bluuebunny/crossref_metadata_2025 huggingface dataset:
Design and Pilot of a Medication Review Clinic in a Dialysis Centre
Authors: Mirkov Sanja R , Ball Patrick A
Published: March 2016

Objectives: The aim of this pilot study was to establish a Medication Review Clinic and undertake a preliminary evaluation of the benefits of providing this service to dialysis patients.

Method: The Medication Review Clinic was piloted at the In‐Centre Dialysis Unit at Middlemore Hospital, Auckland, New Zealand, from April to October 2002. A clinical pharmacist conducted the medication reviews, identified drug‐related problems, provided medication education to the patients, updated medication profiles and liaised with primary care providers. A patient satisfaction survey was performed at the end of the study.

Results: Ninety‐one medication reviews were conducted for 51 patients. Drug‐related problems were identified in 83% of the reviews. One hundred and thirty‐one drug‐related problems were identified by the pharmacist and accepted by the physician. Discrepancies were found between the medications that patients were taking and medications recorded in the In‐Centre Dialysis Unit and 53 adjustments of the medication records were made. The patient satisfaction survey showed that 89% of patients found the information provided by the pharmacist ‘useful’ or ‘very useful’ and 81% expressed a desire to talk to the pharmacist about their medications in future.

Conclusion: The Medication Review Clinic provided regular, structured medication reviews. Actual and potential drugrelated problems were identified and clear and consistent information was provided to both patients and health professionals. According to the patient satisfaction survey, the Medication Review Clinic increased patient awareness of preventable drug‐related morbidity and helped improve the standards of medication use in dialysis patients (this will need to be confirmed). Future research will investigate the effect on the patient's quality of life and the number of drugrelated hospital admissions.
Involvement of Australian Hospital Pharmacists in Developing Clinical Pharmacy in Indonesia
Authors: Mutiara Rina
Published: March 2016

Collaboration between Australian and Indonesian hospital pharmacists began via an e‐mail discussion group. This led to participation in drug information, clinical pharmacy and cytotoxic handling training programs at the Cipto Mangunkusumo Hospital (CMH) in Jakarta and elsewhere in Java. Training and conference attendance in Australia was also arranged. Such training was very valuable for CMH during its attempts to improve the quality of pharmacy services at a time of economic hardship. Unlike Australia, Indonesia does not have a formal clinical pharmacy training program and there is limited opportunity to put pharmaceutical knowledge into practice. Cooperation between Australian and Indonesian hospital pharmacists has continued and will help to provide a basis for education in clinical pharmacy. These programs have the potential to enhance the quality of pharmacy practice in Indonesia.
Thyroid Disease in the Elderly
Authors: Luise Mario A De
Published: March 2016

Thyroid dysfunction, benign and much less commonly, malignant neoplastic changes in the thyroid gland occur frequently in the general population but are more likely to result in undesirable clinical consequences in the elderly, usually because of coexistent pathology such as diminished cardiovascular reserve. This review will highlight the common problem of thyrotoxicosis in nodular thyroid disease in the elderly; such thyrotoxicosis frequently has an iatrogenic basis and is therefore potentially preventable. The treatment of thyrotoxicosis and the relative advantages/disadvantages of therapeutic modalities such as antithyroid drugs, radioiodine and surgical intervention tend to vary between younger and older patients. Radioiodine is more often the treatment of choice in the elderly. Monitoring and treatment of hypothyroidism is also discussed, with emphasis on the substantial risks of rapid correction of low thyroid hormone levels in elderly patients with coexistent ischaemic heart disease. Also discussed is the need to potentially adjust dosage of other pharmacological agents frequently used by elderly patients (e.g. digoxin, warfarin) in states of as yet uncontrolled hypothyroidism or thyrotoxicosis.
Pharmaceutical Care: Impact on Asthma Medication Use
Authors: Simpson Maree D , Burton Deborah L , Burton Mark A , Gissing Peter M , Bowman Scott L
Published: March 2016

Background: Asthma has been recognised as a poorly managed disease state in Australia. Rural areas have been identified as being under‐serviced by health professionals. Pharmacists in rural areas are in a prime position to be involved in the provision of multidisciplinary asthma care.

Aim: This study investigated the impact of spirometry screening on asthma management by pharmacists in rural areas.

Method: A two‐group (intervention: n = 141, control: n = 46) multicentre study design was utilised. The control group was provided with a standard medication review while the intervention group received spirometry testing and a medication review. The study protocol required pharmacists to refer participants to a doctor if required, based on spirometry or medication review results. The researchers assessed asthma severity and adequacy of asthma medication.

Results: Spirometry as an intervention attracted participants to the study pharmacies and provided an opportunity for pharmacists to screen and refer a group who may otherwise be overlooked. Medication review identified suboptimal therapy, potentially contraindicated drug combinations and adverse drug reactions.

Conclusion: Spirometry adds benefit to the provision of pharmaceutical care for people with asthma. This may have additional significance in rural areas where access to other health services is limited.
Evaluation of Mycophenolate for Unregistered Indications
Authors: Sabet Parastoo , Maxwell David J , Brien Jo‐anne E
Published: March 2016

Aim: To describe the use of mycophenolate mofetil for unregistered indications at St Vincent's Hospital, Sydney and to assess the financial impact.

