bluuebunny/crossref_metadata_2025_split huggingface dataset:
Stochastic evolutionary games in dynamic populations
Authors: Huang Weini , Hauert Christoph , Traulsen Arne 
Published: June 2015

AbstractFrequency dependent selection and demographic fluctuations play important roles in evolutionary and ecological processes. Under frequency dependent selection, the average fitness of the population may increase or decrease based on interactions between individuals within the population. This should be reflected in fluctuations of the population size even in constant environ ments. Here, we propose a stochastic model, which naturally combines these two evolutionary ingredients by assuming frequency dependent competition between different types in an individual-based model. In contrast to previous game theoretic models, the carrying capacity of the population and thus the population size is determined by pairwise competition of individuals mediated by evolutionary games and demographic stochasticity. In the limit of infinite population size, the averaged stochastic dynamics is captured by the deterministic competitive LotkaVolterra equations. In small populations, demographic stochasticity may instead lead to the extinction of the entire population. As the population size is driven by the fitness in evolutionary games, a population of cooperators is less prone to go extinct than a population of defectors, whereas in the usual systems of fixed size, the population would thrive regardless of its average payoff.
Disseminated infection caused by Emmonsia pasteuriana in a renal transplant recipient
Authors: Feng Peiying , Yin Songchao , Zhu Guoxing , Li Meirong , Wu Benquan , Xie Yang , Ma Han , Zhang Jun , Cheng Cailian , de Hoog Gerrit Sijbrand , Lu Chun , Lai Wei 
Published: June 2015

AbstractEmmonsia pasteuriana is a thermally dimorphic fungus identified in very few human cases. Here, we report a case of a 43‐year‐old male renal transplant patient from China presenting with multiple painful skin eruptions on his head, nose and left thigh, later accompanied by respiratory failure. Histopathology of the biopsy collected from the left thigh upper ulcer and occipital nodule both demonstrated chronic inflammation with granuloma formation and yeast‐like elements. Emmonsia pasteuriana was cultured from two biopsy specimens and their identity was confirmed by sequencing of the rDNA internal transcribed spacer. The patient in intensive care showed marked clinical improvement with antifungal treatment.
Does presentation of smooth pureed meals improve patients consumption in an acute care setting: A pilot study
Authors: Farrer Olivia , Olsen Carla , Mousley Kate , Teo Emily 
Published: June 2015

AbstractAimMalnutrition is a concern across all Australian hospitals and is associated with negative clinical outcomes in up to 60% inpatients, with a further 10% exacerbated by the presence of dysphagia. Providing adequate nutrition for patients requiring a texture‐modified diet often results in meals that look and taste less appealing and which are nutritionally diluted. This article aims is to review change in oral intake using food moulding techniques within an acute care institution for patients on Texture C—smooth pureed meals.MethodsThis was a 2 week pilot study. Patients were provided smooth pureed lunch either as non‐moulded or a moulded meal. Main meal wastage was weighed and reasons for waste were documented. If patients met the inclusion criteria, a short satisfaction survey was also administered.ResultsAnalysis using a chi‐squared test comparison saw significance in the proportion of patients increasing oral intake from <1/4 meal eaten to >3/4 meal, when in the moulded form (P = 0.03). Median plate waste was reduced by over 100 g in the treatment group but there was no significant change overall. Limited data for patient satisfaction concluded no significance in meal preference.ConclusionsThe pilot study suggests that using a moulded smooth puree diet can increase mean oral intake and reduce main meal wastage, but a larger sample size is required to demonstrate statistical significance. However, the pilot study effect size (0.55) is large enough to warrant further research interest in this area and results do suggest relevancy in clinical practice for replication.
Identification of polyamine‐responsive bacterioplankton taxa in South Atlantic Bight
Authors: Lu Xinxin , Sun Shulei , Hollibaugh James T. , Mou Xiaozhen 
Published: June 2015

