bluuebunny/crossref_metadata_2025_split huggingface dataset:
Sci‐Fri PM: Radiation Therapy, Planning, Imaging, and Special Techniques ‐ 01: On the use of proton radiography to reduce beam range uncertainties and improve patient positioning accuracy in proton therapy
Authors: Collins‐Fekete Charles‐Antoine , Beaulieu Luc , Seco Joao 
Published: August 2016

To present two related developments of proton radiography (pRad) to minimize range uncertainty in proton therapy. The first combines a pRad with an X‐ray CT to produce a patient‐specific relative stopping power (RSP) map. The second aims to improve the pRad spatial resolution for accurate registration prior to the first. The enhanced‐pRad can also be used in a novel proton‐CT reconstruction algorithm.Monte Carlo pRad were computed from three phantoms; the Gammex, the Catphan and an anthropomorphic head. An optimized cubic‐spline estimator derives the most likely path. The length crossed by the protons voxel‐by‐voxel was calculated by combining their estimated paths with the CT. The difference between the theoretical (length×RSP) and measured energy loss was minimized through a least squares optimization (LSO) algorithm yielding the RSP map. To increase pRad spatial resolution for registration with the CT, the phantom was discretized into voxels columns. The average column RSP was optimized to maximize the proton energy loss likelihood (MLE).Simulations showed precise RSP (<0.75%) for Gammex materials except low‐density lung (<1.2%). For the head, accurate RSP were obtained (µ=−0.10%1.5σ=1.12%) and the range precision was improved (ΔR80 of −0.20±0.35%). Spatial resolution was increased in pRad (2.75 to 6.71 lp/cm) and pCT from MLE‐enhanced pRad (2.83 to 5.86 lp/cm).The LSO decreases the range uncertainty (R80σ<1.0%) while the MLE‐enhanced pRad spatial resolution (+244%) and is a great candidate for pCT reconstruction.
Sci‐Fri PM: Radiation Therapy, Planning, Imaging, and Special Techniques ‐ 09: Impact of the distance of reflective markers from linac isocenter on the positional accuracy of an infrared tracking system
Authors: Ali Elsayed , Nyiri Balazs 
Published: August 2016

Purpose:The HexaPOD™ six degree of freedom couchtop is equipped with an optical tracking system, consisting of a stereoscopic camera and a reference frame (RF) carrying infrared reflective markers. The manufacturer recommends placing the RF within 50 cm from linac isocenter (ISO), which is a serious limitation since the RF does not fit around the shoulders of most brain patients. This study quantifies the impact of extended RF distances from ISO on positional accuracy.Methods:An in‐house tool with an estimated resolution of 0.3 mm and 0.1° was used. It is a large cube and a mathematical model of HexaPOD motion to determine the intersection of room lasers with the ruled cube edges. Combinations of translations (±1 and ±3 cm) and rotations (±2.5°) were executed on two HexaPOD couchtops for multiple RF distances from ISO (35 to 77 cm). For each combination, ten laser readings were fed into a least squares algorithm to determine the executed translations and rotations while minimizing operator reading errors.Results:The usable tracking volume is up to an RF distance of 82 cm from ISO. Positional accuracy of the HexaPOD/iGuide system is 0.6 mm and 0.1° (95% confidence). Positional accuracy variations versus RF distance from ISO are statistically insignificant (p = 0.05). Our results generally confirm recent internal estimates by the manufacturer (for future release).Conclusions:RF distances up to 77 cm from ISO are clinically acceptable, provided performing a patient safety study with a verification scan.
Latin American Physical Educators’ Intention to Teach Individuals With Disabilities
Authors: Columna Luis , Hoyos-Cuartas Luz Amelia , Foley John T. , Prado-Perez Jose Rafael , Chavarro-Bermeo Dana Milena , Mora Ana Lorena , Ozols-Rosales Maria Antonieta , Cid Luis Álvarez-del , Rivero Ivana 
Published: August 2016

Purpose:To analyze Latin American physical education (PE) teachers’ intentions toward teaching students with disabilities.Participants:474 in-service PE teachers from 5 different Latin American countries.Method:Descriptive survey. Data were collected using a modified version of the Physical Educators’ Intention Toward Teaching Individuals With Disabilities Survey. Multiple-regression analysis showed significant differences in the attitudes of teachers by gender, the number of adapted-PE courses taken, and years of experience working with individuals with disabilities.Results:The predictor variables had a significant impact on the participants’ intentions toward teaching children with disabilities; however, the effects of these predictor variables differed between countries.
Comparative Performance of Reagents and Platforms for Quantitation of Cytomegalovirus DNA by Digital PCR
Authors: Hayden R. T. , Gu Z. , Sam S. S. , Sun Y. , Tang L. , Pounds S. , Caliendo A. M. 
Published: August 2016

