Evaluation of hemifield sector analysis protocol in multifocal visual evoked potential objective perimetry for the diagnosis and early detection of glaucomatous field defects

CONCLUSIONS: The new HSA protocol used in the mfVEP testing can be applied to detect glaucomatous visual field defects in both glaucoma and glaucoma suspect patients. Using this protocol can provide information about focal visual field differences across the horizontal midline, which can be utilized to differentiate between glaucoma and normal subjects. Sensitivity and specificity of the mfVEP test showed very promising results and correlated with other anatomical changes in glaucoma field loss. PURPOSE: Multifocal visual evoked potential (mfVEP) is a newly introduced method used for objective visual field assessment. Several analysis protocols have been tested to identify early visual field losses in glaucoma patients using the mfVEP technique, some were successful in detection of field defects, which were comparable to the standard automated perimetry (SAP) visual field assessment, and others were not very informative and needed more adjustment and research work. In this study we implemented a novel analysis approach and evaluated its validity and whether it could be used effectively for early detection of visual field defects in glaucoma. METHODS: Three groups were tested in this study; normal controls (38 eyes), glaucoma patients (36 eyes) and glaucoma suspect patients (38 eyes). All subjects had a two standard Humphrey field analyzer (HFA) test 24-2 and a single mfVEP test undertaken in one session. Analysis of the mfVEP results was done using the new analysis protocol; the hemifield sector analysis (HSA) protocol. Analysis of the HFA was done using the standard grading system. RESULTS: Analysis of mfVEP results showed that there was a statistically significant difference between the three groups in the mean signal to noise ratio (ANOVA test, p < 0.001 with a 95% confidence interval). The difference between superior and inferior hemispheres in all subjects were statistically significant in the glaucoma patient group in all 11 sectors (t-test, p < 0.001), partially significant in 5 / 11 (t-test, p < 0.01), and no statistical difference in most sectors of the normal group (1 / 11 sectors was significant, t-test, p < 0.9). Sensitivity and specificity of the HSA protocol in detecting glaucoma was 97% and 86%, respectively, and for glaucoma suspect patients the values were 89% and 79%, respectively.

Peptide binding to HLA-DP proteins at pH 5.0 and pH 7.0:a quantitative molecular docking study

Background: HLA-DPs are class II MHC proteins mediating immune responses to many diseases. Peptides bind MHC class II proteins in the acidic environment within endosomes. Acidic pH markedly elevates association rate constants but dissociation rates are almost unchanged in the pH range 5.0 - 7.0. This pH-driven effect can be explained by the protonation/deprotonation states of Histidine, whose imidazole has a pKa of 6.0. At pH 5.0, imidazole ring is protonated, making Histidine positively charged and very hydrophilic, while at pH 7.0 imidazole is unprotonated, making Histidine less hydrophilic. We develop here a method to predict peptide binding to the four most frequent HLA-DP proteins: DP1, DP41, DP42 and DP5, using a molecular docking protocol. Dockings to virtual combinatorial peptide libraries were performed at pH 5.0 and pH 7.0. Results: The X-ray structure of the peptide - HLA-DP2 protein complex was used as a starting template to model by homology the structure of the four DP proteins. The resulting models were used to produce virtual combinatorial peptide libraries constructed using the single amino acid substitution (SAAS) principle. Peptides were docked into the DP binding site using AutoDock at pH 5.0 and pH 7.0. The resulting scores were normalized and used to generate Docking Score-based Quantitative Matrices (DS-QMs). The predictive ability of these QMs was tested using an external test set of 484 known DP binders. They were also compared to existing servers for DP binding prediction. The models derived at pH 5.0 predict better than those derived at pH 7.0 and showed significantly improved predictions for three of the four DP proteins, when compared to the existing servers. They are able to recognize 50% of the known binders in the top 5% of predicted peptides. Conclusions: The higher predictive ability of DS-QMs derived at pH 5.0 may be rationalised by the additional hydrogen bond formed between the backbone carbonyl oxygen belonging to the peptide position before p1 (p-1) and the protonated ε-nitrogen of His 79β. Additionally, protonated His residues are well accepted at most of the peptide binding core positions which is in a good agreement with the overall negatively charged peptide binding site of most MHC proteins. © 2012 Patronov et al.; licensee BioMed Central Ltd.