SummaryPutrescine and spermidine are short‐chained aliphatic polyamines (PAs) that are ubiquitously distributed in seawater. These compounds may be important sources of dissolved organic carbon and nitrogen for marine bacterioplankton. Here, we used pyrotag sequencing to quantify the response of bacterioplankton to putrescine and spermidine amendments in microcosms established using surface waters collected at various stations in the South Atlantic Bight in October 2011. Our analysis showed that PA‐responsive bacterioplankton consisted of bacterial taxa that are typically dominant in marine systems. Rhodobacteraceae (Alphaproteobacteria) was the taxon most responsive to PA additions at the nearshore site. Gammaproteobacteria of the families Piscirickettsiaceae; Vibrionaceae; and Vibrionaceae and Pseudoalteromonadaceae, were the dominant PA‐responsive taxa in samples from the river‐influenced coastal station, offshore station and open ocean station, respectively. The spatial variability of PA‐responsive taxa may be attributed to differences in composition of the initial bacterial community and variations of in situ physiochemical conditions among sites. Our results also provided the first empirical evidence that Gammaproteobacteria might play an important role in PA transformation in marine systems.
Multidisciplinary team training reduces the decision‐to‐delivery interval for emergency Caesarean section
Authors: Fuhrmann L. , Pedersen T. H. , Atke A. , Møller A. M. , Østergaard D. 
Published: June 2015

BackgroundEmergency Caesarean section is performed when the life of the pregnant woman and/or the foetus is considered at risk. A 30‐min standard for the decision‐to‐delivery interval (DDI) is a common practice and is supported by national organisations including The Danish Society of Obstetrics and Gynaecology. Danish obstetric departments report the DDI to a national database. A national arbitrarily set standard recommends that 95% of ECSs should be achieved within the 30‐min DDI standard. In 2011, 34.4% of ECSs, performed at our hospital, were achieved within the 30‐min time frame. This study aims to evaluate the effect of a simulation‐based team training programme on the proportion of ECSs achieved within a 30‐min time frame.MethodWe performed an interventional before‐and‐after study. We evaluated a total of one hundred 30‐min ECSs before and after the intervention. The primary outcome of interest was the proportion of 30‐min ECSs achieved within a 30‐min time frame.ResultsA total of 20 team training courses were held during May/June 2013. These courses trained 239 of 252 team members (comprised of: 36 obstetricians, 45 scrub nurses, 83 midwifes, 38 anaesthesiologists, 37 nurse anaesthetists) in handling of 30‐min ECS. This corresponds to 95% of staff. The proportion of 30‐min ECSs achieved within a 30‐min time frame was higher after team training (87.5%, 95% CI 79.2–93.4%) compared with before training (74.0%, 95% CI 64.0–82.4%) (P = 0.017).ConclusionTeam training may contribute positively to an increase in the proportion of ECSs achieved within a 30‐min time frame.
Effect‐site concentration of remifentanil for attenuating QTc interval prolongation following intubation in hypertensive female patients
Authors: Kim E. J. , Han D. W. , Song M. K. , Choi S. Y. , Kim S. Y. 
Published: June 2015

BackgroundHaemodynamic changes after sympathetic stimuli like tracheal intubation are more pronounced in hypertensive patients than in normotensive patients. Heart rate (HR)‐corrected QT (QTc) interval changes related to intubation may also be more prominent in hypertensive patients. We hypothesised that there would be a difference in the effect‐site concentration (Ce) of remifentanil to attenuate QTc interval prolongation in normotensive and hypertensive patients following intubation.MethodsTwenty‐two normotensive and 22 hypertensive female patients (≥ 50 year) were enrolled and anaesthesised with remifentanil and propofol using a target‐controlled infusion. All hypertensive patients received oral antihypertensive medications for > 6 months and took the medications in the morning of the surgery. The effective concentration of remifentanil Ce in 50% (EC50) and 95% of the population (EC95) required to maintain QTc interval prolongation < 15 ms following intubation was calculated using the isotonic regression and a bootstrapping approach following the Dixon's up‐and‐down method.ResultsMedian duration of hypertension was 6 years. Isotonic regression revealed that the EC50 (83% confidence interval) of remifentanil Ce for reducing QTc interval prolongation following intubation was 3.8 (3.5‐4.1) ng/ml in normotensive and 6.1 (5.8–6.2) ng/ml in hypertensive female patients. The EC95 (95% confidence interval) of remifentanil Ce was 4.4 (4.3–4.5) ng/ml in normotensive and 6.5 (6.4–6.5) ng/ml in hypertensive female patients.ConclusionThe Ce of remifentanil required to attenuate QTc interval prolongation following intubation was significantly higher in hypertensive patients than it was in normotensive patients. Thus, more caution should be taken related to QTc interval prolongation when intubating hypertensive patients.
Investigating rehabilitation needs of visually impaired young adults according to the International Classification of Functioning, Disability and Health
Authors: van Leeuwen Lisette M. , Rainey Linda , Kef Sabina , van Rens Ger H. M. B. , van Nispen Ruth M. A. 
Published: June 2015