ABSTRACT

A potential benefit of digital PCR is a reduction in result variability across assays and platforms. Three sets of PCR reagents were tested on two digital PCR systems (Bio-Rad and RainDance), using three different sets of PCR reagents for quantitation of cytomegalovirus (CMV). Both commercial quantitative viral standards and 16 patient samples (
n
= 16) were tested. Quantitative accuracy (compared to nominal values) and variability were determined based on viral standard testing results. Quantitative correlation and variability were assessed with pairwise comparisons across all reagent-platform combinations for clinical plasma sample results. The three reagent sets, when used to assay quantitative standards on the Bio-Rad system, all showed a high degree of accuracy, low variability, and close agreement with one another. When used on the RainDance system, one of the three reagent sets appeared to have a much better correlation to nominal values than did the other two. Quantitative results for patient samples showed good correlation in most pairwise comparisons, with some showing poorer correlations when testing samples with low viral loads. Digital PCR is a robust method for measuring CMV viral load. Some degree of result variation may be seen, depending on platform and reagents used; this variation appears to be greater in samples with low viral load values.
First terrestrial occurrence of tistarite (Ti2O3): Ultra-low oxygen fugacity in the upper mantle beneath Mount Carmel, Israel
Authors: Griffin W.L. , Gain S.E.M. , Adams D.T. , Huang J-X. , Saunders M. , Toledo V. , Pearson N.J. , O’Reilly S.Y. 
Published: August 2016

Abstract
The minimum oxygen fugacity (fO2) of Earth’s upper mantle probably is controlled by metal saturation, as defined by the iron-wüstite (IW) buffer reaction (FeO → Fe + O). However, the widespread occurrence of moissanite (SiC) in kimberlites, and a suite of super-reduced minerals (SiC, alloys, native elements) in peridotites in Tibet and the Polar Urals (Russia), suggest that more reducing conditions (fO2 = 6–8 log units below IW) must occur locally in the mantle. We describe pockets of melt trapped in aggregates of corundum crystals ejected from Cretaceous volcanoes in northern Israel which contain high-temperature mineral assemblages requiring extremely low fO2 (IW &lt; −10). One abundant phase is tistarite (Ti2O3), previously known as a single grain in the Allende carbonaceous chondrite (Mexico) and believed to have formed during the early evolution of the solar nebula. It is associated with other reduced phases usually found in meteorites. The development of super-reducing conditions in Earth’s upper mantle may reflect the introduction of CH4 + H2 fluids from the deep mantle, specifically related to deep-seated volcanic plumbing systems at plate boundaries.
Electroacupuncture Restores Spatial Learning and Downregulates Phosphorylated N-Methyl-D-Aspartate Receptors in a Mouse Model of Parkinson's Disease
Authors: Lu Kung-Wen , Yang Jun , Hsieh Ching-Liang , Hsu Yu-Chan , Lin Yi-Wen 
Published: August 2016

Objective Parkinson's disease (PD) is a degenerative disorder of the central nervous system. PD can be classified as idiopathic, acquired or hereditary and may be caused by various factors such as oxidative stress, loss of mitochondrial function, neuronal excitotoxicity or calcium imbalance. Methods We hypothesised that electroacupuncture (EA) at KI3 would reduce neuronal excitotoxicity by regulating N-methyl-D-aspartate (NMDA) receptor function and may represent a novel therapeutic approach for PD. Results Our results showed that deficits in spatial learning (reflected by the escape latency time in the Morris water maze task) and long-term potentiation (LTP) caused by systemic 6-hydroxydopamine (6-OHDA) administration (that damages dopaminergic neurons) could be rescued by EA on day 3. In PD mice, phosphorylated NMDA receptor subunits NR1 and NR2B were elevated (134.03±10.17% and 123.46±3.47% of baseline levels, respectively) but total NR1 and NR2B was unaffected (101.37±3.87% and 102.61±4.22% of baseline, respectively). Elevated levels of pNR1 and pNR2B, and phosphorylated forms of protein kinase A, protein kinase C, α Ca2+/calmodulin-dependent protein kinase extracellular signal-regulated kinases (pERK), and cAMP response element-binding protein were also reduced following EA. Conclusions These novel findings suggest that EA can rescue learning and LTP deficits in a rodent model of PD. The results point to a possible role for EA-based approaches in the clinical treatment of learning deficits associated with PD.
Assessment of Reporting Quality in Randomised Controlled Trials of Acupuncture for Post-Stroke Rehabilitation Using the Consort Statement and Stricta Guidelines
Authors: Zeng Jingchun , Lin Guohua , Li Lixia , Lu Liming , Chen Chuyun , Lu Lihong 
Published: August 2016

