bluuebunny/crossref_metadata_2025 huggingface dataset:
Get SET: aligning anatomy demonstrator programmes with Surgical Education and Training selection criteria
Authors: Rhodes Danielle , Fogg Quentin A. , Lazarus Michelle D.
Published: December 2017

Background

Prevocational doctors aspiring to surgical careers are commonly recruited as anatomy demonstrators for undergraduate and graduate medical programmes. Entry into Surgical Education and Training (SET) is highly competitive and a unique opportunity exists to align anatomy demonstrator programmes with the selection criteria and core competencies of SET programmes. This study used a qualitative approach to (i) determine what criteria applicants for SET are assessed on and (ii) identify criteria that could be aligned with and enhanced by an anatomy demonstrator programme.

Methods

The selection guidelines of all nine surgical specialties for the 2017 intake of SET trainees were analysed using qualitative content analysis methodology.

Results

The Royal Australasian College of Surgeons adopted a holistic approach to trainee selection that assessed both discipline‐specific and discipline‐independent skills. Qualitative content analysis identified eight categories of key selection criteria: medical expertise, scholarly activity, professional identity, interpersonal skills, integrity, self‐management, insight and self‐awareness and community involvement. The structured curriculum vitae was heavily weighted towards discipline‐specific skills, such as medical expertise and scholarly activity. Insufficient information was available to determine the weighting of selection criteria assessed by the structured referee reports or interviews.

Conclusion

Anatomy demonstrator programmes provide prevocational doctors with unique opportunities to develop surgical skills and competencies in a non‐clinical setting. Constructively aligned anatomy demonstrator programmes may be particularly beneficial for prevocational doctors seeking to improve their anatomical knowledge, teaching skills or scholarly activity.
Letter: dose‐response analysis revealed closer relationship between obesity and perioperative outcomes in patients after liver transplantation
Authors: Liu Z. , Mardinoglu A. , Que S.
Published: December 2017

Linked Content

This article is linked to Barone et al papers. To view these articles visit https://doi.org/10.1111/apt.14139 and https://doi.org/10.1111/apt.14446.
Editorial: hepatocellular carcinoma risk in the era of direct‐acting anti‐virals—is the case closed?
Authors: Tan P. S. , Lim S. G.
Published: December 2017

Linked Content

This article is linked to Ogawa et al paper. To view this article visit https://doi.org/10.1111/apt.14380.
Viral kinetics analysis and virological characterization of treatment failures in patients with chronic hepatitis C treated with sofosbuvir and an NS5A inhibitor
Authors: Fourati S. , Guedj J. , Chevaliez S. , Nguyen T. H. T. , Roudot‐Thoraval F. , Ruiz I. , Soulier A. , Scoazec G. , Varaut A. , Poiteau L. , Francois M. , Mallat A. , Hézode C. , Pawlotsky J.‐M.
Published: December 2017

Background

The combination of sofosbuvir (SOF) plus an NS5A inhibitor for 12 weeks is highly efficacious in patients with chronic hepatitis C. As the costs of generic production of sofosbuvir and NS5A inhibitor are rapidly decreasing, the combination of these DAAs will be the standard treatment in most low‐ to middle‐income countries in the future.

Aim

To identify key predictors of response that can be used to tailor treatment decisions.

Methods

A cohort of 216 consecutive patients infected with HCV genotype 1 (1a: n = 57; 1b: n = 77), 2 (n = 4), 3 (n = 33) or 4 (n = 44) were treated with sofosbuvir (SOF) + daclatasvir (n = 176) or SOF + ledipasvir (n = 40) for 12 weeks. The viral kinetics was analysed using the biphasic model and the cure boundary was used to predict time to clear HCV.

Results

The overall SVR rate was high (94.4%; n = 204), regardless of the time to viral suppression or low‐level viraemia at the end of treatment. The model‐based predicted HCV RNA levels at the end of treatment could not differentiate patients who did from those who did not achieve SVR. The presence of NS5A resistance‐associated substitutions [position 28 (OR = 70.3, P<.001) and/or 31 (OR = 61.6, P = .002)] at baseline was predictive of virological failure in cirrhotic patients but was not associated with on‐treatment viral kinetics.

Conclusion

This real‐world study confirms the excellent results of clinical trials with therapies based on a combination of SOF plus an NS5A inhibitor. It suggests that a personalized approach including baseline NS5A inhibitor resistance testing may inform treatment decisions in cirrhotic patients.
General Single-Index Survival Regression Models for Incident and Prevalent Covariate Data and Prevalent Data Without Follow-Up
Authors: Chen Shih-Wei , Chiang Chin-Tsang
Published: December 2017

This article mainly focuses on analyzing covariate data from incident and prevalent cohort studies and a prevalent sample with only baseline covariates of interest and truncation times. Our major task in both research streams is to identify the effects of covariates on a failure time through very general single-index survival regression models without observing survival outcomes. With a strict increase of the survival function in the linear predictor, the ratio of incident and prevalent covariate densities is shown to be a non-degenerate and monotonic function of the linear predictor under covariate-independent truncation. Without such a structural assumption, the conditional density of a truncation time in a prevalent cohort is ensured to be a non-degenerate function of the linear predictor. In light of these features, some innovative approaches, which are based on the maximum rank correlation estimation or the pseudo least integrated squares estimation, are developed to estimate the coefficients of covariates up to a scale factor. Existing theoretical results are further used to establish the -consistency and asymptotic normality of the proposed estimators. Moreover, extensive simulations are conducted to assess and compare the finite-sample performance of various estimators. To illustrate the methodological ideas, we also analyze data from the Worcester Heart Attack Study and the National Comorbidity Survey Replication.
Use of the hCONSORT criteria as a reporting standard for herbal interventions for common dermatoses: a systematic review
Authors: Ornelas J. , Routt E. , Kallis P. , Lev-Tov H.
Published: December 2017

