bluuebunny/crossref_metadata_2025 huggingface dataset:
Giant high occipital encephalocele
Authors: Agrawal Amit , Umamaheshwara Reddy V. , Hegde Kishor V. , Suneetha P. , Kolikipudi Divya Siddharth
Published: March 2016

Encephaloceles are rare embryological mesenchymal developmental anomalies resulting from inappropriate ossification in skull through with herniation of intracranial contents of the sac. Encephaloceles are classified based on location of the osseous defect and contents of sac. Convexity encephalocele with osseous defect in occipital bone is called occipital encephalocele. Giant occipital encephaloceles can be sometimes larger than the size of baby skull itself and they pose a great surgical challenge. Occipital encephaloceles (OE) are further classified as high OE when defect is only in occipital bone above the foramen magnum, low OE when involving occipital bone and foramen magnum and occipito-cervical when there involvement of occipital bone, foramen magnum and posterior upper neural arches. Chiari III malformation can be associated with high or low occipital encephaloceles. Pre-operatively, it is essential to know the size of the sac, contents of the sac, relation to the adjacent structures, presence or absence of venous sinuses/vascular structures and osseous defect size. Sometimes it becomes imperative to perform both CT and MRI for the necessary information. Volume rendered CT images can depict the relation of osseous defect to foramen magnum and provide information about upper neural arches which is necessary in classifying these lesions.
The Model of Unification and the Model of Diversification of Public School Teachers’ Continuing Professional Development in Great Britain, Canada and the USA
Authors: Mukan Nataliya , Myskiv Iryna , Kravets Svitlana
Published: March 2016

In the article the theoretical framework of public school teachers’ continuing professional development (CPD) in Great Britain, Canada and the USA has been presented. The main objectives have been defined as theoretical analysis of scientific and pedagogical literature, which highlights different aspects of the problem under research; presentation and characteristic of two models: the model of unification and the model of diversification of teachers’ professional development in the systems of continuing pedagogical education of Great Britain, Canada and the USA by the dominant traits. Their major components have been defined and specified. Public school teachers’ CPD has been studied by foreign and domestic scientists: content of public school teachers’ CPD (N. Dana Fichtman, M. Rees, A. Ross, S. Zepeda); CPD programs (C. Pratt); public school teachers’ CPD models, methods and forms (K. Duinlan, P. Grimmet, G. Troia, P. Wong); continuous professional education (Ya. Belmaz, А. Kuzminskyy, O. Kuznyetsova). The research methodology comprises theoretical (logical, induction and deduction, comparison and compatibility, structural and systematic, analysis and synthesis) and applied (observations, questioning and interviewing) methods. The research results have been presented.
Transporter Protein-Coupled DPCPX Nanoconjugates Induce Diaphragmatic Recovery after SCI by Blocking Adenosine A1 Receptors
Authors: Minic Zeljka , Zhang Yanhua , Mao Guangzhao , Goshgarian Harry G.
Published: March 2016

Respiratory complications in patients with spinal cord injury (SCI) are common and have a negative impact on the quality of patients' lives. Systemic administration of drugs that improve respiratory function often cause deleterious side effects. The present study examines the applicability of a novel nanotechnology-based drug delivery system, which induces recovery of diaphragm function after SCI in the adult rat model. We developed a protein-coupled nanoconjugate to selectively deliver by transsynaptic transport small therapeutic amounts of an A1 adenosine receptor antagonist to the respiratory centers. A single administration of the nanoconjugate restored 75% of the respiratory drive at 0.1% of the systemic therapeutic drug dose. The reduction of the systemic dose may obviate the side effects. The recovery lasted for 4 weeks (the longest period studied). These findings have translational implications for patients with respiratory dysfunction after SCI.

SIGNIFICANCE STATEMENTThe leading causes of death in humans following SCI are respiratory complications secondary to paralysis of respiratory muscles. Systemic administration of methylxantines improves respiratory function but also leads to the development of deleterious side effects due to actions of the drug on nonrespiratory sites. The importance of the present study lies in the novel drug delivery approach that uses nanotechnology to selectively deliver recovery-inducing drugs to the respiratory centers exclusively. This strategy allows for a reduction in the therapeutic drug dose, which may reduce harmful side effects and markedly improve the quality of life for SCI patients.
Astrocytes Regulate GLP-1 Receptor-Mediated Effects on Energy Balance
Authors: Reiner David J. , Mietlicki-Baase Elizabeth G. , McGrath Lauren E. , Zimmer Derek J. , Bence Kendra K. , Sousa Gregory L. , Konanur Vaibhav R. , Krawczyk Joanna , Burk David H. , Kanoski Scott E. , Hermann Gerlinda E. , Rogers Richard C. , Hayes Matthew R.
Published: March 2016