Objectives To evaluate the completeness of reporting of randomised controlled trials (RCTs) of acupuncture for post-stroke rehabilitation in order to provide information to facilitate transparent and more complete reporting of acupuncture RCTs in this field. Methods Multiple databases were searched from their inception through September 2015. Quality of reporting for included papers was assessed against a subset of criteria adapted from the Consolidated Standards for Reporting Trials (CONSORT) 2010 statement and the Standards for Reporting Interventions in Controlled Trials of Acupuncture (STRICTA) guidelines. Each item was scored 1 if it was reported, or 0 if it was not clearly stated. Descriptive statistical analysis was performed. Cohen's κ-statistics were calculated to assess agreement between the two reviewers. Results A total of 87 RCTs were included in the full text. Based on CONSORT, good reporting was evident for items “Randomised’ in the title or abstract’, ‘Participants’, ‘Statistical methods’, ‘Recruitment’, ‘Baseline data’, and ‘Outcomes and estimation’, with positive rates >80%. However, the quality of reporting for the items ‘Trial design’, ‘Outcomes’, ‘Sample size’, ‘Allocation concealment’, ‘Implementation’, ‘Blinding’, ‘Flow chart’, ‘Intent-to-treat analysis’, and ‘Ancillary analyses’ was very poor with positive rates <10%. Based on STRICTA, the items ‘Number of needle insertions per subject per session’, ‘Responses sought’, and ‘Needle type’ had poor reporting with positive rates <50%. Substantial agreement was observed for most items and good agreement was observed for some items. Conclusions The reporting quality of RCTs in acupuncture for post-stroke rehabilitation is unsatisfactory and needs improvement.
EFFECT OF PASTEURISATION ON THE CONCENTRATIONS OF VITAMIN D COMPOUNDS IN DONOR BREAST MILK
Authors: Gomes Fabio , Shaw Nick , Whitfield Karen , Koorts Pieter , McConachy Helen , Hewavitharana Amitha 
Published: August 2016

AimBreastmilk is considered the most important nutrient and source of supplementation for both term and preterm infants.1 It is composed of many important nutrients, including vitamin D.2 The content of this vitamin in breast milk is usually low, even for lactating mothers with adequate vitamin D status.2 3 Preterm infants are at the great risk of vitamin D deficiency due to decreased transplacental transfer.4 Premature infants are the main recipients of pasteurised donor human milk (PDHM), when their mothers are unable to provide their own.This study aims to evaluate the effect of pasteurisation on the concentrations of vitamin D compounds in donor breast milk.MethodA total of 16 participants, who donated breast milk to the RBWH milk bank, were recruited in this study. Milk samples were obtained pre- and post-Holder pasteurisation. Liquid chromatography tandem mass spectrometry (LC-MS/MS) was used to analyse the samples for vitamins D2 and D3 and 25-hydroxyvitamins D2 and D3 (25(OH)D2 and 25(OH)D3). The significance of differences in vitamin D concentrations between the two groups of milk samples was assessed using the Wilcoxon matched-pairs signed rank test, in which P<0.05 was considered significant.ResultsPasteurisation resulted in a significant reduction (P<0.05) in the content of D2, D3, 25(OH)D2 and 25(OH)D3, with P values of 0.0001 for all targeted analytes. The concentrations of the vitamin D analogues in non-pasteurised milk ranged from 3.6 to 5.0 pM (D2), 1.0 to 9.8 pM (D3), 1.4 to 2.1 pM (25(OH)D2) and 1.2 to 9.3 pM (25(OH)D3). The concentrations of the vitamin D analogues in post-pasteurised milk ranged from 3.0 to 4.0 pM (D2), 0.6 to 9.5 pM (D3), 1.2 to 1.7 pM (25(OH)D2) and 1.1 to 9.1 pM (25(OH)D3). Losses of vitamin D compounds resulting from the pasteurisation process ranged from 10% to 20%.ConclusionPasteurisation significantly affected the concentration of vitamin D compounds in pasteurised donor breast milk.
WHAT IS THE MAXIMUM TEMPERATURE REACHED IN ELASTOMERIC DEVICES UNDER SIMULATED OPAT CONDITIONS?
Authors: Merwe Susanna van Der , Green Helen 
Published: August 2016

