bluuebunny/crossref_metadata_2025_split huggingface dataset:
P56 Does ceftriaxone plus azithromycin reduce gonorrhoea retreatment compared to ceftriaxone plus doxycycline? a retrospective comparison
Authors: Schumacher C , Ghanem K 
Published: May 2012

BackgroundCurrently, the combination of Ceftriaxone (CTX) and Azithromycin (AZM) is favoured over CTX and Doxycycline (DOXY) for treatment of uncomplicatedNeisseria gonorrhoeaeinfections (GC) in both the UK and the USA.Aims/ObjectivesTo retrospectively compare retreatment rates between patients receiving CTX + AZM and those receiving CTX + DOXY.MethodsWe analysed clinic records for all patients treated for GC at either of Baltimore's public STD clinics between January 2004 and June 2011 and measured time to retreatment from the date when the CTX regimen was administered. Patients were censored 2 years after treatment was received or on 30 September 2011, whichever came first. Kaplan–Meier curves and Cox Proportional Hazards models were used to compare retreatment rates.ResultsOverall, 4134 patients were treated for GC with CTX + AZM (n=1185, 31.5%) or CTX + DOXY (2830, 68.5%), 406 (9.8%) of whom were retreated. Treatment regimen was not related to time to retreatment, even when controlling for risk factors associated with re-infection (adjusted HR 0.88, 95% CI 0.70 to 1.14); a sub analysis of patients who were retested for GC within 90 days of CTX treatment also found no difference in retreatment rates across treatment regimens. Other factors that independently increased the risk of retreatment included: being a man who has sex with men, aged <25 years, having a history of GC or chlamydia, and reporting >2 sex partners within the past 6 months at time of CTX treatment. Patients treated after Expedited Partner Therapy (EPT) became available were 30% less likely to be retreated regardless of whether the patient themselves received EPT.Discussion/ConclusionsCompared to CTX + DOXY, CTX + AZM did not provide enhanced efficacy in this population. EPT is associated with a reduction in retreatment rates in the population even among those who did not receive EPT themselves.
P60 Low sperm counts in asymptomatic and symptomatic non-specific urethritis and other sexual health clinic attendees
Authors: Carne C , Chilcott S , Palmer C R , Green O , Bridge S , Walsh R , Gramy-Mason A , O'Donovan M 
Published: May 2012

BackgroundLittle is known about semen parameters among men attending Sexual Health clinics. The significance of asymptomatic non-specific urethritis is controversial.Aims(1) To investigate whether there is a higher incidence of abnormalities in the semen of men with urethritis compared to controls. (2) To investigate whether asymptomatic urethritis has similar effects (if any) on semen to symptomatic urethritis.ObjectiveTo conduct a case-control study of abnormalities in the semen of Sexual Health clinic attendees compared to General Practice controls.MethodsRates of semen abnormalities were compared between the different groups (19 with symptomatic and 27 with asymptomatic NSU, seven with symptomatic non-NSU and 64 clinic controls) and between clinic attendees and 417 patients attending general practice for the first investigation of possible infertility.Results117 clinic volunteers were included in the study. They were shown to have statistically significantly worse total sperm counts (p=0.002), volume of semen (p<0.001) and percentage of abnormal forms (p<0.04) compared to 417 GP controls. Compared to the rest of the clinic volunteers, asymptomatic NSU patients had statistically significantly lower total sperm counts (p<0.02). Asymptomatic NSU patients had statistically significantly lower total sperm counts compared to symptomatic NSU patients (p<0.02). Compared to GP controls, clinic controls had statistically significantly inferior total sperm counts (p=0.009) and semen volume (p<0.001).ConclusionsSexual Health clinic attendees are more likely to have abnormalities of semen than patients attending general practice for a first check for possible infertility. A high rate of abnormal semen findings are found in patients with and without NSU but the highest rate occurred in those with asymptomatic NSU. Is asymptomatic NSU therefore pathogenic and does it require treatment like symptomatic NSU?
P64 High rates of rectalChlamydia trachomatisin women reporting anal sex in the GUM clinic
Authors: Simon S , Hassan-Ibrahim M , Soni S 
Published: May 2012

