bluuebunny/crossref_metadata_2025 huggingface dataset:
MORPHOLOGICAL TYPES AND ARRANGEMENT OF CONE CELLS, AND THE VISUAL ACUITY OF SUTCHI CATFISH PANGASIANODON HYPOPHTHALMUS
Authors: Han Tan Nai , Mukai Yukinori
Published: December 2015

The density and spatial arrangement of photoreceptor cells in the retina reflect the visual environment of a fish. The density of photoreceptor cells also determines the visual acuity. In this study, the morphological types and arrangement of cone cells, and the visual acuity of sutchi catfish Pangasianodon hypophthalmus were determined to obtain fundamental understanding of its vision. The left eyes of the adult sutchi catfish were enucleated, fixed in Bouin’s solution for 24 hours and then preserved in 70% ethanol. The fixed retinae were cut into 17 regions. The nine major regions were the dorso-nasal (DN), dorsal (D), dorso-temporal (DT), nasal (N), bottom (B), temporal (T), ventro-nasal (VN), ventral (V), and ventro-temporal (VT). The 17 regions were then immersed separately in a series of ethanol (from 70% to 100%), cleared with histolene, embedded in paraffin, cut into 6 μm thick tangential sections, and stained with haematoxylin-eosin. The density of cone cells per 0.01 mm2 in each region was counted from the stained sections. Visual acuity was then calculated using cone cell densities and lens radii. Only one type of cone cells, which is the single cone cell, was identified and these single cone cells were closely spaced. The area around the bottom region showed tendency of higher density of single cone cells. These findings provide the fundamental understanding on the adaptation of retinal structure of sutchi catfish to its feeding behaviour.
SCLERACTINIAN CORAL RECRUITMENT DENSITY IN COASTAL WATER OF BALOK, PAHANG, MALAYSIA
Authors: Rani Mohd Husaini , Saad Shahbudin , Akmal Khodzari Mohd Fikri , Ramli Rafindde , Yusof Muhamad Hamizan
Published: December 2015

Study on scleractinian coral recruitment is important in understanding the mechanisms that regulate their population and the resilience of coral reef communities to disturbance. This study aims to investigate temporal recruitment density of scleractinian coral at selected remote area in Balok, Pahang. Two types of settlement plates, which are terra-cotta tiles and artificial reef, were deployed at three stations to determine the recruitment density. The retrieval of the settlement plate was done at every three months interval started from March to September 2014. A total of 159 coral recruits were counted with mean recruitment densities on both terracotta tiles was 1.52 ± 0.65 and artificial reef plate was 4.37 ± 1.84 respectively. Recruitment was dominated by Platygyra (36%) followed by Porites (32%), Fungia (17%), Turbinaria (7%), Acropora (2%), Stylopora (2%), Montipora (1%), Leptoria (1%), Favites (1%) and Echinophyllia (1%). Kruskal - Wallis ANOVA test shown that recruitment densities varied significantly with plate’s orientation (p < 0.05), but not with sampling stations, type of substrates and month retrieval.  Artificial reef plate has better recruitment densities compared to terra-cotta tiles. Coral spat settlement and recruitment patterns were consistent with adult coral distributions. The percentage cover of adult coral varied within the three stations. A total of 33 coral genera from 13 families were recorded during coral video transect survey with Station 3 showed the highest H’ (2.35). Meanwhile, Station 2 showed higher EH’ indexes with 0.82. Therefore, results of this study is important because coral recruitment pattern reflect its adult coral population, and if it closely monitored and harvested sustainably, the survival of parent population could be increased for successful breeding.
ISOLATION OF THERMOTOLERANT BACTERIA PRODUCING FIBRINOLYTIC ENZYME
Authors: Ab. Shukor Nurul Aqilah , Amid Azura , Ismail Mohamed , Abd Samad Nadiah Syuhada
Published: December 2015

Fibrinolytic enzymes were widely used in the treatment of cardiovascular diseases. However, the efficiency of the commercial enzymes are still lack of perfection because there are many side effects as well as not tolerant to downstream processing such as heat sensitive during spray drying process. Therefore, this study presents newly isolated thermophiles bacteria producing fibrinolytic enzyme. Sample was collected from Hot Spring Selayang at Selayang Selangor. Spread plate agar containing skim milk powder growth at pH 7, 53  for 24 hours was utilized to isolate thermotolerant bacteria producing protease. Further isolation on bacteria producing fibrinolytic enzyme was carried out using fibrin plate. 16S rDNA gene sequence analysis was used to identify the genotype of the isolates. 27 colonies of thermotolerant bacteria were isolated, however, only 19 of them showing proteolytic activity. All of the 19 isolates are motile and cocci in shapes, with 4 types of arrangement, which are single, diplo (pair), strepto (chain) and staphylo (cluster). HSP04 and HSP11 are gram positive bacteria and others are gram negative. From 19 isolates only 6 were chosen for further analysis. HSP23 showed the highest fibrinolytic activity compared with others. HSP23 was identified as Bacillus licheniformis with 98 % similarity to Bacillus licheniformis DCM 13 and Bacillus licheniformis strain ATCC 14580.
IN-VITRO ANTI-INFLAMMATORY ACTIVITIES OF EXTRACTS FROM BACTERIA ASSOCIATED WITH MARINE SPONGES: THEONELLA SP.
Authors: Mohd Radzi Siti Aisha , Andriani Yosie , M. Habsah , Tengku Mohamad Tengku Sifzizul , Saidin Jasnizat
Published: December 2015