AimOutpatient parenteral antimicrobial therapy (OPAT), both in children and adults, is increasing in use as part of a cost saving measure for the NHS.1 However there is a general lack of stability data for antibiotics in elastomeric devices. The ‘Yellow Covered Document’2 (YCD), as it is commonly known, specifies the storage conditions, under which stability testing should be carried out ranging from freezing to a worst case scenario of 37°C±2°C. It is assumed that a temperature of 37°C equates to wearing a device reservoir under clothing close to the body e.g. under a winter coat, however evidence supporting this assumption is lacking. The main aim of the study was to determine how warm the solution in an elastomeric device becomes under various simulated conditions to inform future stability studies.MethodThe study was conducted during the winter months. Miniature Type K Thermocouples, were inserted into 2 types of elastomeric devices: 240 ml Baxter Infusor LV 10 (BI) and 120 ml I-Flow Homepump Eclipse® C-Series (IFHE). The elastomeric devices were filled with sterile water to simulate the drug solution. Temperature data was collected from devices stored for 24 hrs in a fridge followed by a 24 hour period at ambient temperature, simulating patients going about their daily lives including wearing devices under clothing when it was cold.ResultsThe water in the BI took 4 hrs 0 min to decrease from 20°C (ambient temperature on the day) to 5°C when refrigerated, compared to 1 hr 22 min for the IFHE. After removal from the fridge the BI took an average of 6 hrs 12 min to reach 20°C compared to 2 hrs 28 min for the IFHE. The average maximum temperature if worn normally, therefore not under any clothing, was 23.3±0.8°C in the BI and 23.8±0.6°C in the IFHE. When worn under clothing the maximum temperature reached in the BI was 28.1°C and in the IFHE 23.4°C.ConclusionSince it is well known that an increase in temperature leads to an increase in drug degradation,3 the results of this study justifies stability testing in elastomeric devices at a more realistic temperature, preventing antibiotics and other drugs potentially being excluded from outpatient parenteral administration. A temperature of 30°C is suggested allowing for slight body temperature variation between patients as well as allowing for warmer days during summer in the UK. It is hypothesised that the delay in temperature change observed for the BI is due to the protective casing around the balloon, acting as an insulator to the environment.
A REALLY WHEEZY WAY TO SAVE MONEY
Authors: Li Grace , Almossawi Ofran , Dulfeker Hasna , Jones Vicky , Taylor Felicity 
Published: August 2016

AimTo compare the palatability of oral non-soluble and oral soluble prednisolone tablets in paediatric patients admitted to the general paediatric wards in an acute London Trust.MethodAs part of ongoing quality improvement initiatives, the Paediatric and Pharmacy departments compared tolerability of soluble versus non-soluble prednisolone in a group of 27 patients. Using a modified 5 point hedonic scale with ‘smiley’ faces we measured palatability and tolerance (swallowed versus refusal or vomiting) over two three week periods: the first period whilst soluble prednisolone was dispensed (n=17) and the second period after the switch to non-soluble prednisolone had been made (n=10). All data were collected by doctors and nurses on the two paediatrics wards.ResultsWe found acceptance of prednisolone to be similar before and after formulations were switched: 2 non-tolerated doses before (n=17) versus 3 non-tolerated doses after the switch (n=10).We found that ‘disguising’ the taste of the non-soluble prednisolone within a portion of sugar free jam, or mixed with 5 ml of sugar-free blackcurrant cordial, helped with acceptance, although both soluble and non-soluble formulations were frequently reported to be “Yuk”!ConclusionsThe Trust has since made the switch to non-soluble prednisolone for all paediatric inpatients and for take home medications. An information leaflet has been developed for parents or carers to understand how to crush the prednisolone tablets. We have not had any parent or carer reported difficulty in preparing or administering the medication.Children under 15 account for 37.8% (20,510 of 54,300) of annual hospital admissions for acute asthma.1 A minimum course of 3 days' oral steroids are recommended in the BTS/SIGN 2014 guideline on the management of asthma.2 This acute Trust covers a population of over 300,000 in deprived boroughs of London.A typical three-day course of soluble prednisolone (at 2 mg/kg as per guidance, or approximately 20 mg) costs £20.88, compared to £2.48 for the equivalent dose of non-soluble prednisolone dispensed with a tablet crusher. Several hospital trusts have switched to using non-soluble prednisolone in order to achieve cost savings, but there have been anecdotal reports of poor palatability, raising concerns about compliance with taking medication once discharged.The switch from a soluble to a non-soluble formulation of prednisolone represents an annual saving of more than £44,000 for this hospital alone and, at scale, could realise substantial potential savings to the NHS, without compromising patients' clinical care.
PRESCRIBING AND MONITORING OF GENTAMICIN IN NEONATES
Authors: Staton Nicola 
Published: August 2016