BackgroundNucleic acid amplification (NAAT) testing forNeisseria gonorrhoeae(GC) andChlamydia trachomatis(CT) is now widely available but not licensed for use at non-genital sites. Despite this, high rates of pharyngeal and rectal GC and CT have been demonstrated in MSM. Currently there is little data on the prevalence of infection at these sites in women reporting oral and anal sex.AimTo determine the prevalence of pharyngeal and rectal CT and GC in women attending GUM.MethodsBetween 1 June and 31 October 2011 all women reporting oral and anal sex were offered pharyngeal and blind rectal swabs as well as cervical testing for CT and GC. Samples were analysed using the BD ProbeTecTM CT/GC Qx Amplified DNA assay in the BD ViperTM system. All women with positive GC NAAT results had swabs sent for GC culture and sensitivities.ResultsMedian age was 25 years (IQR 21–31) and most women were of white ethnicity. 2235 swabs were taken, 124 were excluded due to incomplete labelling. 2111 women had non-genital sampling: 165 rectal swabs only, 1652 pharyngeal swabs only, 147 both sites. In nine and five women the pharynx and rectum were the sole sites of CT infection respectively. In two women, the pharynx was the sole site of GC infection. All women were asymptomatic at throat and rectum (see abstract P64 table 1).Abstract P64 Table 1CT and GC prevalence at different sitesPharynxRectumCervixCT NAAT1.3% (23/1799)7.1% (22/312)6.1% (194/3073)GC NAAT0.28% (5/1799)0.32% (1/312)0.49% (15/3073)GC Culture0.17% (3/1799)0.32% (1/312)0.36% (11/3073)DiscussionRectal CT rates were high among women reporting anal sex. As the antibiotic treatment of cervical and rectal CT differs, this pool of infection could remain untreated. We recommend routinely asking about anal sex and testing where appropriate. Rates of pharyngeal CT were low but higher than GC overall. Although 11 women had pharyngeal CT/GC only, and would have been missed, the cost of detecting one of these infections was £1727 and this has precluded ongoing screening.
P68 Improving the management of chlamydia in non-GUM settings: it to the rescue!
Authors: Zhou C N C , Roberts J , Davies J , Longbone M , Dean G 
Published: May 2012

BackgroundBASHH guidelines recommend all patients diagnosed withChlamydia trachomatis(CT) should be given a detailed explanation of the condition, managed with appropriate antibiotics and have effective partner notification (PN). Patients tested in non-GUM settings may receive sub-optimal management. Following a 2008 audit highlighting several untreated CT cases in the Gynaecology Department (GD) we introduced a bespoke IT lab-link allowing daily downloads of results to GUM health advisers (HA).ObjectivesTo re-audit the management of females tested for CT in GD.MethodsWe performed a retrospective database analysis of all CT tests requested by any of the 11 Gynaecology consultants from June 11 to January 12. Demographic and clinical details were extracted from a prospectively collected lab. database and clinic records. Results were compared with the 2008 audit. Fisher's exact test was used to compare differences between proportions.Results889 tests {864 (97.2%) negative, 16 (1.8%) positive, 9 (1%) not tested—incorrect swab} were requested by GD over 29 weeks. HAs were notified of 100% of results in real time. Median time from notification of positive results to patient contact was 1 day (range 1–60). Median time from positive result to treatment was 7 days (range 1–70). This compares to an upper limit of 168 days in the 2008 audit. Recommended antibiotics were used in all cases. PN outcomes improved from 31% to 75% (p=0.02) and untreated cases decreased from 38% to 18.7% (p=0.2) (see abstract P68 table 1).Abstract P68 Table 1Management of chlamydia positive patientsYearSite 1/2 (%)Age: median (range) yearsCT positive (%)PN complete (%)Untreated (%)200880/2022 (19–40)13/647 (2)4/13 (31)5/13 (38)2011/201279/2233 (14–84)16/889 (1.8)12/16 (75)3/16 (18.7)DiscussionSince the introduction of a referral pathway and automated IT lab-link, management of CT positive patients from GD has improved, in particular PN and proportion left untreated. GUM departments should have a clear pathway for the management of patients diagnosed with STIs in non-GUM settings.
P95 Attitudes to sexual history taking and STI screening in a non-sexual health delivered HIV service
Authors: Salter E F C , Magee E , Allstaff S L 
Published: May 2012