Method: A retrospective drug use evaluation was conducted over a 26‐month period. Adult patients prescribed mycophenolate mofetil for unregistered indications were identified through the pharmacy department's dispensing software, records of individual patient use approvals and patients' medical records.

Results: 28 patients were available for analysis. The most frequent indications were systemic lupus erythematosus (43%) and vasculitis (18%). Other indications were Beh§et's disease, Wegener's granulomatosis, polymyositis, eczema, rheumatoid arthritis, connective tissue disorders and Sjogren's syndrome. During this period, 5.7% of mycophenolate mofetil acquisition costs were associated with unregistered indications.

Conclusion: The use of mycophenolate mofetil for unregistered indications at St Vincent's Hospital was consistent with published experience.
Pulmonary and Hepatic Toxicity Due to Nitrofurantoin
Authors: Mackenzie Fraser D , Storie W John
Published: March 2016

Aim: To present a case of combined pulmonary and hepatic toxicity due to nitrofurantoin.

Clinical features: A 79‐year‐old female developed painless jaundice and exertional dyspnoea over an 8‐week period. A chest X‐ray and computerised tomography chest scan revealed interstitial lung disease with respiratory function tests showing a markedly reduced diffusing lung capacity for carbon monoxide (6.72 mL/min/mmHg). Liver function tests were markedly elevated, consistent with acute hepatitis, but returned to normal following cessation of the drug.

Discussion: Combined hepatic and pulmonary toxicity due to nitrofurantoin is rare.1‐3 The mechanism for pulmonary toxicity is thought to be secondary to the generation of oxygen free radicals in combination with immune‐mediated injury. An immune mechanism is similarly thought to cause the hepatic toxicity.1
Evaluation of Therapeutic Drug Monitoring Services and Comparison of Two Models of Service Provision
Authors: Cocks Hillary J , Kevans Prue , Graham Robert , Brien Jo-anne E
Published: March 2016

Objective: To investigate the impact of two therapeutic drug monitoring (TDM) service models at an acute‐care hospital.

Design: Data were initially collected on the existing model at the hospital. This involved a clinical pharmacology registrar and a specialist pharmacist (TDM team) conducting daily TDM rounds. After a transition period, pharmacists conducted the TDM reviews. The two models were then compared for: the number and types of drug concentrations reviewed, and recommendations made; the method of communicating and documenting recommendations; acceptance rates; and the time required to provide the service. Staff satisfaction was gauged by an anonymous semi‐structured questionnaire completed by the pharmacists.

Results: 172 recommendations were made by the TDM team and 146 by the pharmacists. Verbal recommendations were more frequently made by the pharmacists than by the TDM team (p < 0.05). Acceptance rates by physicians were significantly higher (p < 0.01) when pharmacists made recommendations. The pharmacists indicated that reviewing patients' drug concentrations was feasible and beneficial.

Conclusion: This study has influenced the structure of clinical pharmacy and pharmacology services at the hospital and provided a basis for expansion of the TDM services.
Omitted Medication Doses: Frequency and Severity
Authors: Lawler Christopher , Welch Susan A , Brien Jo‐anne E
Published: March 2016

Aims: To determine the number of omitted medication doses for hospital inpatients, identify the reasons and assess their severity.

Method: The study involved intensive drug chart surveillance over a period of 5 days in two wards that included a wide range of medical and surgical specialties of a metropolitan teaching hospital. Inpatients receiving regular or once‐only medication for at least 5 days were monitored. A multidisciplinary committee assessed the severity of the omitted doses on a visual analogue scale of 0 to 10, where 0 is no potential harm to the patient and 10 is the potential for death.

Results: Drug charts for 67 inpatients were audited. A total of 4887 doses were prescribed of which 369 (7 .6%) were recorded as dose omissions. In 273 of the 369 (74%) omitted doses, there were documented reasons for omission. 120 of the 369 doses omitted were scored for severity, with 86% (103/120) of these considered to have placed the patients at some risk of harm. No omitted doses were rated above 7 in severity.

Conclusion: This study identified a substantial number of doses omitted, and a significant proportion of these were for no clear reason. The majority of the omitted doses were considered to have a potentially negative effect on the patient. Greater awareness of the extent of this problem has facilitated a collaborative effort, led by pharmacists, to improve the medication administration system.
Stakeholder Opinions on the Implementation of Drug and Therapeutics Committee Decisions
Authors: Tan Ee Lyn , Day Richard O , Brien Jo‐anne E
Published: March 2016

Aim: To identify stakeholder recollections of intervention strategies used to implement Drug and Therapeutics Committee decisions and explore stakeholder opinions of the applicability of intervention strategies in an organisational setting.

Method: A sample of stakeholders was invited to participate in focus group discussions. Discussions were audiotaped, transcribed verbatim and thematically analysed.

Results: Themes arising from the focus groups included: face‐to‐face intervention strategies are more effective; published/printed materials had little effect; strategies need to be delivered at the point of care to be effective; implementation of decisions needs to be timely; and tailored strategies are more effective.