In recent years, high numbers of research focusing on secondary metabolites produced by terrestrial bacteria towards anti-inflammatory properties but, minority of them used bacteria associated to marine organism. In this study, 25 bacteria colonies were isolated from sponge Theonella sp. which was collected from Bidong Island, Terengganu. Cytotoxicity and anti-inflammatory activity of secondary metabolites produced by these bacteria were studied using macrophage cell lines: RAW 264.7 .Macrophage plays a role in mammalian immune system by providing defense against a foreign harmful substance for example Lipopolysaccharides (LPS) which induces production of pro-inflammatory mediators such as nitric oxide (NO). Inhibition of NO production in LPS stimulated RAW 264.7 cells is highly established assay to screen for anti-inflammatory activity. All isolates were cultured and supernatants were collected for the extraction of secondary metabolites using diaion HP-20 to obtain crude extracts. Evaluations of the cytotoxicity effect of the extracts on RAW 264.7 were done using MTT assay. The highest concentration sample producing lowest toxicity effect was used for anti-inflammatory assay. Macrophages were induced with LPS before treated with different concentrations of crude metabolites in anti-inflammatory assay. The effects of crude secondary metabolites extracted to the induced macrophage were monitored by observing the inhibition level of Nitric Oxide (NO) released by RAW 264.7 into supernatant and estimated from nitrate standard curve. A preliminary assay revealed that isolate label with TM1.8 and TM 1.9 possesses anti-inflammatory activities of 112.06% and 109.7% respectively for every 1ug/L sample. The result suggested that these two crude extracts were more effective in inhibiting NO production compared to positive control N-Monomethyl-L-arginine Monoacetate (L-NMMA) which showed an inhibitory activity at 87.41% for every 1ug/L sample.
Medial unicondylar knee arthroplasty: technical pearls
Authors: Boniforti Filippo
Published: December 2015

Unicondylar knee arthroplasty implantation is extremely demanding as the prosthesis needs to be integrated in the natural anatomy of the knee. It ensures the integrity of the natural knee kinematic. Some studies and registries data have shown lower success rate in comparison with total knee arthroplasty, and patientrelated factors may have an impact on outcome. While, better results have been published by high volume centres. The indications for surgery should be reconsidered critically, even if medial osteo arthritis of the knee remains the most common. This article sets out the diagnostic, and surgical steps in order to fine tuning the unicompartmental replacement of the knee.
The Number of Trials Required to Obtain a Representative Movement Pattern During a Hurdle Hop Exercise
Authors: Gore Shane J. , Marshall Brendan M. , Franklyn-Miller Andrew D. , Falvey Eanna C. , Moran Kieran A.
Published: December 2015

When reporting a subject’s mean movement pattern, it is important to ensure that reported values are representative of the subject’s typical movement. While previous studies have used the mean of 3 trials, scientific justification of this number is lacking. One approach is to determine statistically how many trials are required to achieve a representative mean. This study compared 4 methods of calculating the number of trials required in a hopping movement to achieve a representative mean. Fifteen males completed 15 trials of a lateral hurdle hop. Range of motion at the trunk, pelvis, hip, knee, and ankle, in addition to peak moments for the latter 3 joints were examined. The number of trials required was computed using a peak intraclass correlation coefficient method, sequential analysis with a bandwidth of acceptable variance in the mean, and a novel method based on the standard error of measurement (SEMind). The number of trials required across all variables ranged from 2 to 12 depending on method, joint, and anatomical plane. The authors advocate the SEMind method as it demonstrated fewer limitations than the other methods. Using the SEMind, the required number of trials for a representative mean during the lateral hurdle hop is 6.
Pulse-Dose Radiofrequency in Athletic Pubalgia: Preliminary Results
Authors: Masala Salvatore , Fiori Roberto , Raguso Mario , Ojango Christine , Morini Marco , Cuzzolino Alessandro , Calabria Eros , Simonetti Giovanni
Published: December 2015

Context:

Chronic pubalgia affects around 10% of athletes.

Objective:

To determine the role of pulse-dose radiofrequency (PDRF) in athletes with chronic pubalgia and investigate the causes with imaging.

Design:

Prospective nonrandomized single-group study.

Patients:

PDRF was performed on 32 patients with a chronic pain that had been refractory to conservative therapies during the last 3 mo.

Intervention:

The genital branches of the genitofemoral, ilioinguinal, and iliohypogastric nerves and the obturator nerve were the goals of treatment. A 10-cm, 20-gauge cannula was inserted with a percutaneous access on the upper and lower edges of the iliopubic branch. After the spindle was removed, a radiofrequency needle with a 10-mm “active tip” was inserted. The radiofrequency technique was performed with 1200 pulses at 45 V and 20-ms duration, followed by a 480-ms silent phase.

Main Outcome Measures:

The follow-up with a clinical examination was performed at 1, 3, 6, and 9 mo after the procedure. During the follow-up visits, the patients were asked to rate their pain on a 0–10 VAS scale.

Results:

All of the enrolled patients completed the study. Mean VAS score before the treatment was 8.4 ± 0.6. Twenty-four patients had a reduction of pain VAS scores more than 50% during all follow-up visits and started training and physiotherapy in the days after the radiofrequency procedure. Six patients, each treated 2 times, had a reduction more than 50% of VAS scores and could start training and physiotherapy only after the 2nd procedure. One patient had no pain relief with 2 treatments. Pain intensity decreased up to 9 mo in 31 patients (mean VAS scores 3.4 ± 0.5 at 6 mo and 3.8 ± 0.9 at 9 mo). No complications were observed.