BackgroundAn audit within our HIV service failed to meet national sexual health targets. Barriers to sexual history (SHx) taking and STI screening include fear of causing offence. This may be more so in HIV services delivered by non-sexual health clinicians.AimTo determine patients' attitudes to SHx taking and STI screening in an infectious diseases-led HIV service.MethodsAn anonymous, semi-structured questionnaire was offered to all clinic attendees from September-December 2011. Data collected included demographics, HIV history, sexual history and attitudes to SHx taking and STI screening.ResultsOf the 101 questionnaires returned; 68% were male and almost two thirds were aged 26–40. 30% were MSM. 35% were in sero-discordant regular relationships. 37% had one partner in the last year and 15% had >1. 35% had a previous STI. 94% agreed with regular syphilis and hepatitis B (HBV) testing. 40% would have declined STI screening if offered; 26% of these were MSM, 16% had >1 partner in the last year and 34% had ≥1 past STI. Only 62% recalled being asked about sex. Preferred sites for sexual health consultations are detailed in abstract P95 table 1.Abstract P95 Table 1Preferred site for delivery of sexual health care (respondents may have given multiple preferences)Service offered (no of respondents)HIV clinic n (%)Sexual health clinic n (%)Primary care n (%)None/other n (%)SHx taking (n=90)70 (78)21 (23)25 (28)7 (8)STI screening (n=90)72 (80)17 (19)11 (12)4 (4)Contraception (n=27)15 (56)5 (19)11 (41)4 (15)Cervical cytology (n=27)7 (25)5 (19)17 (63)3 (11)ConclusionsMost patients found regular HBV and syphilis testing acceptable, however 40% would decline STI screening indicating that they may be uninformed about STIs, be uncertain of their risk and misperceive the invasiveness of STI screening. Most patients found the HIV clinic a preferable site for both SHx taking and STI screening. Specific sexual health training should be delivered to clinicians in non-sexual health led HIV services in order to improve the sexual health of HIV patients.
P97 Women requiring emergency contraception are a high risk group for sexually transmitted infections in future
Authors: Varma R 
Published: May 2012

BackgroundWomen in UK are able to get emergency hormonal contraception from various sources including general practice, community contraception clinic, A&E, pharmacies and GUM services. Other than the GUM services most other providers are not offering integrated sexual health services so the screening and prevention of sexually transmitted disease (STI) may be inadequate.AimThe aim of this study was to find the incidence of STI in this group of clients requesting emergency contraception at the time of their visit for emergency contraception and in subsequent visits within 6 months of the index visit.MethodsWe did a retrospective review of all electronic consultations in which Levonelle was issued during 6 months from January 2011 to June 2011. 102 consultations were identified by electronic search using search term Levonelle. Data were collected on Excel spreadsheet and analysed.Results102 consultations were identified for 91 patients. Median age was 20 (range 15–42), 55% (50/91) were Black Caribbean. On the day of the index visit for emergency contraception, out of the 102 consultations 79 had STI screen (77%). We detected STI in six women (7.5%). Five women hadChlamydia trachomatisand one had gonorrhoea. In the subsequent 6 months, 59 out of the original 91 women (64%) returned to our services. Out of these 59 women, 52 (88%) underwent STI screen. 15 women out of the 52 tested (28.8%) had a positive diagnosis of STI. 9/52 (17.3%) hadChlamydia trachomatisinfection, 3/52(5.7%) had gonorrhoea; two patients had bothChlamydia trachomatisand gonorrhoea. The other STI diagnosed were trichomonas vaginalis 2/52(3.8%), first episode genital herpes infection 2/52(3.8%) and 1/52 (1.95%) had first episode genital warts.ConclusionWomen who attend for emergency contraception are at high risk of contacting future sexually transmitted infections and should be advised to have screening for sexually transmitted infection at 3 and/or 6 months. More research is needed in this sub group of women to improve the sexual health of the community.
Protecting against data breaches; living with mistakes
Authors: Hong Jason , Linden Greg 
Published: May 2012

The
Communications
Web site, http://cacm.acm.org, features more than a dozen bloggers in the BLOG@CACM community. In each issue of
Communications
, we'll publish selected posts or excerpts.

