bluuebunny/crossref_metadata_2025_split huggingface dataset:
Commitment to care: a qualitative study of intensive care nurses' perspectives of end‐of‐life care in an Islamic context
Authors: Borhani F. , Hosseini S.H. , Abbaszadeh A. 
Published: February 2014

BackgroundCurrently, end‐of‐life care is a significant issue and a topic of debate in intensive care settings but understanding of nurses' perspectives about this within an Islamic context is surprisingly lacking.AimThe purpose of this study was to explore intensive care nurses' perspectives of the end‐of‐life care in South‐east of Iran.MethodsA descriptive qualitative research approach was used to engage 12 intensive care nurses from three intensive care units of teaching hospitals affiliated to Kerman University of Medical Science in a semi‐structured interview. Interview transcripts were analysed using an inductive coding approach.ResultsFour major categories emerged from analysis of the interviews: commitment to care, awareness of dying patients, caring relationships, and dealing with barriers and ethical issues. The first category was emphasized and appeared dominant in all interviews.LimitationBecause of specific socio‐cultural and environmental factors, the findings of this study may not be applicable in other contexts, but enhance our knowledge about the topic in an Islamic context.ConclusionsThis study emphasizes the importance of looking at the end‐of‐life care for critical terminally ill patients within the context of spiritual milieu associated with commitment to a compassionate care until the last moment of their life. Intensive nurses, faced with various barriers and ethical issues, instead were focused on physical and spiritual care and believed that it should fulfil their role in the challenging process.Implications for nursing and health policyThese findings indicate that there is a need for policies that help increase the quality of life of dying patients. It is imperative that nursing managers and policy makers in Iran consider these findings to improve end‐of‐life care in intensive setting. More training programmes, further education and research on the topic, should be implemented.
Two‐stage two‐dimensional guillotine cutting stock problems with usable leftover
Authors: Andrade R. , Birgin E.G. , Morabito R. 
Published: February 2014

AbstractIn this study, we solve the nonexact two‐stage two‐dimensional guillotine cutting problem considering usable leftovers, in which stock plates remainders of the cutting patterns (nonused material or trim loss) can be used in the future, if they are large enough to fulfill future demands for items (ordered smaller plates). This cutting problem can be characterized as a residual bin‐packing problem because of the possibility of putting back into stock residual pieces, as the trim loss of each cutting/packing pattern does not necessarily represent waste of material depending on its size. Two bilevel mathematical programming models to represent this nonexact two‐stage two‐dimensional residual bin‐packing problem are presented. The models basically consist of cutting/packing the ordered items using a set of plates of minimum cost and, among all possible solutions of minimum cost, choosing one that maximizes the value of the generated usable leftovers. Because of special characteristics of these bilevel models, they can be reformulated as one‐level mixed integer programming models. Results of some numerical experiments are presented to show that the models represent appropriately the problem and illustrate their performance.
Session 3: Maneuver your lenses! What are new practices under today's fast changing contexts?
Authors: TAMURA HIROSHI 
Published: February 2014

The third session examines new practices in ethnography – from blogging communities to mediation between digital and analog interviews – it questions what works and what doesn't, and how retrospective, introspective and prospective insights conjoin in this new ‘fast subject’ world.We are in the midst of a social, technical, educational and industrial upheaval. Many public and private sectors are in transition. As ethnographic researchers adapt to and move between and within temporary, digital, quick field studies, and yet bridge rural migrations in modern urban contexts, they, too, are in the process of mediating practices and theories. This session explores the ways in which ethnography today relates to blogging communities and new users, how mediation between digital and analog interviews can develop insights, what works and what doesn't for online education, and how retrospective, introspective and prospective insights conjoin in this ‘fast subject’ world. To discuss, six authors in this session will present their views by developing theoretical frameworks, unique research processes, and an artful prescription of research field.
People and Energy: A design‐led approach to understanding everyday energy use behaviour
Authors: LOCKTON DAN , BOWDEN FLORA , GREENE CATHERINE , BRASS CLARE , GHEERAWO RAMA 
Published: February 2014