Background

The use of complementary and alternative medicine (CAM) is increasing in Western countries, including in the area of dermatology. However, Western healthcare providers have not integrated CAM into regular practice owing to a lack of reliable data supporting its use. To encourage high-quality research related to the use of CAM and specifically herbal interventions, the CONsolidated Standards Of Reporting Trials (CONSORT) extension criteria on reporting herbal interventions (hCONSORT) were published in 2006.

Objectives

To evaluate the adherence of randomized controlled trials (RCTs) investigating herbal interventions for acne, atopic dermatitis (AD) and psoriasis to the hCONSORT criteria.

Methods

A comprehensive search of the PubMed, Embase and Cochrane Library databases was conducted. RCTs published between 2009 and 2014 assessing therapeutic outcomes of plant-based interventions for acne, AD or psoriasis were included. Investigators determined the number of unique hCONSORT criteria satisfied per report. anova was used to examine differences in scores by disease entity.

Results

The vast majority of reviewed studies reported < 50% of information recommended in the hCONSORT criteria. Limitations include the small number of dermatological conditions examined, exclusion of reports based on language and lack of assessment of overall adherence to CONSORT criteria.

Conclusions

Our data indicate lack of adherence to hCONSORT extension criteria. Adherence to hCONSORT guidelines should be encouraged in order to provide high-quality reporting of research on herbal interventions in dermatology. Doing so may ease the integration of CAM into conventional medical practice and provide actionable data to providers.
Inverse correlation of Vδ2+ T‐cell recovery with EBV reactivation after haematopoietic stem cell transplantation
Authors: Liu Jiangying , Bian Zhilei , Wang Xiaoyu , Xu Lan‐Ping , Fu Qiang , Wang Chenguang , Chang Ying‐Jun , Wang Yu , Zhang Xiao‐Hui , Jiang Zhengfan , Huang Xiao‐Jun
Published: December 2017

Epstein–Barr virus (EBV) reactivation remains a life‐threatening complication in recipients of a haploidentical haematopoietic stem cell transplantation (haploHSCT). Reconstitution of adaptive T lymphocytes is generally compromised at the early stages following transplant, suggesting an important role of other effector cells in preventing EBV infection. Our previous studies demonstrated that recovery of CD4−CD8− T cells negatively correlated with EBV reactivation after haploHSCT. In this prospective study on 132 adult patients with haematopoietic malignancy, recovery of T‐cell subpopulations was characterized post‐haploHSCT. We showed that the median counts of peripheral Vδ2 cells were continuously lower in recipients with EBV reactivation compared with controls at 30, 60 and 90 days after haploHSCT (P values: 0·006, <0·001 and 0·019, respectively). Landmark study further indicated that the cumulative incidence of EBV reactivation was significantly decreased in recipients with higher day‐30 Vδ2 counts. Activation of Vδ2 cells upon EBV reactivation was accompanied by an induction of cell apoptosis. Cytotoxic effect of Vδ2 cells on EBV‐infected cells was confirmed by in vitro experiments. Together, our findings uncovered a significant correlation of recovered Vδ2 with EBV reactivation following haploHSCT. These results will help to better understand the intrinsic anti‐virus immunity and develop γδ T‐based therapy strategies after haematopoietic transplantation.
Intracranial 4D flow magnetic resonance imaging reveals altered haemodynamics in sickle cell disease
Authors: Václavů Lena , Baldew Zelonna A. V. , Gevers Sanna , Mutsaerts Henri J. M. M. , Fijnvandraat Karin , Cnossen Marjon H. , Majoie Charles B. , Wood John C. , VanBavel Ed , Biemond Bart J. , van Ooij Pim , Nederveen Aart J.
Published: December 2017

Stroke risk in children with sickle cell disease (SCD) is currently assessed with routine transcranial Doppler ultrasound (TCD) measurements of blood velocity in the Circle of Willis (CoW). However, there is currently no biomarker with proven prognostic value in adult patients. Four‐dimensional (4D) flow magnetic resonance imaging (MRI) may improve risk profiling based on intracranial haemodynamics. We conducted neurovascular 4D flow MRI and blood sampling in 69 SCD patients [median age 15 years (interquartile range, IQR: 12–50)] and 14 healthy controls [median age 21 years (IQR: 18–43)]. We measured velocity, flow, lumen area and endothelial shear stress (ESS) in the CoW. SCD patients had lower haematocrit and viscosity, and higher velocity, flow and lumen area, with lower ESS compared to healthy controls. We observed significant age‐related decline in haemodynamic 4D flow parameters; velocity (Spearman's ρ = −0·36 to −0·61), flow (ρ = −0·26 to −0·52) and ESS (ρ = −0·14 to −0·54) in SCD patients. Further analysis in only adults showed that velocity values were similar in SCD patients compared to healthy controls, but that the additional 4D flow parameters, flow and lumen area, were higher, and ESS lower, in the SCD group. Our data suggest that 4D flow MRI may identify adult patients with an increased stroke risk more accurately than current TCD‐based velocity.
Recent advances in understanding the pathogenesis and management of reticular dysgenesis
Authors: Hoenig Manfred , Pannicke Ulrich , Gaspar Hubert B. , Schwarz Klaus
Published: December 2017