Practitioner perspectives on supply chain management and logistics:a study from the United Kingdom

Purpose: The focus of this paper is the evolution of supply chain management (SCM) and logistics, as well as of the relationship between them. Its purpose is to generate deep insights into practice, particularly in relation to the fundamental issue of how practitioners define these key terms and phrases. Research approach: A largely qualitative study which involved in depth interviews with managers from two third party logistics providers (3PLs)/distributors, two retailers and two manufacturers from the United Kingdom. This interview protocol is based on the template used in a previous study published over a decade ago. Findings and originality: The data collected during the focussed interviews in the United Kingdom is contrasted with results from the earlier study. The findings suggest that there is variation between practitioners particularly in relation to what SCM is specifically concerned with. This variation mirrors to a large extent the differing orientations and emphases evident in the many theoretical definitions of SCM that have been proposed in recent decades. Research impact: The authors introduced the concept of refined replication in SCM research. This allows previous research to be built upon in order to test understanding of SCM theory and its practical implementation among SCM professionals in the United Kingdom. Practical impact: A profile of SCM understanding and adoption by firms in the United Kingdom is presented .

Discovering biomarkers for antidepressant response:protocol from the Canadian biomarker integration network in depression (CAN-BIND) and clinical characteristics of the first patient cohort

Background: Major Depressive Disorder (MDD) is among the most prevalent and disabling medical conditions worldwide. Identification of clinical and biological markers ("biomarkers") of treatment response could personalize clinical decisions and lead to better outcomes. This paper describes the aims, design, and methods of a discovery study of biomarkers in antidepressant treatment response, conducted by the Canadian Biomarker Integration Network in Depression (CAN-BIND). The CAN-BIND research program investigates and identifies biomarkers that help to predict outcomes in patients with MDD treated with antidepressant medication. The primary objective of this initial study (known as CAN-BIND-1) is to identify individual and integrated neuroimaging, electrophysiological, molecular, and clinical predictors of response to sequential antidepressant monotherapy and adjunctive therapy in MDD. Methods: CAN-BIND-1 is a multisite initiative involving 6 academic health centres working collaboratively with other universities and research centres. In the 16-week protocol, patients with MDD are treated with a first-line antidepressant (escitalopram 10-20 mg/d) that, if clinically warranted after eight weeks, is augmented with an evidence-based, add-on medication (aripiprazole 2-10 mg/d). Comprehensive datasets are obtained using clinical rating scales; behavioural, dimensional, and functioning/quality of life measures; neurocognitive testing; genomic, genetic, and proteomic profiling from blood samples; combined structural and functional magnetic resonance imaging; and electroencephalography. De-identified data from all sites are aggregated within a secure neuroinformatics platform for data integration, management, storage, and analyses. Statistical analyses will include multivariate and machine-learning techniques to identify predictors, moderators, and mediators of treatment response. Discussion: From June 2013 to February 2015, a cohort of 134 participants (85 outpatients with MDD and 49 healthy participants) has been evaluated at baseline. The clinical characteristics of this cohort are similar to other studies of MDD. Recruitment at all sites is ongoing to a target sample of 290 participants. CAN-BIND will identify biomarkers of treatment response in MDD through extensive clinical, molecular, and imaging assessments, in order to improve treatment practice and clinical outcomes. It will also create an innovative, robust platform and database for future research. Trial registration: ClinicalTrials.gov identifier NCT01655706. Registered July 27, 2012.

Protocol optimization for the mild detemplation of mesoporous silica nanoparticles resulting in enhanced texture and colloidal stability

Porosity development of mesostructured colloidal silica nanoparticles is related to the removal of the organic templates and co-templates which is often carried out by calcination at high temperatures, 500-600 °C. In this study a mild detemplation method based on the oxidative Fenton chemistry has been investigated. The Fenton reaction involves the generation of OH radicals following a redox Fe3+/Fe2+ cycle that is used as catalyst and H2O2 as oxidant source. Improved material properties are anticipated since the Fenton chemistry comprises milder conditions than calcination. However, the general application of this methodology is not straightforward due to limitations in the hydrothermal stability of the particular system under study. The objective of this work is three-fold: 1) reducing the residual Fe in the resulting solid as this can be detrimental for the application of the material, 2) shortening the reaction time by optimizing the reaction temperature to minimize possible particle agglomeration, and finally 3) investigating the structural and textural properties of the resulting material in comparison to the calcined counterparts. It appears that the Fenton detemplation can be optimized by shortening the reaction time significantly at low Fe concentration. The milder conditions of detemplation give rise to enhanced properties in terms of surface area, pore volume, structural preservation, low Fe residue and high degree of surface hydroxylation; the colloidal particles are stable during storage. A relative particle size increase, expressed as 0.11%·h-1, has been determined.