Conclusion: These results could guide future implementation strategies for Drug and Therapeutics Committee decisions.
Tranquilliser Use in Elderly Psychiatric Patients
Authors: Ng Kwong H , Alderman Christopher P
Published: March 2016

Aim: To examine characteristics of tranquilliser use in a small cohort of elderly psychiatric patients, and to analyse clinical correlates associated with tranquilliser dependence.

Method: A structured interview was used to obtain medical and psychiatric history, medication usage data, and basic health service utilisation data. Anxiety symptoms were assessed using the Hamilton Anxiety Rating Scale, and tranquilliser dependence was evaluated using a separate validated questionnaire.

Results: 29 patients with a mean age of 73.2 ± 7.3 years completed the study. Benzodiazepines were the most frequently encountered tranquillisers (n = 24, 82.8%), and temazepam was the most commonly used drug (n = 14). The mean weekly benzodiazepine usage expressed in diazepam equivalents was 74.0 ± 37.3 mg. 27 subjects (93.1 %) were found to have a clinically significant anxiety syndrome, with a mean Hamilton Anxiety Rating Scale score of31.8 ± 11.5. Of particular concern was the apparent high prevalence of tranquilliser dependence (n = 17, 58.6%). Current alcohol consumption was shown to be associated with tranquilliser dependence (p = 0.028), and the use of tranquillisers for more than 6 months was found to be associated with a significantly higher benzodiazepine dependence score (p = 0.008) and more extensive hospitalisation in the preceding 5 years (p = 0.028).

Conclusion: This study provided some insight into the characteristics of tranquilliser use in a small sample of elderly Australians. Further studies are required to confirm these findings and provide direction for subsequent interventions.
Reporting, Review and Application of Near‐Miss Prescribing Medication Incident Data
Authors: D'Souza Deirdre C , Koller Lorraine J , Ng Kingsley , Thornton Penelope D
Published: March 2016

Prospective drug chart review by pharmacists is an important risk minimisation strategy in the detection and prevention of prescribing medication incidents (PMis). Feedback reporting to the clinical team facilitates learning from and the identification and prevention of system‐based PMis. At Westmead Hospital, Sydney, the establishment of a relational database ofprevented‐PMis in November 2001 enabled such feedback reporting. Assessment of the reporting process after 12 months indicated review and application of the data within quality frameworks, value in improving prescribing practice and continued interest in receiving the reports. Implementation of feedback reporting has facilitated learning from PMis beyond the prescriber to the team and organisational levels. PMI data have been incorporated into ‘safe prescribing’ training programs for junior doctors. The proactive role of the clinical pharmacist in ensuring safe medication outcomes has been highlighted. Establishment of data management and reporting processes may assist future incorporation into wider incident‐monitoring systems.
Optimising the Medication Management Continuum in a Private Hospital
Authors: Leach Helen J
Published: March 2016

Aim: To audit the discharge process in a private hospital setting with a focus on clarity of discharge instructions.

Method: A form was developed to collect data relating to the discharge process. The pharmacists for the neurology, surgical and cardiology wards at The Melbourne Private Hospital collected data over a 2‐week period during December 2003.

Results: Data relating to 270 patients discharged were collected. These data showed that discharge instructions were indicated on the drug chart in 52 (19%) cases. Discharge instructions were documented in the patient's case notes in 14 (5%) cases. Discharge prescriptions were written for submission to the Health Insurance Commission (as applicable), in 108 (40%) cases. Prescribers were contacted to clarify discharge instructions in 32 (12%) discharge episodes. Discharge medication requirements were established in consultation with the patient in 59 (22%) discharge episodes.

Conclusion: The private hospital setting provides a number of challenges in obtaining complete and accurate information on discharge medication requirements. The pharmacist plays an important role in identifying the patient's discharge medication requirements and optimising the utilisation of the Pharmaceutical Benefits Scheme.
Community‐Acquired Pneumonia
Authors: Maxwell David J , Easton Kylie L
Published: March 2016

Background: The National Prescribing Service is funding a project to improve patient outcomes through implementation of national guidelines for management of community‐acquired pneumonia (CAP). There is evidence that knowledge of and adherence to the CAP guidelines in the Therapeutic Guidelines: Antibiotic in Australian hospitals is suboptimal. These guidelines incorporate a pneumonia severity index (PSI) and all antibiotic recommendations are based on the PSI score.

Aim: To provide a literature‐based overview of the current evidence and opinion regarding the management of CAP and the recommendations of the Therapeutic Guidelines: Antibiotic.

Method: The literature review was conducted using Medline (1966‐present) and Embase (1980‐present) databases.

Results: A range of CAP severity assessment tools, including the PSI, were identified. There were also a number of international CAP guidelines with different recommendations for treatment.