Astrocytes are well established modulators of extracellular glutamate, but their direct influence on energy balance-relevant behaviors is largely understudied. As the anorectic effects of glucagon-like peptide-1 receptor (GLP-1R) agonists are partly mediated by central modulation of glutamatergic signaling, we tested the hypothesis that astrocytic GLP-1R signaling regulates energy balance in rats. Central or peripheral administration of a fluorophore-labeled GLP-1R agonist, exendin-4, localizes within astrocytes and neurons in the nucleus tractus solitarius (NTS), a hindbrain nucleus critical for energy balance control. This effect is mediated by GLP-1R, as the uptake of systemically administered fluorophore-tagged exendin-4 was blocked by central pretreatment with the competitive GLP-1R antagonist exendin-(9–39).Ex vivoanalyses show prolonged exendin-4-induced activation (live cell calcium signaling) of NTS astrocytes and neurons; these effects are also attenuated by exendin-(9–39), indicating mediation by the GLP-1R.In vitroanalyses show that the application of GLP-1R agonists increases cAMP levels in astrocytes. Immunohistochemical analyses reveal that endogenous GLP-1 axons form close synaptic apposition with NTS astrocytes. Finally, pharmacological inhibition of NTS astrocytes attenuates the anorectic and body weight-suppressive effects of intra-NTS GLP-1R activation. Collectively, data demonstrate a role for NTS astrocytic GLP-1R signaling in energy balance control.

SIGNIFICANCE STATEMENTGlucagon-like peptide-1 receptor (GLP-1R) agonists reduce food intake and are approved by the Food and Drug Administration for the treatment of obesity, but the cellular mechanisms underlying the anorectic effects of GLP-1 require further investigation. Astrocytes represent a major cellular population in the CNS that regulates neurotransmission, yet the role of astrocytes in mediating energy balance is largely unstudied. The current data provide novel evidence that astrocytes within the NTS are relevant for energy balance control by GLP-1 signaling. Here, we report that GLP-1R agonists activate and internalize within NTS astrocytes, while behavioral data suggest the pharmacological relevance of NTS astrocytic GLP-1R activation for food intake and body weight. These findings support a previously unknown role for CNS astrocytes in energy balance control by GLP-1 signaling.
Iron Level and Myelin Content in the Ventral Striatum Predict Memory Performance in the Aging Brain
Authors: Steiger Tineke K. , Weiskopf Nikolaus , Bunzeck Nico
Published: March 2016

Age-related memory impairments have been associated with structural changes in the dopaminergic system, but the underlying mechanisms remain unclear. Recent work indicates that iron accumulation might be of particular relevance. As iron accumulates, a degeneration of myelin sheaths has been observed in the elderly, but the relationship between both and their impact on memory performance in healthy elderly humans remain important open questions. To address this issue, we combined an established behavioral paradigm to test memory performance [verbal learning memory test (VLMT)] with state of the art quantitative magnetic resonance imaging techniques allowing us to quantify the degree of myelination and iron accumulation via markers of tissue microstructure in a group of young (18–32 years) and healthy elderly humans (55–79 years). As expected, we observed a decrease in gray matter volume and myelin, and an increase of iron in the elderly relative to the young subjects within widespread brain regions, including the basal ganglia. Furthermore, higher levels of iron within the ventral striatum were accompanied by a negative correlation between myelin and iron specific for the elderly participants. Importantly, both markers of iron and myelin (and their ratio) predicted the performance of the elderly in the VLMT. This suggests that ventral striatum iron accumulation is linked to demyelination and impairments in declarative memory. Together, our data provide novel insights into underlying microstructural mechanisms of memory decline in the elderly.

SIGNIFICANCE STATEMENTMemory decline in healthy elderly is a common phenomenon, but the underlying neural mechanisms remain unclear. We used a novel approach that allowed us to combine behavior and whole-brain measures of iron, myelin, and gray matter in the participant's individual subspace to analyze structure–structure and structure–behavior interactions. We were able to show, that age-related high levels of iron are accompanied by a negative correlation of iron and myelin in the ventral striatum, which predicted individual memory performance. As such, our findings provide unprecedented insights into the basic mechanisms of memory decline in the elderly.
Promoter-Specific Effects of DREADD Modulation on Hippocampal Synaptic Plasticity and Memory Formation
Authors: López Alberto J. , Kramár Enikö , Matheos Dina P. , White André O. , Kwapis Janine , Vogel-Ciernia Annie , Sakata Keith , Espinoza Monica , Wood Marcelo A.
Published: March 2016

Designer receptors exclusively activated by designer drug (DREADDs) are a novel tool with the potential to bidirectionally drive cellular, circuit, and ultimately, behavioral changes. We used DREADDs to evaluate memory formation in a hippocampus-dependent task in mice and effects on synaptic physiology in the dorsal hippocampus. We expressed neuron-specific (hSyn promoter) DREADDs that were either excitatory (HM3D) or inhibitory (HM4D) in the dorsal hippocampus. As predicted, hSyn–HM3D was able to transform a subthreshold learning event into long-term memory (LTM), and hSyn–HM4D completely impaired LTM formation. Surprisingly, the opposite was observed during experiments examining the effects on hippocampal long-term potentiation (LTP). hSyn–HM3D impaired LTP and hSyn–HM4D facilitated LTP. Follow-up experiments indicated that the hSyn–HM3D-mediated depression of fEPSP appears to be driven by presynaptic activation of inhibitory currents, whereas the hSyn–HM4D-mediated increase of fEPSP is induced by a reduction in GABAAreceptor function. To determine whether these observations were promoter specific, we next examined the effects of using the CaMKIIα promoter that limits expression to forebrain excitatory neurons. CaMKIIα–HM3D in the dorsal hippocampus led to the transformation of a subthreshold learning event into LTM, whereas CaMKIIα–HM4D blocked LTM formation. Consistent with these findings, baseline synaptic transmission and LTP was increased in CaMKIIα–HM3D hippocampal slices, whereas slices from CaMKIIα–HM4D mice produced expected decreases in baseline synaptic transmission and LTP. Together, these experiments further demonstrate DREADDs as being a robust and reliable means of modulating neuronal function to manipulate long-term changes in behavior, while providing evidence for specific dissociations between LTM and LTP.