Conclusions:

PDRF is an effective and safe technique in management of chronic pubalgia in athletes.
Bioinspired large-scale aligned porous materials assembled with dual temperature gradients
Authors: Bai Hao , Chen Yuan , Delattre Benjamin , Tomsia Antoni P. , Ritchie Robert O.
Published: December 2015

A bidirectional freezing method to assemble ceramic particles into porous nacre-like scaffolds aligned over centimeter-scales.
Engineering a nanopore with co-chaperonin function
Authors: Ho Ching-Wen , Van Meervelt Veerle , Tsai Keng-Chang , De Temmerman Pieter-Jan , Mast Jan , Maglia Giovanni
Published: December 2015

A recombinant GroES nanopore reveals the dynamics and kinetics of the allosteric intermediates of the GroEL protein-folding reaction.
Comprehensive Genomic Analyses of the OM43 Clade, Including a Novel Species from the Red Sea, Indicate Ecotype Differentiation among Marine Methylotrophs
Authors: Jimenez-Infante Francy , Ngugi David Kamanda , Vinu Manikandan , Alam Intikhab , Kamau Allan Anthony , Blom Jochen , Bajic Vladimir B. , Stingl Ulrich
Published: December 2015

The OM43 clade within the family
Methylophilaceae
of
Betaproteobacteria
represents a group of methylotrophs that play important roles in the metabolism of C
1
compounds in marine environments and other aquatic environments around the globe. Using dilution-to-extinction cultivation techniques, we successfully isolated a novel species of this clade (here designated MBRS-H7) from the ultraoligotrophic open ocean waters of the central Red Sea. Phylogenomic analyses indicate that MBRS-H7 is a novel species that forms a distinct cluster together with isolate KB13 from Hawaii (Hawaii-Red Sea [H-RS] cluster) that is separate from the cluster represented by strain HTCC2181 (from the Oregon coast). Phylogenetic analyses using the robust 16S-23S internal transcribed spacer revealed a potential ecotype separation of the marine OM43 clade members, which was further confirmed by metagenomic fragment recruitment analyses that showed trends of higher abundance in low-chlorophyll and/or high-temperature provinces for the H-RS cluster but a preference for colder, highly productive waters for the HTCC2181 cluster. This potential environmentally driven niche differentiation is also reflected in the metabolic gene inventories, which in the case of the H-RS cluster include those conferring resistance to high levels of UV irradiation, temperature, and salinity. Interestingly, we also found different energy conservation modules between these OM43 subclades, namely, the existence of the NADH:quinone oxidoreductase complex I (NUO) system in the H-RS cluster and the nonhomologous NADH:quinone oxidoreductase (NQR) system in the HTCC2181 cluster, which might have implications for their overall energetic yields.
Multiple Posttranslational Modifications of Leptospira biflexa Proteins as Revealed by Proteomic Analysis
Authors: Stewart Philip E. , Carroll James A. , Olano L. Rennee , Sturdevant Daniel E. , Rosa Patricia A.
Published: December 2015

The saprophyte
Leptospira biflexa
is an excellent model for studying the physiology of the medically important
Leptospira
genus, the pathogenic members of which are more recalcitrant to genetic manipulation and have significantly slower
in vitro
growth. However, relatively little is known regarding the proteome of
L. biflexa
, limiting its utility as a model for some studies. Therefore, we have generated a proteomic map of both soluble and membrane-associated proteins of
L. biflexa
during exponential growth and in stationary phase. Using these data, we identified abundantly produced proteins in each cellular fraction and quantified the transcript levels from a subset of these genes using quantitative reverse transcription-PCR (RT-PCR). These proteins should prove useful as cellular markers and as controls for gene expression studies. We also observed a significant number of
L. biflexa
membrane-associated proteins with multiple isoforms, each having unique isoelectric focusing points.
L. biflexa
cell lysates were examined for several posttranslational modifications suggested by the protein patterns. Methylation and acetylation of lysine residues were predominately observed in the proteins of the membrane-associated fraction, while phosphorylation was detected mainly among soluble proteins. These three posttranslational modification systems appear to be conserved between the free-living species
L. biflexa
and the pathogenic species
Leptospira interrogans
, suggesting an important physiological advantage despite the varied life cycles of the different species.
Enhancement of Swimming Speed Leads to a More-Efficient Chemotactic Response to Repellent
Authors: Karmakar Richa , Uday Bhaskar R. V. S. , Jesudasan Rajesh E. , Tirumkudulu Mahesh S. , Venkatesh K. V.
Published: December 2015

Negative chemotaxis refers to the motion of microorganisms away from regions with high concentrations of chemorepellents. In this study, we set controlled gradients of NiCl
2
, a chemorepellent, in microchannels to quantify the motion of
Escherichia coli
over a broad range of concentrations. The experimental technique measured the motion of the bacteria in space and time and further related the motion to the local concentration profile of the repellent. Results show that the swimming speed of bacteria increases with an increasing concentration of repellent, which in turn enhances the drift velocity. The contribution of the increased swimming speed to the total drift velocity was in the range of 20 to 40%, with the remaining contribution coming from the modulation of the tumble frequency. A simple model that incorporates receptor dynamics, including adaptation, intracellular signaling, and swimming speed variation, was able to qualitatively capture the observed trend in drift velocity.
Markerless Gene Deletion with Cytosine Deaminase in Thermus thermophilus Strain HB27
Authors: Wang Lei , Hoffmann Jana , Watzlawick Hildegard , Altenbuchner Josef
Published: December 2015