AbstractPurposeTo gain qualitative insight into the rehabilitation needs of visually impaired young adults (18–25 years) and how these needs relate to the International Classification of Functioning, Disability and Health (ICF) and patient characteristics.MethodsRehabilitation needs and patient characteristics of young adults (N = 392) who applied for multidisciplinary services in 2012 and 2013 were obtained from structured and semi‐structured intake records. Linking rules were used to assess how the needs related to Environmental Factors, Body Functions, Body Structures, and Activity and Participation (A&P) ICF components. The relationship between the type of rehabilitation goal and patient characteristics was assessed using multivariate logistic regression analyses.ResultsMost rehabilitation needs (67.6%; N = 510) were found on the A&P component of the ICF. Most prevalent needs were related to ‘major life areas’ (e.g. finding internship or job), followed by the chapters: ‘mobility’ (e.g. self‐reliance in travelling), ‘communication’ (e.g. using communication devices and techniques), ‘general tasks and demands’ (e.g. psychological aspects of vision loss) and ‘domestic life’ (e.g. household tasks). Patients in one of the multidisciplinary rehabilitation centres (odds ratio (OR) = 7.07; 95% confidence interval (CI) [2.97–16.83]) and patients with comorbidity (OR = 3.82; 95% CI [1.62–9.02]) were more likely to report rehabilitation needs related to chapter E3 ‘support and relationships’.Conclusion
‘Major life areas’ prevail in the content of rehabilitation needs, but tend to overshadow topics regarding peer interaction and social, community and civic life. A suitable survey method for young adults with visual impairments is required that contains rehabilitation domains and goals relevant to their lives and development.
Clinical application of 3D display device in ophthalmology: measurement of metamorphopsia
Authors: Kim Ji Won , Kim Yun Taek 
Published: June 2015

AbstractPurposeTo develop a new tool for detecting metamorphopsia.MethodEvaluation of diagnostic test. Novel tool for measuring metamorphopsia was developed using commercial 3D display. Fifty‐eight patients diagnosed with macular disease, which included epiretinal membrane, age‐related macular degeneration, central serous chorioretinopathy and macular hole, as confirmed by macular optical coherence tomography were tested with Amsler grid and novel method. The subjective perception of metamorphopsia and its effect on the lives of the participants with macular disease was also evaluated using a brief questionnaire. The sensitivity and specificity to subjective perception of metamorphopsia were compared.ResultsThe sensitivity and specificity were 66.7% and 97.7%, respectively, using the Amsler grid test, and 100% and 90.7%, respectively, using the 3D novel metamorphopsia test developed for this study.ConclusionsThe detection rate of metamorphopsia in macular disease using novel metamorphopsia test was significantly higher than that using the Amsler grid test. This novel approach to detecting for metamorphopsia can also be used at home for self‐assessment.
Macrolides do not affect the incidence of moderate and severe bronchopulmonary dysplasia in symptomatic ureaplasma‐positive infants
Authors: Anbu Chakkarapani Aravanan , Paes Bosco , Shivananda Sandesh 
Published: June 2015

AbstractAimThe aim of this study was to compare the incidence of bronchopulmonary dysplasia (BPD) in symptomatic ureaplasma‐positive treated preterm infants and asymptomatic preterm infants not tested or treated for ureaplasma.MethodsA retrospective matched cohort study was conducted in a tertiary, neonatal unit between January 2007 and December 2012. Infants ≤29 completed weeks with signs and symptoms suggesting ureaplasma pneumonia who received macrolides comprised the study group. Infants ≤29 weeks without signs and symptoms not tested or treated with macrolides were the controls. Infants were mandatorily matched for gestational age ± one week or birthweight ± 100 grams.ResultsThere were 31 infants in the study group and 62 in the control group. The baseline demographic data of both groups were similar on the whole. The incidence of moderate and severe BPD, defined by oxygen dependency or the need for continuous positive airway pressure at 36 weeks of postconceptual age, was 45.2% in the study group and 40.3% in the controls (p = 0.65). There was no significant difference in morbidities or mortality between the groups.ConclusionA selective approach of treating symptomatic ureaplasma‐positive preterm infants with macrolides did not affect the incidence of moderate and severe BPD.
Randomised clinical trial: gut microbiome biomarkers are associated with clinical response to a low FODMAP diet in children with the irritable bowel syndrome
Authors: Chumpitazi B. P. , Cope J. L. , Hollister E. B. , Tsai C. M. , McMeans A. R. , Luna R. A. , Versalovic J. , Shulman R. J. 
Published: June 2015