SIGNIFICANCE STATEMENTThis study evaluates the efficacy of designer receptors exclusively activated by designer drug (DREADDs) as a means of bidirectionally modulating the hippocampus in not only a hippocampus-dependent task but also in hippocampal synaptic plasticity. This is the first study to evaluate the effects of DREADD-mediated inhibition and excitation in hippocampal long-term potentiation. More specifically, this study evaluates the effect of promoter-specific expression of DREADD viruses in a heterogenic cell population, which revealed surprising effects of different promoters. With chemogenetics becoming a more ubiquitous tool throughout studies investigating circuit-specific function, these data are of broad interest to the neuroscientific community because we have shown that promoter-specific effects can drastically alter synaptic function within a specific region, without parallel changes at the level of behavior.
Dysfunctional Calcium and Glutamate Signaling in Striatal Astrocytes from Huntington's Disease Model Mice
Authors: Jiang Ruotian , Diaz-Castro Blanca , Looger Loren L. , Khakh Baljit S.
Published: March 2016

Astrocytes tile the entire CNS, but their functions within neural circuits in health and disease remain incompletely understood. We used genetically encoded Ca2+and glutamate indicators to explore the rules for astrocyte engagement in the corticostriatal circuit of adult wild-type (WT) and Huntington's disease (HD) model mice at ages not accompanied by overt astrogliosis (at approximately postnatal days 70–80). WT striatal astrocytes displayed extensive spontaneous Ca2+signals, but did not respond to cortical stimulation, implying that astrocytes were largely disengaged from cortical input in healthy tissue. In contrast, in HD model mice, spontaneous Ca2+signals were significantly reduced in frequency, duration, and amplitude, but astrocytes responded robustly to cortical stimulation with evoked Ca2+signals. These action-potential-dependent astrocyte Ca2+signals were mediated by neuronal glutamate release during cortical stimulation, accompanied by prolonged extracellular glutamate levels near astrocytes and tightly gated by Glt1 glutamate transporters. Moreover, dysfunctional Ca2+and glutamate signaling that was observed in HD model mice was largely, but not completely, rescued by astrocyte specific restoration of Kir4.1, emphasizing the important contributions of K+homeostatic mechanisms that are known to be reduced in HD model mice. Overall, our data show that astrocyte engagement in the corticostriatal circuit is markedly altered in HD. Such prodromal astrocyte dysfunctions may represent novel therapeutic targets in HD and other brain disorders.

SIGNIFICANCE STATEMENTWe report how early-onset astrocyte dysfunction without detectable astrogliosis drives disease-related processes in a mouse model of Huntington's disease (HD). The cellular mechanisms involve astrocyte homeostasis and signaling mediated by Kir4.1, Glt1, and Ca2+. The data show that the rules for astrocyte engagement in a neuronal circuit are fundamentally altered in a brain disease caused by a known molecular defect and that fixing early homeostasis dysfunction remedies additional cellular deficits. Overall, our data suggest that key aspects of altered striatal function associated with HD may be triggered, at least in part, by dysfunctional astrocytes, thereby providing details of an emerging striatal microcircuit mechanism in HD. Such prodromal changes in astrocytes may represent novel therapeutic targets.
Agonist-Specific Recruitment of Arrestin Isoforms Differentially Modify Delta Opioid Receptor Function
Authors: Pradhan Amynah A. , Perroy Julie , Walwyn Wendy M. , Smith Monique L. , Vicente-Sanchez Ana , Segura Laura , Bana Alia , Kieffer Brigitte L. , Evans Christopher J.
Published: March 2016

Ligand-specific recruitment of arrestins facilitates functional selectivity of G-protein-coupled receptor signaling. Here, we describe agonist-selective recruitment of different arrestin isoforms to the delta opioid receptor in mice. A high-internalizing delta opioid receptor agonist (SNC80) preferentially recruited arrestin 2 and, in arrestin 2 knock-outs (KOs), we observed a significant increase in the potency of SNC80 to inhibit mechanical hyperalgesia and decreased acute tolerance. In contrast, the low-internalizing delta agonists (ARM390, JNJ20788560) preferentially recruited arrestin 3 with unaltered behavioral effects in arrestin 2 KOs. Surprisingly, arrestin 3 KO revealed an acute tolerance to these low-internalizing agonists, an effect never observed in wild-type animals. Furthermore, we examined delta opioid receptor–Ca2+channel coupling in dorsal root ganglia desensitized by ARM390 and the rate of resensitization was correspondingly decreased in arrestin 3 KOs. Live-cell imaging in HEK293 cells revealed that delta opioid receptors are in pre-engaged complexes with arrestin 3 at the cell membrane and that ARM390 strengthens this membrane interaction. The disruption of these complexes in arrestin 3 KOs likely accounts for the altered responses to low-internalizing agonists. Together, our results show agonist-selective recruitment of arrestin isoforms and reveal a novel endogenous role of arrestin 3 as a facilitator of resensitization and an inhibitor of tolerance mechanisms.