We developed a counterselectable deletion system for
Thermus thermophilus
HB27 based on cytosine deaminase (encoded by
codA
) from
Thermaerobacter marianensis
DSM 12885 and the sensitivity of
T. thermophilus
HB27 to the antimetabolite 5-fluorocytosine (5-FC). The deletion vector comprises the pUC18 origin of replication, a thermostable kanamycin resistance marker functional in
T. thermophilus
HB27, and
codA
under the control of a constitutive putative trehalose promoter from
T. thermophilus
HB27. The functionality of the system was demonstrated by deletion of the
bglT
gene, encoding a β-glycosidase, and three carotenoid biosynthesis genes,
CYP175A1
,
crtY
, and
crtI
, from the genome of
T. thermophilus
HB27.
Posterior reversible encephalopathy syndrome with thalamic involvement during vasopressor treatment of vertebrobasilar vasospasm after subarachnoid hemorrhage
Authors: Madaelil Thomas Philip , Dhar Rajat
Published: December 2015

Hemodynamic augmentation is the primary medical intervention employed to reverse neurological deficits associated with vasospasm and delayed cerebral ischemia following aneurysmal subarachnoid hemorrhage. Failure to improve despite induced hypertension (IH) may raise concern for persistent hypoperfusion and prompt even more aggressive blood pressure augmentation. However, posterior reversible encephalopathy syndrome (PRES) is a hyperperfusion syndrome reported as a rare complication of IH that may confound this picture. We report a case of PRES with prominent thalamic involvement and impaired level of consciousness secondary to blood pressure augmentation for the treatment of symptomatic vertebrobasilar vasospasm. Recognition of this syndrome in distinction to worsening ischemia is particularly critical, as normalization of blood pressure should lead to rapid clinical improvement.
Management of dens in dente associated with a chronic periapical lesion
Authors: Mehta Vivek , Raheja Anupama , Singh Rajeev Kumar
Published: December 2015

Dens in dente is characterised as a developmental anomaly resulting from invagination of the enamel organ into the dental papilla. It is a rare malformation of teeth, showing a wide spectrum of morphological variations such as gemination, microdontia, taurodontism, dentinogenesis imperfecta, supernumerary tooth and hyperplasias, resulting frequently in early pulp necrosis. Maxillary lateral incisors are the commonest teeth to be affected by dental malformations—supernumerary tooth, talon cusp, congenitally missing tooth and dens in dente. We describe the management of a case of dens in dente in a maxillary lateral incisor with a periradicular lesion.
Meta-analysis of the effectiveness of traditional Chinese herbal formula Zhen Wu Decoction for the treatment of hypertension
Authors: Xiong Xingjiang , Wang Pengqian , Li Shengjie
Published: December 2015

Objectives

Zhen Wu Decoction (ZWD), a famous classic herbal formula documented in traditional Chinese medicine (TCM), is widely available in China for treating hypertensive patients with kidneyyangdeficiency and fluid retention syndrome. This systematic review aims to evaluate the effectiveness and safety of ZWD for hypertension.

Methods

Cochrane Central Register of Controlled Trials, PubMed, Embase, the Chinese National Knowledge Infrastructure, the Chinese Scientific Journal Database, the Chinese Biomedical Literature Database, and the Wanfang Database were searched from their inception to November 2014. Randomised controlled trials of ZWD used alone or in combination with antihypertensive drugs against placebo, no intervention or antihypertensive drugs in hypertensive patients were identified. Two assessors independently reviewed each trial. The Cochrane risk of bias assessment tool was used for quality assessment.

Results

Seven trials involving 472 hypertensive patients were identified. Compared with antihypertensive drugs, ZWD showed no significant effects in lowering blood pressure (BP) (n=177; risk ratio (RR) 1.06; 95% CI 0.87 to 1.28; p=0.58); however, ZWD plus antihypertensive drugs (ZPAD) significantly lowered systolic BP (n=80; weighted mean difference (WMD) −14.00 mm Hg, 95% CI −18.84 to −9.16 mm Hg; p<0.00001), diastolic BP (n=80; WMD −8.00 mm Hg, 95% CI −11.35 to −4.65 mm Hg; p<0.00001), and BP (n=215; RR 1.21, 95% CI 1.08 to 1.37; p=0.001). TCM symptoms and syndromes were significantly improved by either ZWD (n=177; RR 1.58, 95% CI 1.28 to 1.95; p<0.0001) or ZPAD (n=215; RR 1.30, 95% CI 1.14 to 1.49; p=0.0001). Adverse effects were not reported.

Conclusions

This systematic review revealed no definite conclusion about the application of ZWD for hypertension due to the poor methodological quality, high risk of bias, and inadequate reporting on clinical data. More rigorously designed trials, especially addressing continuous BP and adverse effects, are warranted.
Alcohol consumption and mortality in patients with mild Alzheimer's disease: a prospective cohort study
Authors: Berntsen Sine , Kragstrup Jakob , Siersma Volkert , Waldemar Gunhild , Waldorff Frans Boch
Published: December 2015

Objective

To investigate the association between alcohol consumption and mortality in patients recently diagnosed with mild Alzheimer's disease (AD).

Design

A post hoc analysis study based on a clinical trial population.

Setting

The data reported were collected as part of the Danish Alzheimer's Intervention Study (DAISY), a longitudinal multicentre randomised controlled study on the efficacy of psychosocial intervention in patients with mild AD across five county districts in Denmark.

Participants

321 patients with mild AD (Mini-Mental State Examination ≥20) were included. Data regarding current daily alcohol consumption were obtained from the patient's primary caregivers at inclusion.