SummaryBackgroundA low fermentable oligosaccharides, disaccharides, monosaccharides and polyols (FODMAP) diet can ameliorate symptoms in adult irritable bowel syndrome (IBS) within 48 h.AimTo determine the efficacy of a low FODMAP diet in childhood IBS and whether gut microbial composition and/or metabolic capacity are associated with its efficacy.MethodsIn a double‐blind, crossover trial, children with Rome III IBS completed a 1‐week baseline period. They then were randomised to a low FODMAP diet or typical American childhood diet (TACD), followed by a 5‐day washout period before crossing over to the other diet. GI symptoms were assessed with abdominal pain frequency being the primary outcome. Baseline gut microbial composition (16S rRNA sequencing) and metabolic capacity (PICRUSt) were determined. Metagenomic biomarker discovery (LEfSe) compared Responders (≥50% decrease in abdominal pain frequency on low FODMAP diet only) vs. Nonresponders (no improvement during either intervention).ResultsThirty‐three children completed the study. Less abdominal pain occurred during the low FODMAP diet vs. TACD [1.1 ± 0.2 (SEM) episodes/day vs. 1.7 ± 0.4, P < 0.05]. Compared to baseline (1.4 ± 0.2), children had fewer daily abdominal pain episodes during the low FODMAP diet (P < 0.01) but more episodes during the TACD (P < 0.01). Responders were enriched at baseline in taxa with known greater saccharolytic metabolic capacity (e.g. Bacteroides, Ruminococcaceae, Faecalibacterium prausnitzii) and three Kyoto Encyclopedia of Genes and Genomes orthologues, of which two relate to carbohydrate metabolism.ConclusionsIn childhood IBS, a low FODMAP diet decreases abdominal pain frequency. Gut microbiome biomarkers may be associated with low FODMAP diet efficacy.ClinicalTrials.gov identifier: NCT01339117.
Why is Pain Still Under‐Treated in the Emergency Department? Two New Hypotheses
Authors: Carter Drew , Sendziuk Paul , Eliott Jaklin A. , Braunack‐Mayer Annette 
Published: June 2015

AbstractAcross the world, pain is under‐treated in emergency departments (EDs). We canvass the literature testifying to this problem, the reasons why this problem is so important, and then some of the main hypotheses that have been advanced in explanation of the problem. We then argue for the plausibility of two new hypotheses: pain's under‐treatment in the ED is due partly to (1) an epistemic preference for signs over symptoms on the part of some practitioners, and (2) some ED practices that themselves worsen pain by increasing patients' anxiety and fear. Our argument includes the following logic. Some ED practitioners depart from formal guidance in basing their acute pain assessments on observable features rather than on patient reports of pain. This is potentially due to an epistemic preference for signs over symptoms which aims to circumvent intentional and/or unintentional misrepresentation on the part of patients. However, conducting pain assessments in line with this epistemic preference contributes to the under‐treatment of pain in at least three respects, which we detail. Moreover, it may do little to help the practitioner circumvent any intentional misrepresentation on the part of the patient, as we explain. Second, we examine at least four ED practices that may be contributing to the under‐treatment of pain by increasing patient anxiety and fear, which can worsen pain. These practices include failing to provide orienting information and partially objectifying patients so as to problem‐solve along lines pre‐established by modern medical science. We conclude by touching on some potential solutions for ED practice.
Risks, severity and timing of infections in patients with multiple myeloma: a longitudinal cohort study in the era of immunomodulatory drug therapy
Authors: Teh Benjamin W. , Harrison Simon J. , Worth Leon J. , Spelman Tim , Thursky Karin A. , Slavin Monica A. 
Published: June 2015