SIGNIFICANCE STATEMENTAgonists that bind to the same receptor can produce highly distinct signaling events and arrestins are a major mediator of this ligand bias. Here, we demonstrate that delta opioid receptor agonists differentially recruit arrestin isoforms. We found that the high-internalizing agonist SNC80 preferentially recruits arrestin 2 and knock-out (KO) of this protein results in increased efficacy of SNC80. In contrast, low-internalizing agonists (ARM390 and JNJ20788560) preferentially recruit arrestin 3 and, surprisingly, KO of arrestin 3 produces acute tolerance and impaired receptor resensitization to these agonists. Arrestin 3 is in pre-engaged complexes with the delta opioid receptor at the cell membrane and low-internalizing agonists promote this interaction. This study reveals a novel role for arrestin 3 as a facilitator of receptor resensitization.
Aštuntoji tarptautinė mokslinė konferencija Prof. Jono Puzino skaitymai: „Ankstyvosios priešistorės paminklaviečių peržiūra: senosios medžiagos vertinimas, naujų teorijų kūrimas“ (skiriama habil. dr. Rimutės Rimantienės 95-am gimtadieniui)
Authors: Šatavičius Egidijus , Gudaitienė Gabrielė
Published: March 2016

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Archeologijos katedros leidiniai 2010–2015 metais
Authors: Merkevičius Algimantas
Published: March 2016

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Effect of age and social connection on perceived anxiety over radiation exposure among decontamination workers in Fukushima Prefecture, Japan
Authors: Hidaka Tomoo , Kakamu Takeyasu , Hayakawa Takehito , Kumagai Tomohiro , Jinnouchi Takanobu , Sato Sei , Tsuji Masayoshi , Nakano Shinichi , Koyama Kikuo , Fukushima Tetsuhito
Published: March 2016

Objectives

To reveal the effect of age and other factors on perceived anxiety over radiation exposure among decontamination workers in Fukushima Prefecture, Japan.

Methods

Asurvey questionnaire was sent to 1505 workers, with questions regarding age, presence of a written employment contract, previous residence, radiation passbook ownership, presence of close persons for consultation, knowledge of how to access public assistance, and a four‐point scale of radiation‐related anxiety (1 = “ Very much, ” 2 = “ Somewhat,” 3=“A little bit,” and 4=“None”). The relationships between the degree of anxiety and variables were analyzed using the chi‐square test and residual analysis.

Results

In all, 512 participants responded to the questionnaire. The mean age of participants was 46.2 years (SD: 13.1, range: 18‐77). Of them, 50, 233, 168, and 61 workers chose “Very much,” “Somewhat,” “A little bit,” and “None, ” respectively, on the anxiety scale. Chi‐square test showed that participants aged 61 years and over had higher degrees of anxiety (p<0.001). Ordinal logistic regression showed that the degree of anxiety increased if they did not have a written contract (p =0.042) or persons to consult (p=0.034) and if they routinely checked the dose rate (p=0.046).

Conclusions

Decontamination workers who do not have a written contract or who are in socially isolated situations have greater anxiety over radiation exposure. Thus, it is important to both create supportive human relationships for consultation and enhance labor management in individual companies.
Effects of occupational illness on labor productivity: A socioeconomic aspect of informal sector workers in urban Bangladesh
Authors: Sarker Abdur Razzaque , Sultana Marufa , Mahumud Rashidul Alam , Ahmed Sayem , Ahmed Mohammad Wahid , Hoque Mohammad Enamul , Islam Ziaul , Gazi Rukhsana , Khan Jahangir A.M.
Published: March 2016

Objectives

The informal sector is the dominant area of employment and the economy for any developing country including Bangladesh. The cost of productivity loss due to absence from work or presenteeism with illness has rarely been examined in the Bangladesh context. This current study, therefore, attempted to examine the impact of ill health of informal sector workers on labor productivity, future earning, and healthcare‐related expenditure.

Methodology

A cross‐sectional survey was conducted among three occupational groups of informal workers (rickshaw pullers, shopkeepers and restaurant workers) that were generally found in all urban areas in Bangladesh. A total of 557 informal workers were surveyed for this study.

Results

Most of the respondents (57%) reported that they had been affected by some type of illness for the last six months. The overall average healthcare expenditure of informal workers was US $48.34, while restaurant workers expended more (US$53.61) . Self reported sickness absenteeism was highest (50.37days) in the case of shop keepers, followed by rickshaw pullers (49.31 days), in the last six months. Considering the income loss due to illness in the past six months, the rickshaw pullers were exposed to the highest income loss (US$197.15), followed by the shop keepers (US$151.39).

Conclusions

Although the informal sector contributes the most to the economy of Bangladesh, the workers in this sector have hardly any financial protection. This study provides critical clues to providing financial and social protection to informal sector workers in Bangladesh.
Current prevalence rate of latex allergy: Why it remains a problem?
Authors: Wu Miaozong , McIntosh James , Liu Jian
Published: March 2016

Objectives

This article aims to review the current prevalence rate of latex allergy among healthcare workers, susceptible patients, and the general public, and to investigate why latex is still a ubiquitous occupational health hazard.

Methods

Scientific publications on PubMed, particularly those published within the last five years, and current regulations from agencies such as Food and Drug Administration (FDA) were reviewed. Consumer and commercial products that may contain latex were also surveyed.

