiana, USA (VBLA); and Barataria Bay, Louisiana, USA (BBLA). Barataria Bay, Louisiana received heavy oiling from the Deepwater Horizon oil spill. Method development included determining optimal wavelengths for PAH detection, fish oil matrix interferences, and influence of solvent concentration on extraction. Results showed that some fish oils contained high molecular weight PAH-like compounds in addition to other fluorescent compounds such as albumin and vitamin A and vitamin E. None of these naturally occurring compounds interfered with detection of high molecular weight PAHs. However, data suggested that the lipid component of fish oil was altering fluorescence spectra by supporting the formation of PAH excimers. For example, the most intense excitation wavelength for hydroxypyrene shifted from Ex285/Em430 to Ex340/Em430. Comparison of Deepwater Horizon crude oil and fish oil spectra indicated that some fish oils contained crude oil–like PAHs. Using wavelengths of Ex360/Em430, fish oil concentrations were calculated as 3.92 μg/g, 0.61 μg/g, and 0.14 μg/g for a Delaware Bay sample, BBLA 2011, and VBLA 2011, respectively. Overall, these results supported using menhaden fish oil to track PAH exposures spatially and temporally. Environ Toxicol Chem 2015;34:1946–1958. © 2015 SETAC
A morphometric and taxonomic study of Anthurium augustinum complex (Araceae), endemic to the Brazilian Atlantic Forest
Authors: Cardozo Ana Paula , Godinho Temponi Lívia , Moreira de Andrade Ivanilza , Mayo Simon Joseph , de Camargo Smidt Eric
Published: April 2015

The Anthurium augustinum (Araceae) complex (including A. augustinum K. Koch & Lauche, A. hatschbachii E. G. Gonç., A. jureianum Cath. & Olaio, A. laucheanum K. Koch, A. lhotzkyanum Schott, A. lucidum Kunth, A. maximiliani Schott and A. parvum N.E.Br.) is endemic to the Brazilian Atlantic Forest. Some of these taxa are strictly endemic, with only the type population known, and may occur in sympatry. These species share a leaf morphology in which the blade is deflexed at the petiole insertion and is usually cordate, or rarely rounded at the base due to congenital fusion of the basal lobes. Taxonomic delimitation of the species in this group is difficult because of overlap in diagnostic characters such as deflexed leaf blade, cordate, rounded or semi‐oval leaf base and camptodromous venation. The objective of the study was to test whether these taxa could be recognized using leaf morphometrics. Elliptic Fourier analysis was carried out on a sample of 257 individuals in 12 natural populations. The results of multivariate analyses indicated that in various comparisons, leaf shape was not diagnostic due overlap of variation within and between populations of different species. Consequently, we propose that A. laucheanum, A. lhotzkyanum and A. maximiliani should be regarded as synonyms of A. augustinum, and that the following five species be recognized in this complex: A. augustinum, A. hatschbachii, A. jureianum, A. lucidum and A. parvum. We also formally designate two neotypes (A. laucheanum, A. maximiliani), one lectotype (A. augustinum) and one epitype (A. augustinum). (© 2014 WILEY‐VCH Verlag GmbH & Co. KGaA, Weinheim)
Information Flow, Trading Activity and Commodity Futures Volatility
Authors: Clements Adam E. , Todorova Neda
Published: April 2015

Based on unique news data relating to gold and crude oil, we investigate how news volume and sentiment, shocks in trading activity, market depth and trader positions unrelated to information flow covary with realized volatility. Positive shocks to the rate of news arrival, and negative shocks to news sentiment exhibit the largest effects. After controlling for the level of news flow and cross‐correlations, net trader positions play only a minor role. These findings are at odds with those of [Wang (2002a). The Journal of Futures Markets, 22, 427–450; Wang (2002b). The Financial Review, 37, 295–316], but are consistent with the previous literature which doesn't find a strong link between volatility and trader positions. © 2015 Wiley Periodicals, Inc. Jrl Fut Mark 36:88–104, 2016
Securing the future
Authors: Cozier Muriel
Published: April 2015