SummaryWe defined the epidemiology and clinical predictors of infection in patients with multiple myeloma (MM) receiving immunomodulatory drugs (IMiDs), proteasome inhibitors (PI) and autologous haematopoietic stem cell transplant (ASCT) in a large longitudinal cohort study. Clinical and microbiology records of patients with MM diagnosed between January 2008 and December 2012 were reviewed to capture patient demographics, characteristics of myeloma and infections (type, severity, outcomes). Conditional risk set modelling was used to determine clinical predictors of infection. One hundred and ninety‐nine patients with MM with 771 episodes of infection were identified. 44·6% of infections were clinically defined, 35·5% were microbiologically defined and 19·9% were fever of unknown focus. There was a bimodal peak in incidence of bacterial (4–6 and 70–72 months) and viral infections (7–9 and 52–54 months) following disease diagnosis. Chemotherapy regimens high‐dose melphalan [hazard ratio (HR) = 2·07], intravenous cyclophosphamide (HR = 1·96) and intensive combination systemic chemotherapy (HR = 1·86) and cumulative doses of corticosteroid (HR = 3·06 at highest dose) were independently associated with increased risk of infection overall (P < 0·05). IMiDs and PI and other clinical factors were not independently associated with increased risk of infection. New approaches to prevention and treatment of infection should focus upon identified periods of risk and treatment‐related risk factors.
HbA2: biology, clinical relevance and a possible target for ameliorating sickle cell disease
Authors: Steinberg Martin H. , Rodgers Griffin P. 
Published: June 2015

SummaryHbA2, a tetramer of α‐ and δ‐globin chains, provides a diagnostic clue to the presence of β‐thalassaemia trait. This minor haemoglobin, which forms about 2–3% of the total, has no known physiological role, but has the interesting property of preventing polymerization of deoxy‐sickle haemoglobin. If it were possible to increase the level of HbA2 sufficiently it could have a benefit in sickle cell disease similar to that of foetal haemoglobin. Moreover, HbA2 is present in all erythrocytes, an advantage not found with foetal haemoglobin, which is heterocellularly expressed. The molecular basis of HbA2 gene (HBD) expression is partially understood, and with new molecular tools, it might be possible to induce levels of HbA2 that could be clinically important. However, high concentrations of this positively charged haemoglobin might damage the erythrocyte membrane; also, the reciprocal relationship of δ‐ and γ‐globin gene (HBD and HBG1/2, respectively) expression might negate any benefit of increasing transcription of the former.
RNAi Silencing of IL‐1β and TNF‐α in the Treatment of Post‐traumatic Arthritis in Rabbits
Authors: Tang Qiang , Hao Liang , Peng Yuanxiang , Zheng Yating , Sun Kuo , Cai Feng , Liu Chunlong , Liao Qi 
Published: June 2015

Post‐traumatic arthritis is a secondary complication to severe joint trauma. With the disease progression, it may eventually lead to osteoarthritis in patients whose age is considerably younger than patients with traditional bone arthritis. The main objective of this study was to explore the feasibility of using lentiviral‐mediated RNA interference silencing of IL‐1β and TNF‐α to treat post‐traumatic arthritis in rabbits. About 48 New Zealand rabbits underwent bilateral knee joint surgery to stimulate traumatic arthritis. They were then randomly divided into four groups of 12 rabbits each. The histopathology of the cartilage was observed, and the changes were assessed by Mankin scoring. ELISA was used to detect the expression of IL‐1β and TNF‐α in the synovial fluid. (i) Compared with the control group, the transfection and co‐transfected groups displayed reduced cartilage damage and speed of degeneration. The co‐transfected group showed the greatest alleviation of symptoms. The Mankin score was statistically different (p < 0.01). (ii) Compared with the control group, the expression of IL‐1β or TNF‐α was reduced in the respective transfection groups (p < 0.01 in both groups) and IL‐1β and TNF‐α were reduced in the co‐transfected group (p < 0.01). The co‐transfected group showed the lowest expression of the three experimental groups of both IL‐1β and TNF‐α (p < 0.01). Lentivirus‐mediated RNA interference can knock down the expression of IL‐1β and TNF‐α in joint fluids and, in a synergistic effect when two siRNAs are co‐transfected, ease cartilage degeneration.