Results

Approximately 12 million tons of natural rubber latex is produced annually and is widely used to manufacture millions of consumer and commercial products. Only limited number of latexderived products have been approved and regulated by government agencies, such as FDA, whereas the majority of finished products do not label whether they contain latex. Owing to millions of unidentifiable products containing latex and many routes for exposure to latex, preventing contact with latex allergens and reducing the prevalence of latex allergy are more difficult than expected. Reported data suggest that the average prevalence of latex allergy worldwide remains 9.7%, 7.2%, and 4.3% among healthcare workers, susceptible patients, and general population, respectively.

Conclusions

Latex‐derived products are ubiquitous, and latex allergy remains a highly prevalent health risk in many occupations and to the general population. Developing alternative materials and increasing the ability to identify and label latex‐derived products will be practicable approaches to effectively control the health risks associated with latex.
Work stress and cardiovascular disease: a life course perspective
Authors: Li Jian , Loerbroks Adrian , Bosma Hans , Angerer Peter
Published: March 2016

Individuals in employment experience stress at work, and numerous epidemiological studies have documented its negative health effects, particularly on cardiovascular disease (CVD). Although evidence on the various interrelationships between work stress and CVD has been accumulated, those observations have not yet been conceptualized in terms of a life course perspective. Using the chain of risk model, we would like to propose a theoretical model incorporating six steps: (1) work stress increases the risk of incident CVD in healthy workers. (2) Among those whose work ability is not fully and permanently damaged, work stress acts as a determinant of the process of return to work after CVD onset. (3) CVD patients experience higher work stress after return to work. (4) Work stress increases the risk of recurrent CVD in workers with prior CVD. (5) CVD patients who fully lose their work ability transit to disability retirement. (6) Disability retirees due to CVD have an elevated risk of CVD mortality. The life course perspective might facilitate an in‐depth understanding of the diverse interrelationships between work stress and CVD, thereby leading to work stress management interventions at each period of the lifespan and three‐level prevention of CVD.
Teacher Education Curriculum in context of Information &Communication Technology
Authors:   Research Scholar, IGNOU, Delhi, Gupta Deepty
Published: March 2016

Today’s teachers need to update their knowledge and skills as the school curriculum and technologies are changing rapidly. Shift from Blackboard to Smart classrooms had changed the facet of the modern classrooms. Information Communication technologies (ICTs) can substantially support the education system if a teacher is enough competent to use the tools. For this the curriculum of teacher education system should also contribute for preparing prospective teachers. This research has been done to identify the gaps in the curriculum of teacher education system in context of ICT in perspective of the National Policies and Documents. The researcher has content analyzed the curriculum of 5 major universities in Delhi and National Capital Region (NCR) and tried to give the suggestions for inserting component of ICT while preparing new curriculum for B.Ed. course.
Institutional and Gender Differences on Job Stress among Teachers at Secondary Stage
Authors:   Lovely School of Education, Lovely Professional university, Phagwara, Punajb, India-144008, Kumar Vijay
Published: March 2016

Present study intends to study the level of job stress among the secondary school teachers in hoshiarpur district. 2×2 factorial design has been employed on the scores of various dimensions of job stress between male and female government and private school teachers. In total the sample comprised of 200 teachers from schools situated in urban and rural settings of the district. The findings of the study revealed that (a) secondary schools teachers serving in government and private schools exhibit similar job stress, (b) male teachers working in secondary schools felt more job stress than female teachers; (c) males are not able to develop good interpersonal relationships; and (d) females were found working without any motive resulting in experiencing more job stress.
Rapid Recovery Pathway After Spinal Fusion for Idiopathic Scoliosis
Authors: Muhly Wallis T. , Sankar Wudbhav N. , Ryan Kelly , Norton Annette , Maxwell Lynne G. , DiMaggio Theresa , Farrell Sharon , Hughes Rachel , Gornitzky Alex , Keren Ron , McCloskey John J. , Flynn John M.
Published: March 2016

BACKGROUND:

Posterior spinal fusion (PSF) for adolescent idiopathic scoliosis (AIS) is associated with significant pain and prolonged hospitalization. There is evidence that early mobilization and multimodal analgesia can accelerate functional recovery and reduced length of stay (LOS). Using these principles, we implemented a quality improvement initiative to enable earlier functional recovery in our AIS–PSF population.

METHODS:

We designed and implemented a standardized rapid recovery pathway (RRP) with evidence-based management recommendations for children aged 10 to 21 years undergoing PSF for AIS. Our primary outcome, functional recovery, was assessed using statistical process control charts for LOS and average daily pain scores. Our process measures were medication adherence and order set utilization. The balancing measure was 30-day readmission rate.

RESULTS:

We included 322 patients from January 1, 2011 to June 30, 2015 with 134 (42%) serving as historical controls, 104 (32%) representing our transition population, and 84 (26%) serving as our RRP population. Baseline average LOS was 5.7 days and decreased to 4 days after RRP implementation. Average daily pain scores remained stable with improvement on postoperative day 0 (3.8 vs 4.9 days) and 1 (3.8 vs 5 days) after RRP implementation. In the second quarter of 2015, gabapentin (91%) and ketorolac (95%) use became routine and order set utilization was 100%. Readmission rates did not increase as a result of this pathway.

