bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comparison of two inoculation methods forMicrosporum canisculture using the toothbrush sampling technique
Authors: Di Mattia Diana , Fondati Alessandra , Monaco Moira , Pasquetti Mario , Peano Andrea 
Published: December 2018

BackgroundThe fungal culture toothbrush method is a common method for obtaining material for fungal cultures to diagnose dermatophytosis. The optimal technique for inoculation onto the agar surface has not been studied.Hypothesis/objectivesTo compare two inoculation techniques; the first involved pressing the toothbrush onto the plate surface (Procedure A) and the second involved pressing the toothbrush onto the agar, as well as transferring hairs and scales entrapped in the bristles. (Procedure B). The hypothesis was that transferring hairs onto the plate would increase the likelihood of obtaining positive cultures.AnimalsTwenty‐six cattery‐housed cats were sampled using the toothbrush technique. Two toothbrush samples were obtained from each cat.Methods and materialsThe two toothbrush samples from each cat were randomized to Procedure A or B, and the investigator was blinded to inoculation technique. Cultures were performed on a medium specific for dermatophytes. The number of positive plates, and the presence and abundance of colonies of dermatophytes and contaminant moulds were compared between the two techniques.ResultsTwenty‐one cats were culture‐positive forMicrosporum canis. Procedure A resulted in a significantly higher number (P < 0.01) of positive plates (20 of 21; 95%) compared with Procedure B (seven of 21; 33%). These results were due mainly to higher plate invasion by contaminant moulds, using Procedure B.Conclusions and clinical importanceBased upon the findings of this study, the optimum inoculation technique is to press toothbrush bristles onto agar plates to maximize growth ofM. canisand minimize introduction of contaminant inoculation.
Confused health and nutrition claims in food marketing to children could adversely affect food choice and increase risk of obesity
Authors: García Ada L , Morillo-Santander Gabriela , Parrett Alison , Mutoro Antonina N 
Published: December 2018

ObjectivesTo investigate the nutritional quality of foods marketed to children in the UK and to explore the use of health and nutrition claims.DesignThis cross-sectional study was carried out in a wide range of UK food retailers. Products marketed to children above the age of 1 year containing any of a range of child friendly themes (i.e. cartoons, toys and promotions), and terms suggesting a nutritious or healthy attribute such as ‘one of 5-a-day’, on product packaging were identified both in stores and online. Information on sugar, salt and fat content, as well as health and nutrition claims, was recorded. The Ofcom nutrient profiling model (NPM) was used to assess if products were healthy.ResultsThree hundred and thirty-two products, including breakfast cereals, fruit snacks, fruit-based drinks, dairy products and ready meals, were sampled. The use of cartoon characters (91.6%), nutrition claims (41.6%) and health claims (19.6%) was a common marketing technique. The one of 5-a-day claim was also common (41.6%), but 75.4% (103) of products which made this claim were made up of less than 80 g of fruit and vegetables. Sugar content (mean±SD per 100 g) was high in fruit snacks (48.4±16.2 g), cereal bars (28.9±7.5 g) and cereals (22.9±8.0 g). Overall, 41.0% of the products were classified as less healthy according to the Ofcom NPM.ConclusionA large proportion of products marketed to children through product packaging are less healthy, and claims used on product packaging are confusing. Uniform guidance would avoid confusion on nutritional quality of many popular foods.
Golf habits among physicians and surgeons: observational cohort study
Authors: Koplewitz Gal , Blumenthal Daniel M , Gross Nate , Hicks Tanner , Jena Anupam B 
Published: December 2018

