bluuebunny/crossref_metadata_2025_split huggingface dataset:
Survival, cold tolerance and seasonality of infection of European horse chestnut (Aesculus hippocastanum) by Pseudomonas syringae pv. aesculi
Authors: Laue B. E. , Steele H. , Green S. 
Published: February 2014

Bleeding canker of European horse chestnut, caused by the pathogenic bacterium Pseudomonas syringae pv. aesculi (Pae), is now an established disease throughout several countries in northwest Europe after first emerging in 2001–2002. Pae infects the woody branches of horse chestnut directly via natural discontinuities in the bark, such as lenticels, leaf scars and leaf traces, and nodes. However, the timing of infection in relation to seasonality of host development, and the dispersal mechanisms of Pae, in particular its ability to survive and spread in soil and water, remains unknown. In this study, infection of freshly cut horse chestnut shoots by Pae was assessed at monthly intervals over a 12 month period. Pae infected the greatest numbers of lenticels and leaf scars of horse chestnut when inoculated onto actively elongating shoots in spring and early summer, whereas lesion extension from artificial wound sites was greatest after inoculation during early dormancy. Soil survival experiments showed that Pae was still detectable and viable after 50 weeks' incubation in sterile soil and 41 weeks' incubation in nonsterile soil in the absence of host debris. Pae also remained viable and pathogenic after 1 year's storage in King's B broth at −20 and −80°C, and was not killed by freeze/thaw treatments. Thus Pae is able to survive independently for extended periods in soil and water, and can tolerate lengthy periods of freezing at very low temperatures. Such information may facilitate a greater understanding of the epidemiology and spread of Pae in northern Europe.
Altering the primacy bias—How does a prior task affect mismatch negativity?
Authors: Mullens Daniel , Woodley Jessica , Whitson Lisa , Provost Alexander , Heathcote Andrew , Winkler István , Todd Juanita 
Published: February 2014

AbstractThe role in which two tones are first encountered in an unattended oddball sequence affects how deviance detection, reflected by mismatch negativity, treats them later when the roles reverse: a “primacy bias.” We tested whether this effect is modulated by previous behavioral relevance assigned to the two tones. To this end, sequences in which the roles of the two tones alternated were preceded by a go/no‐go task in which tones were presented with equal probability. Half of the participants were asked to respond to the short sounds, the other half to long sounds. Primacy bias was initially abolished but returned dependent upon the go‐stimulus that the participant was assigned. Results demonstrate a long‐term impact of prior learning on deviance detection, and that even when prior importance/equivalence is learned, the bias ultimately returns. Results are discussed in terms of persistent go‐stimulus specific changes in responsiveness to sound.
Diagnostic performance comparison of the Chartis System and high‐resolution computerized tomography fissure analysis for planning endoscopic lung volume reduction
Authors: Gompelmann Daniela , Eberhardt Ralf , Slebos Dirk‐Jan , Brown Matthew S. , Abtin Fereidoun , Kim Hyun J. , Holmes‐Higgin Debby , Radhakrishnan Sri , Herth Felix J.F. , Goldin Jonathan 
Published: February 2014

AbstractBackground and objectiveEndobronchial valve (EBV) therapy is optimized in patients who demonstrate little or no collateral ventilation (CV). The accuracy of the Chartis System and visual assessment of high‐resolution computerized tomography (HRCT) fissure completeness by a core radiology laboratory for classifying CV status was compared by evaluating the relationship of each method with target lobe volume reduction (TLVR) after EBV placement.MethodsRetrospective HRCT fissure analysis of a study population who underwent catheter‐based measurement of CV followed by complete occlusion of the targeted lobe by EBV. Accuracy, sensitivity, specificity, positive predictive value and negative predictive value of the HRCT fissure analysis and the catheter‐based measurement of CV for predicting TLVR was determined.ResultsAccuracy for correctly classifying TLVR with EBV was similar for Chartis System and HRCT fissure analysis (74 vs 77%). The sensitivity and specificity of the Chartis measurement were 86% and 61% and those of HRCT fissure analysis 75% and 79%. Patients with TLVR ≥350 mL had statistically significant improvement in respiratory function, exercise performance and quality of life measures.ConclusionsWhen evaluating patients for likelihood of successful EBV therapy, the Chartis System CV assessment and HRCT fissure analysis appear to have comparable accuracy. Both techniques were found to be beneficial for EBV procedure planning.
Lymphangiosarcoma in 12 dogs: a case series (1998–2013)
Authors: Curran K. M. , Halsey C. H. C. , Worley D. R. 
Published: February 2014