Conclusion: Evidence and opinion supports the guidelines in the Therapeutic Guidelines: Antibiotic relating to the severity assessment tool and antibiotic choice. Judicious use of antibiotics for CAP is required to reduce bacterial resistance in hospitals and the community.
Pharmacological Management of Parkinson's Disease
Authors: Iansek Robert
Published: March 2016

Parkinson's disease is an incurable neurodegenerative disease of the elderly. Although symptoms can be ameliorated by drugs, optimum management requires a multidisciplinary approach. Pharmacotherapy is usually initiated with levodopa using gradual dosage titration. Initial therapy with dopamine agonists such as cabergoline can be considered in younger patients. Cabergoline can also be used to reduce levodopa dosage in patients who develop dyskinesia. End‐of‐dose effects may require more frequent levodopa administration and the addition of a catechol‐O‐methyl transferase inhibitor such as entacapone. In mid‐stage disease a degree of dyskinesia may be accepted in order to maintain movement capacity. Cabergoline can also be used for levodopa sparing. In advanced disease, fluctuations between on and off states become rapid and disabling. Levodopa dosage can be further refined with a liquid formulation and apomorphine may be used to overcome sudden off periods.
Processes for the Assessment and Introduction of New Medicines in New Zealand Hospitals
Authors: Tordoff June M , Norris Pauline T , Kennedy Julia M , Reith David M
Published: March 2016

Aim: To determine the processes used for the assessment and introduction of new medicines in New Zealand public hospitals.

Method: In July 2002, a questionnaire‐based, cross‐sectional survey was undertaken of the processes used to assess and introduce new medicines in all 30 public hospitals in New Zealand employing one or more pharmacists.

Results: 29 hospitals (97%) responded. 22 hospitals (76%) used formal processes for the introduction of new medicines and 7 (24%) used informal processes. Formal processes were used more frequently by tertiary and secondary hospitals. 24/29 hospitals reported 261 applications for new medicines (median 6.5, range 1 to 66)—58% approved with restrictions, 22% with no restrictions, 10% rejected and 10% pending. Most decisions (79%) were made in 1 to 3 months. 27 hospitals (93%) had Medicine and Therapeutics Committees and 80% of decisions had input from the committee. Clinicians provided data on acquisition cost more frequently than on cost‐effectiveness. Provision of economic data appeared low, particularly for ‘cost per life year gained’ and ‘cost per quality adjusted life year’.

Conclusion: The majority of hospitals used a formal process to introduce new medicines. Data on efficacy, safety and acquisition cost were considered important in decision making; the use of pharmacoeconomic data was limited.

J Pharm Pract Res 2004; 34: 267–71.
Phenytoin Infusion Revisited: Stability and Administration
Authors: Milne Dianne J , Foo Josephine , Sharley Nicholas A , Milne Robert W
Published: March 2016

Background Manufacturers of phenytoin injection recommend that it be given without dilution by direct IV injection. Direct IV injection presents well‐recognised side effects which can be minimised by giving phenytoin as an infusion.

Aim: To assess the stability of Phenytoin Injection (DBL) in sodium chloride 0.9% prepared for infusion in Viaflex bags and a Buretrol extension set.

Method: Admixtures containing 3, 6 and 10 mg/mL of phenytoin were prepared in sodium chloride 0.9% and stored in Viaflex bags, extension sets and beakers exposed to air (controls) for 6 hours. The concentration of phenytoin in the Viaflex bags was measured by UV absorption spectrophotometry. All the admixtures were inspected for microscopic particulate matter and the pH measured at intervals over 6 hours.

Results: In the Viaflex bags there were no changes in the phenytoin concentration, minimal change in pH(< 0.1) and no particulate matter over 6 hours. In the extension sets and beakers, particulate matter was minimal at 2 hours and extensive beyond this time. There was an overall decrease of 0.30 and 0.32 pH units in samples from the extension sets and beakers.

Conclusion: Phenytoin Injection (DBL) can be given as an IV infusion in sodium chloride 0.9% provided it is prepared in a Viaflex bag and infused within 2 hours of preparation.

J Pharm Pract Res 2004; 34: 272–5.
Dissolution of Extemporaneous Paracetamol Capsules
Authors: Mukhtar Sadaf , Olsen Warren A , McLachlan Andrew J
Published: March 2016

Aim: To investigate the dissolution characteristics of extemporaneously prepared capsules containing hypromellose and paracetamol tablets.

Method: Capsules of varying sizes containing paracetamol (powdered tablets) with varying amounts of hypromellose (4–20% w/w) were extemporaneously prepared. Dissolution was investigated using a USP dissolution testing apparatus. Paracetamol dissolution was quantitated using UV absorption spectrophotometry. The impact of hypromellose content, tablet excipients, capsule size, content weight and mixing methods were investigated.

Results: Over a 4‐hour period, paracetamol dissolution decreased with increasing hypromellose content. Paracetamol dissolution was 100% from capsules containing 4% hypromellose and 52 ± 3% from capsules containing 20% hypromellose. Reformulated tablets with different formulations resulted in different dissolution rates. The dissolution rate was faster from small capsules and slower from capsules with a lower content weight. The method used to mix the powders also had a significant effect on the dissolution rate.

Conclusion: Modified‐release delivery systems can be extemporaneously prepared from reformulated tablets using hypromellose. Hypromellose content, tablet excipients, capsule size, content weight and mixing methods have an impact on the dissolution rate.

J Pharm Pract Res 2004; 34: 276–81.
New Zealand Pharmacists and Pharmacist‐Only Medicines
Authors: Norris Pauline T
Published: March 2016

Background: In New Zealand pharmacist‐only medicines are available over‐the‐counter and must be sold by pharmacists. This gives pharmacists an opportunity to counsel consumers and ensure that the medicine is appropriate.