Reducing home energy use is a major societal challenge, involving behaviour change alongside infrastructure improvements. However, many approaches lump ‘energy demand’ together as something homogeneous, addressable primarily through quantitative feedback, rather than basing interventions on an understanding of why people use energy as they do. Our contention is that people don't set out to ‘use energy’: its use is a side effect of solving everyday problems, meeting needs for comfort, light, cooking, cleaning, entertainment, and so on.Design researchers at the Royal College of Art have been carrying out ethnographic research with a diverse range of householders, investigating nuances of daily interactions with heating and lighting, meters and appliances—alongside people's understanding of energy and how their actions affect its use. Insights, integrated with household monitoring data, will inform the co‐design of prototype products and services to help people reduce their energy use while meeting needs.
Real‐time PCR for identification of the soybean aphid, Aphis glycines Matsumura
Authors: Naaum A. M. , Foottit R. G. , Maw H. E. L. , Hanner R. 
Published: February 2014

AbstractThe soybean aphid (Aphis glycines Matsumura) is an economically significant pest in North America, causing extensive damage to soybean crops through direct feeding damage and disease transmission. If unchecked, this pest could cause billions of dollars of damage to soybean crops. Identification of the soybean aphid can be difficult due to its small size, complex life cycle and morphological plasticity. Generally, an expert is required to identify a specimen. Additionally, identification of some life stages, such as eggs, is impossible. DNA barcoding has been successfully used to differentiate aphid species, including A. glycines, based on sequencing of a standardized gene region. Although this method represents an important step towards accurate identification, samples must still be sent to specialized facilities for analysis. Using existing DNA barcode sequences in the publically accessible Barcode of Life Data System (BOLD; www.boldsystems.org), species‐specific differences were identified and used to develop a real‐time PCR assay to identify soybean aphids. This assay can be run on portable systems for rapid, accurate and simple identification in the field. The use of a non‐destructive DNA extraction protocol allows the original insect to be vouchered and therefore available for further study if necessary. This work represents an important step in soybean aphid management.
Oviposition, adult longevity and temperature effects on the eggs of Tetanocera elata (Fab.) (Diptera: Sciomyzidae): a potential biocontrol agent for slugs
Authors: Hynes T. , Mc Donnell R. J. , Gormally M. J. 
Published: February 2014

AbstractPestiferous slugs in organic and conventional farming systems damage crops, reduce yield and quality, and reduce profits; however, no biological control agent that is both efficacious and inexpensive has yet been developed. One potential biological control agent is the slug‐feeding Tetanocera elata (Fab.), for which scant scientific data are currently available regarding optimum growing conditions. This study examined the effect of constant temperatures (14, 17, 20, 23 and 26°C) and ambient outdoor and laboratory temperatures on the duration of the egg stage of T. elata. In general, mean and median duration of incubation decreased as temperatures increased, with the highest (52%) and lowest (20%) hatch rates occurring at 14 and 26°C, respectively. Longevity and oviposition rates for T. elata are discussed in the context of mass biocontrol production systems, and possible reasons for low hatch rates for eggs stored at 2–3°C are discussed in the context of the phenology of the species.
Sleep disorders in cirrhotics; How can we detect ?
Authors: Gencdal Genco , Gunsar Fulya , Meral Cenk E. , Salman Esin , Gürsel Berna , Oruç Nevin , Karasu Zeki , Ersöz Galip , Akarca Ulus Salih 
Published: February 2014