The UK could be on the brink of becoming the first country in the world to start work on a carbon capture and storage (CCS) equipped industrial cluster. Located in the north east of England in a region known as Teesside, this industrial hub is home to some of the UK's largest emitters of CO2. At the same time the region provides jobs and training and produces raw material that puts the UK on the world stage for innovation and development. Here Sarah Tennison, Low Carbon Economy Manager at Tees Valley Unlimited, talks to GHGS&T about the Teesside Collective project and explains that this is not just an option, it is a must.
Uncovering phase‐coupled oscillatory networks in electrophysiological data
Authors: van der Meij Roemer , Jacobs Joshua , Maris Eric
Published: April 2015

Phase consistent neuronal oscillations are ubiquitous in electrophysiological recordings, and they may reflect networks of phase‐coupled neuronal populations oscillating at different frequencies. Because neuronal oscillations may reflect rhythmic modulations of neuronal excitability, phase‐coupled oscillatory networks could be the functional building block for routing information through the brain. Current techniques are not suited for directly characterizing such networks. To be able to extract phase‐coupled oscillatory networks we developed a new method, which characterizes networks by phase coupling between sites. Importantly, this method respects the fact that neuronal oscillations have energy in a range of frequencies. As a consequence, we characterize these networks by between‐site phase relations that vary as a function of frequency, such as those that result from between‐site temporal delays. Using human electrocorticographic recordings we show that our method can uncover phase‐coupled oscillatory networks that show interesting patterns in their between‐site phase relations, such as travelling waves. We validate our method by demonstrating it can accurately recover simulated networks from a realistic noisy environment. By extracting phase‐coupled oscillatory networks and investigating patterns in their between‐site phase relations we can further elucidate the role of oscillations in neuronal communication. Hum Brain Mapp 36:2655–2680, 2015. © 2015 Wiley Periodicals, Inc.
Characterization of endolymphatic sac tumors and von Hippel–Lindau disease in the International Endolymphatic Sac Tumor Registry
Authors: Bausch Birke , Wellner Ulrich , Peyre Mathieu , Boedeker Carsten C. , Hes Frederik J. , Anglani Mariagiulia , de Campos Jose M. , Kanno Hiroshi , Maher Eamonn R. , Krauss Tobias , Sansó Gabriela , Barontini Marta , Letizia Claudio , Hader Claudia , Schiavi Francesca , Zanoletti Elisabetta , Suárez Carlos , Offergeld Christian , Malinoc Angelica , Zschiedrich Stefan , Glasker Sven , Bobin Serge , Sterkers Olivier , Ba Huy Patrice Tran , Giraud Sophie , Links Thera , Eng Charis , Opocher Giuseppe , Richard Stephane , Neumann Hartmut P. H. ,   for the International Endolymphatic Sac Tumor (ELST) Consortium
Published: April 2015

Background

Endolymphatic sac tumors (ELSTs) are, with a prevalence of up to 16%, a component of von Hippel–Lindau (VHL) disease. Data from international registries regarding heritable fraction and characteristics, germline VHL mutation frequency, and prevalence are lacking.

Methods

Systematic registration of ELSTs from international centers of otorhinolaryngology and from multidisciplinary VHL centers’ registries was performed. Molecular genetic analyses of the VHL gene were offered to all patients.

Results

Our population‐based registry comprised 93 patients with ELST and 1789 patients with VHL. The prevalence of VHL germline mutations in apparently sporadic ELSTs was 39%. The prevalence of ELSTs in patients with VHL was 3.6%. ELST was the initial manifestation in 32% of patients with VHL‐ELST.

Conclusion

Prevalence of ELST in VHL disease is much lower compared to the literature. VHL‐associated ELSTs can be the first presentation of the syndrome and mimic sporadic tumors, thus emphasizing the need of molecular testing in all presentations of ELST. © 2015 Wiley Periodicals, Inc. Head Neck 38: 673–679, 2016
A primer for hydrology: the beguiling simplicity of Water's journey from rain to stream at 30
Authors: Bishop Kevin , Seibert Jan
Published: April 2015

Water's journey from rain to stream by Harald Grip and Allan Rodhe (1985, in Swedish: Vattnets väg från regn till bäck) was one of the first textbooks to present groundwater contributions as a major feature of runoff generation, with implications for water quality and management. Three decades later, we have the privilege of presenting a special issue of Hydrological Processes, ‘Runoff Generation in a Nordic Light: 30 Years with Water's Journey from Rain to Stream’ that seeks to introduce the book to a larger audience and continue the journey of ideas that the authors set in motion with their book. Copyright © 2015 John Wiley & Sons, Ltd.
ABCB1 and ABCG2 restrict the brain penetration of a panel of novel EZH2‐Inhibitors
Authors: Zhang Ping , de Gooijer Mark C. , Buil Levi C.M. , Beijnen Jos H. , Li Gang , van Tellingen Olaf
Published: April 2015