Aim: To assess New Zealand community pharmacists’ views about the requirements for the sale of pharmacist‐only medicines.

Method: A questionnaire was sent to all community pharmacies in New Zealand. Responses to an open‐ended question about the requirements for the sale of pharmacist‐only medicines were analysed thematically.

Results: Pharmacists largely agreed that it was appropriate to counsel consumers purchasing pharmacist‐only medicines. They identified a range of barriers: consumer attitudes and expectations; advertising; other pharmacists’ practice; practicalities of retail pharmacy; gender issues; and remuneration.

Conclusion: There appeared to be a high level of support among pharmacists for professional involvement in the sale of pharmacist‐only medicines.

J Pharm Pract Res 2004; 34: 282–4.
Public Health—Recognising the Role of Australian Pharmacists
Authors: Jackson John K , Sweidan Michelle , Spinks Jean M , Snell Beverley , Duncan Gregory J
Published: March 2016

This article describes the philosophy of public health as it relates to the work of pharmacists. Individual patient care provided by pharmacists when supplying medicines is placed within a public health framework and existing public health roles performed by pharmacists are presented. Newly emerging public health roles and public health opportunities for pharmacists in developing countries are outlined. Education relevant to the practice of public health is discussed both as a component of pharmacy training and as a specific field of postgraduate education that pharmacists may pursue.

J Pharm Pract Res 2004; 34: 290–2.
Mirtazapine‐Associated Rapid Weight Gain and Decreased Physical Activity
Authors: Kethini Thejaswarup , Alderman Christopher P , Doecke Christopher J
Published: March 2016

Background: Mirtazapine‐associated weight gain is widely documented. However, data demonstrating changes in physical activity associated with mirtazapine have not been published.

Aim: To describe a case of rapid weight gain and decreased physical activity associated with mirtazapine.

Clinical features: A 55‐year‐old Caucasian man was admitted after attempting suicide and was diagnosed with post‐traumatic stress disorder and depression. He was treated with mirtazapine 30 mg daily and zopiclone 15 mg at night during 5 weeks of hospitalisation and discharged on the same therapy. As a part of a research protocol, the patient was followed closely for 17 weeks after first observation, and his body weight, physical activity and biochemical parameters were recorded.

Outcomes: The patient's weight increased by 10 kg within 2 weeks of starting mirtazapine, and at the end of the 17‐week follow‐up period the total weight gain was 17.5 kg. The fasting blood glucose and serum lipid concentrations had also increased. At the conclusion of the follow‐up period, physical activity levels had decreased by 40% relative to baseline. An objective causality assessment revealed that the relationship between mirtazapine and weight gain could be regarded as possible.

Conclusion: Patients on mirtazapine should be monitored for changes in weight and offered information about diet and exercise to assist in weight management.

J Pharm Pract Res 2004; 34: 308–9.
Urinary Incontinence in the Elderly
Authors: Bird Margaret R
Published: March 2016

Urinary incontinence is a common disability with considerable personal and carer burden in the elderly. Drugs play a role in causing and treating urinary incontinence and lower urinary tract symptoms. This article will discuss the therapeutic approach to managing urinary incontinence in the older person.

J Pharm Pract Res 2004; 34: 319–21.
Effect of nitrogen fertilisation on the amino acid digestibility of different triticale genotypes in caecectomised laying hens
Authors: Siegert Wolfgang , Boguhn Jeannette , Maurer Hans Peter , Weiss Jochen , Zuber Tobias , Möhring Jens , Rodehutscord Markus
Published: March 2016

BACKGROUND

The influence of nitrogen fertilisation and genotype on the amino acid (AA) digestibility of triticale grain was investigated in caecectomised laying hens. Three genotypes, Grenado, EAW6002 and Lasko, were cultivated with and without nitrogen fertilisation at the end of the heading stage. The six triticale variants as well as a basal diet were each used to feed seven laying hens in a 7 × 7 Latin square design.

RESULTS

Nitrogen fertilisation influenced the digestibility of Cys, Glu, Phe and Ser in some triticale genotypes and reduced Ala, Ile, Lys, Met and Val digestibility in all genotypes (P < 0.05). Nitrogen fertilisation increased the concentration of all AAs in the grain. Consequently, the concentration of digestible AAs in the grains was increased for most AAs upon nitrogen fertilisation. Overall, Lys had the lowest digestibility, whereas that of Glu and Pro was the highest. For the triticale genotypes, the level of AA digestibility was highest for EAW6002 followed by Lasko and Grenado, with significant differences (P < 0.05) between genotypes for some but not all AAs.

CONCLUSION

The results indicated that the accuracy of the digestible AA supply for hen feeding might benefit from considering fertilisation and genotype‐specific digestibility data in feed formulation. © 2016 Society of Chemical Industry
Multimodal cancer care in poor prognosis cancers: Resection drives long‐term outcomes
Authors: Healy Mark A. , Yin Huiying , Wong Sandra L.
Published: March 2016

Background and Objectives

Hospitals with high complex oncologic surgical volume have improved short‐term outcomes. However, for long‐term outcomes, the influence of other therapies must be considered. We compared effects of resection with other therapies on long‐term outcomes across U.S. hospitals.