Thermal detemplation of SBA-15 mesophases. Effect of the activation protocol on the framework contraction

The potential use of the solvothermal extraction (SE) as a preliminary step to calcination for detemplating SBA-15 mesophases is investigated; aiming to reduce the amount of organics to be burnt and thereby the corresponding structural shrinkage. A systematic study was carried out by soxhlet extraction on mesophases hydrothermally aged between 90 and 130 C. The mesophases containing variable amounts of template were then treated by calcination or pyrolysis/calcination. TGA was applied to quantify the template amount after the various treatments. The as obtained materials were characterized by SAXS and Ar ad/desorption for structural and textural information while 1H NMR gave information about the integrity of the as-recycled template. The study shows that solvothermal conditions remove considerably the template, typically from 50 to 10-20 wt.%, mainly extracted from the primary mesopores. Possible reuse of the extracted template is questionable as it is poor in polyethyleneoxide compared to the synthesis block-copolymer, Pluronic P123. For all thermal protocols applied (direct calcination, calcination after solvent-extraction or pyrolysis/calcination after solvent extraction), the thermal shrinkage decreases with the aging temperature; that is consistent with the condensation degree of the silica. For each mesophase, it was found that the thermal shrinkage becomes less pronounced when the material is fully templated; thus the template can serve as structural support or can control the mass transfer of O2 and thereby the oxidation rate of the template burning. © 2013 Elsevier Inc. All rights reserved.

Performance optimisation of the MAC protocol with multiple contention slots in MIMO ad hoc networks

The multiple-input multiple-output (MIMO) technique can be used to improve the performance of ad hoc networks. Various medium access control (MAC) protocols with multiple contention slots have been proposed to exploit spatial multiplexing for increasing the transport throughput of MIMO ad hoc networks. However, the existence of multiple request-to-send/clear-to-send (RTS/CTS) contention slots represents a severe overhead that limits the improvement on transport throughput achieved by spatial multiplexing. In addition, when the number of contention slots is fixed, the efficiency of RTS/CTS contention is affected by the transmitting power of network nodes. In this study, a joint optimisation scheme on both transmitting power and contention slots number for maximising the transport throughput is presented. This includes the establishment of an analytical model of a simplified MAC protocol with multiple contention slots, the derivation of transport throughput as a function of both transmitting power and the number of contention slots, and the optimisation process based on the transport throughput formula derived. The analytical results obtained, verified by simulation, show that much higher transport throughput can be achieved using the joint optimisation scheme proposed, compared with the non-optimised cases and the results previously reported.

Perceptions and experiences of the implementation, management, use and optimisation of electronic prescribing systems in hospital settings:protocol for a systematic review of qualitative studies

Introduction: There is increasing evidence that electronic prescribing (ePrescribing) or computerised provider/physician order entry (CPOE) systems can improve the quality and safety of healthcare services. However, it has also become clear that their implementation is not straightforward and may create unintended or undesired consequences once in use. In this context, qualitative approaches have been particularly useful and their interpretative synthesis could make an important and timely contribution to the field. This review will aim to identify, appraise and synthesise qualitative studies on ePrescribing/CPOE in hospital settings, with or without clinical decision support. Methods and analysis: Data sources will include the following bibliographic databases: MEDLINE, MEDLINE In Process, EMBASE, PsycINFO, Social Policy and Practice via Ovid, CINAHL via EBSCO, The Cochrane Library (CDSR, DARE and CENTRAL databases), Nursing and Allied Health Sources, Applied Social Sciences Index and Abstracts via ProQuest and SCOPUS. In addition, other sources will be searched for ongoing studies (ClinicalTrials.gov) and grey literature: Healthcare Management Information Consortium, Conference Proceedings Citation Index (Web of Science) and Sociological abstracts. Studies will be independently screened for eligibility by 2 reviewers. Qualitative studies, either standalone or in the context of mixed-methods designs, reporting the perspectives of any actors involved in the implementation, management and use of ePrescribing/CPOE systems in hospital-based care settings will be included. Data extraction will be conducted by 2 reviewers using a piloted form. Quality appraisal will be based on criteria from the Critical Appraisal Skills Programme checklist and Standards for Reporting Qualitative Research. Studies will not be excluded based on quality assessment. A postsynthesis sensitivity analysis will be undertaken. Data analysis will follow the thematic synthesis method. Ethics and dissemination: The study does not require ethical approval as primary data will not be collected. The results of the study will be published in a peer-reviewed journal and presented at relevant conferences.