AbstractObjectivesTo examine patterns of golfing among physicians: the proportion who regularly play golf, differences in golf practices across specialties, the specialties with the best golfers, and differences in golf practices between male and female physicians.DesignObservational study.SettingComprehensive database of US physicians linked to the US Golfing Association amateur golfer database.Participants41 692 US physicians who actively logged their golf rounds in the US Golfing Association database as of 1 August 2018.Main outcome measuresProportion of physicians who play golf, golf performance (measured using golf handicap index), and golf frequency (number of games played in previous six months).ResultsAmong 1 029 088 physicians, 41 692 (4.1%) actively logged golf scores in the US Golfing Association amateur golfer database. Men accounted for 89.5% of physician golfers, and among male physicians overall, 5.5% (37 309/683 297) played golf compared with 1.3% (4383/345 489) among female physicians. Rates of golfing varied substantially across physician specialties. The highest proportions of physician golfers were in orthopedic surgery (8.8%), urology (8.1%), plastic surgery (7.5%), and otolaryngology (7.1%), whereas the lowest proportions were in internal medicine and infectious disease (<3.0%). Physicians in thoracic surgery, vascular surgery, and orthopedic surgery were the best golfers, with about 15% better golf performance than specialists in endocrinology, dermatology, and oncology.ConclusionsGolfing is common among US male physicians, particularly those in the surgical subspecialties. The association between golfing and patient outcomes, costs of care, and physician wellbeing remain unknown.
Health economics of targeted intraoperative radiotherapy (TARGIT-IORT) for early breast cancer: a cost-effectiveness analysis in the United Kingdom
Authors: Vaidya Anil , Vaidya Param , Both Brigitte , Brew-Graves Chris , Bulsara Max , Vaidya Jayant S 
Published: December 2018

ObjectiveThe clinical effectiveness of targeted intraoperative radiotherapy (TARGIT-IORT) has been confirmed in the randomised TARGIT-A (targeted intraoperative radiotherapy-alone) trial to be similar to a several weeks’ course of whole-breast external-beam radiation therapy (EBRT) in patients with early breast cancer. This study aims to determine the cost-effectiveness of TARGIT-IORT to inform policy decisions about its wider implementation.SettingTARGIT-A randomised clinical trial (ISRCTN34086741) which compared TARGIT with traditional EBRT and found similar breast cancer control, particularly when TARGIT was given simultaneously with lumpectomy.MethodsCost-utility analysis using decision analytic modelling by a Markov model. A cost-effectiveness Markov model was developed using TreeAge Pro V.2015. The decision analytic model compared two strategies of radiotherapy for breast cancer in a hypothetical cohort of patients with early breast cancer based on the published health state transition probability data from the TARGIT-A trial. Analysis was performed for UK setting and National Health Service (NHS) healthcare payer’s perspective using NHS cost data and treatment outcomes were simulated for both strategies for a time horizon of 10 years. Model health state utilities were drawn from the published literature. Future costs and effects were discounted at the rate of 3.5%. To address uncertainty, one-way and probabilistic sensitivity analyses were performed.Main outcome measuresQuality-adjusted life-years (QALYs).ResultsIn the base case analysis, TARGIT-IORT was a highly cost-effective strategy yielding health gain at a lower cost than its comparator EBRT. Discounted TARGIT-IORT and EBRT costs for the time horizon of 10 years were £12 455 and £13 280, respectively. TARGIT-IORT gained 0.18 incremental QALY as the discounted QALYs gained by TARGIT-IORT were 8.15 and by EBRT were 7.97 showing TARGIT-IORT as a dominant strategy over EBRT. Model outputs were robust to one-way and probabilistic sensitivity analyses.ConclusionsTARGIT-IORT is a dominant strategy over EBRT, being less costly and producing higher QALY gain.Trial registration numberISRCTN34086741; post results
A surveillance study to determine the accuracy of mild traumatic brain injury diagnosis in an emergency department: protocol for a retrospective cohort study
Authors: Pozzato Ilaria , Cameron Ian D , Meares Susanne , Kifley Annette , Vu Kim Van , Liang Anthony , Gillett Mark , Craig Ashley , Gopinath Bamini 
Published: December 2018