AbstractBackground & AimsSleep disorders (SDs) are common in cirrhotics and are often associated with hepatic encephalopathy. SDs negatively affect patients' daily activities and work efficiency. For this reason, early diagnosis is important. The methods used for diagnosis of SDs are not practical and need longer periods of application and evaluation. In this study, we aimed to investigate sleep disorders and related clinical parameters in cirrhosis and also wanted to investigate the using of Sleep Timing and Sleep Quality Screening questionnaire (STSQS), a simple form with a short application time, for diagnosis of SDs and its correlation with Pittsburg Sleep Quality Index (PSQI) form.MethodsCirrhotic patients and age‐matched healthy volunteers were enrolled. Patients were excluded from this study if they had neuropsychiatric disease or used excessive alcohol or drugs known to affect sleep. Both groups completed validated Turkish form of PSQI and STSQS. SD was defined as PSQI score (0–21) of >5 or STSQS ≥5.ResultsOne hundred and thirty‐one cirrhotic patients and 18 healthy volunteers were enrolled. SDs in cirrhotics and control group were detected 56.5% and 27.8% by PSQI, 49.6% and 16.7% by STSQS respectively. SDs are the most frequent in the Child C patients, and the least frequent in the Child A patients (P > 0.05). No correlation was found between the MELD score and SDs. SDs were more common in cirrhotic patients with hypoalbuminaemia and low haemoglobin levels. In addition, the patients with decompensated cirrhosis had more frequently SDs than the patients with compensated cirrhosis. In the patient group, sleep latency and total sleep time, sleep parameters were correlated with SDs. STSQS had statistical significant correlation with PSQI for diagnosis of SDs.ConclusionSDs are common in cirrhotics and STSQS could be an appropriate and practical method for diagnosis of SDS in these patients. We can use it in cirrhotic patients at outpatient clinics.
Trans‐arterial chemo‐embolization is safe and effective for elderly advanced hepatocellular carcinoma patients: results from an international database
Authors: Cohen Matan J. , Levy Izhar , Barak Orly , Bloom Allan I. , Fernández‐Ruiz Mario , Di Maio Massimo , Perrone Francesco , Poon Ronnie T. , Shouval Daniel , Yau Thomas , Shibolet Oren 
Published: February 2014

AbstractObjectiveHepatocellular carcinoma (HCC) incidence among elderly patients is increasing. Trans‐arterial chemo‐embolization (TACE) prolongs survival in selected HCC patients. The safety and efficacy of TACE in elderly patients has not been extensively studied. The objective of this study was to assess the safety and efficacy of TACE in elderly patients (older than 75) with HCC.DesignCombined HCC registries (Spain, Italy, China and Israel) and cohort design analysis of patients who underwent TACE for HCC.ResultsFive hundred and forty‐eight patients diagnosed and treated between 1988 and 2010 were included in the analysis (China 197, Italy 155, Israel 102 and Spain 94,). There were 120 patients (22%) older than 75 years and 47 patients (8.6%) older than 80. Median (95% CI) survival estimates were 23 (17–28), 21 (17–26) and 19 (15–23) months (P = 0.14) among patients aged younger than 65, 65–75 and older than 75 respectively. An age above 75 years at diagnosis was not associated with worse prognosis, hazard ratio of 1.05 (95% CI 0.75–1.5), controlling for disease stage, sex, diagnosis year, HBV status and stratifying per database. No differences in complication rates were found between the age groups.ConclusionsTACE is safe for patients older than 75 years. Results were similar over different eras and geographical locations. Though selection bias is inherent, the results suggest overall adequate selection of patients, given the similar outcomes among the different age groups.
Pumping Ca2+ up H+ gradients: a Ca2+–H+ exchanger without a membrane
Authors: Swietach Pawel , Leem Chae‐Hun , Spitzer Kenneth W. , Vaughan‐Jones Richard D. 
Published: February 2014

AbstractCellular processes are exquisitely sensitive to H+ and Ca2+ ions because of powerful ionic interactions with proteins. By regulating the spatial and temporal distribution of intracellular [Ca2+] and [H+], cells such as cardiac myocytes can exercise control over their biological function. A well‐established paradigm in cellular physiology is that ion concentrations are regulated by specialized, membrane‐embedded transporter proteins. Many of these couple the movement of two or more ionic species per transport cycle, thereby linking ion concentrations among neighbouring compartments. Here, we compare and contrast canonical membrane transport with a novel type of Ca2+–H+ coupling within cytoplasm, which produces uphill Ca2+ transport energized by spatial H+ ion gradients, and can result in the cytoplasmic compartmentalization of Ca2+ without requiring a partitioning membrane. The mechanism, demonstrated in mammalian myocytes, relies on diffusible cytoplasmic buffers, such as carnosine, homocarnosine and ATP, to which Ca2+ and H+ ions bind in an apparently competitive manner. These buffer molecules can actively recruit Ca2+ to acidic microdomains, in exchange for the movement of H+ ions. The resulting Ca2+ microdomains thus have the potential to regulate function locally. Spatial cytoplasmic Ca2+–H+ exchange (cCHX) acts like a ‘pump’ without a membrane and may be operational in many cell types.
Kibdelomycin Is a Potent and Selective Agent against Toxigenic Clostridium difficile
Authors: Miesel Lynn , Hecht David W. , Osmolski James R. , Gerding Dale , Flattery Amy , Li Fangbiao , Lan Jing , Lipari Philip , Polishook Jon D. , Liang Lianzhu , Liu Jenny , Olsen David B. , Singh Sheo B. 
Published: February 2014

