bluuebunny/crossref_metadata_2025_split huggingface dataset:
Anti‐microbial Use in Animals: How to Assess the Trade‐offs
Authors: Rushton J. 
Published: April 2015

SummaryAntimicrobials are widely used in preventive and curative medicine in animals. Benefits from curative use are clear – it allows sick animals to be healthy with a gain in human welfare. The case for preventive use of antimicrobials is less clear cut with debates on the value of antimicrobials as growth promoters in the intensive livestock industries. The possible benefits from the use of antimicrobials need to be balanced against their cost and the increased risk of emergence of resistance due to their use in animals. The study examines the importance of animals in society and how the role and management of animals is changing including the use of antimicrobials. It proposes an economic framework to assess the trade‐offs of anti‐microbial use and examines the current level of data collection and analysis of these trade‐offs. An exploratory review identifies a number of weaknesses. Rarely are we consistent in the frameworks applied to the economic assessment anti‐microbial use in animals, which may well be due to gaps in data or the prejudices of the analysts. There is a need for more careful data collection that would allow information on (i) which species and production systems antimicrobials are used in, (ii) what active substance of antimicrobials and the application method and (iii) what dosage rates. The species need to include companion animals as well as the farmed animals as it is still not known how important direct versus indirect spread of resistance to humans is. In addition, research is needed on pricing antimicrobials used in animals to ensure that prices reflect production and marketing costs, the fixed costs of anti‐microbial development and the externalities of resistance emergence. Overall, much work is needed to provide greater guidance to policy, and such work should be informed by rigorous data collection and analysis systems.
First Report on the Efficiency of Oral Vaccination of Foxes against Rabies in Serbia
Authors: Lupulovic D. , Maksimovic Zoric J. , Vaskovic N. , Bugarski D. , Plavsic B. , Ivanovic N. , Petrovic T. , Pusic I. , Marcic D. , Grgic Z. , Lazic S. 
Published: April 2015

SummaryRabies is one of the oldest known zoonotic diseases that has significant impact on public health, but still remains neglected in Serbia. Rabies virus can infect humans and other mammals and causes inflammation of the brain associated with encephalomyelitis and neurological symptoms. In 2010, Veterinary Directorate (national Competent Authority for animal health in Serbia) has started multi‐annual project of oral rabies vaccination of foxes and other wild carnivores (e.g. jackals), as support of long‐term programme of eradication of rabies in Serbia, co‐funded by EU (financed by Instrument for Pre‐Accession Assistance). Monitoring of the effectiveness of oral vaccination campaigns has been carried out in continuation from 2011 and was based on: (i) post‐mortem laboratory examination of brain tissue of target animals (foxes, jackals and other carnivores) by fluorescent antibody test (FAT), (ii) detection of antibodies against rabies virus in serum samples by ELISA and (iii) detection of tetracycline biomarker in the mandibles for the evaluation of vaccine bait uptake. From September 2011 to May 2014, the total number of 4943 brain tissue samples, 4241 sera and 4971 mandibles were analysed. Confirmed rabies‐positive brains decreased from 10 in 2011/2012 to 6 in 2012/2013 and eventually to 1 positive case in 2013/2014. The seroconversion rate increased from 10.48% (133/1269) in 2011/2012 to 20.11% (362/1800) in 2012/2013 and 42.23% (495/1172) in 2013/2014. Along with the seroconversion, the number of detected tetracycline‐positive mandibles demonstrated an increasing tendency in the same period, being 49.67% (682/1373) in 2011/2012, 62.60% (1294/2067) in 2012/2013 and 90.33% (1383/1531) in the monitoring programme carried out in 2013/2014. Presented results confirmed that ORV of foxes and other wildlife in Serbia against rabies was successful and characterized by steady increase of vaccine baits uptake and immunization of animals.
Hybrid Vibrio cholerae El Tor Lacking SXT Identified as the Cause of a Cholera Outbreak in the Philippines
Authors: Klinzing David C. , Choi Seon Young , Hasan Nur A. , Matias Ronald R. , Tayag Enrique , Geronimo Josefina , Skowronski Evan , Rashed Shah M. , Kawashima Kent , Rosenzweig C. Nicole , Gibbons Henry S. , Torres Brian C. , Liles Veni , Alfon Alicia C. , Juan Maria Luisa , Natividad Filipinas F. , Cebula Thomas A. , Colwell Rita R. 
Published: April 2015