AbstractLymphangiosarcoma (LAS) is an uncommon malignant neoplasia arising from lymphatic endothelium; little information exists regarding therapy. Single institutional retrospective review for canine LAS histopathology diagnoses over a 15‐year period yielded 12 dogs. Ten dogs were presented for a mass and/or swelling at cervical, trunk or limb regions. Prior to diagnosis, 10 dogs received empiric wound therapy. Cytology performed in 10 consisted of mild inflammation. Survival ranged from 60, 168 and 876 days for three dogs with palliation; 90 days with prednisone in one; 182 days with chemotherapy in one; 240, 267, 487, 630 and 941 days for five receiving surgery; and 574 days for one receiving surgery, radiation and chemotherapy. One dog is alive with recurrence at 243 days following surgery and carboplatin chemotherapy. Clinical improvement existed in LAS dogs receiving multimodal therapies. Early tissue biopsies are recommended for progressive oedematous lesions of unknown origin.
Inhibitors of TonB Function Identified by a High-Throughput Screen for Inhibitors of Iron Acquisition in Uropathogenic Escherichia coli CFT073
Authors: Yep Alejandra , McQuade Thomas , Kirchhoff Paul , Larsen Martha , Mobley Harry L. T. 
Published: February 2014

ABSTRACT

The urinary tract is one of the most common sites of infection in humans, and uropathogenic
Escherichia coli
(UPEC) is the main causative agent of urinary tract infections. Bacteria colonizing the urinary tract face extremely low iron availability. To counteract this, UPEC expresses a wide variety of iron acquisition systems. To exploit iron acquisition in UPEC as a global target for small-molecule inhibition, we developed and carried out a whole-cell growth-based high throughput screen of 149,243 compounds. Our primary assay was carried out under iron-limiting conditions. Hits in the primary screen were assayed using two counterscreens that ruled out iron chelators and compounds that inhibit growth by means other than inhibition of iron acquisition. We determined dose-response curves under two different iron conditions and purchased fresh compounds for selected hits. After retesting dose-response relationships, we identified 16 compounds that arrest growth of UPEC only under iron-limiting conditions. All compounds are bacteriostatic and do not inhibit proton motive force. A loss-of-target strategy was employed to identify the cellular target of these inhibitors. Two compounds lost inhibitory activity against a strain lacking TonB and were shown to inhibit irreversible adsorption of a TonB-dependent bacteriophage. Our results validate iron acquisition as a target for antibacterial strategies against UPEC and identify TonB as one of the cellular targets.

IMPORTANCE
Half of women will suffer at least one episode of urinary tract infection (UTI) during their lifetime. The current treatment for UTI involves antibiotic therapy. Resistance to currently used antibiotics has steadily increased over the last decade, generating a pressing need for the development of new therapeutic agents. Since iron is essential for colonization and scarce in the urinary tract, targeting iron acquisition would seem to be an attractive strategy. However, the multiplicity and redundancy of iron acquisition systems in uropathogenic
Escherichia coli
(UPEC) make it difficult to pinpoint a specific cellular target. Here, we identified 16 iron acquisition inhibitors through a whole-cell high-throughput screen, validating iron acquisition as a target for antibacterial strategies against UPEC. We also identified the cellular target of two of the inhibitors as the TonB system.
Patient-reported confidence in primary healthcare: are there disparities by ethnicity or language?
Authors: Wong Sabrina T , Black Charlyn , Cutler Fred , Brooke Rebecca , Haggerty Jeannie L , Levesque Jean-Frederic 
Published: February 2014