Enhancer of Zeste Homolog 2 (EZH2) has emerged as a promising therapeutic target for treatment of a broad spectrum of tumors including gliomas. We explored the interactions of five novel, structurally similar EZH2 inhibitors (EPZ005687, EPZ‐6438, UNC1999, GSK343 and GSK126) with P‐glycoprotein (P‐gp/ABCB1) and breast cancer resistance protein (BCRP/ABCG2). The compounds were screened by in vitro transwell assays and EPZ005687, EPZ‐6438 and GSK126 were further tested in vivo using wild‐type (WT), Abcb1 and/or Abcg2 knockout mice. All EZH2 inhibitors are transported by P‐gp and BCRP, although in vitro the transporter affinity of GSK126 was obscured by very low membrane permeability. Both P‐gp and Bcrp1 restrict the brain penetration of EPZ005687 and GSK126, whereas the brain accumulation of EPZ‐6438 is limited by P‐gp only and efflux of EPZ‐6438 was completely abrogated by elacridar. Intriguingly, an unknown factor present in all knockout mouse strains causes EPZ005687 and EPZ‐6438 retention in plasma relative to WT mice, a phenomenon not seen with GSK126. In WT mice, the GSK126 tissue‐to‐plasma ratio for all tissues is lower than for EPZ005687 or EPZ‐6438. Moreover, the oral bioavailability of GSK126 is only 0.2% in WT mice, which increases to 14.4% in Abcb1;Abcg2 knockout mice. These results are likely due to poor membrane permeability and question the clinical usefulness of GSK126. Although all tested EZH2 inhibitors are substrates of P‐gp and BCRP, restricting the brain penetration and potential utility for treatment of glioma, EPZ‐6438 would be the most suitable candidate of this series.
Access to High‐Cost Drugs: Decision Makers' Perspectives
Authors: Gallego Gisselle , Melocco Terry , Taylor Susan J , Brien Jo‐anne E
Published: April 2015

Aim

To explore the attitudes, perceptions and concerns among decision makers about equity of access to high‐cost drugs in public hospitals.

Method

25 in‐depth, semi‐structured interviews were conducted with senior hospital administrators, directors of pharmacy and senior medical doctors. Topics included the decision‐making process and associated problems, and solutions to issues of access to high‐cost drugs. Interviews were audiotaped, transcribed verbatim and thematically analysed.

Results

Healthcare funding models were perceived as obstacles to equity of access to high‐cost drugs. Participants were concerned that there were inequities in decisions for individual patients according to public or private sector status. Tertiary public hospitals were seen to be at the ‘cutting edge’ and therefore were required to fund new and expensive drugs. This meant prioritising between patient groups and individuals. Participants had difficulty in identifying solutions. They suggested that ethical principles should be considered in addition to safety, efficacy and cost. Most wanted a transparent, accountable, evidence‐based decision‐making process.

Conclusion

Decision makers were concerned about equity of access to high‐cost drugs in public hospitals. They were also concerned about processes for decision making and the outcomes of these decisions.
Does Antibiotic Choice Affect Length of Stay for Community‐Acquired Pneumonia?
Authors: McKellar Alice C
Published: April 2015

Background

Antibiotic choice for community‐acquired pneumonia (CAP) should reflect disease severity, likely pathogens and its effect on antimicrobial resistance. Consensus guidelines do not recommend third‐generation cephalosporins for routine therapy in CAP.

Aim

To determine whether the choice of antibiotics may have an impact on how long patients with CAP remain hospitalised.

Method

A retrospective review of patients with pneumonia admitted to a hospital was conducted for a 10‐month period. Adult patients with pneumonic consolidation on chest X‐ray were included. Pneumonia Severity Index (PSI) was used to stratify severity and antibiotic therapy was assessed for concordance with the Therapeutic Guidelines: Antibiotic, version 11.