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http://cacm.acm.org/blogs/blog-cacm
Jason Hong writes about security breaches and offers a three-pronged approach. Greg Linden discusses the differences between computers and the human brain and their tolerance of errors.
Time-aware approaches to information retrieval
Authors: Kanhabua Nattiya 
Published: May 2012

In this thesis, we address major challenges in searching temporal document collections. In such collections, documents are created and/or edited over time. Examples of temporal document collections are web archives, news archives, blogs, personal emails and enterprise documents. Unfortunately, traditional IR approaches based on term-matching only can give unsatisfactory results when searching temporal document collections. The reason for this is twofold: the contents of documents are strongly time-dependent, i.e., documents are about events happened at particular time periods, and a query representing an information need can be time-dependent as well, i.e., a temporal query.
Our contributions in this thesis are different time-aware approaches within three topics in IR: content analysis, query analysis, and retrieval and ranking models. In particular, we aim at improving the retrieval effectiveness by 1) analyzing the contents of temporal document collections, 2) performing an analysis of temporal queries, and 3) explicitly modeling the time dimension into retrieval and ranking.
Leveraging the time dimension in ranking can improve the retrieval effectiveness if information about the creation or publication time of documents is available. In this thesis, we analyze the contents of documents in order to determine the time of non-timestamped documents using temporal language models. We subsequently employ the temporal language models for determining the time of implicit temporal queries, and the determined time is used for re-ranking search results in order to improve the retrieval effectiveness.
We study the effect of terminology changes over time and propose an approach to handling terminology changes using time-based synonyms. In addition, we propose different methods for predicting the effectiveness of temporal queries, so that a particular query enhancement technique can be performed to improve the overall performance. When the time dimension is incorporated into ranking, documents will be ranked according to both textual and temporal similarity. In this case, time uncertainty should also be taken into account. Thus, we propose a ranking model that considers the time uncertainty, and improve ranking by combining multiple features using learning-to-rank techniques.
Through extensive evaluation, we show that our proposed time-aware approaches outperform traditional retrieval methods and improve the retrieval effectiveness in searching temporal document collections.
Available online at: http://www.idi.ntnu.no/research/doctor_theses/nattiya.pdf.
Anti-Myeloma Effects of the Novel Anthracycline Derivative INNO-206
Authors: Sanchez Eric , Li Mingjie , Wang Cathy , Nichols Cydney M. , Li Jennifer , Chen Haiming , Berenson James R. 
Published: May 2012

Abstract
Purpose: Doxorubicin has shown efficacy especially in combination treatment for the treatment of multiple myeloma; however, its side effects limit its use. INNO-206 is an albumin-binding prodrug of doxorubicin, which is released from albumin under acidic conditions. Because INNO-206 has not been previously evaluated in any hematologic malignancy, we determined its anti–multiple myeloma effects.
Experimental Design: The anti–multiple myeloma effect of INNO-206 at different pH levels on multiple myeloma cell proliferation using multiple myeloma cell lines with the MTS assay and antiangiogenic activity using the chorioallantoic membrane/feather bud assay were determined. The anti–multiple myeloma effects and toxicity of INNO-206 were also compared with conventional doxorubicin and PEGylated liposomal doxorubicin (PLD) alone, and in combination with bortezomib, using our multiple myeloma xenograft models.
Results: INNO-206 inhibited blood vessel formation and reduced multiple myeloma cell growth in a pH-dependent fashion. INNO-206 alone produced marked anti–multiple myeloma effects in vivo at doses that doxorubicin was toxic, and the combination of INNO-206 plus bortezomib produced increased anti–multiple myeloma effects compared with either agent alone. In contrast, all mice receiving bortezomib with doxorubicin or PLD died.
Conclusions: These findings show that INNO-206 produces anti–multiple myeloma effects in vitro and in vivo. It also enhances the antitumor effects of bortezomib. These results suggest that INNO-206 may provide patients with multiple myeloma with an anthracycline that may be administered safely at higher doses compared with free doxorubicin, resulting in superior efficacy compared with the currently available anthracyclines to treat this B-cell malignancy. Clin Cancer Res; 18(14); 3856–67. ©2012 AACR.
Do Pharmacokinetics Explain Persistent Restenosis Inhibition by a Single Dose of Paclitaxel?
Authors: Speck Ulrich , Cremers Bodo , Kelsch Bettina , Biedermann Melanie , Clever Yvonne P. , Schaffner Silvio , Mahnkopf Dirk , Hanisch Uli , Böhm Michael , Scheller Bruno 
Published: May 2012

Background—
The purpose of this study was to investigate the elimination of paclitaxel from the arterial wall after a single short administration with a coated balloon.