Main outcome

All-cause mortality retrieved from The Danish Civil Registration System over a period of 36 months after baseline.

Results

Information about alcohol consumption was obtained from all 321 study participants: 8% were abstinent, 71% only had alcohol occasionally (1 or <1 unit/day), 17% had 2–3 units/day and 4% had more than 3 units/day. An analysis adjusted for a range of potential confounders demonstrated a reduced mortality for patients with moderate alcohol consumption (2–3 units/day): HR 0.23 (95% CI (0.08 to 0.69)) compared with patients who had 1 or <1 unit/day. Mortality was not significantly different in abstinent patients or in patients with an alcohol consumption of more than 3 units/day, compared with patients drinking 1 or <1 unit/day.

Conclusions

In this cohort of patients with mild AD, moderate alcohol consumption (2–3 units/day) was associated with a significantly lower mortality over a period of 36 months. Further studies are needed in this area. These may especially focus on the association between alcohol consumption and cognitive decline in patients with AD.
Single and mixed dyslipidaemia in Canadian primary care settings: findings from the Canadian primary care sentinel surveillance network database
Authors: Asghari Shabnam , Aref-Eshghi Erfan , Godwin Marshall , Duke Pauline , Williamson Tyler , Mahdavian Masoud
Published: December 2015

Objectives

Dyslipidaemia is a major risk factor to cardiovascular disease (CVD)—the leading cause of death worldwide. Limited data are available about the prevalence of various dyslipidaemia in Canada. The objective of this study is to describe the prevalence of various single and mixed dyslipidaemia within the Canadian population in a primary care setting.

Setting

A cross-sectional study, using the Canadian Primary Care Sentinel Surveillance Network (CPCSSN), was undertaken.

Participants

Non-pregnant adults older than 20 years were included.

Outcome measures

Canadian guidelines were used to define dyslipidaemia. Descriptive statistics and multivariate regression analyses were conducted to compare the prevalence of single/mixed dyslipidaemia.

Results

134 074 individuals with a mean age of 59.2 (55.8% women) were identified. 34.8% of this population had no lipid abnormality, whereas 35.8%, 17.3% and 3.2% had abnormalities in one, two and three lipid components, respectively. Approximately 86% of these patients did not receive any lipid-lowering medication. Among the medication users (14%), approximately 12% were on statin monotherapy. Statin users (n=16 036) had a lower rate of low-density lipoprotein dyslipidaemia compared to non-medication users (3% vs 17%), whereas the prevalence of high-density lipoprotein (HDL) (20% vs 12%) and triglycerides (TG) (12% vs 7%) dyslipidaemia were higher in statin users. Statin users had a greater prevalence of HDL, TG and combined HDL-TG dyslipidaemia compared to non-medication users (OR 1.44, 95% CI 1.36 to 153), (OR 1.18, 95% CI 1.10 to 1.27) and (OR 1.30, 95% CI 1.22 to 1.38), respectively, (all p values<0.0001).

Conclusions

One of every five patients in primary care settings in Canada is suffering from mixed dyslipidaemia. The overall prevalence of dyslipidaemia remains the same between treated and untreated groups, although the type of abnormal lipid component is considerably different. Among the CVD risk factors, obesity has the greatest effect on the prevalence of all types of dyslipidaemia.
Implementing guidelines to routinely prevent chronic vascular disease in primary care: the Preventive Evidence into Practice cluster randomised controlled trial
Authors: Harris Mark Fort , Parker Sharon M , Litt John , van Driel Mieke , Russell Grant , Mazza Danielle , Jayasinghe Upali W , Del Mar Chris , Lloyd Jane , Smith Jane , Zwar Nicholas , Taylor Richard , Powell Davies Gawaine
Published: December 2015

Objective

To evaluate an intervention to improve implementation of guidelines for the prevention of chronic vascular disease.

Setting

32 urban general practices in 4 Australian states.

Randomisation

Stratified randomisation of practices.

Participants

122 general practitioners (GPs) and practice nurses (PNs) were recruited at baseline and 97 continued to 12 months. 21 848 patient records were audited for those aged 40–69 years who attended the practice in the previous 12 months without heart disease, stroke, diabetes, chronic renal disease, cognitive impairment or severe mental illness.

Intervention

The practice level intervention over 6 months included small group training of practice staff, feedback on audited performance, practice facilitation visits and provision of patient education and referral information.

Outcome measures

Primary: 1. Change in proportion of patients aged 40–69 years with smoking status, alcohol intake, body mass index (BMI), waist circumference (WC), blood pressure (BP) recorded and for those aged 45–69 years with lipids, fasting blood glucose and cardiovascular risk in the medical record. 2. Change in the level of risk for each factor.

Secondary

change in self-reported frequency and confidence of GPs and PNs in assessment.

Results

Risk recording improved in the intervention but not the control group for WC (OR 2.52 (95% CI 1.30 to 4.91)), alcohol consumption (OR 2.19 (CI 1.04 to 4.64)), smoking status (OR 2.24 (1.17 to 4.29)) and cardiovascular risk (OR 1.50 (1.04 to 2.18)). There was no change in recording of BP, lipids, glucose or BMI and no significant change in the level of risk factors based on audit data. The confidence but not reported practices of GPs and PNs in the intervention group improved in the assessment of some risk factors.

Conclusions

This intervention was associated with improved recording of some risk factors but no change in the level of risk at the follow-up audit.