Results

99 patients were included. The average length of stay across all risk classes was 8.5 days (range: 1–43). For patients receiving antibiotics concordant with the Therapeutic Guidelines: Antibiotic, there was a trend towards decreased length of stay in all classes, except for the most severe category (class V). Length of stay was significantly less for patients with the least severe disease (class I). The main reason for non‐concordance was the use of ceftriaxone in patients without contraindications to a combination of benzylpenicillin, gentamicin and a macrolide.

Conclusion

Concordant use of antibiotics in patients with CAP could be associated with a decreased length of stay for inpatients with a PSI class of I to IV.
Contrast Media—Implications for Pharmacists
Authors: To The‐Phung , Boon Ou Daniel Kwong , Schelleman Anthony
Published: April 2015

Although contrast media are commonly used in hospital practice, there is limited attention to their use by pharmacists. Contrast media have the potential to cause a range of adverse reactions, including contrast‐induced nephropathy. Some reactions are unpredictable and cannot be prevented; however, other reactions may be abated with careful consideration of the patient's clinical status and risk factors, as well as various prophylactic measures. An understanding of contrast media properties can help pharmacists to enhance drug safety when reviewing or dispensing drug orders or counselling patients around the time of contrast‐enhanced diagnostic procedures.
Complementary and Alternative Medicine Use in the Elderly
Authors: Moses Geraldine
Published: April 2015

Recent surveys suggest that the elderly are more frequent users of complementary and alternative medicines (CAMs) than the general population—up to 80% have reported using at least one CAM on a regular basis in the past year. Although many reasons are cited for their interest in CAMs, the elderly commonly state that CAMs are not used as ‘alternatives’, but rather as ‘supplements’ to compensate for aspects perceived to be lacking in conventional care. Although high‐level evidence supports the use of some CAMs in specific conditions, their use in the elderly presents significant challenges as this population is burdened by polypharmacy, decreased functional reserve and chronic disease. Preventing adverse reactions and drug interactions associated with CAM use is complicated by the fact that fewer than 50% of older patients disclose CAM use to their doctor or pharmacist. This article is a guide for health professionals who wish to advise the elderly consumer on the rational use of CAMs.
Consumer use of Consumer Medicine Information
Authors: Koo Michelle MM , Krass Ines , Aslani Parisa
Published: April 2015

Aim

To examine the use of Consumer Medicine Information (CMI) by Australian consumers.

Method

A structured questionnaire was administered to eligible consenting consumers from randomly selected community pharmacies in metropolitan Sydney in 2001. All data were coded and frequency distributions were examined for responses to all questions. The construct validity and reliability of the ‘attitude to CMI’ statements were tested using exploratory factor analysis and Cronbach's alpha, respectively.

Results

A total of 226 useable questionnaires were collected from 17 community pharmacies. Consumers had a median age of 56.5 (range 18–92) years and 51% (n = 136) were female. Consumers had variable understanding of CMI and the majority reported receiving one on the day of interview or in the past—mainly as a package insert, and without the involvement of a health professional. Of those who received CMI in the past, two‐thirds reported reading it, resulting in positive as well as negative impacts. Analysis of the ‘attitude to CMI’ section yielded 4 factors explaining 52.8% of the total variance. These were interpreted as: perception of disease/condition (α = 0.86), role of carer (α = 0.85), health locus of control (α = 0.67), and readability and presentation (α = 0.59).

Conclusion

Many consumers read CMI, mainly in the form of package inserts. There are issues that need to be addressed to optimise the use of CMI by consumers. In order to achieve this, greater involvement from health professionals is necessary.
Initial Assessment of an Internet‐Based Medication Record
Authors: Calabretto Jean‐Pierre , Warren Jim
Published: April 2015

Aim

To assess the usability of an Internet‐based medication record designed to enhance communication between patients and community pharmacists following discharge from hospital.

Method

A secure, Internet‐based ‘medicine cabinet’ to record consumers' medicines and related issues was developed. It was shared by consumers and community pharmacists under the control of the consumer. Opinions were sought via questionnaire from participating consumers and pharmacists.

Results

A pilot ran from December 2001 to August 2003 and responses of 8 families and 6 pharmacists were evaluated. In general, consumers considered the virtual medicine cabinet to be of value and easy to use although it was not often used. Half the group indicated that they would continue to use the system. Pharmacists similarly thought the concept useful, although usage was low. Technology issues, particularly with smartcards, caused problems for both groups.