Reticular Dysgenesis is a rare immunodeficiency which is clinically characterized by the combination of Severe Combined Immunodeficiency (SCID) with agranulocytosis and sensorineural deafness. Mutations in the gene encoding adenylate kinase 2 (AK2) were identified to cause this phenotype. In this review, we will demonstrate important clinical differences between reticular dysgenesis and other SCID entities and summarize recent concepts in the understanding of the pathophysiology of the disease and the management strategies for this difficult condition.
The inhibitory effects of capillarisin on cell proliferation and invasion of prostate carcinoma cells
Authors: Tsui Ke‐Hung , Chang Ying‐Ling , Yang Pei‐Shan , Hou Chen‐Pang , Lin Yu‐Hsiang , Lin Bing‐Wei , Feng Tsui‐Hsia , Juang Horng‐Heng
Published: December 2017

Objectives

Capillarisin (Cap), an active component of Artemisia capillaris root extracts, is characterized by its anti‐inflammatory, anti‐oxidant and anti‐cancer properties. Nevertheless, the functions of Cap in prostate cancer have not been fully explored. We evaluated the potential actions of Cap on the cell proliferation, migration and invasion of prostate carcinoma cells.

Materials and methods

Cell proliferation and cell cycle distribution were measured by water‐soluble tetrazolium‐1 and flow cytometry assays. The expression of cyclins, p21, p27, survivin, matrix metallopeptidase (MMP2 and MMP9) were assessed by immunoblotting assays. Effects of Cap on invasion and migration were determined by wound closure and matrigel transmigration assays. The constitutive and interlukin‐6 (IL‐6)‐inducible STAT3 activation of prostate carcinoma cells were determined by immunoblotting and reporter assays.

Results

Capillarisin inhibited androgen‐independent DU145 and androgen‐dependent LNCaP cell growth through the induction of cell cycle arrest at the G0/G1 phase by upregulating p21 and p27 while downregulating expression of cyclin D1, cyclin A and cyclin B. Cap decreased protein expression of survivin, MMP‐2, and MMP‐9 and therefore blocked the migration and invasion of DU145 cells. Cap suppressed constitutive and IL‐6‐inducible STAT3 activation in DU145 and LNCaP cells.

Conclusions

Our data indicate that Cap blocked cell growth by modulation of p21, p27 and cyclins. The inhibitory effects of Cap on survivin, MMP‐2, MMP‐9 and STAT3 activation may account for the suppression of invasion in prostate carcinoma cells. Our data suggest that Cap might be a therapeutic agent in treating advanced prostate cancer with constitutive STAT3 or IL‐6‐inducible STAT3 activation.
Knowledge of naloxone and take‐home naloxone programs among a sample of people who inject drugs in Australia: Variations across capital cities
Authors: Dietze Paul M. , Stare Mark , Cogger Shelley , Nambiar Dhanya , Olsen Anna , Burns Lucinda , Lenton Simon
Published: December 2017

Introduction and Aims

Take‐home naloxone (THN) programs targeting people who inject drugs (PWID) have been running in some Australian states and territories since 2012. In this study, we aimed to determine the extent to which PWID in the capital cities of all Australian states and territories are aware of naloxone and THN programs, whether awareness of these programs has changed over time.

Design and Methods

Data were obtained from cross‐sectional surveys of a total of 2088 PWID conducted annually as part of the Illicit Drug Reporting System from 2013 to 2015. Specific questions about THN added to the survey in 2013 allowed assessment of the extent to which sampled PWID were aware of naloxone and its function and THN programs in Australia and whether they had participated in a THN program. These main outcomes were examined over time and across states and territories using a mix of descriptive statistics and logistic regression.

Results

Over 80% of the sample reported having heard of naloxone across survey years. Less than half of the participants reported having heard of THN programs in 2013 (35%), but this increased to just over (52%) half in 2015 (P < 0.01). Changes over time differed across cities with increases in reports of having heard of THN occurring over time most clearly in those cities with operational THN programs.

Discussion and Conclusions

Around half of the PWID sampled for this study are aware of THN programs. Further work is needed to ensure widespread awareness of THN programs which should include implementing THN in all Australian states and territories.
Non‐interacting impacts of fertilization and habitat area on plant diversity via contrasting assembly mechanisms
Authors: Harvey Eric , MacDougall Andrew S.
Published: December 2017

Aim

The local‐ and regional‐based forms of anthropogenic change reducing grassland diversity are generally identified, but these scale‐dependent processes tend to co‐occur with unclear interactive effects. Here, we explicitly test how common local and regional perturbations simultaneously affect plant alpha and beta diversity in a multiyear community assembly experiment using fragments of grassland habitat of various sizes. We hypothesized that local disturbances and decreasing patch size would interact, suppressing local diversity while homogenizing composition among patches.