ABSTRACT

Cholera continues to be a global threat, with high rates of morbidity and mortality. In 2011, a cholera outbreak occurred in Palawan, Philippines, affecting more than 500 people, and 20 individuals died.
Vibrio cholerae
O1 was confirmed as the etiological agent. Source attribution is critical in cholera outbreaks for proper management of the disease, as well as to control spread. In this study, three
V. cholerae
O1 isolates from a Philippines cholera outbreak were sequenced and their genomes analyzed to determine phylogenetic relatedness to
V. cholerae
O1 isolates from recent outbreaks of cholera elsewhere. The Philippines
V. cholerae
O1 isolates were determined to be
V. cholerae
O1 hybrid El Tor belonging to the seventh-pandemic clade. They clustered tightly, forming a monophyletic clade closely related to
V. cholerae
O1 hybrid El Tor from Asia and Africa. The isolates possess a unique multilocus variable-number tandem repeat analysis (MLVA) genotype (12-7-9-18-25 and 12-7-10-14-21) and lack SXT. In addition, they possess a novel 15-kb genomic island (GI-119) containing a predicted type I restriction-modification system. The CTXΦ-RS1 array of the Philippines isolates was similar to that of
V. cholerae
O1 MG116926, a hybrid El Tor strain isolated in Bangladesh in 1991. Overall, the data indicate that the Philippines
V. cholerae
O1 isolates are unique, differing from recent
V. cholerae
O1 isolates from Asia, Africa, and Haiti. Furthermore, the results of this study support the hypothesis that the Philippines isolates of
V. cholerae
O1 are indigenous and exist locally in the aquatic ecosystem of the Philippines.

IMPORTANCE
Genetic characterization and phylogenomics analysis of outbreak strains have proven to be critical for probing clonal relatedness to strains isolated in different geographical regions and over time. Recently, extensive genetic analyses of
V. cholerae
O1 strains isolated in different countries have been done. However, genome sequences of
V. cholerae
O1 isolates from the Philippines have not been available for epidemiological investigation. In this study, molecular typing and phylogenetic analysis of
Vibrio cholerae
isolated from both clinical and environmental samples in 2011 confirmed unique genetic features of the Philippines isolates, which are helpful to understand the global epidemiology of cholera.
Risk factors which predispose first-time traumatic anterior shoulder dislocations to recurrent instability in adults: a systematic review and meta-analysis
Authors: Olds M , Ellis R , Donaldson K , Parmar P , Kersten P 
Published: April 2015

BackgroundRecurrent instability following a first-time anterior traumatic shoulder dislocation may exceed 26%. We systematically reviewed risk factors which predispose this population to events of recurrence.MethodsA systematic review of studies published before 1 July 2014. Risk factors which predispose recurrence following a first-time traumatic anterior shoulder dislocation were documented and rates of recurrence were compared. Pooled ORs were analysed using random-effects meta-analysis.ResultsTen studies comprising 1324 participants met the criteria for inclusion. Recurrent instability following a first-time traumatic anterior shoulder dislocation was 39%. Increased risk of recurrent instability was reported in people aged 40 years and under (OR=13.46), in men (OR=3.18) and in people with hyperlaxity (OR=2.68). Decreased risk of recurrent instability was reported in people with a greater tuberosity fracture (OR=0.13). The rate of recurrent instability decreased as time from the initial dislocation increased. Other factors such as a bony Bankart lesion, nerve palsy and occupation influenced rates of recurrent instability.ConclusionsSex, age at initial dislocation, time from initial dislocation, hyperlaxity and greater tuberosity fractures were key risk factors in at least two good quality cohort studies resulting in strong evidence as concluded in the GRADE criteria. Although bony Bankart lesions, Hill Sachs lesions, occupation, physiotherapy treatment and nerve palsy were risk factors for recurrent instability, the evidence was weak using the GRADE criteria—these findings relied on poorer quality studies or were inconsistent among studies.
Serial measurement of Wessex Head Injury Matrix in the diagnosis of patients in vegetative and minimally conscious states: a cohort analysis
Authors: Turner-Stokes Lynne , Bassett Paul , Rose Hilary , Ashford Stephen , Thu Aung 
Published: April 2015