CONCLUSIONS:

Implementation of a standardized RRP with multimodal pain management and early mobilization strategies resulted in reduced LOS without an increase in reported pain scores or readmissions.
N-acetylcysteine: an old drug with variable Anti-influenza properties
Authors: Casanova Tomas , Garigliany Mutien
Published: March 2016

N-acetylcysteine (NAC) is a mucolytic drug commonly used as an adjuvant therapy in patients with respiratory conditions associated with excessive mucus production. NAC also has antioxidant activities which proved useful in the management of oxidative stress. These antioxidant capacities of NAC are mostly indirect, via a pro-glutathione effect where NAC provides L-cysteine residues required for glutathione synthesis. This activity is thought to be the basis of the protective effect of NAC administration in influenza patients and in mouse models of the disease. NAC was shown to limit lung inflammation, damage associated with the virus, and limit viral growth, at least in vitro. However, the antiviral activity was highly variable depending on the influenza A strain. The reasons for these inter-strain variations are still unknown but might be related to the level of NF-κB activation required for the virus to achieve its infectious cycle.
Review of the Interaction Between Body Composition and Clinical Outcomes in Metastatic Renal Cell Cancer Treated With Targeted Therapies
Authors: Yip Steven M. , Heng Daniel Y.C. , Tang Patricia A.
Published: March 2016

Treatment of metastatic renal cell cancer (mRCC) currently focuses on inhibition of the vascular endothelial growth factor pathway and the mammalian target of rapamycin (mTOR) pathway. Obesity confers a higher risk of RCC. However, the influence of obesity on clinical outcomes in mRCC in the era of targeted therapy is less clear. This review focuses on the impact of body composition on targeted therapy outcomes in mRCC. The International Metastatic Renal Cell Carcinoma Database Consortium database has the largest series of patients evaluating the impact of body mass index (BMI) on outcomes in mRCC patients treated with targeted therapy. Overall survival was significantly improved in overweight patients (BMI ≥ 25 kg/m2), and this observation was externally validated in patients who participated in Pfizer trials. In contrast, sarcopenia is consistently associated with increased toxicity to inhibitors of angiogenesis and mTOR. Strengthening patients with mRCC and sarcopenia, through a structured exercise program and dietary intervention, may improve outcomes in mRCC treated with targeted therapies. At the same time, the paradox of obesity being a risk factor for RCC while offering a better overall survival in response to targeted therapy needs to be further evaluated.
A New Adaptive Fuzzy PID Control Method and Its Applicance in FCBTM
Authors: Lai Jingang , Zhou Hong , Hu Wenshan
Published: March 2016

The process of tension control for material testing using the Flexible ircuit Board testing machine (FCBTM) is featured with multi-variable, nonlinearity, ime delays and time variation. In order to ensure the tension precision, the stability of ervo motor’ speed and the reliability of test results, this paper establishes an accurate ystem model for the FCBTM, in which a novel three-dimensional adaptive fuzzy ID controller is designed. Specially, the simulation results show that the proposed daptive fuzzy control method is not only robust to the external disturbance but also ith more excellent dynamic and steady-state characteristics than traditional ones.
Assessing treatment response to prophylactic lithium use in patients with bipolar disorder
Authors: Silva Luiz Fernando de Almeida Lima e , Loureiro Júlia Cunha , Franco Stephany Caroline Raposo , Santos Marilza de Lima , Secolin Rodrigo , Lopes-Cendes Iscia , Dantas Clarissa de Rosalmeida , Banzato Claudio E. M.
Published: March 2016

ABSTRACT Objetive To identify potential clinical and epidemiological predictors of long-term response to lithium treatment. Methods A total of 40 adult outpatients followed in an university hospital, with confirmed diagnosis of bipolar disorder and with history of lithium use for at least a six months period, had their response to this medication assessed through the use of a standardized instrument. The ALDA scale is based on retrospective clinical data, in our study assessed through a thoroughly reviewed of the medical charts, and is used to evaluate the clinical improvement with the treatment (Criterion A), corrected by the acknowledgement of possible confounding factors, such as duration of the treatment, compliance and concomitant use of additional medications (Criterion B), in order to estimate the response that can be specifically attributable to lithium. Results Our study found an inverse relation between the number of mood episodes with psychotic symptoms and lithium treatment outcome. Conclusion The results reinforce the hypothesis that lithium seems to be less efficacious in patients with bipolar disorder who present psychotic symptoms.
Screening for physical inactivity among adults: the value of distance walked in the six-minute walk test. A cross-sectional diagnostic study
Authors: Sperandio Evandro Fornias , Arantes Rodolfo Leite , Silva Rodrigo Pereira da , Matheus Agatha Caveda , Lauria Vinícius Tonon , Bianchim Mayara Silveira , Romiti Marcello , Gagliardi Antônio Ricardo de Toledo , Dourado Victor Zuniga
Published: March 2016