Methods

We examined claims in the Surveillance, Epidemiology, and End Results (SEER)‐Medicare dataset for patients with esophageal (EC) and pancreatic (PC) cancers between 2005–2009, with follow‐up through 2011, performing multivariable Cox proportional hazards analyses. We stratified hospitals by volume and compared rates of treatments in the context of survival.

Results

We studied 905 EC and 3,293 PC patients at 138 and 375 hospitals, respectively. For EC, resection rates were significantly higher (32.9% vs. 9.5%, P < 0.001) in the highest versus lowest volume hospitals. Adjusted survival was also statistically significantly better (48.5% vs. 43.1%, P < 0.001). For PC, resection rates were also statistically significantly higher (30.1% vs. 12.0%, P < 0.001) with higher adjusted survival (21.5% vs. 19.9%, P = 0.01). We did not find variation in rates of other cancer treatments across hospitals.

Conclusions

A significant association exists between long‐term survival and rates of cancer‐directed surgery across hospitals, without variation in rates of other therapies. Access to resection appears to be key to reducing variation in long‐term survival. J. Surg. Oncol. 2016;113:599–604. © 2016 Wiley Periodicals, Inc.
Trajectories of PTSD Among Lower Manhattan Residents and Area Workers Following the 2001 World Trade Center Disaster, 2003–2012
Authors: Welch Alice E. , Caramanica Kimberly , Maslow Carey B. , Brackbill Robert M. , Stellman Steven D. , Farfel Mark R.
Published: March 2016

Group‐based trajectory modeling was used to explore empirical trajectories of symptoms of posttraumatic stress disorder (PTSD) among 17,062 adult area residents/workers (nonrescue/recovery workers) enrolled in the World Trade Center (WTC) Health Registry using 3 administrations of the PTSD Checklist (PCL) over 9 years of observation. Six trajectories described PTSD over time: low‐stable (48.9%), moderate‐stable (28.3%), moderate‐increasing (8.2%), high‐stable (6.0%), high‐decreasing (6.6 %), and very high‐stable (2.0%). To examine factors associated with improving or worsening PTSD symptoms, groups with similar intercepts, but different trajectories were compared using bivariate analyses and logistic regression. The adjusted odds of being in the moderate‐increasing relative to the moderate‐stable group were significantly greater among enrollees reporting low social integration (OR = 2.18), WTC exposures (range = 1.34 to 1.53), job loss related to the September 11, 2001 disaster (OR = 1.41), or unmet mental health need/treatment (OR = 4.37). The odds of being in the high‐stable relative to the high‐decreasing group were significantly greater among enrollees reporting low social integration (OR = 2.23), WTC exposures (range = 1.39 to 1.45), or unmet mental health need/treatment (OR = 3.42). The influence of severe exposures, scarce personal/financial resources, and treatment barriers on PTSD trajectories suggest a need for early and ongoing PTSD screening postdisaster.
Engineered Biomaterials to Enhance Stem Cell‐Based Cardiac Tissue Engineering and Therapy
Authors: Hasan Anwarul , Waters Renae , Roula Boustany , Dana Rahbani , Yara Seif , Alexandre Toubia , Paul Arghya
Published: March 2016

Cardiovascular disease is a leading cause of death worldwide. Since adult cardiac cells are limited in their proliferation, cardiac tissue with dead or damaged cardiac cells downstream of the occluded vessel does not regenerate after myocardial infarction. The cardiac tissue is then replaced with nonfunctional fibrotic scar tissue rather than new cardiac cells, which leaves the heart weak. The limited proliferation ability of host cardiac cells has motivated investigators to research the potential cardiac regenerative ability of stem cells. Considerable progress has been made in this endeavor. However, the optimum type of stem cells along with the most suitable matrix‐material and cellular microenvironmental cues are yet to be identified or agreed upon. This review presents an overview of various types of biofunctional materials and biomaterial matrices, which in combination with stem cells, have shown promises for cardiac tissue replacement and reinforcement. Engineered biomaterials also have applications in cardiac tissue engineering, in which tissue constructs are developed in vitro by combining stem cells and biomaterial scaffolds for drug screening or eventual implantation. This review highlights the benefits of using biomaterials in conjunction with stem cells to repair damaged myocardium and give a brief description of the properties of these biomaterials that make them such valuable tools to the field.

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Ferroelectric Polymers and Their Energy‐Related Applications
Authors: Li Qi , Wang Qing
Published: March 2016

The discovery of ferroelectric phenomenon in polymers in early 1970s has aroused tremendous research interests in these soft materials with intriguing physical properties, and led to a broad range of applications. Since then the understanding of physical origin of ferroelectricity in these macromolecules has been fast deepened by virtue of the rapid development of ferroelectric polymer science, which in turn has enabled better design of ferroelectric polymers with improved performance. Over the last two decades, as boosted by the increasing demand for advanced energy technologies, great progress has been made in understanding and developing new ferroelectric polymers toward energy‐related applications. This trend article summarizes the important aspects and recent advances in the research area of ferroelectric polymers, covering from understanding of material fundamentals, through synthesis and processing techniques, to applications in energy conversion and storage.