ObjectiveTo evaluate serial application of the Wessex Head Injury Matrix (WHIM) in diagnosis of prolonged disorders of consciousness (PDOC). Specifically, to determine whether the trajectory of change predicts outcome status, and whether the current hierarchical order of WHIM items is correct for this context.DesignAnalysis of prospectively gathered clinical cohort data.SettingConsecutive admissions to a tertiary in-patient neurorehabilitation service for evaluation of PDOC in real-life clinical practice, over a 10-year period (2004–2014).ParticipantsPatients (n=65) presenting in sudden-onset vegetative (VS) or minimally conscious states (MCS). Mean age 38.4 (sd14.1) years; male:female ratio 66%:33%. Aetiology of brain injury: 40(62%) traumatic; 12(19%) vascular; 11(17%) hypoxic; 3(3%) other.Primary outcome measureWHIM alongside detailed clinical evaluation.MethodsThe WHIM was administered serially by the multidisciplinary team throughout an in-patient evaluation programme (mean length 74 (sd42) days). Patients were divided into four groups, according to PDOC status on discharge (VS, MCS-Minus, MCS-Plus or Emerged).ResultsWHIM hierarchical scores (Most Advanced Behaviour (MAB)) correlated with PDOC status at discharge (Pearson r=0.49, p<0.001). In the original order, the MAB distinguished the ‘VS’, ‘MCS’ and ‘Emerged’ categories (analysis of variance (ANOVA) post hoc p<0.001), but not the subgroups of MCS-Minus and MCS-Plus. In stepwise regression analysis, MAB-Ex (excluding two items) accounted for 68% of the variance in PDOC status at discharge. On multilevel statistical modelling, trajectory of change in MAB separated the four PDOC groups, both at individual and at group level (p<0.001). After reordering of items, the new-order MAB accounted for more (73%) of the variance in PDOC status, and also distinguished significantly between MCS-Minus and MCS-Plus groups at discharge (p<0.002).ConclusionsThe WHIM is a useful diagnostic tool in PDOC, and trajectory of change is an important predictor of outcome. The proposed new hierarchical order requires further evaluation in future multicentre analyses.
Health professionals’ and service users’ perspectives of shared care for monitoring wet age-related macular degeneration: a qualitative study alongside the ECHoES trial
Authors: Townsend D , Reeves B C , Taylor J , Chakravarthy U , O'Reilly D , Hogg R E , Mills N 
Published: April 2015

ObjectivesTo explore the views of eye health professionals and service users on shared community and hospital care for wet or neovascular age-related macular degeneration (nAMD).MethodUsing maximum variation sampling, 5 focus groups and 10 interviews were conducted with 23 service users and 24 eye health professionals from across the UK (consisting of 8 optometrists, 6 ophthalmologists, 6 commissioners, 2 public health representatives and 2 clinical eye care advisors to local Clinical Commissioning Groups). Data were transcribed verbatim and analysed thematically using constant comparative techniques derived from grounded theory methodology.ResultsThe needs and preferences of those with nAMD appear to be at odds with the current service being provided. There was enthusiasm among health professionals and service users about the possibility of shared care for nAMD as it was felt to have the potential to relieve hospital eye service burden and represent a more patient-centred option, but there were a number of perceived barriers to implementation. Some service users and ophthalmologists voiced concerns about optometrist competency and the potential for delays with referrals to secondary care if stable nAMD became active again. The health professionals were divided as to whether shared care was financially more efficient than the current model of care. Specialist training for optometrists, under the supervision of ophthalmologists, was deemed to be the most effective method of training and was perceived to have the potential to improve the communication and trust that shared care would require.ConclusionsWhile shared care is perceived to represent a promising model of nAMD care, voiced concerns suggest that there would need to be greater collaboration between ophthalmology and optometry, in terms of interprofessional trust and communication.Trial registration numberISRCTN07479761.
Does a quality management system improve quality in primary care practices in Switzerland? A longitudinal study
Authors: Goetz Katja , Hess Sigrid , Jossen Marianne , Huber Felix , Rosemann Thomas , Brodowski Marc , Künzi Beat , Szecsenyi Joachim 
Published: April 2015