Methods and Results—

Slightly oversized paclitaxel-coated balloons (dose 3 or 9 μg/mm
2
) without or with premounted stents were inflated in nonatherosclerotic coronary arteries of either young domestic pigs or adult Goettingen minipigs. The paclitaxel content of plasma, arterial segments, and residual hearts (without treated arteries) was measured for up to 180 days using high-performance liquid chromatography/ultraviolet detection or mass spectrometry. Angiograms were evaluated for lumen narrowing. The paclitaxel concentration in plasma remained <10 ng/mL. In arteries of domestic pigs and minipigs treated with paclitaxel-coated balloons with premounted stents, 10%±5% or 21%±8% of dose, respectively, was initially detected and decreased to 3.5%±3.1% of dose (domestic pig) by Day 7. Within 6 months it fell with a half-life of 1.9 months to 0.40%±0.35%. After 3 months the concentration in the arterial wall was 17±11 μmol/L. Without a stent, drug transfer to the vessel wall was somewhat reduced and elimination faster. Immediately after treatment up to 26%±4% of dose was detected in the residual whole hearts. It dropped with a half-life of 45 days to 1.5%±0.6% of dose (0.3 μmol/L) within 6 months.

Conclusions—
After a single local administration with coated balloons, paclitaxel stays in the vessel wall of pigs long enough to explain persistent inhibition of neointimal proliferation. The pharmacokinetics of paclitaxel does, however, not exclude other reasons for sustained efficacy such as early blocking of processes initiating excessive and prolonged neointimal proliferation.
Use of an Intrapericardial, Continuous-Flow, Centrifugal Pump in Patients Awaiting Heart Transplantation
Authors: Aaronson Keith D. , Slaughter Mark S. , Miller Leslie W. , McGee Edwin C. , Cotts William G. , Acker Michael A. , Jessup Mariell L. , Gregoric Igor D. , Loyalka Pranav , Frazier O.H. , Jeevanandam Valluvan , Anderson Allen S. , Kormos Robert L. , Teuteberg Jeffrey J. , Levy Wayne C. , Naftel David C. , Bittman Richard M. , Pagani Francis D. , Hathaway David R. , Boyce Steven W. 
Published: May 2012

Background—
Contemporary ventricular assist device therapy results in a high rate of successful heart transplantation but is associated with bleeding, infections, and other complications. Further reductions in pump size, centrifugal design, and intrapericardial positioning may reduce complications and improve outcomes.

Methods and Results—

We studied a small, intrapericardially positioned, continuous-flow centrifugal pump in patients requiring an implanted ventricular assist device as a bridge to heart transplantation. The course of investigational pump recipients was compared with that of patients implanted contemporaneously with commercially available devices. The primary outcome, success, was defined as survival on the originally implanted device, transplantation, or explantation for ventricular recovery at 180 days and was evaluated for both noninferiority and superiority. Secondary outcomes included a comparison of survival between groups and functional and quality-of-life outcomes and adverse events in the investigational device group. A total of 140 patients received the investigational pump, and 499 patients received a commercially available pump implanted contemporaneously. Success occurred in 90.7% of investigational pump patients and 90.1% of controls, establishing the noninferiority of the investigational pump (
P
<0.001; 15% noninferiority margin). At 6 months, median 6-minute walk distance improved by 128.5 m, and both disease-specific and global quality-of-life scores improved significantly.

Conclusions—
A small, intrapericardially positioned, continuous-flow, centrifugal pump was noninferior to contemporaneously implanted, commercially available ventricular assist devices. Functional capacity and quality of life improved markedly, and the adverse event profile was favorable.

Clinical Trial Registration—

URL:
http://www.clinicaltrials.gov
. Unique identifier: NCT00751972.
Differential Brain Activity during Emotional versus Nonemotional Reversal Learning
Authors: Nashiro Kaoru , Sakaki Michiko , Nga Lin , Mather Mara 
Published: May 2012

Abstract
The ability to change an established stimulus–behavior association based on feedback is critical for adaptive social behaviors. This ability has been examined in reversal learning tasks, where participants first learn a stimulus–response association (e.g., select a particular object to get a reward) and then need to alter their response when reinforcement contingencies change. Although substantial evidence demonstrates that the OFC is a critical region for reversal learning, previous studies have not distinguished reversal learning for emotional associations from neutral associations. The current study examined whether OFC plays similar roles in emotional versus neutral reversal learning. The OFC showed greater activity during reversals of stimulus–outcome associations for negative outcomes than for neutral outcomes. Similar OFC activity was also observed during reversals involving positive outcomes. Furthermore, OFC activity is more inversely correlated with amygdala activity during negative reversals than during neutral reversals. Overall, our results indicate that the OFC is more activated by emotional than neutral reversal learning and that OFC's interactions with the amygdala are greater for negative than neutral reversal learning.