Location

North America.

Methods

We conducted a three‐year grassland assembly experiment, factorially manipulating local perturbation (nitrogen addition and mowing) and patch area for 36 patches over 13 ha. We quantified the individual and interactive effects of these local and regional factors on plant alpha and beta diversity within (quadrat scale) and among patches (patch scale). We also used a null model approach to disentangle between stochastic‐ and niche‐based assembly mechanisms.

Results

We detected a gradient of assembly outcomes driven by two non‐interacting factors—the effects of N fertilization on alpha (negative) and beta (positive) diversity regardless of spatial scale and the scale‐dependant effect of increasing patch size on alpha (positive) and beta (positive) diversity. These effects unfolded over time, with the constraints on richness and composition shifting from dispersal‐based during the first sampling year to perturbation‐and size‐based factors at year two and three. Fertilization effects were driven by a mixture of deterministic (i.e., selection at the species level) and stochastic (i.e., random extinctions) processes resulting in a decline in local richness but an increase in spatial heterogeneity in species composition. Area appeared to influence alpha diversity mainly via stochastic “sampling effect”—larger patches represented a larger sample of the regional pool. Niche‐based processes, however, led to convergence in beta diversity among smaller patches driving a positive overall effect of area on beta diversity.

Main conclusion

Our results illustrate how diversity regulation in contemporary grasslands can be simultaneously shaped by local and regional factors acting additively but via contrasting assembly mechanisms that operate at different spatial and temporal scales.
The child's best interest: ethical guide or ideology?
Authors: Dan Bernard
Published: December 2017

Video Podcast: https://www.youtube.com/watch?v=PvPTxc7OCRw&feature=youtu.be
A Head‐count Measure of Rank Mobility and its Directional Decomposition
Authors: Bossert Walter , Can Burak , D'Ambrosio Conchita
Published: December 2017

We propose and characterize a new measure of rank mobility. The index is given by the head count of those whose positions change in the move from one period to the next divided by population size. The interpretation of this head‐count ratio is straightforward and intuitive. In addition, we illustrate how the measure can be decomposed into an index of upwards mobility and an index of downwards mobility. The axioms used in our characterization results are appealing and easy to justify. We conclude with an application to the Human Development Index, a summary measure of average achievement in key dimensions of human development: a long and healthy life, being knowledgeable and having a decent standard of living.
From manageable to losing control: a grounded theory study of psychosis risk syndrome
Authors: Cheng Sunny Chieh , Schepp Karen G. , Liu Chen‐Chung , McGrath Barbara G. , Walsh Elaine , Chen Eleanor
Published: December 2017

Aim

The purpose of this study is to develop a theoretical explanation of the prodromal schizophrenia process, or so‐called psychosis risk syndrome, by describing patients’ own experiences with symptoms, thoughts and feelings.

Methods

A total of 40 interviews were conducted in Taiwan. A Grounded Theory method was selected because of its demonstrated effectiveness in generating theory around dynamic and complex processes on which little is known, all of which is the case with psychosis risk syndrome. Constant comparison analysis, memo writing, member checking, and theoretical sampling were adopted.

Results

A core theoretical framework was developed in which the process of the psychosis risk syndrome is described as proceeding from manageable to uncontrollable. Four stages emerged from the analysis: (1) something is wrong, (2) boiling up, (3) breaking point, and (4) losing control.

Conclusions

The framework resulting from this Grounded Theory research is innovative in presenting patterns and clinical staging that marks the progression from premorbid stage to full‐blown psychosis. In addition to specifying the detailed process through in‐depth interviews, this research makes two fundamental contributions by: (1) adding evidence to current science and (2) taking patients’ experience into consideration to improve the validity of screening tools and design appropriate intervention programs for people with early warning signs of developing schizophrenia.
Incident reporting in dentistry: Clinical supervisor's awareness, practice and perceived barriers
Authors: AlBlaihed R. M. , AlSaeed M. I. , Abuabat A. A. , Ahsan S. H.
Published: December 2017

Background

The significance of patient safety and risk management in dentistry has surfaced as dental settings bear delicate procedures carried out by teams utilising numerous devices and tools in complex environments.

Aim and objectives

Our aim is to assess awareness, practice, attitude and perceived barriers of reporting incidents amongst dental clinical supervisors working at dental colleges in Riyadh, Saudi Arabia. The objectives are as follows: (i) Determine if correlations exist between socio‐demographic data and supervisors’ awareness, practice, attitude and perceived barriers. (ii) Identify most common perceived barriers.

Materials and methods

An online questionnaire was sent to the 450 clinical supervisors working at five dental colleges of Riyadh. The collected data included items assessing the awareness, practice and attitude of reporting students’ incidents along with the perceived barriers.

Results

A response rate of (60.1% n = 264 of 450) was established. The majority of the respondents (62.9% n = 166) were aware of the incident reporting policy. Yet, only (35.4% n = 93) of them had completed an incident reporting form before. Most of the participants (90.5% n = 239) agreed on the necessity of reporting student's incidents, but only (67.0% n = 177) agreed on the necessity of reporting well‐handled incidents. The possible negative relationship with students was the most agreed on barrier to reporting.