IntroductionPrevious literature confirms that a mild traumatic brain injury (mTBI) may result in long-term emotional impacts and, in vulnerable subgroups, cognitive deficits. The accurate diagnosis of mTBI and its written documentation is an important first step towards providing appropriate and timely clinical care. Surveillance studies involving emergency department (ED) and hospital-based data need to be prioritised as these provide incident mTBI estimates. This project will advance existing research findings by estimating the occurrence of mTBI among those attending an ED and quantifying the accuracy of mTBI diagnoses recorded by ED staff through a comprehensive audit of ED records.Methods and analysisRetrospective chart reviews (between June 2015 and June 2016) of electronic clinical records from an ED in Sydney (New South Wales, Australia) will be conducted. The study population will include persons aged 18–65 years who attended the ED with any clinical features potentially indicative of mTBI. The WHO operational criteria for the clinical identification of mTBI cases is the presence of: (1) a Glasgow Coma Scale (GCS) of 13–15 after 30 min postinjury or on presentation to hospital; (2) one or more of the following: post-traumatic amnesia (PTA) of less than 24 hours’ duration, confusion or disorientation, a witnessed loss of consciousness for ≤30 min and/or a positive CT brain scan. We estimate that 30 000 ED attendances will be screened and that a sample size of 500 cases with mTBI will be identified during this 1-year period, which will provide reliable estimates of mTBI occurrence in the ED setting.Ethics and disseminationThe study was approved by the Northern Sydney Local Health District Ethics Committee. The committee deemed this study as low risk in terms of ethical issues. The written papers from this study will be submitted for publication in quality peer-reviewed medical and health journals. Study findings will be disseminated via presentations at national/international conferences and peer-reviewed journals.
Evaluation of DementiaNet, a network-based primary care innovation for community-dwelling patients with dementia: protocol for a longitudinal mixed methods multiple case study
Authors: Richters Anke , Nieuwboer Minke S , Perry Marieke , Olde Rikkert Marcel G M , Melis Rene J F , van der Marck Marjolein A 
Published: December 2018

IntroductionPrimary healthcare professionals will increasingly be required to manage and optimise their treatment for patients with dementia. With DementiaNet, we aim to reduce the burden of dementia on healthcare services and society through implementation and facilitation of integrated network-based care with increased dementia expertise. DementiaNet is designed as a stepwise approach including clinical leadership, quality improvement cycles and interprofessional training, which are tailor-made to the local context. For example, the composition of the network and improvement goals are tailored to the local context and availability. Here, we describe the linked evaluation study which aims to provide insight in effectiveness, process and mechanism of the DementiaNet approach through an innovative evaluation design.Methods and analysisWe designed a longitudinal, mixed methods, multiple case study. Study population consists of two levels: (i) local DementiaNet networks of primary care professionals and (ii) patients and informal caregivers who receive care from these networks. At the start and after 12 and 24 months, quantitative data are collected for each network on: level of network maturity, quality of care indicators and outcomes reported by informal caregivers of dementia patients. We assess changes in networks over time and the association with quality of care and informal caregiver-reported outcomes. Throughout the study, logs about each network are registered. Additionally, semi-structured interviews with network members and informal caregivers will provide insight in experiences and opinions regarding effects and mechanisms through which changes in quantitative outcomes are effectuated. Rich narratives will be constructed about the development of the local networks using collected data.Ethics and disseminationThe study protocol was reviewed by the local medical ethics committee; formal judgement was not required (protocol number: 2015–2053). The findings of this study will be disseminated through peer-reviewed publications, conference presentations and presentations for healthcare professionals where appropriate.
Rationale and design of a multicentre, prospective, randomised, controlled clinical trial to evaluate the efficacy of the adipose graft transposition procedure in patients with a myocardial scar: the AGTP II trial
Authors: Gastelurrutia Paloma , Gálvez-Montón Carolina , Cámara Maria Luisa , Bustamante-Munguira Juan , García-Pavia Pablo , Avanzas Pablo , Alberto San Román J , Pascual-Figal Domingo , Teresa Eduardo de , Crespo-Leiro Maria G , Manito Nicolás , Núñez Julio , Fernández-Avilés Francisco , Caballero Ángel , Teis Albert , Lupón Josep , Brugada Ramón , Martín Carlos , Silva Jacobo , Revilla-Orodea Ana , Cánovas Sergio J , Melero Jose M , Cuenca-Castillo Jose J , Gonzalez-Pinto Angel , Bayes-Genis Antoni 
Published: December 2018