ObjectiveTo examine whether confidence in primary healthcare (PHC) differs among ethnic–linguistic groups and which PHC experiences are associated with confidence.DesignA cross-sectional study where patient surveys were administered using random digit dialling. Regression models identify whether ethnic–linguistic group remains significantly associated with confidence in PHC.SettingBritish Columbia, Canada.Main outcome measuresConfidence in PHC measured using a 0–10 scale, where a higher score indicates increased confidence in the ability to get needed PHC services.ParticipantsCommunity-dwelling adults in the following ethnic–linguistic groups: English-speaking Chinese, Chinese-speaking Chinese, English-speaking South Asians, Punjabi-speaking South Asians and English-speakers of presumed European descent.FindingsBased on a sample of 1211 respondents, confidence in PHC differed by ethnicity and the ability to speak English. Most of the differences in confidence by ethnic–linguistic group can be explained by various aspects of care experience. Patient experiences associated with lower confidence in PHC were: if care was received outside Canada, having to wait months to see their regular doctor and rating the quality of healthcare as good or fair/poor. Better patient experiences of their doctor being concerned about their feelings and being respectful and if they found wait times acceptable were associated with higher levels of confidence in PHC. The final regression model explained 30% of the variance.ConclusionsImproving the delivery of PHC services through positive interactions between patients and their usual provider and acceptability of wait times are examples of how the PHC system can be strengthened.
CARING FOR THOSE WHO DIE AT HOME – THE USE AND VALIDATION OF ‘CARE OF THE DYING EVALUATION’ (CODE) WITH BEREAVED RELATIVES
Authors: Mayland Catriona , Lees Carolyn , Germain Alison , Jack Barbara , Cox Trevor , Mason Stephen , West Angela , Ellershaw John 
Published: February 2014

Background‘CODE’ is a 40-item self-completion post-bereavement questionnaire, focused on the last days of life and based on key components of best practice for care of the dying. CODE is a shortened, more user-friendly version of an original validated instrument, ‘Evaluating Care and Health Outcomes–for the Dying’ (ECHO-D).AimTo assess the validity and reliability of CODE by conducting: cognitive ‘think aloud’ interviews; test-retest analysis; and assessing internal consistency and construct validity of three key composite sub-scales–‘CARE’; ‘ENVIRONMENT’; and ‘COMMUNICATION’.MethodsA post-bereavement survey was conducted with 291 next-of-kin (NOK) to patients who died at home in Northwest England from advanced incurable illness. All NOK were invited to complete the CODE questionnaire and also asked if willing to undertake a cognitive interview and/or complete CODE for a second time a month later.Test-retest reliability was assessed using: percentage agreement; Kappa statistic and Spearman's correlation co-efficient. For each sub-scale, Cronbach's alpha and item-total correlations were used to assess internal consistency. Confirmatory factor analysis was used to assess construct validity.Results72 bereaved relatives (24.7% response rate) returned the completed CODE questionnaire, and 25 completed CODE for a second time. 15 cognitive interviews were undertaken. All interviewees found CODE sensitively worded and easy to understand. Minor revisions were suggested to provide additional clarity. Test-retest analysis showed all except two questions had moderate or good stability. Although the ENVIRONMENT scale was not perceived as relevant within the home setting, all three sub-scales scales showed good construct validity and internal consistency (Cronbach's alpha>0.79).Conclusions‘CODE’ represents a user-friendly, comprehensive outcome measure for care of the dying. This preliminary data, despite small numbers, builds on previous work with ECHO-D and provides support for CODE's validity and reliability. CODE could potentially be used to benchmark individual organisations and identify areas for improvement.
EVALUATING CURRENT ASSESSMENT AND TREATMENT OF DELIRIUM BY UK PALLIATIVE CARE PHYSICIANS
Authors: Elliot Victoria , Lowe Emma , Owen Rebecca , Adams Charlotte , Sheils Rachel 
Published: February 2014