Conclusion

This study shows that certain demographics of supervisors had significant relationship with their awareness, attitude, perceived barriers and practice. Awareness of the policy and form was linked to the increase in supervisors’ practice, although they tend to report verbally rather than in writing. The possible negative relationship with students was the most common perceived barrier.
Response of pore structures to long‐term fertilization by a combination of synchrotron radiation X‐ray microcomputed tomography and a pore network model
Authors: Yu X. , Hong C. , Peng G. , Lu S.
Published: December 2017

Pore structure is sensitive to land management, fertilization and tillage. The response of pore structure to long‐term fertilizer application is crucial for understanding the mechanisms of various soil processes involved. In this study, the effect of chemical fertilizer and organic manure on microscale pore structure and the pore network in soil was quantified by synchrotron‐based X‐ray microcomputed tomography (SR‐mCT) and a pore network model. Macroaggregates of 5–7 mm in diameter were collected from a paddy soil (Typic Haplustalf) with a long‐term fertilization experiment established in 1996 under an annual rice–wheat crop rotation. The treatments were control (CK), chemical fertilizers (NPK), rice straw (RS), pig manure (PM), chemical fertilizer plus straw (NPK + RS) and chemical fertilizer plus pig manure (NPK + PM). Results showed that the application of NPK greatly reduced the C/I ratio (ratio of connected porosity and isolated porosity) of the macroaggregates compared with all the other treatments. The pore network model revealed that application of NPK reduced the complexity of the pore network system. Heatmap analyses showed that NPK increased the isolated porosity of macroaggregates and that straw markedly changed the pore shape by increasing the proportion of elongated pores, whereas the PM increased the connected porosity of macroaggregates. From our results, we believe a ‘good pore structure’ comprised a moderate total porosity and C/I ratio, which can balance the air, water exchange and moisture, and nutrient retention. We considered that total porosity and C/I ratio were the crucial pore variables to evaluate the effect of fertilization on pore structures at the microscale level. Therefore, we proposed that total porosity and the C/I ratio in macroaggregates could be used as effective indicators to evaluate the response of pore structure to fertilization. Application of a balanced approach of chemical fertilizer together with manure (NPK + PM) or straw (NPK + RS) improved pore structure. This suggested that fertilization management should include the integrated use of both mineral fertilizer and organic manure or straw to maintain a suitable pore environment in soil.

Highlights

Effects of long‐term fertilization on pore structure of macroaggregates of paddy soil.

Pore system of macroaggregates investigated by pore network model and cluster analysis.

Application of NPK (alone or combined with organic matter) will increase proportion of isolated pores.

The C/I ratio has the potential to predict change in pore structure of soil at the aggregate scale.
Changes in courtship behaviour following rejection: The influence of female phenotype in Drosophila melanogaster
Authors: Balaban‐Feld Jesse , Valone Thomas J.
Published: December 2017

Courtship can be costly and so selection should favour individual males that reduce courtship towards female types that have a low probability of resulting in copulation. One way males can do this is by associating previous courtship failure with the traits of particular rejecting females. We characterised changes in male Drosophila melanogaster courtship behaviour following a failed mating attempt with one of the four female phenotypes that varied in size, age or mating status. To do this, we assessed individual courtship behaviour for each male presented again with a female of the same phenotype that previously rejected him. Males reduced subsequent courtship most strongly for recently mated (sexually non‐receptive) females. More interestingly, males also significantly reduced courtship activity following a failed mating experience from old females but did not do so for control (large, young, virgin) or small females. As such, males significantly reduced courtship towards both female types possessing chemical cues associated with their phenotype (age and mating status), but not towards a female phenotype based on physical characteristics (body size). Our results suggest that males are able to modify their courtship behaviour following experience, but that they are better prepared to associate chemical traits that may be more reliable indicators of the likelihood of courtship failure.
Vonoprazan‐ vs proton‐pump inhibitor‐based first‐line 7‐day triple therapy for clarithromycin‐susceptible Helicobacter pylori: A multicenter, prospective, randomized trial
Authors: Sue Soichiro , Ogushi Marina , Arima Isao , Kuwashima Hirofumi , Nakao Satoshi , Naito Makoto , Komatsu Kazuo , Kaneko Hiroaki , Tamura Toshihide , Sasaki Tomohiko , Kondo Masaaki , Shibata Wataru , Maeda Shin
Published: December 2017

Background

The eradication rate of vonoprazan‐based first‐line triple therapy (combined with clarithromycin and amoxicillin) (V‐AC) was reported to be 97.6% in patients with clarithromycin (CAM)‐susceptible Helicobacter pylori in a phase III study, whereas our real‐world, prospective, multicenter cohort study yielded an eradication rate <90%.

Objective

To validate the eradication rate of V‐AC using CAM‐susceptible testing in a multicenter, prospective, randomized trial.

Methods

We included 147 treatment‐naïve H. pylori‐positive patients [41 with CAM‐resistant infections and 106 with CAM‐susceptible infections]. The CAM‐susceptible group patients were randomized to either the V‐AC group (vonoprazan 20 mg bid, amoxicillin 750 mg bid, and clarithromycin 200 or 400 mg bid) or PPI‐AC group (lansoprazole 30 mg, rabeprazole 10 mg, or esomeprazole 20 mg bid; amoxicillin 750 mg bid; and clarithromycin 200 or 400 mg bid). All CAM‐resistant H. pylori were eradicated by V‐AC, as measured by the urea breath test around 8 weeks after eradication. Safety was evaluated by patient questionnaires.