Conclusion

Many participants found the virtual medicine cabinet useful, and most thought that the concept had worth. This pilot did not identify any stimulation of consumer‐pharmacist communication.
Extemporaneous Isoniazid Mixture: Stability Implications
Authors: Haywood Alison , Mangan Martina , Grant Gary , Glass Beverley
Published: April 2015

Background

Isoniazid mixtures are compounded in Australia using commercially available isoniazid tablets.

Aim

To determine the stability of isoniazid 10 mg/mL mixture compounded from commercially available isoniazid tablets.

Method

The stability of the compounded isoniazid mixture stored at a range of temperatures (4–60 °C) was assessed with high performance liquid chromatography. Differential scanning calorimetry was used to investigate the compatibility of isoniazid with the excipient, lactose.

Results

The compounded isoniazid mixture exhibited significant degradation (≥ 10% after 3 days at 4 and 25 °C), whereas the control (using isoniazid powder) retained desired stability (> 90% at 30 days) under identical conditions. A replicate control formulation, spiked with lactose, produced statistically similar degradation profiles to that of the compounded isoniazid mixture (p > 0.05), indicating lactose to be responsible for the degradation of isoniazid. The thermoanalytical studies demonstrated an incompatibility between isoniazid and lactose (broadening and shifting of melting endotherm of isoniazid at 171.46 °C).

Conclusion

The British Pharmaceutical Codex specifies the use of isoniazid powder for compounding isoniazid mixture. This study highlights the importance for stability evaluations on all modified extemporaneous preparations in order to ensure that quality pharmaceuticals are delivered to patients.
Paediatric Severe Community‐Acquired Pneumonia in India
Authors: Angalakuditi Mallik V , Sunderland V Bruce
Published: April 2015

Aim

To evaluate the prescribing patterns of antibiotics and antipyretics and their dosage for severe community‐acquired pneumonia (SCAP) in a paediatric population before and after an educational intervention in a rural Indian hospital.

Method

Physician prescribing patterns for SCAP were collected prospectively in a cohort of paediatric patients (pre‐intervention group). An educational intervention strategy was developed and implemented using data from baseline prescribing patterns and the Therapeutic Guidelines: Antibiotic recommendations for treatment of SCAP. An analysis to evaluate the impact of drug selection and dosing following the intervention was conducted in a second patient cohort (post‐intervention group).

Results

There were 146 patients in the pre‐intervention group and 155 in the post‐intervention group. Antibiotic choices were within the guidelines in both groups. All of the patients in the pre‐intervention group received dexamethasone with every dose of antibiotic. Post‐intervention, the use of dexamethasone was eliminated. For the pre‐intervention group, 97% of the antibiotic doses and 55% of the antipyretic doses were classified as inappropriate. Inappropriate prescribing of antibiotic and antipyretic doses was significantly reduced to 89% (p = 0.002) and 10% (p < 0.001) respectively, following the intervention.

Conclusion

There was some improvement in prescribing appropriate doses of antibiotics and antipyretics for SCAP following the educational intervention.
Emergence of Adverse Reactions to Tramadol in Children and Adolescents at a Paediatric Hospital
Authors: Juliana Gisela Santa , Titchen Thirza , Cranswick Noel
Published: April 2015

Background

The use of tramadol at The Royal Children's Hospital, Melbourne has dramatically increased. This has coincided with the emergence of adverse drug reactions (ADRs).

Aim

To investigate potential adverse reactions to tramadol in children and adolescents as compared with adults.

Method

The ADR program at the hospital detects both spontaneously reported ADRs and those identified by medical records coding reports. For this study, reported reactions to tramadol were retrieved from the hospital's ADR database. Comparison with reports from the Australian Adverse Drug Reaction Advisory Committee and the literature was made.

Results

8 ADR reports implicating tramadol in patients aged from 14 months to 22 years were identified.

Conclusion

Some insight was gained into the possible adverse effects of tramadol in children and adolescents, which are similar to the reported profile of adverse reactions in adults. Further pharmacovigilance studies are required to expand on these findings and provide direction to ensure the safe use of tramadol in this age group.
Identification of Medication Errors by Nurses During a Simulated Ward, Medication Safety Orientation Program
Authors: Coombes Ian D , Heel Alison CY , Stowasser Danielle A , Reid Carol M , Henderson Amanda , Mitchell Charles A
Published: April 2015

Aim

To assess the ability of nurses to identify medication errors and apply strategies to prevent adverse drug events.