BackgroundDelirium is a common condition seen in all areas of clinical medicine, particularly in patients with advanced disease. Its prevalence is expected to rise from the current level of 28-90% with the use of more aggressive anti-cancer treatments. The condition is often under recognised but can be distressing for both patients and their relatives.AimsThe objective of this study was to establish how palliative care physicians in the UK assess and treat delirium (including drug treatment).MethodsA questionnaire was developed and sent via the Association of Palliative Medicine to all UK members. The questionnaire contained 10 questions with multiple choice answers but also allowed space for free text.ResultsThe results highlighted that currently physicians most commonly use no screening tools for diagnosing delirium (35%). They also highlighted that when treating delirium, conservative measures, such as quiet environment and reassurance, are opted for first, as well as identifying and treating reversible causes. However, when drug treatments are required haloperidol is the most popular choice (88.1%).ConclusionsThere is current consensus amongst surveyed UK palliative care physicians that conservative management of delirium should be used prior to medications, and that all reversible causes should be investigated. When drug treatment is required Haloperidol is the most popular drug which is in keeping with current NICE guidance. Recommendations for broader research include a screening tool for distress that could be validated in a palliative care population. It is also recognised that there is a lack of high quality evidence about which drugs to use when trying to restore cognitive function in palliative care patients. However, it may be that we should consider extrapolating the evidence from the NICE guidance to our patients, given the characteristics of the patients in the studies included.
THE BURDEN OF END OF LIFE CARE—PROMOTING THE PSYCHOLOGICAL RECOVERY OF INFORMAL CARE GIVERS
Authors: Brown Michelle , Brock Martin 
Published: February 2014

BackgroundThe National End of Life Programme (DOH 2010) has set out a direction of travel for social care at the end of life and important targets include commissioning and delivery of person centred and integrated care for both patients care givers and families.From the point of view of care giving the burden is likely to increase as there will likely be fewer carers and more people dying at home with complex care needs (Seale 2000 )Carers are a valuable part of care delivery in the UK and valuing and supporting them with compassionate philosophy should be a key strategy (Brown 2012) yet the Health Care Commission in 2008 found that the most consistent complaint from caregivers was related to end of life care.There is a body of research describing the adverse effects of care giving including stress, anxiety and mortality (Gaugleret al2004).Integrating relative and family in end of life care decisions and increasing understanding of the end of life process appears to be beneficial for both the patient experience and the psychological recovery of the relatives (Schulzet al2003).AimsImprove psychological recovery of informal care giversFacilitate informal care givers' awareness of the end of life processAssist informal care givers in developing self-compassion and coping strategiesFramework: Development of a 6 week psycho-educational support group for informal care givers either during or post end of life careFormat of group will include educational components and peer support activities.Group Facilitated by Palliative Care Expert & CBT Psychotherapist.ConclusionConsidering the increase of care giving at home, including end of life, informal caregivers require more comprehensive support than currently available to enable their psychological recovery.Increasing awareness of the end of life process and development of self-compassion is likely to enable this recovery.
RECOGNITION OF THE DETERIORATING AND DYING PATIENT
Authors: Meredith Joanne , Kendall Margaret , Waller Gwen 
Published: February 2014

BackgroundThe trust has been committed to the Transforming End of Life Care (EOLC) programme for over a year and is required to collect data for the matrix developed by the programme and for Merseyside and Cheshire clinical network. The matrix is a valuable way to measure the implementation of tools/enablers at the end of life, both nationally and locally.Gathering evidence through audit has demonstrated the need for quality tools/enablers or End of Life Care facilitation at Trust level and supports the sustainability of such tools/facilitation by identifying gaps in knowledge and skills and training requirements of the health care professionals caring for patients.AimThe overall aim of the audit supports a process of continuous improvement in the care of persons at the end of life, including their families against the Quality Standards for End of Life Care NICE (2012) and Good Practice Guide towards EOLC (GMC) 2010 in the acute setting.This is achieved through the following measures:The use of recognised EOLC tools and enablers as part of the National End of Life Care Transform Programme guidance for acute trusts.Assessing the quality of documentation as a patient deteriorates and dies.MethodA hand search of the case notes was undertaken for all patients who had died within the trust during May 2013. Evidence was sought for a written medical plan with escalation decisions, diagnosis of dying, documented conversations with the patient or the family about deterioration and/or dying and use of EOLC tools.ResultsThere is very limited evidence within the case notes that imminent death was recognised and documented. However the majority of patients who died did have a Do Not Attempt Resuscitiation (DNAR) status documented. Low rates of referral to Specialist palliative care teams were noted, and anticipatory medication was prescribed in a limited number of cases.ConclusionThe use of tools or enablers support and guide recognition and documentation of the dying phase.
MANAGEMENT OF METASTATIC SPINAL CORD COMPRESSION: AUDIT
Authors: Hanchanale Sarika , Neoh Karen , Waldock Joy , Lenton James , Naik Jay 
Published: February 2014