Trial registration number

Australian and New Zealand Clinical Trials Register (ANZCTR): ACTRN12612000578808, results.
Learning from positively deviant wards to improve patient safety: an observational study protocol
Authors: Baxter Ruth , Taylor Natalie , Kellar Ian , Lawton Rebecca
Published: December 2015

Introduction

Positive deviance is an asset-based approach to improvement which has recently been adopted to improve quality and safety within healthcare. The approach assumes that solutions to problems already exist within communities. Certain groups or individuals identify these solutions and succeed despite having the same resources as others. Within healthcare, positive deviance has previously been applied at individual or organisational levels to improve specific clinical outcomes or processes of care. This study explores whether the positive deviance approach can be applied to multidisciplinary ward teams to address the broad issue of patient safety among elderly patients.

Methods and analysis

Preliminary work analysed National Health Service (NHS) Safety Thermometer data from 34 elderly medical wards to identify 5 ‘positively deviant’ and 5 matched ‘comparison’ wards. Researchers are blinded to ward status. This protocol describes a multimethod, observational study which will (1) assess the concurrent validity of identifying positively deviant elderly medical wards using NHS Safety Thermometer data and (2) generate hypotheses about how positively deviant wards succeed. Patient and staff perceptions of safety will be assessed on each ward using validated surveys. Correlation and ranking analyses will explore whether this survey data aligns with the routinely collected NHS Safety Thermometer data. Staff focus groups and researcher fieldwork diaries will be completed and qualitative thematic content analysis will be used to generate hypotheses about the strategies, behaviours, team cultures and dynamics that facilitate the delivery of safe patient care. The acceptability and sustainability of strategies identified will also be explored.

Ethics and dissemination

The South East Scotland Research Ethics Committee 01 approved this study (reference: 14/SS/1085) and NHS Permissions were granted from all trusts. Findings will be published in peer-reviewed, scientific journals, and presented at academic conferences.

Trial registration number

This study is registered on the UK Clinical Research Network Study Portfolio (reference number—18050).
Protocol for ACCESS: a qualitative study exploring barriers and facilitators to accessing the emergency contraceptive pill from community pharmacies in Australia
Authors: Hussainy Safeera Yasmeen , Ghosh Ayesha , Taft Angela , Mazza Danielle , Black Kirsten Isla , Clifford Rhonda , Gudka Sajni , Mc Namara Kevin Peter , Ryan Kath , Jackson John Keith
Published: December 2015

Introduction

The rate of unplanned pregnancy in Australia remains high, which has contributed to Australia having one of the highest abortion rates of developed countries with an estimated 1 in 5 women having an abortion. The emergency contraceptive pill (ECP) offers a safe way of preventing unintended pregnancy after unprotected sex has occurred. While the ECP has been available over-the-counter in Australian pharmacies for over a decade, its use has not significantly increased. This paper presents a protocol for a qualitative study that aims to identify the barriers and facilitators to accessing the ECP from community pharmacies in Australia.

Methods and analysis

Data will be collected through one-on-one interviews that are semistructured and in-depth. Partnerships have been established with 2 pharmacy groups and 2 women's health organisations to aid with the recruitment of women and pharmacists for data collection purposes. Interview questions explore domains from the Theoretical Domains Framework in order to assess the factors aiding and/or hindering access to ECP from community pharmacies. Data collected will be analysed using deductive content analysis. The expected benefits of this study are that it will help develop evidence-based workforce interventions to strengthen the capacity and performance of community pharmacists as key ECP providers.

Ethics and dissemination

The findings will be disseminated to the research team and study partners, who will brainstorm ideas for interventions that would address barriers and facilitators to access identified from the interviews. Dissemination will also occur through presentations and peer-reviewed publications and the study participants will receive an executive summary of the findings. The study has been evaluated and approved by the Monash Human Research Ethics Committee.
Conversion of colonoscopy to flexible sigmoidoscopy: an unintended consequence of quality measurement in endoscopy
Authors: Thompson Chris , Ismail Tariq , Radley Simon , Walt Robert , Ward Stephen Thomas
Published: December 2015

Objective

To quantify the proportion of requests for colonoscopy that are performed as flexible sigmoidoscopy and documented reasons for this in ordinary UK hospital practice. To determine the effect these requests have on colonoscopy completion rate if they are included in the denominator of the calculated rate by individual endoscopist.

Design

Retrospective study of 22 months flexible sigmoidoscopy practice at a major UK teaching hospital. All flexible sigmoidoscopies performed had their associated request form examined.

Setting

UK NHS University Hospital.

Patients

All patients receiving outpatient flexible sigmoidoscopy from January 2013 to October 2014 with no exclusions.

Intervention

Conversion of colonoscopy to flexible sigmoidoscopy.

Main outcome measures

Conversion of colonoscopy to flexible sigmoidoscopy, reason for conversion and adjusted colonoscopy completion rate.

Results

71 of the 3526 flexible sigmoidoscopies performed (2.0%), representing 71 of 5905 colonoscopy requests (1.2%). Conversion reason was noted only in 26 (37%) of converted cases. Adjustment of colonoscopy completion rate to include conversions pushed four of our unit's 22 endoscopists below the UK national 90% standard.