Results

The intention‐to‐treat and per‐protocol eradication rates of V‐AC in the CAM‐susceptible H. pylori‐infected patients were 87.3% (95% confidence interval 75.5%‐94.7%) and 88.9% (77.4%‐95.8%). The respective eradication rates of PPI‐AC were 76.5% (62.5%‐87.2%) and 86.7% (73.2%‐94.9%). No significant difference was observed between the V‐AC and PPI‐AC regimes in terms of the intention‐to‐treat (P = .21) or per‐protocol (P = .77) analyses. The questionnaire scores did not differ significantly between the groups. Both the intention‐to‐treat and per‐protocol eradication rates of V‐AC in the CAM‐resistant patients were 82.9% (67.9%‐92.8%).

Conclusion

The eradication rate of V‐AC treatment in the CAM‐susceptible H. pylori‐infected patients was <90%, as was that by PPI‐AC, thus V‐AC is not ideal regimen in CAM‐susceptible H. pylori. However, the 82.9% eradication rate of V‐AC in the CAM‐resistant infections may indicate the potential of V‐AC with modified dose, dosing interval, and treatment duration. (UMIN000016337).
Learning from the past to inform the future
Authors: Grant Maria J.
Published: December 2017

In this final issue of 2017, we are in a reflective mood at the Health Information and Libraries Journal as we say goodbye to Audrey Marshall, Regular Feature Editor of Dissertations into Practice. While Audrey departs, Dissertations into Practice is now a firm fixture of the Health Information and Libraries Journal; there remains no better place for students to see their writing, possibly for the first time, in print. This issue also provides an opportunity to review the breadth of health information writing through the editorials of past Virtual Issues of the Health Information and Libraries Journal, all still available, free of charge, via the journal's home page at http://wileyonlinelibrary.com/journal/hilj.
The political economy of global reserve assets
Authors: James Harold , Lombardi Domenico
Published: December 2017

This article focuses on the political economy that shaped the Special Drawing Right (SDR) by examining the three drivers of reform that influenced the creation of the SDR and resulted in changes in the international monetary system (IMS) and the International Monetary Fund (IMF). The three factors examined are, first, informal intergovernmental forums working outside the framework of the IMF; second, the eclipse of the IMF as the central institution of the IMS; and finally, the lack of reference to the private sector in the discussions, even though capital movements were the central cause of strains in the IMS. The article concludes that the resulting limitations of the SDR solution—an institutional change brought about by the compromise between parties to the discussions—meant that major imperfections in the IMS remained unresolved.
Violence in mental health settings: A systematic review
Authors: Spaducci Gilda , Stubbs Brendon , McNeill Ann , Stewart Duncan , Robson Debbie
Published: December 2017

The introduction of smoke‐free policies is increasingly common in mental health settings, to improve health. However, a barrier to implementing smoke‐free polices is staff concern that violence will increase. We conducted a systematic review comparing the rates of violence before and after the introduction of smoke‐free policies in mental health settings. Two authors searched major electronic databases. We included studies reporting the prevalence of violence (verbal and/or physical or combined) before and after the introduction of a smoke‐free policy in a mental health, forensic, or addiction setting. We included 11 studies in the review. A narrative synthesis was used to describe the key results of each study. Six studies measured physical violence specifically; four reported a decrease or no change and two reported a short‐term increase. Five of these six studies also measured verbal violence; two found an increase, with one of the studies reporting that this increase was temporary. Three reported a decrease in verbal violence. A further five studies evaluated the rate of combined verbal and physical violence; four reported a decrease or no change and the other an increase. We conclude that the introduction of smoke‐free policies generally does not lead to an increase in violence. There is a need for more robust studies to support this finding. However, the conclusions from this review may be a step in reducing staff concerns.
Ensuring inclusion and combatting discrimination in social protection programmes: The role of human rights standards
Authors: Sepúlveda Carmona Magdalena
Published: December 2017

Recent years have witnessed the significant expansion of social protection programmes around the world. Yet, a vast number of poor and vulnerable people, including children, women, ethnic minorities, and persons with disabilities, remain uncovered, especially in lower‐income countries. This article argues that a better understanding of the principle of equality and non‐discrimination, as defined under international human rights law, can guide practitioners and policy‐makers to design and implement more inclusive social protection systems. Compliance with this principle is also necessary under the 2030 Agenda for Sustainable Development and the International Labour Organization's social security standards. The article first analyses the scope and content of the legal principle of equality and non‐discrimination, giving attention to the standards commonly used to assess compliance with it. It then applies these standards as analytical tools to assess how and when discrimination may occur in the implementation of non‐contributory social protection programmes. Finally, it explores the challenges that social protection practitioners face when applying the principle of equality and non‐discrimination in social protection programmes.
Parameters for determination of Candida albicans virulence in murine peritonitis
Authors: Kretschmar M. , Bertsch T. , Göller M. , Schaller M. , Hof H. , Nichterlein T.
Published: December 2017