IntroductionMetastatic spinal cord compression (MSCC) is a medical emergency, prompt management is required to preserve neurological function. A retrospective audit of MSCC management in the Mid Yorkshire NHS trust in 2012 was conducted.AimsTo compare current practice to NICE guidance, and also record patients' diagnosis, signs, symptoms and three month survival. MRI and radiotherapy time from request were calculated. The prescription of dexamethasone, Low molecular weight heparin (LMWH), analgesia and gastric protection were assessed.ResultsTwenty seven patients were identified as having MSCC. The most common cancers were lung, prostate and breast, but 15% of patients had no malignant diagnosis at the time of presentation. Most patients had back pain (23), with duration from one day to three months. Fifteen patients had reduced mobility and four patients had bladder dysfunction. Twenty three patients were suspected of having MSCC, three were suspected of having spinal metastasis and one patient was thought to have a slipped disc. Only 53% of the patients with suspected MSCC had an MRI performed within 24 hours. The regional oncology team was contacted in all cases. LMWH and analgesia were given in 96% of the patients. All patients received steroids, but dexamethasone prescribing and dose reduction was inconsistent. Two thirds of patients had radiotherapy within one day. Three month survival was 56%.ConclusionMRI scan within 24 hours was just over 50% and should be 100%; reasons for delay include patients being too unwell to transfer and transport issues, but these were only in a few cases. This is a complex problem, especially if patients are out patients, and requires improved radiology capacity. We recommended staff education and a local protocol, which should include guidelines on standardisation of dexamethasone prescribing. The audit should be repeated once the protocol has been in place for 6–12 months.
IMPACT OF A CANCER OF UNKNOWN PRIMARY (CUP) SERVICE ON END OF LIFE PLANNING FOR PATIENTS WITH METASTATIC DISEASE
Authors: Marshall Jackie , Stewart James , Hancock Louise , Gillmore Roopinder 
Published: February 2014

BackgroundNICE recommends every cancer centre should establish a consultant-led CUP team (oncology, palliative care consultants and specialist nurse) (NICE CG 104). One of the aims of this service is to ensure patients with imaging suggestive of metastatic disease have early review by oncology and palliative care.Table 1Outcome measures comparing the two time period.20092012Number of patients915Mean age (range) (years)73 (35–92)82 (46–94)Mean LOS (range) (days)18.6 (4–51)6.7 (2–15)p<0.004% Died in hospital (absolute numbers)67 (6/9)7 (1/15)p<0.002% Readmission33 (1/3)14 (2/14)p>0.4% Oncology review33 (3/9)100 (15/15)p<0.0005% Palliative care33 (3/9)100 (15/15)p<0.0005p<0.05 significant Age and LOS were analysed using t-test other data were compared using a chi-squared test.AimThis analysis assessed the impact of a CUP service on patients diagnosed with metastatic cancer who were not fit enough for active treatment.MethodsClinical notes were reviewed for all acute hospital admissions with an imaging-based diagnosis of metastatic cancer, who did not go onto receive active treatment. A retrospective analysis performed prior to the establishment of the CUP team (January-April 2009), was compared to prospective data following the launch of the CUP service (June-December 2012).ResultsFollowing establishment of the CUP team – mean length of stay was significantly reduced (6.7 days, 18.6 days, p<0.004) and only one patient was unable to be discharged to their preferred place of death. Furthermore all patients were reviewed by palliative care to optimise symptom control (Table 1).ConclusionsEarly assessment by the CUP service facilitates specialist input from oncology and palliative care, successful discharge planning, with reduced length of stay and rates of readmission.