A case study of the development of the Argentinean community college system

In the 1980's and 1990's, Argentina was undergoing significant political, social and economic changes as a result of the change over from a military driven government to elected governments. A major aspect of the change was an increased emphasis on privatization, and promotion of foreign and domestic investment in Argentina. Higher education leaders were increasingly drawn into developing a national strategy for changing the educational structure to help facilitate changes in other aspects of the society. Preliminary reviews by the Argentinean higher education leaders indicated that adaptation of the American community college promised to help achieve the national goals. ^ The purpose of this study was to determine: if and how the community college concept, an American invention, could be adapted to function in Argentina, a nation with a significantly different history of political, social, cultural and economic development. Achieving this purpose involved: identifying the key leaders in the movement that developed to apply the community college concept in Argentina; the study of their perspectives regarding the movement as it developed; and tracking the assistance given by selected American community college leaders. ^ The case study method was employed in this research, using interview and historical data collection. Key leaders from higher education in the United States and Argentina were interviewed in-depth, to determine their views. An interview protocol with appropriate sub-questions was followed to ensure complete coverage. The interviewees identified several major areas of education in need of change including, the system, access to the system, new areas of study, integration into the hemisphere and, in general, decentralization. Historical review revealed a steady development of the community college concept in Argentina reflected in documentation of events, conceptual writings and legal structures. ^ It was concluded that there is a community college structure beginning to emerge that, so far, in broad outline, follows the structure developed in the United States. It is anticipated however, that future developments will include conceptual aspects to the model reflective of Argentina. ^

Development of an odor management plan for industrial stationary sources in an urban environment: A case study for Broward County, Florida

Objectionable odors remain at the top of air pollution complaints in urban areas such as Broward County that is subject to increasing residential and industrial developments. The odor complaints in Broward County escalated by 150 percent for the 2001 to 2004 period although the population increased by only 6 percent. It is estimated that in 2010 the population will increase to 2.5 million. Relying solely on enforcing the local odor ordinance is evidently not sufficient to manage the escalating odor complaint trends. An alternate approach similar to odor management plans (OMPs) that are successful in managing major malodor sources such as animal farms is required. ^ This study aims to develop and determine the feasibility of implementing a comprehensive odor management plan (COMP) for the entire Broward County. Unlike existing OMPs for single sources where the receptors (i.e. the complainants) are located beyond the boundary of the source, the COMP addresses a complex model of multiple sources and receptors coexisting within the boundary of the entire county. Each receptor is potentially subjected to malodor emissions from multiple sources within the county. Also, the quantity and quality of the source/receptor variables are continuously changing. ^ The results of this study show that it is feasible to develop a COMP that adopts a systematic procedure to: (1) Generate maps of existing odor complaint areas and malodor sources, (2) Identify potential odor sources (target sources) responsible for existing odor complaints, (3) Identify possible odor control strategies for target sources, (4) Determine the criteria for implementing odor control strategies, (5) Develop an odor complaint response protocol, and (6) Conduct odor impact analyses for new sources to prevent future odor related issues. Geographic Information System (GIS) is used to identify existing complaint areas. A COMP software that incorporates existing United States Environmental Protection Agency (EPA) air dispersion software is developed to determine the target sources, predict the likelihood of new complaints, and conduct odor impact analysis. The odor response protocol requires pre-planning field investigations and conducting surveys to optimize the local agency available resources while protecting the citizen's welfare, as required by the Clean Air Act. ^

Validation study of the Colorado Learning Attitudes about Science Survey at a Hispanic-serving institution

The Colorado Learning Attitudes about Science Survey (CLASS) has been widely acknowledged as a useful measure of student cognitive attitudes about science and learning. The initial University of Colorado validation study included only 20% non-Caucasian student populations. In this Brief Report we extend their validation to include a predominately under-represented minority population. We validated the CLASS instrument at Florida International University, a Hispanic-serving institution, by interviewing students in introductory physics classes using a semistructured protocol, examining students’ responses on the CLASS item statements, and comparing them to the items’ intended meaning. We find that in our predominately Hispanic population, 94% of the students’ interview responses indicate that the students interpret the CLASS items correctly, and thus the CLASS is a valid instrument. We also identify one potentially problematic item in the instrument which one third of the students interviewed consistently misinterpreted.