Using intraperitoneal (i. p.) infection of mice with Candida albicans we determined which parameters might be useful for characterization of virulence in this model. Upon i. p. infection of mice with two reference strains striking differences in lethality were detected. These differences in virulence corresponded with invasion of the liver and pancreas by the virulent strain and with a lack of invasion by the avirulent strain. The virulent strain was able to release high amounts of the enzymes alanine aminotransferase (ALT) and α‐amylase (AM) from liver and pancreas into the blood plasma. Most likely, these enzymes were released by penetration of hyphae into the cytoplasm which was shown with electron microscopy. When invasion slowed down, there was also a drop in the activities of ALT and AM measured in the blood of infected mice. As both strains disseminated to the heart, kidneys, and lungs, dissemination into these organs was no reliable parameter for virulence in this model. However, only the virulent strain was able to reach the brain and to germinate in the kidneys and brain. In contrast to invasion and enzyme activities, the fungal load in the peritoneal cavity and in the neighbouring organs appeared not to be related with virulence. This may be concluded from the fact that there were no differences in the absolute colony forming units (cfu) and the length of persistence of both strains when similar inocula were used. We conclude that the ability of a given strain of C. albicans to invade neighbouring organs, to reach the brain upon dissemination and germination in the brain and kidneys may be used for measurement of virulence in this model when virulence is defined as lethality.
Cytokine modulation of specific and nonspecific immunity to Candida albicans
Authors: Romani Luigina
Published: December 2017

Recent observations on reciprocal regulation of humoral and cell‐mediated immunity to Candida albicans are presented and their significance in the exploration of the host‐fungus‐relationship is discussed.
Antifungal activity of the new azole UK‐109, 496 (voriconazole)
Authors: Kappe R.
Published: December 2017

The in vitro activity of voriconazole fully includes Aspergillus, and also emerging moulds like Fusarium, Pseudallescheria boydii, and Penicillium marneffei. The minimal inhibitory concentrations of voriconazole for Candida krusei and Candida glabrata, which are resistant or less susceptible to fluconazole, promise clinical efficacy, although they are ten times higher (0.30–0.39 μg/ml) than those for Candida albicans and other Candida spp. (0.001–0.05 μg/ml). The endemic fungal pathogens Histoplasma capsulatum, Coccidioides immitis, Blastomyces dermatitidis, Paracoccidioides brasiliensis, as well as Cryptococcus neoformans, and the dermatophytes are also fully susceptible to voriconazole. The zygomycetes and Sporothrix schenckii remain a problem.

Voriconazole has been shown to be effective against invasive aspergillosis (IA) and fluconazole‐resistant candidosis in animal models, when administered in doses between 2.5 and 45 mg/kg/day. The pharmacokinetics of voriconazole in man produced sustained high blood and tissue levels following oral and intravenous applications of 50 to 200 mg/day. Side effects included fully reversible mild to moderate visual disturbances (8 to 44 %) and raised liver function enzymes (6 to 8 %).

In conclusion, voriconazole is highly active against Aspergillus and most other medically relevant fungi, it is applicable intravenously, and it appears to have an acceptable safety profile.
Early empiric antifungal therapy of infections in neutropenic patients comparing fluconazole with amphotericin B/flucytosine
Authors: Silling G. , Fegeler W. , Roos N. , Essink M. , Büchner T.
Published: December 2017

We compared the efficacy and tolerability of fluconazole (FCA) with amphotericin B/flucytosine (ABF) in neutropenic patients with haematological malignancies. Antifungal therapy started on day 4 when fever was unresponsive to antibiotics or on day 1 together with the antibiotics, if there was evidence of mycosis. If patients did not respond to FCA after 7 days they switched to ABF. 98 patients, 51 FCA and 47 ABF were included in the study. Response to fever was achieved in 28/51 FCA patients and in another 16 after switching to ABF. So in overall 44/51 (86.2%) of the FCA and 37/47 (78.8%) of the ABF group defervescence was observed. 46 patients (21 FCA, 25 ABF) developed radiological signs of pneumonia. Resolution of infiltrates was achieved in 5/21 FCA and 20/25 ABF patients, and another 10 of 15 initially not responding patients showed regression when switched to ABF, 5 of these had highly suspected aspergillosis. Adverse events occured in 19.6% of FCA and 97.9% of ABF patients. In conclusion fluconazole and amphotericin B/flucytosine seem to be equally effective. In view of its lower toxicity fluconazole may be preferred as first line empiric antifungal agent, but in case of nonresponse, pneumonia or aspergillosis it may be replaced by amphotericin B combined with flucytosine.
Antifungal susceptibilities and genetic relatedness of serial Trichophyton rubrum isolates from patients with onychomycosis of the toenail
Authors: Bradley M. C. , Leidich S. , Isham N. , Elewski B. E. , Ghannoum M. A.
Published: December 2017

Onychomycosis is a common fungal disease infecting up to 20% of the population over age 40. The major causative agent of onychomycosis is Trichophyton rubrum. Uncontrolled infection may eventually lead to penetration of the newly forming nail plate. In spite of the encouraging cure rate with recent antifungal agents such as the allylamines (terbinafine) and azoles (itraconazole and fluconazole) some patients inevitably fail therapy. In this investigation, a group of patients from a multi‐center study designed to assess the efficacy of terbinafine with known cases of onychomycosis were selected for evaluation. Nail samples from this patient group were colonized with T. rubrum throughout the terbinafine therapy. Antifungal susceptibility testing was performed on these T. rubrum isolates to detect change in MIC values. Strain relatedness was examined using random amplified polymorphic DNA (RAPD) technique. Our results revealed failure of patients to clear T. rubrum is not related to the development of resistance to the drug. While species determination was possible, we were not able to identify differences that would indicate reinfection with a new strain. Analysis of patient demographic data revealed that 70% of patients were over 45 years old, 56.6% were previously treated with antifungals, 60% came from family history with onychomycosis and 13 % were diabetic. In conclusion, our data indicate that patients' failure to clear onychomycosis was not associated with resistant development. Failure of terbinafine therapy may be dependent on host‐related factors.
Antifungal prophylaxis with itraconazole oral solution in neutropenic patients
Authors: Kibbler C. C.
Published: December 2017