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Fabrication of Polymer‐Ag Honeycomb Hybrid Film by Metal Complexation Induced Phase Separation at the Air/Water Interface
Authors: Mir Sajjad Husain , Ochiai Bungo
Published: March 2016

A new facile approach for the fabrication of polymer‐Ag honeycomb film is reported. A polymer‐Ag+ honeycomb thin film is obtained by casting a CHCl3 solution of a functional graft copolymer on aqueous silver nitrate solution, leading to metal complexation induced phase separation at the air/water interface. The film is reduced by UV irradiation to give a polymer‐Ag honeycomb film with regular morphology. Pyrolysis of the film gives a translucent Ag honeycomb film.

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Innovative Poly(Ionic Liquid)s by the Polymerization of Deep Eutectic Monomers
Authors: Isik Mehmet , Ruiperez Fernando , Sardon Haritz , Gonzalez Alba , Zulfiqar Sonia , Mecerreyes David
Published: March 2016

The incorporation of ionic liquid (IL) chemistry into functional polymers has extended the properties and applications of polyelectrolytes. However, ILs are expensive due to the presence of fluorinated anions or complicated synthetic steps which limit their technological viability. Here, we show a new family of poly(ionic liquid)s (PILs) which are based in cheap and renewable chemicals and involves facile synthetic approaches. Thus, deep eutectic monomers (DEMs) are prepared for the first time by using quaternary ammonium compounds and various hydrogen bond donors such as citric acid, terephthalic acid or an amidoxime. The deep eutectic formation is made through a simple mixing of the ingredients. Differential scanning calorimetry, nuclear magnetic resonance (NMR) and computational studies reveal the formation of the DEMs due to the ionic interactions. The resulting DEMs are liquid which facilitates their polymerization using mild photopolymerization or polycondensation strategies. Spectroscopic characterizations reveal the successful formation of the polymers. By this way, a new family of PILs can be synthesized which can be used for different applications. As an example, the polymers show promising performance as solid CO2 sorbents. Altogether the deep eutectic monomer route can lead to non‐toxic, cheap and easy‐to‐prepare alternatives to current PILs for different applications.

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Impact of intensive lifestyle intervention on preference‐based quality of life in type 2 diabetes: Results from theLookAHEADtrial
Authors: Zhang Ping , Hire Don , Espeland Mark A. , Knowler William C. , Thomas Sheikilya , Tsai Adam G. , Glick Henry A. ,   the Look AHEAD Research Group
Published: March 2016

Objective

To assess the effect of an intensive lifestyle intervention (ILI) compared with standard diabetes support and education (DSE) on preference‐based health‐related quality of life (HRQOL) in persons with overweight or obesity and type 2 diabetes.

Methods

Look AHEAD was a multisite, randomized trial of 5,145 participants assigned to ILI or DSE. Four instruments were administered during the trial: Feeling Thermometer (FT), Health Utilities Index Mark 2 (HUI2), Health Utilities Index Mark 3 (HUI3), and Short Form 6D (SF‐6D). Linear mixed effect models were used to estimate the mean difference in preference scores by treatment group for 9 years.

Results

The ILI had higher mean FT (0.019, 95% CI, 0.015‐0.024,P < 0.001) and SF‐6D (0.011, 95% CI, 0.006‐0.014,P < 0.001) scores than the DSE. No significant group differences were observed for the HUI2 (0.004, 95% CI, −0.003 to 0.010,P = 0.23) and HUI3 (0.004, −0.004 to 0.012,P = 0.36). In year 1, the ILI had higher mean preference scores for all instruments. Thereafter, the increases remained significant only for FT and SF‐6D, and the effects also become smaller.

Conclusions

ILI aimed at reducing body weight among persons with overweight or obesity and type 2 diabetes improves preference‐based HRQOL in the short term, but its long‐term effect is unclear.
Temporal proteomic profiling of Chlamydia trachomatis–infected HeLa‐229 human cervical epithelial cells
Authors: Tan Grace Min Yi , Lim Hui Jing , Yeow Tee Cian , Movahed Elaheh , Looi Chung Yeng , Gupta Rishein , Arulanandam Bernard P. , Abu Bakar Sazaly , Sabet Negar Shafiei , Chang Li‐Yen , Wong Won Fen
Published: March 2016

Chlamydia trachomatis is the leading causative agent of bacterial sexually transmitted infections worldwide which can lead to female pelvic inflammatory disease and infertility. A greater understanding of host response during chlamydial infection is essential to design intervention technique to reduce the increasing incidence rate of genital chlamydial infection. In this study, we investigated proteome changes in epithelial cells during C. trachomatis infection by using an isobaric tags for relative and absolute quantitation (iTRAQ) labeling technique coupled with a liquid chromatography‐tandem mass spectrometry (LC‐MS3) analysis. C. trachomatis (serovar D, MOI 1)–infected HeLa‐229 human cervical carcinoma epithelial cells (at 2, 4 and 8 h) showed profound modifications of proteome profile which involved 606 host proteins. MGST1, SUGP2 and ATXN10 were among the top in the list of the differentially upregulated protein. Through pathway analysis, we suggested the involvement of eukaryotic initiation factor 2 (eIF2) and mammalian target of rapamycin (mTOR) in host cells upon C. trachomatis infection. Network analysis underscored the participation of DNA repair mechanism during C. trachomatis infection. In summary, intense modifications of proteome profile in C. trachomatis–infected HeLa‐229 cells indicate complex host‐pathogen interactions at early phase of chlamydial infection.
An overview of innovations and industrial solutions in Protein Microarray Technology
Authors: Gupta Shabarni , Manubhai K. P. , Kulkarni Vishwesh , Srivastava Sanjeeva
Published: March 2016