Method

This was a prospective study of the incidence of error detection in simulated medication scenarios at a teaching hospital. All newly employed registered nurses (n = 591) were asked to administer medications in six scenarios containing errors with potential for patient harm. Feedback was provided to participants at the end of each scenario. The main outcome measures were: self‐reported incidence of detection of errors and modification of practice in accordance with knowledge, knowledge of concept but error not detected, or the error being a new concept.

Results

63 to 85% of nurses reported that they would have detected the error and taken appropriate action; 11 to 30% had some concept of the error but would not have detected it; and for 2 to 7% the error was a new concept. 32% could identify the errors in all six scenarios and initiate appropriate action.

Conclusion

In this study, nurses frequently failed to detect medication errors. Practical medication risk awareness training, improvements in the safety of medication systems and pharmacist review of medication are of paramount importance.
Experiencing Pharmacy Practice in Rural Tanzania
Authors: McLachlan Gina B
Published: April 2015

Mvumi Hospital is located in a rural area of central Tanzania. It is a general hospital that has to cope with the wide variety of medical and surgical presentations encountered in this area of East Africa. Health care delivery is limited by distance and the endemic poverty of the population. Common presentations include malaria, anaemia, meningitis, cholera, dysentery, tick‐borne relapsing fever, severe malnutrition in children, and complications of AIDS. Helping to provide the pharmacy service during a six‐month period of voluntary work was a rewarding experience that can be highly recommended for pharmacists wishing to broaden their global perspective.
Mandatory Electronic Sources of Approved Product Information—Are They Up‐To‐Date?
Authors: Baker Jaclyn L
Published: April 2015

Background

The Pharmacy Board of Victoria mandates that all pharmacies and pharmacy departments have access to an up‐to ‐date source of approved product information.

Aim

To compare the currency of product information profiles from electronic sources to those obtained from the manufacturer.

Method

Product information profiles for 48 commonly dispensed medicines were obtained from the manufacturers and approval/amendment dates compared to those in the two electronic sources. Profiles with discrepancies in dates were manually scanned to determine the extent of the differences.

Results

81 product information profiles were reviewed and 20 had discrepancies in dates between the profiles obtained from the manufacturers and that on the electronic sources. 18 profiles were found to be not current. 16% of the profiles examined contained discrepancies. The most common changes were in presentation and drug interactions.

Conclusion

This study showed that electronic sources have delays in capturing changes to product information.
Smoking Cessation: COPD Patients' Perspective
Authors: George Johnson , Kong David CM , Santamaria Nick M , Ioannides‐Demos Lisa L , Stewart Kay
Published: April 2015

Background

Smoking cessation is the most useful and cost effective way to reduce the risk of developing chronic obstructive pulmonary disease (COPD) and stop its progression. Long‐term success rates with smoking cessation programs are known to be poor.

Aim

To identify factors influencing the outcomes of smoking cessation programs in COPD patients from their perspective.

Method

In‐depth interviews were conducted with 27 patients with a history of smoking, chosen from a cohort of 173 patients with moderate to severe COPD participating in a community‐based randomised trial.

Results

The study sample consisted of 6 females and 21 males with a mean age of 69.6 years and a mean smoking history of 58.5 ± 34.1 pack years. 6 patients continued to smoke at the time of the interview. Patients had attempted both pharmacological and non‐pharmacological methods for quitting. Smoking cessation in COPD patients was influenced by various barriers and facilitators pertaining to patient, health, treatment and healthcare providers.

Conclusion

Health professionals may be able to improve the outcomes of smoking cessation programs in COPD patients by being more proactive in offering combination smoking cessation interventions with adequate follow‐up.
Pre‐emptive Discharge Prescription‐Processing System
Authors: Masood Noman , Garrett Timothy , Sumpter Margaret , Buchan Dona
Published: April 2015

Aim

To implement and evaluate a pre‐emptive discharge prescription‐processing system.

Method

Patients on two wards were reviewed in anticipation of their discharge. Medications were prepared in advance of the discharge prescription using a pharmacist‐generated order. Pharmacist‐generated discharge orders were compared and tested for concordance with the final prescription at the time of discharge.