IntroductionCardiac adipose tissue is a source of progenitor cells with regenerative capacity. Studies in rodents demonstrated that the intramyocardial delivery of cells derived from this tissue improves cardiac function after myocardial infarction (MI). We developed a new reparative approach for damaged myocardium that integrates the regenerative properties of cardiac adipose tissue with tissue engineering. In the adipose graft transposition procedure (AGTP), we dissect a vascularised flap of autologous pericardial adipose tissue and position it over the myocardial scarred area. Following encouraging results in acute and chronic MI porcine models, we performed the clinical trial (NCT01473433, AdiFLAP trial) to evaluate safety in patients with chronic MI undergoing coronary artery bypass graft. The good safety profile and trends in efficacy warranted a larger trial.Study designThe AGTP II trial (NCT02798276) is an investigator initiated, prospective, randomised, controlled, multicentre study to assess the efficacy of the AGTP in 108 patients with non-revascularisable MI. Patients will be assigned to standard clinical practice or the AGTP. The primary endpoint is change in necrotic mass ratio by gadolinium enhancement at 91 and 365 days. Secondary endpoints include improvement in regional contractibility by MRI at 91 and 365 days; changes in functional MRI parameters (left ventricular ejection fraction, left and right ventricular geometric remodelling) at 91 and 365 days; levels of N-terminal prohormone of brain natriuretic peptide (NT-proBNP) at 7, 91 and 365 days; appearance of arrhythmias from 24 hour Holter monitoring at 24 hours, and at 91 and 365 days; all cause death or re-hospitalisation at 365 days; and cardiovascular death or re-hospitalisation at 365 days.Ethics and disseminationThe institutional review board approved the trial which will comply with the Declaration of Helsinki. All patients will provide informed consent. It may offer a novel, effective and technically simple technique for patients with no other therapeutic options. The results will be submitted to indexed medical journals and national and international meetings.Trial registration numberClinicalTrials.gov:NCT02798276, pre-results.
Tunnel driving occupational environment and hearing loss in train drivers in China
Authors: Peng Yong , Fan Chaojie , Hu Lin , Peng Shuangling , Xie Pengpeng , Wu Fugui , Yi Shengen 
Published: December 2018

ObjectiveHearing loss caused by high levels of noise is a potential occupational health disorder among train drivers around the world. This study aims to investigate the relationship between tunnel driving occupational environment and hearing loss in train drivers, to provide some insights into helping reduce hearing loss among train drivers.MethodsThis study analysed cross-sectional data for 1214 train drivers who work at China Railway Guangzhou Group. Health examination was taken by physicians with professional licences, and audiometric testing was performed by health technicians in a sound-isolated room. T/R is defined as the ratio of the length of the tunnels to the length of the railway along drivers’ work routes. Different multivariate models and stratified models were established for sensitivity analysis. A multivariable logistic regression model was used to estimate the ORs of hearing loss associated with tunnel driving occupational environment.ResultsThe adjusted OR for high-frequency hearing loss in association with the highest T/R levels (30%–45%) versus the lowest T/R levels (<15%) was 3.72 (95% CI 1.43 to 9.69). The corresponding OR for speech-hearing loss was 1.75 (95% CI 0.38 to 8.06). The sensitivity analysis shows our results are suitable for various alternative models.ConclusionsThis study found that there was a significant association between tunnel driving occupational environment and hearing loss. Train drivers who work in a higher T/R environment have worse hearing loss.
Re-engineering the post-myocardial infarction medicines optimisation pathway: a retrospective analysis of a joint consultant pharmacist and cardiologist clinic model
Authors: Khatib Rani , Patel Nasrin , Laverty Una , Mcgawley Gina , McLenachan Jim , Shield Sarah , Hall Alistair S 
Published: December 2018

BackgroundInadequate medicines optimisation and adherence are significant problems among patients taking secondary prevention medications following myocardial infarction (MI). A novel joint consultant cardiology pharmacist and cardiologist medicines optimisation clinic was initiated for patients recently discharged following MI.MethodsPatients completed a locally developed tool, the ‘My Experience of Taking Medicines’ questionnaire, designed to allow sharing of barriers to adherence with medications. They then attended a clinic with the consultant pharmacist or cardiologist (or both). Secondary prevention medicines needs and barriers to adherence were identified and discussed, and an action plan developed. The data provided are from a retrospective review of 270 post-MI patients attending the service between October 2015 and December 2016.ResultsMean age was 67.3 years and 67.8% were male. The mean time from discharge to first outpatient clinic attendance was reduced by 56.1% (49.4 days vs 88 days before the service began). More than 95% of patient without planned non-pharmacological intervention postdischarge did not need a cardiologist’s input. Levels of medicines optimisation were improved substantially after attendance: patients receiving a recommended angiotensin-converting enzyme inhibitor/angiotensin receptor blocker dose increased from 16.3% to 73.9% (p<0.001); patients receiving a recommended beta-blocker dose increased from 6.2% to 46.1% (p<0.001). Patient concerns about their medications were significantly decreased (all p<0.001). Rates of non-adherence fell by 42.6%–70.8% at 3–6 months post-clinic. Readmission rates also declined after the service opened.ConclusionsA medicines optimisation and patient adherence strategy based on a joint consultant cardiology pharmacist and cardiologist clinic can improve both adherence and outcomes post-MI.
Mobility performance among community-dwelling older Filipinos who lived in urban and rural settings: A preliminary study
Authors: Lunar Frances Rom , Marquez Jan Paul , Quianzon Francine Kier , Policarpio Ben Joshua , Santelices Leslie Anne , Velasco Mariah Kristine , Quinto Ramielle Joie , Gorgon Edward James 
Published: December 2018