ABSTRACT: CONTEXT AND OBJECTIVES: Accelerometry provides objective measurement of physical activity levels, but is unfeasible in clinical practice. Thus, we aimed to identify physical fitness tests capable of predicting physical inactivity among adults. DESIGN AND SETTING: Diagnostic test study developed at a university laboratory and a diagnostic clinic. METHODS: 188 asymptomatic subjects underwent assessment of physical activity levels through accelerometry, ergospirometry on treadmill, body composition from bioelectrical impedance, isokinetic muscle function, postural balance on a force platform and six-minute walk test. We conducted descriptive analysis and multiple logistic regression including age, sex, oxygen uptake, body fat, center of pressure, quadriceps peak torque, distance covered in six-minute walk test and steps/day in the model, as predictors of physical inactivity. We also determined sensitivity (S), specificity (Sp) and area under the curve of the main predictors by means of receiver operating characteristic curves. RESULTS: The prevalence of physical inactivity was 14%. The mean number of steps/day (≤ 5357) was the best predictor of physical inactivity (S = 99%; Sp = 82%). The best physical fitness test was a distance in the six-minute walk test and ≤ 96% of predicted values (S = 70%; Sp = 80%). Body fat > 25% was also significant (S = 83%; Sp = 51%). After logistic regression, steps/day and distance in the six-minute walk test remained predictors of physical inactivity. CONCLUSION: The six-minute walk test should be included in epidemiological studies as a simple and cheap tool for screening for physical inactivity.
Migrant nurses in Brazil: demographic characteristics, migration flow and relationship with the training process
Authors: Silva Kênia Lara , Sena Roseni Rosângela de , Tavares Tatiana Silva , Belga Stephanie Marques Moura Franco , Maas Lucas Wan Der
Published: March 2016

Objective to analyze the migration of nurses in Brazil, describe the demographic characteristics of migrant nurses, the main migration flows, and establish relationships with the training process. Method a descriptive, exploratory study, based on 2010 Census data. The data were analyzed using descriptive statistics. Result there were 355,383 nurses in Brazil in 2010. Of these, 36,479 (10.3%) reported having moved compared to the year 2005: 18,073 (5.1%) for intrastate migration, 17,525 (4.8%) interstate migration, and 871 (0.2%) international migration. Females (86.3%), Caucasians (65.2%), and unmarried (48.3%) nurses prevailed in the population, without considerable variation between groups according to migration situation. The findings indicate that the migration flows are driven by the training process for states that concentrate a greater number of courses and positions in undergraduate and graduate studies, and the motivation of employment opportunity in regions of economic expansion in the country. Conclusion it is necessary to deepen the discussion on the movement of nurses in Brazil, their motivations, and international migration.
Access to surgical assistance: challenges and perspectives
Authors: Tostes Maria Fernanda do Prado , Covre Eduardo Rocha , Fernandes Carlos Alexandre Molena
Published: March 2016

Objective to characterize the access to surgical assistance in Brazil. Method documentary study, with a quantitative approach, developed from information of the Caixa Preta da Saúde [Health Black Box] database, of the Brazilian Medical Association. Results in the one-year period 3773 cases related to health care in Brazil were recorded. There were 458 (12.3%) records on surgical assistance. Of these, most, 339 (74.1%), involved the lack of access in all regions of Brazil. The main access constraint was the prolonged waiting time for surgery. Other constraints were the excessive waiting for medical appointment with experts, doing examinations and cancellation of surgeries. Conclusion the access to surgical assistance, by users of the Brazilian health system, is not widely guaranteed, reinforcing the need for integrated governmental actions, organization of the health care network, management of health care and human resources to overcome the challenges imposed to achieve the Universal Access to Health and Universal Health Coverage.
Prevention of catheter-associated urinary tract infection: implementation strategies of international guidelines
Authors: Andrade Vera Lúcia Fonseca , Fernandes Filipa Alexandra Veludo
Published: March 2016

Objective to describe strategies used by health professionals on the implementation of the Centers for Disease Control and Prevention guidelines for the prevention of urinary infection related to catheterism. Method systematic review on literature based on data from CINAHL(r), Nursing & Allied Health Collection, Cochrane Plus Collection, MedicLatina, MEDLINE(r), Academic Search Complete, ACS - American Chemical Society, Health Reference Center Academic, Nursing Reference Center, ScienceDirect Journals and Wiley Online Library. A sample of 13 articles was selected. Results studies have highlighted the decrease of urinary tract infection related to catheterism through reminder systems to decrease of people submitted to urinary catheterism, audits about nursing professionals practice and bundles expansion. Conclusion the present review systemizes the knowledge of used strategies by health professionals on introduction to international recommendations, describing a rate decrease of such infection in clinical practice.
Fish fauna from Sapucaí-Mirim River, tributary of Grande River, upper Paraná River basin, Southeastern Brazil
Authors: Oliveira Alexandre Kannebley de , Garavello Julio Cesar , Cesario Vinicius Vendramini , Cardoso Rodrigo Torres
Published: March 2016