Docking and simulation study of the enantiospecificity of chiral epoxidation reactions catalyzed by chloroperoxidase

Chloroperoxidase (CPO), a 298-residue glycosylated protein from the fungus Caldariomyces fumago, is probably the most versatile heme enzyme yet discovered. Interest in CPO as a catalyst is based on its power to produce enantiomerically enriched products. Recent research has focused its attention on the ability of CPO to epoxidize alkenes in high regioselectivity and enantioselectivity as an efficient and environmentally benign alternative to traditional synthetic routes. There has been little work on the nature of ligand binding, which probably controls the regio- and enantiospecifity of CPO. Consequently it is here that we focus our work. We report docking calculations and computer simulations aimed at predicting the enantiospecificity of CPO-catalyzed epoxidation of three model substrates. On the basis of this work candidate mutations to improve the efficiency of CPO are predicted. In order to accomplish these aims, a simulated annealing and molecular dynamics protocol is developed to sample potentially reactive substrate/CPO complexes.

From Theory-Inspired to Theory-Based Interventions : A Protocol for Developing and Testing a Methodology for Linking Behaviour Change Techniques to Theoretical Mechanisms of Action

This research is funded by UK Medical Research Council grant number MR/L011115/1. We would like to thank the 105 experts in behaviour change who have committed their time and offered their expertise for study 2 of this research. We are also very grateful to all those who sent us peer-reviewed behaviour change intervention descriptions for study 1. Finally, we would like thank Dr. Emma Beard and Dr. Dan Dediu for their statistical input and to all the researchers, particularly Holly Walton, who have assisted in the coding of papers for study 1.

Design and protocol for the Focusing on Clozapine Unresponsive Symptoms (FOCUS) trial : a randomised controlled trial

Acknowledgements Thank you to all the participants who agreed to take part in the trial. This study was supported NHS Research Scotland (NRS), through Chief Scientist Office (CSO) and the Scottish Mental Health Research Network, and the Clinical Research Network-Mental Health. We are grateful to the Psychosis Research Unit (PRU) Service User Reference Group (SURG) for their consultation regarding the design of the study and contribution to the developments of study related materials. We are grateful to our Independent Trial Steering Committee and Independent Data Monitoring Committee for provided oversight of the trial. Funding This project was funded by the National Institute for Health Research Health Technology Assessment (NIHR HTA) programme (project number10/101/02) and will be published in full in Health Technology Assessment. Visit the HTA programme website for further project information. The views and opinions expressed therein are those of the authors and do not necessarily reflect those of the HTA programme, NIHR, NHS or the Department of Health.

Assessment of nutritional status of patients on hemodilaysis: a single center study from Jeddah, Saudi Arabia.

Malnutrition (MN) is prevalent worldwide in hemodialysis patients (HDP); however it has not been assessed in HDP living in Jeddah, Saudi Arabia. The purpose of this study was to estimate the prevalence of MN in HDP at the Jeddah Kidney Center as well as to determine if the 7-point subjective global assessment (SGA) correlates with anthropometric [Body Mass Index (BMI), Tricep Skinfold Thickness (TSF), Mid-Arm Muscle Circumference (MAMC)], or biochemical (albumin) measurements. In a cross sectional, descriptive study, 270 HDP were assessed for MN. Over half of the HDP were malnourished, with 47.8% moderately and 6.3% severely malnourished. Fifty-eight percent of HDP did not adhere to their diet prescription. As albumin, BMI, TSF, and MAMC decreased, malnutrition became more severe (p < .01). Patients who were female (OR=.43, p=.001), older (OR=.45, p=.001), with no education (OR=3.10, p=.001), underweight (OR=3.56, p<.001), small TSF (OR=1.12, p=.001), and small MAMC (OR=1.15, p=.001) were more likely to be malnourished. The prevalence of MN is high in these HDP. A consistent nutritional assessment protocol is warranted and should be implemented to decrease MN in Saudi HDP.