The complexity involving protein array technology reflects in the fact that instrumentation and data analysis are subject to change depending on the biological question, technical compatibility of instruments and software used in each experiment. Industry has played a pivotal role in establishing standards for future deliberations in sustenance of these technologies in the form of protein array chips, arrayers, scanning devices, and data analysis software. This has enhanced the outreach of protein microarray technology to researchers across the globe. These have encouraged a surge in the adaptation of “nonclassical” approaches such as DNA‐based protein arrays, micro‐contact printing, label‐free protein detection, and algorithms for data analysis. This review provides a unique overview of these industrial solutions available for protein microarray based studies. It aims at assessing the developments in various commercial platforms, thus providing a holistic overview of various modalities, options, and compatibility; summarizing the journey of this powerful high‐throughput technology.
Impact of surface charge density and motor force upon polyelectrolyte packaging in viral capsids
Authors: Cao Qianqian , Bachmann Michael
Published: March 2016

By means of Langevin molecular dynamics simulations, we study the packaging dynamics of flexible and semiflexible polyelectrolytes in spherical cavities that resemble viral capsids. We employ a coarse‐grained model of the polymer–capsid complex that allows us to perform simulations of a 900mer and investigate the influence of surface charges inside the capsid and an additional motor force, acting on the polymer in the portal region of the cavity, on the packaging process. Our results indicate that it is most efficient if surface charges are present that initially promote the formation of an ordered surface layer inside the capsid. Once these charges are screened, the motor force pulls in the remaining part of the chain. Additionally, the simulations also demonstrate that the packaging dynamics depends on the counterion valence. © 2016 Wiley Periodicals, Inc. J. Polym. Sci., Part B: Polym. Phys. 2016, 54, 1054–1065
From stringy particle physics to moduli stabilisation and cosmology
Authors: Honecker Gabriele
Published: March 2016

Intersecting D6‐branes provide a geometrically intuitive road to stringy particle physics models, where D6‐branes stuck at orbifold singularities can lead to the stabilisation of deformation moduli, and the QCD axion can arise from the open string sector in a very constrained way compared to pure field theory. We demonstrate this interplay of different physical features here through an explicit model.
How middle managers manage the political environment to achieve market goals: Insights from China's state‐owned enterprises
Authors: Guo Yidi , Huy Quy Nguyen , Xiao Zhixing
Published: March 2016

Research summary: Although the middle management literature has identified various bridging roles performed by middle managers in the market environment, it is relatively vague about whether and how they manage the political environment to achieve market‐related goals. In an inductive field study of four large state‐owned enterprises based in mainland Communist China, operational middle managers were found to take an active role in dealing with political actors to achieve market efficiency in their local environments, performing two distinct bridging strategies. Our field study suggests that middle managers are better equipped than their bosses (top executives) as well as their subordinates (frontline employees) to perform the bridging function between competing market and political imperatives in various local settings.

Managerial summary: For firms that operate in diverse geographies, it is challenging for a handful of top executives to deal with numerous political actors. This burden could be shared with operational middle managers, who play a bridging role by drawing on their operational knowledge and local networks. Our research on middle managers who work under the scrutiny of political actors in China found that they bridge market and political ideology by conveying common features that seem legitimate to both. They also bridge market goals and political actors with personal affect. Compared to top executives and frontline employees, middle managers have unique advantages in performing these bridging functions. Firms can enhance their strategy execution ability by training middle managers in dealing with political actors in diverse contexts. Copyright © 2016 John Wiley & Sons, Ltd.
Organizational knowledge networks and local search: The role of intra‐organizational inventor networks
Authors: Paruchuri Srikanth , Awate Snehal
Published: March 2016

Research summary: While firms tend to build on their own knowledge, we distinguish between depth and breadth of local search to investigate the drivers of these behaviors. Given that inventors in a firm carry out the knowledge creation activities, we strive to identify inventors responsible for these behaviors by employing the notion of an intra‐firm inventor network. A longitudinal examination of 14,575 inventors from four large semiconductor firms using patent data supports our hypotheses that the reach of inventors in the intra‐firm network and their span of structural holes have independent and interactive effects on these two types of local search behaviors. These findings have implications for research on exploitation and exploration, organizational knowledge, knowledge networks, and micro‐foundations.

Managerial summary: Large amounts of knowledge may reside within firm boundaries, and managers are interested in understanding who may leverage this knowledge to generate novel ideas. We focus on collaborations among knowledge workers to address this question. Using the collaborations among all knowledge workers in a firm, we show that those who have higher reach to all others and those who form bridges to connect unconnected groups of workers tend to leverage not only more organizational knowledge, but also knowledge that is more dispersed in the organization. Managers could use these insights to shape the use of organizational knowledge by firm inventors, and also to make decisions about granting or withholding access to internal knowledge platforms for knowledge workers. Copyright © 2016 John Wiley & Sons, Ltd.