ObjectivesTo examine the effectiveness of the quality management programme—European Practice Assessment—in primary care in Switzerland.DesignLongitudinal study with three points of measurement.SettingPrimary care practices in Switzerland.ParticipantsIn total, 45 of 91 primary care practices completed European Practice Assessment three times.OutcomesThe interval between each assessment was around 36 months. A variance analyses for repeated measurements were performed for all 129 quality indicators from the domains: ‘infrastructure’, ‘information’, ‘finance’, and ‘quality and safety’ to examine changes over time.ResultsSignificant improvements were found in three of four domains: ‘quality and safety’ (F=22.81, p<0.01), ‘information’ (F=27.901, p<0.01) and ‘finance’ (F=4.073, p<0.02). The 129 quality indicators showed a significant improvement within the three points of measurement (F=33.864, p<0.01).ConclusionsThe European Practice Assessment for primary care practices thus provides a functioning quality management programme, focusing on the sustainable improvement of structural and organisational aspects to promote high quality of primary care. The implementation of a quality management system which also includes a continuous improvement process would give added value to provide good care.
Seroprevalence and awareness of human papillomavirus infection and cervical cancer screening results among reproductive-aged Georgian women
Authors: Butsashvili Maia , Abzianidze Tinatin , Kajaia Maia , Agladze Dodo , Kldiashvili Ekaterine , Bednarczyk Robert , McNutt Louise-Anne , Kamkamidze George 
Published: April 2015

IntroductionAs is the case in many developing countries, more than half of the new cervical cancer cases in Georgia are late-stage diagnoses, thus reducing the opportunity for effective treatment. A state cancer screening programme was launched in Tbilisi in 2006; 5 years later the programme had expanded to other regions in Georgia.MethodsThis study was designed to estimate awareness about human papillomavirus (HPV), cervical cancer screening, the HPV vaccine, and the seroprevalence of HPV infection among reproductive-aged Georgian women. Study participants were recruited from four women's consultation centres in different regions of Georgia. Data were collected through interviewer-administered questionnaires and HPV seroprevalence was assessed for HPV types 6/11/16/18.ResultsOf the 500 study participants, 52.0% were aware of HPV and 36.4% stated that the main cause of cervical cancer is HPV. Of those aware of HPV, 78% reported attending for cervical cancer screening at least once during their lifetime. Half (50.8%) of all respondents were unaware of the HPV vaccine. Of the women who agreed to be tested for anti-HPV antibodies (n=317), 21.1% were positive. Women reporting no condom use were more likely to have HPV antibodies (prevalence ratio 2.77; 95% confidence interval 1.79–4.27). Awareness of cervical cancer screening was significantly associated with HPV seropositivity. With multivariate analysis, both absence of condom use and lack of knowledge about cervical cancer screening were independently associated with HPV seropositivity.ConclusionMore comprehensive public awareness campaigns should be developed to raise awareness about HPV screening and prevention.
Factors associated with discussion of sexual activity and contraception in women with HIV
Authors: Stewart Zoe A , Shipley Kate , Spelman Tim , Giles Michelle L 
Published: April 2015

ObjectivesContraceptive use is important for reproductive-aged women living with HIV to plan and optimise safety of pregnancies. Clinicians play a vital role in counselling patients about contraception and safe sexual activity. This study aimed to determine the frequency and predictors of discussions regarding sexual activity and contraceptive use.MethodsRetrospective clinical study of all reproductive-aged women (n=128) treated for HIV between 2010 and 2012 at two metropolitan hospitals. Evidence of discussion between treating doctors and patients regarding sexual activity and contraception and variables including patient age, gender of doctor, time since HIV diagnosis, previous pregnancy, country of birth and antiretroviral regimen were obtained from medical records.ResultsSexual activity status was documented for 54% of the women and discussion regarding contraception was recorded for less than one-third of the study participants. Contraceptive use was not recorded in 63% of the medical records. In the study cohort 27% of the women used contraception, 10% did not use contraception, and when a discussion regarding sexual activity was documented, contraception was 3.7 times more likely to also be discussed (p=0.04). Excluding women who were pregnant, women who were documented as using contraception were 1.8 times as likely to have had a discussion about contraception documented (p=0.05). After adjustment for other factors, previous pregnancy, gender of doctor and age of patient were not associated with discussions regarding sexual activity or contraception.ConclusionsDiscussions regarding sexual activity and contraception between HIV-infected women of reproductive age and their clinicians were inconsistent and suboptimal. Mechanisms to facilitate regular discussion about sexual activity and contraception between clinicians and women with HIV warrant further investigation.
Plasmonic Diodes THz Response to Impulse Train and Stochastic Optical Excitations
Authors: Karishy S. , Ajaka J. , Varani L. , Palermo C. 
Published: April 2015