The fish species composition of Sapucaí-Mirim River is herein reported and discussed in the faunistic context of Grande and Paranaíba river basins, both formers of the Paraná River. The Sapucaí-Mirim is an important tributary of this hydrographic system, flowing to the left bank of Grande River in a region occupied by the reservoir of the Porto Colombia hydroelectric power plant, at São Paulo state northeastern region, in southeastern Brazil. The poorly known fish diversity of the Sapucaí-Mirim River is presented on basis of sampling efforts conducted in the main river channel and three creeks located at the mid and lower sections of the basin, allowing comparisons of the fish fauna of these two sections in the light of available information of fish inhabiting Grande and Paranaíba river basins. The study of the fish composition resulted in the recognition of 68 species in the Sapucaí-Mirim River, belonging to 23 families distributed in seven orders, all commonly found in upper Paraná River basin: Characiformes (32 spp.), Siluriformes (25 spp.), Labriformes (4 spp.), Gymnotiformes (3 spp.), Cyprinodontiformes (2 spp.), Perciformes (one species) and Synbranchiformes (one species). Most of the species are representative of the native ichthyofauna, but the total diversity also includes allochthonous species, which were chiefly found in the lower stretch studied. Some species found in the Sapucaí-Mirim River require great areas for their maintenance, as do large-sized species, known to have migratory reproductive habits. Also, the diversity of small and medium-sized species found and their distinct morphological and biological attributes, allied to the occurrence of endangered fish species, indicate that the Sapucaí-Mirim River basin is an important place for fish diversity maintenance in the Grande River hydrographic system.
Puma (Puma concolor) predation on tapir (Tapirus terrestris)
Authors: Azevedo Fernando Cesar Cascelli , Canuto Vagner , Souza Fernanda , Widmer Cynthia Elisa
Published: March 2016

The process of forest fragmentation affects mostly top predators, which are more prone to first disappear. Pumas, Puma concolor, are known to have a generalist diet that includes a wide variety of wild and domestic prey species. The capacity of adapting their diet to consuming prey in anthropogenic habitats may be the reason for this species' success in incorporating anthropogenic areas with different levels of fragmentation as part of its habitat. Here we report a case of puma consumption of a large wild prey species, the tapir, Tapirus terrestris. From March 2012 to October 2013 we collected 85 puma's scats opportunistically inside fragments of the Atlantic Forest in the Parana state, Brazil. In one of the scats we found hairs and some hooves of a tapir, as well as puma hairs. We propose two hypotheses that may explain the occurrence of tapir in a pumás scat: (1) an event of scavenging or (2) an event of predation on a juvenile tapir. The most likely explanation for this event may be the predation of a juvenile in response to a possible abundant presence of tapirs in the study area. This event adds to our understanding of the great plasticity of this species to adapt to an altered landscape. To our knowledge, this is the first report of a puma scavenging or predation event on a tapir.
Potential ecological distribution of alien mollusk Corbicula largillierti and its relationship with human disturbance in a semi-arid reservoir
Authors: Azevêdo Evaldo de Lira , Barbosa José Etham de Lucena , Vidigal Teofânia Heloisa Dutra Amorim , Marques João Carlos , Callisto Marcos , Molozzi Joseline
Published: March 2016

The introduction of exotic mollusk species has resulted in loss of biodiversity in semi-arid neotropical aquatic ecosystems. This study aims to relate the presence and density of Corbicula largillierti species to human disturbance, providing data for the conservation and management of aquatic ecosystems. Specimens were collected at Epitácio Pessoa reservoir in December 2011 and June 2012, presenting densities of 20.96 and 62.89 individuals per square meter, respectively. Anthropic disturbance metrics were calculated considering the presence, type and intensity of disturbance in littoral, riparian and flood zones. The occurrence of C. largillierti was mainly associated to the variables total phosphorus (261.05 ± 342.22 µg/L) and total nitrogen (440.79 ± 103.77 µg/L), near to tributaries. The occurrence of exotic mollusk species is evidence of the need for freshwater ecosystem conservation and management, particularly in reservoirs used for water supply.
Mudança e Teoria Ator-Rede: Humanos e Não Humanos em Controvérsias na Implementação de um Centro de Serviços Compartilhados
Authors: Cerretto Clovis , Domenico Silvia Marcia Russi De
Published: March 2016

Resumo Em uma ontologia de fluxo, a realidade é mudança, ao passo que as organizações formais são tentativas de organização desse fluxo, a partir do trabalho de estabilização de controvérsias sob a ótica da Actor-Network Theory (ANT). Considerando essa abordagem, na qual o social é um coletivo de humanos e não humanos em redes, este estudo visa a compreender como ocorre a agência de não humanos e humanos, bem como a agência de sua associação, em processos de mudança de foco não tecnológico. Para tanto, adotou-se o estudo de caso qualitativo longitudinal, conduzido de abril de 2011 a julho de 2012, na Empresa X, uma prestadora de serviços públicos do Estado de São Paulo, onde ocorria a implementação de um Centro de Serviços Compartilhados (CSC). Para a construção dos dados, empregaram-se observação participante, grupos de foco, entrevistas, documentos e audiovisuais, visando à multivocalidade. Mediante a cartografia de controvérsias, com o apoio de programas de redes dinâmicas, quadros e mapas mentais, descreve-se a implementação do CSC, em três escalas, de diferentes amplitudes, considerando-se dezessete anos da Empresa X. As controvérsias foram mapeadas segundo temas, argumentos, actantes e suas posições assumidas, sublinhando-se a agência de não humanos que atuaram na qualidade de mediadores. Das 40 controvérsias mais significativas, apenas 13 transformaram-se em caixas-pretas, levando o CSC a não ser pontualizado no fim da pesquisa. As principais contribuições do estudo dizem respeito à problematização do controle em processos de mudança, geralmente tomados pelas empresas como mudanças episódicas planejadas, bem como à metodologia para abordar a tentativa de organização do processo contínuo de mudança que constitui as organizações.