Conclusions

Conversion to flexible sigmoidoscopy occurs in 1.2% of patients originally booked for colonoscopy. The reason for this conversion is often unqualified and may be inappropriate. Conversion can affect the colonoscopy completion rate, and therefore, should be included in endoscopists’ overall performance statistics.
Tumour initiating cells and IGF/FGF signalling contribute to sorafenib resistance in hepatocellular carcinoma
Authors: Tovar Victoria , Cornella Helena , Moeini Agrin , Vidal Samuel , Hoshida Yujin , Sia Daniela , Peix Judit , Cabellos Laia , Alsinet Clara , Torrecilla Sara , Martinez-Quetglas Iris , Lozano Juan José , Desbois-Mouthon Christèle , Solé Manel , Domingo-Domenech Josep , Villanueva Augusto , Llovet Josep M
Published: December 2015

Objective

Sorafenib is effective in hepatocellular carcinoma (HCC), but patients ultimately present disease progression. Molecular mechanisms underlying acquired resistance are still unknown. Herein, we characterise the role of tumour-initiating cells (T-ICs) and signalling pathways involved in sorafenib resistance.

Design

HCC xenograft mice treated with sorafenib (n=22) were explored for responsiveness (n=5) and acquired resistance (n=17). Mechanism of acquired resistance were assessed by: (1) role of T-ICs by in vitro sphere formation and in vivo tumourigenesis assays using NOD/SCID mice, (2) activation of alternative signalling pathways and (3) efficacy of anti-FGF and anti-IGF drugs in experimental models. Gene expression (microarray, quantitative real-time PCR (qRT-PCR)) and protein analyses (immunohistochemistry, western blot) were conducted. A novel gene signature of sorafenib resistance was generated and tested in two independent cohorts.

Results

Sorafenib-acquired resistant tumours showed significant enrichment of T-ICs (164 cells needed to create a tumour) versus sorafenib-sensitive tumours (13 400 cells) and non-treated tumours (1292 cells), p<0.001. Tumours with sorafenib-acquired resistance were enriched with insulin-like growth factor (IGF) and fibroblast growth factor (FGF) signalling cascades (false discovery rate (FDR)<0.05). In vitro, cells derived from sorafenib-acquired resistant tumours and two sorafenib-resistant HCC cell lines were responsive to IGF or FGF inhibition. In vivo, FGF blockade delayed tumour growth and improved survival in sorafenib-resistant tumours. A sorafenib-resistance 175 gene signature was characterised by enrichment of progenitor cell features, aggressive tumorous traits and predicted poor survival in two cohorts (n=442 patients with HCC).

Conclusions

Acquired resistance to sorafenib is driven by T-ICs with enrichment of progenitor markers and activation of IGF and FGF signalling. Inhibition of these pathways would benefit a subset of patients after sorafenib progression.
Testing chemical weathering proxies in Miocene–Recent fluvial-derived sediments in the South China Sea
Authors: Hu Dengke , Clift Peter D. , Wan Shiming , Böning Philipp , Hannigan Robyn , Hillier Stephen , Blusztajn Jerzy
Published: December 2015

Reconstructing variations in the intensity of chemical weathering in river basins is crucial if we are to understand how climate change impacts environment and whether there are feedbacks between climate and weathering processes. Quantifying chemical weathering is, however, a complicated process, involving a number of competing proxies. We compare weathering records from the Pearl River delta of southern China and Ocean Drilling Program (ODP) Sites 1144 and 1146 on the northeastern slope of the South China Sea in order to test which proxies are the most widely applicable and robust. Comparison with speleothem rainfall records indicates that K/Al tracks precipitation variations most closely and out-performs the widely used Chemical Index of Alteration (CIA). Correlation of K/Al and kaolinite/illite indicates that this clay ratio is also an effective proxy of weathering intensity across all sites and timescales. Kaolinite/smectite, and to a lesser extent smectite/(illite+chlorite), are also indicative of weathering intensity, but show more scatter between sites that may be linked to provenance effects. Mg/Al is relatively immune to grain-size effects, but does not correlate well with other proxies. K/Rb is a reasonably reliable indicator of chemical weathering intensity and may be more sensitive than CIA or K/Al to weathering changes over short timescales and when weathering is not too intense.
87
Sr/
86
Sr can be useful but can be influenced by both grain size and provenance effects. In general marine archives of fluvial sediment may record variations in weathering linked to climate, but these are increasingly signals of reworking going further offshore.
Synchronous Last Glacial Maximum across the Anatolian peninsula
Authors: Akçar Naki , Yavuz Vural , Yeşilyurt Serdar , Ivy-Ochs Susan , Reber Regina , Bayrakdar Cihan , Kubik Peter W. , Zahno Conradin , Schlunegger Fritz , Schlüchter Christian
Published: December 2015

Uludağ is a prominent mountain in northwestern Turkey where glacial deposits have been documented in the Kovuk Valley and the glacial history has been reconstructed based on 31 cosmogenic
10
Be exposure ages from glacially transported boulders and bedrock. The results suggest that the Kovuk Glacier began advancing before 26.5±1.6 ka. It reached its maximum extent at 20.3±1.3 ka, followed by a re-advance at 19.3±1.2 ka, both during the global Last Glacial Maximum (LGM) within Marine Isotope Stage 2. The timing of the LGM glaciations in the Kovuk Valley is consistent with the investigated LGM glaciations in other mountains of Anatolia, the Mediterranean and the Alps. Based on the geomorphological ice margin reconstruction and using the accumulation/ablation area ratio (AAR) approach, the equilibrium line altitude (ELA) of the Kovuk LGM glacier was
c.
2000 m above sea level for an estimated AAR of 0.67. This indicates a
c.
1000 m lowering of the ELA for the LGM compared with the modern ELA estimate. These lines of evidence are consistent with the LGM glaciers that have been documented elsewhere in the Anatolian Mountains.