Background: The impact of residential setting on the performance of older adults on commonly used instruments of mobility has not been closely investigated. Objective: This study aimed to (1) explore whether mobility test performance differed between those who lived in urban and rural communities, and (2) report preliminary reference values for these tests according to residential setting. Methods: The study used a descriptive design. Individuals who were aged 60 years and above, had no significant disability, and resided in urban and rural areas in the Philippines ([Formula: see text]), participated in the study. Researchers measured mobility performance using the 10-Meter Walk Test (10MWT) (both comfortable gait velocity (CGV) and fast gait velocity (FGV)), Five Times Sit to Stand Test (FTSST), and Six-Minute Walk Test (6MWT). Preliminary reference values for the mobility tests were presented as means, standard deviations, and 95% confidence intervals. Scores were compared based on residential setting (urban versus rural). Results: Urban-dwellers scored consistently better compared to their rural counterparts on the CGV, FGV, FTSST, and 6MWT using independent samples [Formula: see text]-test ([Formula: see text]). Data were further divided according to age and sex, and comparison of the mobility test scores between urban- and rural-dwellers within each subgroup showed similar differences ([Formula: see text]). Conclusion: Results provide preliminary evidence for the influence of residential setting on the mobility test performance of Filipino older adults. The study provides a good starting point for confirmatory research with a representative sample to (1) illustrate differences in mobility performance according to residential setting, (2) investigate how specific factors associated with residential settings contribute to differences in mobility performance, and (3) determine the extent to which clinicians should consider an older person’s residential setting when interpreting mobility test results.
Differential Subcellular Localization Regulates Oncogenic Signaling by ROS1 Kinase Fusion Proteins
Authors: Neel Dana S. , Allegakoen David V. , Olivas Victor , Mayekar Manasi K. , Hemmati Golzar , Chatterjee Nilanjana , Blakely Collin M. , McCoach Caroline E. , Rotow Julia K. , Le Anh , Karachaliou Niki , Rosell Rafael , Riess Jonathan W. , Nichols Robert , Doebele Robert C. , Bivona Trever G. 
Published: December 2018

Abstract

Chromosomal rearrangements involving receptor tyrosine kinases (RTK) are a clinically relevant oncogenic mechanism in human cancers. These chimeric oncoproteins often contain the C-terminal kinase domain of the RTK joined in cis to various N-terminal, nonkinase fusion partners. The functional role of the N-terminal fusion partner in RTK fusion oncoproteins is poorly understood. Here, we show that distinct N-terminal fusion partners drive differential subcellular localization, which imparts distinct cell signaling and oncogenic properties of different, clinically relevant ROS1 RTK fusion oncoproteins. SDC4-ROS1 and SLC34A2-ROS1 fusion oncoproteins resided on endosomes and activated the MAPK pathway. CD74-ROS1 variants that localized instead to the endoplasmic reticulum (ER) showed compromised activation of MAPK. Forced relocalization of CD74-ROS1 from the ER to endosomes restored MAPK signaling. ROS1 fusion oncoproteins that better activate MAPK formed more aggressive tumors. Thus, differential subcellular localization controlled by the N-terminal fusion partner regulates the oncogenic mechanisms and output of certain RTK fusion oncoproteins.

Significance:
ROS1 fusion oncoproteins exhibit differential activation of MAPK signaling according to subcellular localization, with ROS1 fusions localized to endosomes, the strongest activators of MAPK signaling.