Results

260 patients taking 2014 medications were reviewed of which 897 (45%) did not require dispensing (p < 0.05) based on information gathered during pharmacist review. The total estimated cost of items was $10 790.50 while cost for items dispensed was $5818.80—a 46% reduction was achieved (p < 0.05). 154 patients were given printed lists of their medications and 208 consumer medicine information leaflets were supplied. A significant level of concordance was found between pharmacist and doctor‐generated prescriptions.

Conclusion

A pre‐emptive discharge prescription‐processing system can potentially result in cost and time savings.
Improving Quality Improvement Models
Authors: Maxwell David J , Graudins Linda , Kaye Karen I
Published: April 2015

Background

The quality of health care can be improved through the monitoring, evaluation, reporting and feedback of current practice. Drug use evaluation methodology has been used for many years as a process for improving health care through the optimisation of prescribing practice. The Institute for Healthcare Improvement 'Breakthrough Series' has also been promoted widely as a useful tool for improving health care.

Aim

The aim of this paper is to familiarise readers with these methods, by analysing similarities and differences, and qualitatively evaluating their merits as quality improvement tools.

Discussion

Although both methods involve similar activities (identifying desired practice, measuring current practice, developing and implementing changes, feeding back into the process) there are differences in the application of each model in the healthcare setting that should be considered when planning quality improvement activities. We hypothesise that synergy may be achieved by combining elements of both approaches.

Conclusion

Further research is required to test if a combination of these methods results in effective and sustainable improvements in the quality of medicines use and measurable improvements in healthcare outcomes.
Telepharmacy—Enabling Technology to Provide Quality Pharmacy Services in Rural and Remote Communities
Authors: Kimber Michael B , Peterson Gregory M
Published: April 2015

The provision of quality pharmacy services to rural and remote communities is influenced by the National Strategy for the Quality Use of Medicines. The implementation of this strategy is challenged by the shortage of pharmacists in rural areas. Australia compares unfavourably with both the UK and US in this regard. The Fourth Community Pharmacy Agreement between the Commonwealth of Australia and the Pharmacy Guild commits the parties to 13 key objectives and makes provision for funding initiatives for professional pharmacy programs. Two of these programs are medication reviews and e‐health initiatives. Telepharmacy, as an enabling technology, represents a unique and innovative way to deliver quality pharmacy services to rural areas. Telepharmacy operations are in place in other countries. In the US, two principal models are in Washington State and North Dakota, although other states such as Texas, Nebraska and Alaska also have telepharmacy models in place. Studies in Australia have had mixed results and have not been as successful. However, there are some promising models that have been employed in telemedicine, including for the delivery of physiotherapy and other allied health services. It is of key importance to involve pharmacists in telepharmacy services and a key initiative to be studied soon in Far North Queensland will involve home medication reviews being conducted via telepharmacy.
Analgesic Selection in Patients on Abstinence Therapies
Authors: Valoppi Glenn , Taylor Simone E
Published: April 2015

Many Australians are prescribed drugs such as naltrexone, methadone and buprenorphine to assist with abstinence from illicit drug abuse and alcoholism. Abstinence therapies influence the efficacy of standard opioid analgesics. Non‐opioid alternatives can often provide effective analgesia. In some situations the use of opioids is unavoidable. The acute pain management of two patients using naltrexone is described, followed by a review of acute pain management options for patients receiving abstinence therapies.
Audit of Ticarcillan/Clavulanate Usage in a Large Teaching Hospital
Authors: Mackenzie Fraser D , Pillans Peter I , Reinhold Johannes , Looke David F , Sturtevant Joanna M
Published: April 2015

Aim

To assess compliance with ticarcillin/clavulanate prescribing guidelines, appropriateness of prescribing and to identify any patterns of inappropriate use that may aid in improving prescribing.

Method

Patients on ticarcillin/clavulanate were prospectively reviewed over an 8‐week period. Data collected included: demographics, diagnosis, hospital or community‐acquired infection, specific bacteriology, type of treatment, dose, dose quantity, appropriateness of treatment, and compliance with guidelines.

Results

100 patients on ticarcillin/clavulanate were reviewed and 65% were compliant with guidelines. Treatment was considered appropriate in 76% of patients. Non‐compliant/inappropriate usage was most commonly observed in community‐acquired pneumonia.

Conclusion

This audit indicated widespread use of ticarcillin/clavulanate outside hospital prescribing guidelines, although in some cases, use was considered appropriate.