Supplementary material:
An input file for exposure age calculation in the CRONUS-Earth online calculator and an KML file for sample locations are available at
http://www.geolsoc.org.uk/SUP18878
Internet-Delivered Psychological Treatments
Authors: Andersson Gerhard
Published: December 2015

During the past 15 years, much progress has been made in developing and testing Internet-delivered psychological treatments. In particular, therapist-guided Internet treatments have been found to be effective for a wide range of psychiatric and somatic conditions in well over 100 controlled trials. These treatments require (a) a secure web platform, (b) robust assessment procedures, (c) treatment contents that can be text based or offered in other formats, and (d) a therapist role that differs from that in face-to-face therapy. Studies suggest that guided Internet treatments can be as effective as face-to-face treatments, lead to sustained improvements, work in clinically representative conditions, and probably are cost-effective. Despite these research findings, Internet treatment is not yet disseminated in most places, and clinical psychologists should consider using modern information technology and evidence-based treatment programs as a complement to their other services, even though there will always be clients for whom face-to-face treatment is the best option.
Hearing in Insects
Authors: Göpfert Martin C. , Hennig R. Matthias
Published: December 2015

Insect hearing has independently evolved multiple times in the context of intraspecific communication and predator detection by transforming proprioceptive organs into ears. Research over the past decade, ranging from the biophysics of sound reception to molecular aspects of auditory transduction to the neuronal mechanisms of auditory signal processing, has greatly advanced our understanding of how insects hear. Apart from evolutionary innovations that seem unique to insect hearing, parallels between insect and vertebrate auditory systems have been uncovered, and the auditory sensory cells of insects and vertebrates turned out to be evolutionarily related. This review summarizes our current understanding of insect hearing. It also discusses recent advances in insect auditory research, which have put forward insect auditory systems for studying biological aspects that extend beyond hearing, such as cilium function, neuronal signal computation, and sensory system evolution.
The Governance of International Finance
Authors: Frieden Jeffry
Published: December 2015

Contemporary international finance raises important questions about whether, and how, it might be overseen by national governments and international institutions. Inasmuch as global financial stability is a global public good, there is a normative case for governance structures to try to achieve this goal—whether they take the form of interstate cooperation or international institutions. This, however, does not mean that national states will necessarily be willing or able to work together to provide this global public good, as the incentives to free-ride are enormous. Nonetheless, the past 25 years do indicate that there has been some movement toward the provision of such global public goods as financial harmonization and a semblance of global lender-of-last-resort facilities. The record is spotty, but the trend appears to be in the direction of more global governance of global finance.
Fast-Discharging Apparatus 0 - 400 A / 2 - 4.2 V for Testing of Lithium Cells
Authors: Martis Jan , Vorel Pavel , Prochazka Petr , Cipin Radoslav , Pazdera Ivo
Published: December 2015

This paper describes an apparatus developed for testing fast-discharging processes of lithium cells. The device is equipped with a current control loop which enables to set the discharging current manually in a range from 0 to ca. 400 A. A constant current discharging independent on the load voltage is ensured this way. In principle the load is created with a set of power MOSFETs operating in linear regime. Further, some passive power resistors are used to decrease the MOSFET power loss and to equalize the currents of individual MOSFETs. An analog control circuit is used. The developed device was used for testing the LiFePO4 cell of type AS-71J0280-2AA0-110 (3.2 V / 200 Ah). Its discharging characteristics with various constant discharging currents were measured and compared with the datasheet values. Also its charging characteristics (CC/CV method) were measured.
Effect of Zinc Ions on the Second Voltage Plateau of Non-Sintered Ni(OH)2 Electrodes
Authors: Chladil Ladislav , Vanýsek Petr , Cech Ondrej
Published: December 2015

Our contribution is focused on the investigation of non-sintered electrodes behavior in electrolyte with different amount of dissolution zinc concentration. For experiment were select the three type of commonly used electrolytes. Except of pure KOH electrolyte, we also choose the electrolyte with addition of LiOH and electrolyte with reduced zinc solubility which contain also KF and K2CO3 additives. The capacity of first and second voltage plateau in terms of different electrolytes and different zinc contain were obtain and evaluate. For getting more information about the electrode behavior also the EIS spectra in different state of charge were obtain and compared. Among other it was concluded that higher amount of zinc concentration near to saturated state can lead to propagation of second voltage plateau capacity of non-sintered Ni(OH)2 electrode.
Thin Layers of Lead for Use in Lithium Cells As the Negative Electrode
Authors: Jahn Michal , Sedlaříková Marie , Vondrák Jiří
Published: December 2015

In this paper I present fundamental characteristics of thin layers by electrochemical deposition from aprotic electrolytes. Deposited layers are studied from the perspective of their surface, of electrochemical characteristics and possible application in lithium batteries.
Study on Self-Discharge Behavior of Lithium-Sulfur Batteries
Authors: Knap Vaclav , Stroe Daniel Ioan , Swierczynski Maciej , Teodorescu Remus , Schaltz Erik
Published: December 2015

Lithium-Sulfur (Li-S) batteries are a promising energy storage technology, which draws interest due to their high theoretical limits in terms of specific capacity, specific energy and energy density. However as a drawback, they suffer from a high self-discharge rate, which is mainly caused by ongoing polysulfide shuttle. In this paper, the self-discharge behavior of Li-S batteries is experimentally investigated, considering various conditions as depth-of-discharge, temperature and idling time. The self-discharge rate under different conditions is identified and quantified. Moreover, a methodology for estimating the capacity of the high voltage plateau based on a self-discharge constant was analyzed; however, the method needs further improvements in order to estimate this capacity accurately for all conditions.