The role of itraconazole in anti‐fungal prophylaxis has been limited by the low bioavailability of the capsule formulation but the bioavailability of the oral solution is much improved. Three multi‐centre studies using itraconazole solution (5 mg/kg/day) have recently been completed. The UK trial compared itraconazole solution with fluconazole suspension (100 mg/day). No invasive aspergillosis occurred in the itraconazole arm and there were more fungal deaths due to proven/suspected infection in the fluconazole group than in the itraconazole group (0 versus 7, p = 0.024). An Italian study compared itraconazole solution with placebo. Proven, suspected and superficial fungal infections were fewer in the itraconazole arm compared with placebo, with significant differences in proven and suspected systemic fungal infections (itraconazole 24% versus placebo 33 %, p = 0.035). The third study compared itraconazole with amphotericin B capsules (2 g/day). There were more invasive fungal infections, Aspergillus infections and fungal deaths in the amphotericin B arm than with itraconazole but none of these differences were statistically significant.

Azole prophylaxis in neutropenic patients may reduce the incidence of Candida infections, empirical amphotericin B usage, and the incidence of proven fungal infections. Itraconazole may be more effective than fluconazole in preventing invasive aspergillosis. All of these effects are more pronounced in high risk patients.
A bundled quality improvement program to standardize clinical blood pressure measurement in primary care
Authors: Boonyasai Romsai T. , Carson Kathryn A. , Marsteller Jill A. , Dietz Katherine B. , Noronha Gary J. , Hsu Yea‐Jen , Flynn Sarah J. , Charleston Jeanne M. , Prokopowicz Greg P. , Miller Edgar R. , Cooper Lisa A.
Published: December 2017

We evaluated use of a program to improve blood pressure measurement at 6 primary care clinics over a 6‐month period. The program consisted of automated devices, clinical training, and support for systems change. Unannounced audits and electronic medical records provided evaluation data. Clinics used devices in 81.0% of encounters and used them as intended in 71.6% of encounters, but implementation fidelity varied. Intervention site systolic and diastolic blood pressure with terminal digit “0” decreased from 32.1% and 33.7% to 11.1% and 11.3%, respectively. Improvement occurred uniformly, regardless of sites’ adherence to the measurement protocol. Providers rechecked blood pressure measurements less often post‐intervention (from 23.5% to 8.1% of visits overall). Providers at sites with high protocol adherence were less likely to recheck measurements than those at low adherence sites. Comparison sites exhibited no change in terminal digit preference or repeat measurements. This study demonstrates that clinics can apply a pragmatic intervention to improve blood pressure measurement. Additional refinement may improve implementation fidelity.
Angiopoietin‐like protein 8/betatrophin correlates with hepatocellular lipid content independent of insulin resistance in non‐alcoholic fatty liver disease patients
Authors: Hong Beverly S , Liu Juan , Zheng Jing , Ke Weijian , Huang Zhimin , Wan Xuesi , He Xiaoying , Xiao Haipeng , Li Yanbing
Published: December 2017

Aims/Introduction

To explore angiopoietin‐like protein 8 (ANGPTL‐8) levels, and its association with hepatocellular lipid content (HCL) and insulin resistance in patients with different extents of non‐alcoholic fatty liver disease (NAFLD).

Materials and Methods

In 48 adults were recruited, of which 12 had no NAFLD (HCL < 5.5%; group 1), 18 had mild NAFLD (5.5% ≤ HCL < 10.0%; group 2) and 18 had moderate‐to‐severe NAFLD (HCL ≥ 10.0%; group 3). The peripheral insulin sensitivity of all participants was monitored by a hyperinsulinemic‐euglycemic clamp (M value), as well as the magnetic resonance image of HCL. Serum ANGPTL‐8, blood glucose levels and lipid profiles were also recorded in the study.

Results

Group 3 had a worse metabolic profile, and had the highest ANGPTL‐8 level (1,129 ± 351 pg/mL vs 742 ± 252 pg/mL, 765 ± 301 pg/mL, P = 0.001) compared with those in group 1 and group 2. In all metabolic profiles, HCL positively correlated the strongest with ANGPTL‐8 (r = 0.436, P = 0.042). Multivariate stepwise linear regression analysis showed ANGPTL‐8 and alanine aminotransferase were independent determinants of HCL (P = 0.002, P < 0.001, respectively), and these two indexes explained 67.4% of the variation of HCL (P < 0.001).

Conclusions

ANGPTL‐8 was positively correlated with hepatocellular lipid content independent of obesity and insulin resistance, indicating that ANGPTL‐8 might be a new and important important predictor of the severity of NAFLD.