ABSTRACT

Clostridium difficile
is the causative agent of
C. difficile
-associated diarrhea (CDAD), with increased risk in elderly populations. Kibdelomycin, a novel natural-product inhibitor of type II topoisomerase enzymes, was evaluated for activity against
C. difficile
and gastrointestinal anaerobic organisms. Toxigenic
C. difficile
isolates (
n
= 168) from U.S. hospitals and anaerobic Gram-positive and Gram-negative organisms (
n
= 598) from Chicago-area hospitals were tested. Kibdelomycin showed potent activity against toxigenic
C. difficile
(MIC
90
= 0.25 μg/ml) and most Gram-positive aerobic organisms but had little activity against
Bacteroides
species (MIC
50
> 32 μg/ml;
n
= 270). Potent anti-
C. difficile
activity was also observed in the hamster model of
C. difficile
colitis. Dosing at 1.6 mg/kg (twice-daily oral dose) resulted in protection from a lethal infection and a 2-log reduction in
C. difficile
cecal counts. A 6.25-mg/kg twice-daily oral dose completely eliminated detectable
C. difficile
counts in cecal contents. A single 6.25-mg/kg oral dose showed that cecal contents were exposed to the drug at >2 μM (eightfold higher than the MIC), with no significant plasma exposure. These findings support further exploration of kibdelomycin for development of an anti-
C. difficile
agent.
Co-Trimoxazole Prophylaxis Is Associated with Reduced Risk of Incident Tuberculosis in Participants in the Swiss HIV Cohort Study
Authors: Hasse Barbara , Walker A. Sarah , Fehr Jan , Furrer Hansjakob , Hoffmann Matthias , Battegay Manuel , Calmy Alexandra , Fellay Jacques , Di Benedetto Caroline , Weber Rainer , Ledergerber Bruno 
Published: February 2014

ABSTRACT

Co-trimoxazole reduces mortality in HIV-infected adults with tuberculosis (TB), and
in vitro
data suggest potential antimycobacterial activity of co-trimoxazole. We aimed to evaluate whether prophylaxis with co-trimoxazole is associated with a decreased risk of incident TB in Swiss HIV Cohort Study (SHCS) participants. We determined the incidence of TB per 1,000 person-years from January 1992 to December 2012. Rates were analyzed separately in participants with current or no previous antiretroviral treatment (ART) using Poisson regression adjusted for CD4 cell count, sex, region of origin, injection drug use, and age. A total of 13,431 cohort participants contributed 107,549 person-years of follow-up: 182 patients had incident TB—132 (73%) before and 50 (27%) after ART initiation. The multivariable incidence rate ratios for cumulative co-trimoxazole exposure per year for persons with no previous ART and current ART were 0.70 (95% confidence interval [CI], 0.55 to 0.89) and 0.87 (95% CI, 0.74 to 1.0), respectively. Co-trimoxazole may prevent the development of TB among HIV-positive persons, especially among those with no previous ART.
Antimicrobial Activity of Ceftaroline Tested against Drug-Resistant Subsets of Streptococcus pneumoniae from U.S. Medical Centers
Authors: Flamm Robert K. , Sader Helio S. , Farrell David J. , Jones Ronald N. 
Published: February 2014

ABSTRACT

Streptococcus pneumoniae
isolates (6,958) were collected from patients at 163 U.S. medical centers during 2009 through 2012. Isolates were evaluated for multidrug resistance (MDR) to penicillin, ceftriaxone, erythromycin, tetracycline, trimethoprim-sulfamethoxazole, and levofloxacin. Ceftaroline was 16-fold more potent than ceftriaxone (MIC
50
/MIC
90
, ≤0.25/2 μg/ml) against all isolates. For MDR isolates (35.2% of tested strains), ceftaroline (MIC
50
/MIC
90
, 0.06/0.25 μg/ml; 100.0% susceptible) was the most active agent tested, being 8-fold more potent than ceftriaxone (MIC
50
/MIC
90
, 0.5/2 μg/ml) and 16-fold more potent than penicillin (MIC
50
/MIC
90
, 1/4 μg/ml).
Azithromycin Resistance Is Coevolving with Reduced Susceptibility to Cephalosporins in Neisseria gonorrhoeae in Ontario, Canada
Authors: Allen Vanessa G. , Seah Christine , Martin Irene , Melano Roberto G. 
Published: February 2014