AimTo evaluate the implementation of the National Institute for Health and Care Excellence (NICE) clinical guideline1 with regards to the prescribing, exposure and therapeutic drug level monitoring of gentamicin in early onset neonatal infection.MethodA selection of drug charts for babies who were prescribed gentamicin within 72 hrs of birth were reviewed. The number of doses of gentamicin administered, C-reactive protein (CRP) results, blood culture results and gentamicin trough levels were recorded. A new gentamicin prescription chart was developed based on the NICE clinical guideline1 and the National Patient Safety Agency (NPSA) alert2 on the safer use of gentamicin for neonates, and was launched on the Neonatal Intensive Care Unit (NICU). A number of months after the new gentamicin prescription chart was introduced, and had therefore had time to become embedded into practice, a selection of babies' drug charts were reviewed and the same information as previously was documented. The information obtained before and after the introduction of the new gentamicin prescription chart was compared.ResultsPrior to the new gentamicin prescription chart 16 prescriptions for gentamicin were reviewed, and in total 47 doses of gentamicin were administered. Blood cultures were negative after five days in all 16 patients. In total 9 gentamicin trough levels were taken with only one level being >2 mg/L. Following the introduction of the new prescription chart another 16 prescriptions for gentamicin were reviewed, and in total 38 doses of gentamicin were administered. Again blood cultures were negative after five days in all 16 patients. In total 14 gentamicin trough levels were taken with two levels being >2 mg/L. Prior to the new gentamicin prescription chart 50% of babies received more than one dose of gentamicin despite having two CRP results <10. This is compared to 31% of babies following the introduction of the new gentamicin prescription chart.ConclusionIt can be concluded that the new gentamicin prescription chart has resulted in a reduction in the exposure of babies to gentamicin, as all babies now have it administered at 36 hourly intervals. There has also been an increase in blood monitoring of trough gentamicin levels, as they are now taken prior to the second dose rather than the third dose. Therefore the new gentamicin prescription chart is safer as toxic levels are identified sooner, which reduces the risk of babies suffering adverse effects.Since the introduction of the new gentamicin prescription chart 31% of babies received more than the necessary number of gentamicin doses, as dictated by the CRP results and blood culture result at 36 hrs. This is a learning point which will be highlighted to the medical and nursing staff on NICU.
Associations of neonatal high birth weight with maternal pre-pregnancy body mass index and gestational weight gain: a case–control study in women from Chongqing, China
Authors: Xie Yao Jie , Peng Rong , Han Lingli , Zhou Xiaoli , Xiong Zhengai , Zhang Yuan , Li Junnan , Yao Ruoxue , Li Tingyu , Zhao Yong 
Published: August 2016

ObjectivesTo examine the associations of maternal pre-pregnancy body mass index (BMI) and gestational weight gain (GWG) with neonatal high birth weight (HBW) in a sample of Chinese women living in southwest China.MethodsA hospital-based case–control study was conducted in Chongqing, China. A total of 221 mothers who delivered HBW babies (>4.0 kg) were recruited as cases and 221 age-matched (2-year interval) mothers with normal birth weight babies (2.5–4.0 kg) were identified as controls. ORs were estimated using conditional logistic regression analysis. For the analysis, pre-pregnancy BMI was categorised as underweight/normal weight/overweight and obesity and GWG was categorised as inadequate/appropriate/excessive.ResultsAmong the cases, mean pre-pregnancy BMI was 21.8±2.8 kg/m2, mean GWG was 19.7±5.1 kg and mean neonatal birth weight was 4.2±0.2 kg. In the controls, the corresponding values were 21.1±3.1 kg/m2, 16.4±5.0 kg and 3.3±0.4 kg, respectively. More cases than controls gained excessive weight during pregnancy (80.1% vs 48.4%, p<0.001). No significant association was found between pre-pregnancy BMI and HBW babies (OR=1.04, 95% CI 0.97 to 1.11; p>0.05). GWG was positively related to HBW after adjustment for gravidity, gestational age, newborns' gender and family income (OR=1.18, 95% CI 1.12 to 1.25; p<0.001). The adjusted OR of delivering HBW babies was 5.39 (95% CI 2.94 to 9.89; p<0.001) for excessive GWG versus appropriate GWG. This OR was strengthened among pre-pregnancy normal weight women (OR=10.27, 95% CI 3.20 to 32.95; p<0.001).ConclusionsOverall, the findings suggest a significantly positive association between GWG and HBW. However, pre-pregnancy BMI shows no independent relationship with HBW.