Terahertz (THz) plasma oscillation in n+nn+ InGaAs vertical diodes is studied by using a numerical approach based on the hydrodynamic (HD) equations. The 1D HD model is coupled to 1D Poisson equation. We simulate the diode response to the optical excitation of plasma waves at room temperature. Our results clearly show the presence of 3D plasma resonances in the THz frequency domain. The selection of appropriately shaped optical excitation pulses helps in the realization of the detected frequency. The investigation is completed by introducing stochastic perturbations according to the Langevin equation.
β-Blockers, Pneumonia, and Outcome After Ischemic Stroke
Authors: Sykora Marek , Siarnik Pavel , Diedler Jennifer ,   VISTA Acute Collaborators, Lees K.R. , Alexandrov A. , Bath P.M. , Bluhmki E. , Bornstein N. , Claesson L. , Davis S.M. , Donnan G. , Diener H. C. , Fisher M. , Ginsberg M. , Gregson B. , Grotta J. , Hacke W. , Hennerici M.G. , Hommel M. , Kaste M. , Lyden P. , Marler J. , Muir K. , Sacco R. , Shuaib A. , Teal P. , Wahlgren N.G. , Warach S. , Weimar C. 
Published: April 2015

Background and Purpose—
Increased sympathetic drive after stroke is involved in the pathophysiology of several complications including poststroke immunudepression. β-Blocker (BB) therapy has been suggested to have neuroprotective properties and to decrease infectious complications after stroke. We aimed to examine the effects of random pre- and on-stroke BB exposure on mortality, functional outcome, and occurrence of pneumonia after ischemic stroke.

Methods—
Data including standard demographic and clinical variables as well as prestroke and on-stroke antihypertensive medication, incidence of pneumonia, functional outcome defined using modified Rankin Scale and mortality at 3 months were extracted from the Virtual International Stroke Trials Archive. For statistical analysis multivariable Poisson regression was used.

Results—
In total, 5212 patients were analyzed. A total of 1155 (22.2%) patients were treated with BB before stroke onset and 244 (4.7%) patients were newly started with BB in the acute phase of stroke. Mortality was 17.5%, favorable outcome (defined as modified Rankin Scale, 0–2) occurred in 58.2% and pneumonia in 8.2% of patients. Prestroke BB showed no association with mortality. On-stroke BB was associated with reduced mortality (adjusted risk ratio, 0.63; 95% confidence interval, 0.42–0.96). Neither prestroke BB nor on-stroke BB showed an association with functional outcome. Both prestroke and on-stroke BB were associated with reduced frequency of pneumonia (adjusted risk ratio, 0.77; 95% confidence interval, 0.6–0.98 and risk ratio, 0.49; 95% confidence interval, 0.25–0.95).

Conclusions—
In this large nonrandomized comparison, on-stroke BB was associated with reduced mortality. Prestroke and on-stroke BB were inversely associated with incidence of nosocomial pneumonia. Randomized trials investigating the potential of β-blockade in acute stroke may be warranted.
The Past Tense Debate Revisited: Electrophysiological Evidence for Subregularities of Irregular Verb Inflection
Authors: Regel Stefanie , Opitz Andreas , Müller Gereon , Friederici Angela D. 
Published: April 2015

Abstract
Neuropsychological research investigating mental grammar and lexicon has largely been based on the processing of regular and irregular inflection. Past tense inflection of regular verbs is assumed to be generated by a syntactic rule (e.g., show-ed), whereas irregular verbs consist of rather unsystematic alternations (e.g., caught) represented as lexical entries. Recent morphological accounts, however, hold that irregular inflection is not entirely rule-free but relies on morphological principles. These subregularities are computed by the syntactic system. We tested this latter hypothesis by examining alternations of irregular German verbs as well as pseudowords using ERPs. Participants read series of irregular verb inflection including present tense, past participle, and past tense forms embedded in minimal syntactic contexts. The critical past tense form was correct (e.g., er sang [he sang]) or incorrect by being either partially consistent (e.g., *er sung [*he sung]) or inconsistent (e.g., *er sing [*he sing]) with the proposed morphological principles. Correspondingly, in a second experimental block, pseudowords (e.g., tang/*tung/*ting) were presented. ERPs for real words revealed a biphasic ERP pattern consisting of a negativity and P600 for both incorrect forms in comparison to the correct equivalents. Most interestingly, the P600 amplitude for the incorrect forms was gradually modulated by the type of anomaly with medium amplitude for consistent past tense forms and largest amplitude for inconsistent past tense forms. ERPs for pseudoword past tense forms showed a similar gradual modulation of N400. The findings support the assumption that irregular verbs are processed by rule-based mechanisms because of subregularities of their past tense inflection.