ABSTRACT

Azithromycin (AZM) is routinely recommended as a component of dual therapy for gonorrhea in combination with third-generation cephalosporins (3GC). In this study, we examined the prevalence of AZM-resistant (AZM
r
)
Neisseria gonorrhoeae
from July 2010 to February 2013, assessed the rate of concurrent cephalosporin resistance under the current treatment recommendations, and analyzed the clonal distribution of AZM
r
isolates in Ontario, Canada. Nineteen AZM
r
clinical isolates (one per patient; MIC, ≥2 μg/ml) were included in the study. Susceptibility profiles of these isolates to 11 antibiotics, molecular typing, characterization of macrolide resistance mechanisms, and penicillin-binding protein 2 (PBP2) patterns were determined for all the isolates. Two groups were defined based on AZM
r
level; group A isolates displayed high-level resistance (MIC, ≥2,048 μg/ml) due to mutations (A2143G) in the four copies of the 23S rRNA
rrl
gene, and group B isolates had moderate resistance to AZM (MICs, 2 to 8 μg/ml, C2599T mutation in the
rrl
gene), with a subgroup belonging to sequence type 3158 (ST3158) (
n
= 8), which also showed reduced susceptibility to 3GC (MICs, 0.12 to 0.25 μg/ml, PBP2 pattern XXXIV). This AZM
r
phenotype was not observed in previous provincial surveillance in 2008 (the ST3158 clone was found, with AZM MICs of 0.25 to 0.5 μg/ml associated with
mtrR
mutations). We hypothesized that the AZM mutant prevention concentration (MPC) in the ST3158 subpopulation we found in 2008 was higher than the MPC in wild-type isolates (AZM MIC, ≤0.031 μg/ml), increasing the chances of additional selection of AZM
r
mutations. Full AZM resistance is now emerging in this clone together with reduced susceptibility to 3GC, threatening the future efficacy of these antibiotics as therapeutic options for treatment of gonorrhea.
Exposure to Ceftobiprole Is Associated with Microbiological Eradication and Clinical Cure in Patients with Nosocomial Pneumonia
Authors: Muller A. E. , Punt N. , Mouton J. W. 
Published: February 2014

ABSTRACT

The percentage of the dosing interval that the non-protein-bound plasma concentration is above the MIC (%
f
T>MIC) for cephalosporins has been shown to correlate with microbiological outcomes in preclinical studies. However, clinical data are scarce. Using data from a randomized double-blind phase 3 clinical trial, we explored the relationship of ceftobiprole exposure with microbiological and clinical outcomes in patients with nosocomial pneumonia. The individual ceftobiprole exposure was determined for different pharmacokinetic (PK)/pharmacodynamic (PD) indices using individual pharmacokinetic data and a previously published population model. The MICs used in the analysis were the highest MICs for any bacterium cultured at baseline or the end of treatment (EOT). Outcomes were microbiological cure at EOT and clinical cure at test of cure (TOC). Multiple logistic regression (MLR) and classification and regression tree (CART) analyses were applied to determine the relationships among exposure, patient characteristics, and outcomes. MLR indicated that the %
f
T>MIC of ceftobiprole was the best predictor for both microbiological eradication and clinical cure. CART analysis showed a breakpoint value of 51.1% (
n
= 159;
P
= 0.0024) for clinical cure, whereas it was 62.2% (
n
= 251;
P
< 0.0001) for microbiological eradication. Other factors also contributed, particularly to clinical outcome. These included the difference between VAP and non-VAP patients, systemic inflammatory response syndrome (SIRS), creatinine clearance, the use of anti-
Pseudomonas
combination therapy, and Acute Physiology and Chronic Health Evaluation II (APACHE-II) score. There is a strong correlation between microbiological eradication and clinical cure with exposure to ceftobiprole. The %
f
T>MIC required to result in a favorable clinical outcome is >51% of the dosing interval, which is in line with the values found for microbiological eradication, the comparator ceftazidime, and preclinical models.