bluuebunny/crossref_metadata_2025 huggingface dataset:
Infrared Red Intubation System (IRRIS) guided flexile videoscope assisted difficult airway management
Authors: Kristensen M. S. , Fried E. , Biro P.
Published: October 2017

Background

Tracheal intubation with a flexible scope is a cornerstone technique in patients with severely difficult airways, but may fail. We report on a technique, Infrared Red Intubation System (IRRIS), that seems to facilitate the identification of the glottis.

Methods

The IRRIS is placed over the patient's cricothyroid membrane and emits blinking infrared light through the patient's skin into the subglottic space. When a flexible videoscope (one that does not filter infrared light) is introduced into the airway, it will display this as a blinking white light emerging from the glottis, retrograde transillumination, showing the pathway to the trachea. We have introduced this as an adjunct when managing our patients with difficult airways. We describe the technique and retrospectively report on the first ten patients where it was used.

Results

All ten patients had significant pathology in the airway, radiation therapy, predictors for difficult intubation and/or morbid obesity. In all cases the blinking light was visible during the flexible endoscopy and provided unambiguous identification of the glottis, from a distance. The blinking nature of the light from the IRRIS helped to distinguish it from the reflections in the mucosa that inevitably arise when the mucosa is hit by the light from the flexible scope itself.

Conclusion

The addition of the IRRIS technique to intubation with flexible videoscopes may be a tool that will make intubation of the most difficult airways easier and may be of special help to the clinician who only rarely uses flexible videoscopes for tracheal intubation.
Insertion methods comparison for The Streamlined Liner of the Pharynx Airway in children by novice
Authors: Chen Y. , Bai J. , Wang R.
Published: October 2017

Background

The Streamlined Liner of the Pharynx Airway (SLIPA™) is a popular supraglottic airway device used for pediatric anesthesia. However, based on the anatomical features of pediatric patients, novice residents are expected to have difficulties inserting the device. The objective of this work was to improve the SLIPA insertion by modifying the device.

Methods

A total of 134 children were randomized into two groups. Anesthesia was standardized among all patients except for the way in which the SLIPA was inserted. One group underwent the conventional method of insertion (Group C), while the modified group received a SLIPA that was bent120° at the ‘bridge’ point with an intubating stylet (Group M). The primary outcome was insertion success rate, and the secondary outcomes included insertion time, incidence of complications and hemodynamic responses to insertion.

Results

The insertion success rate was significantly higher in Group M than Group C (94% vs. 73%, Χ2 = 10.659, P = 0.001). The insertion time for Group M [29.31 (25.91–35.60) seconds] was shorter than for Group C [34.72 (26.81–42.58) seconds] (Z = −2.381, P = 0.017). Trends in heart rate (F = 0.260, P = 0.794), mean blood pressure (F = 0.167, P = 0.683) did not significantly differ between the two groups over time. In terms of complications, we found no significant differences between groups (P > 0.05).

Conclusion

The 120° bend improved SLIPA insertion when performed by novice, as reflected by higher insertion success rates and shorter insertion times, with no statistical differences in hemodynamic response to insertion or the incidence rates of complications between the two groups.
A fungal endophyte of a palatable grass affects preference of large herbivores
Authors: Hernández‐Agramonte Ignacio M. , Semmartin María , Omacini Marina , Durante Martín , Gundel Pedro E. , De Battista José
Published: October 2017

Temperate grasses frequently acquire resistance to herbivores through a symbiosis with epichloid fungi that produces alkaloids of variable deterrent effects. However, in those cases without apparent endophyte negative effects on domestic herbivores, it is not clear whether plant consumption or preference is affected or not. We performed three experiments with 1‐year‐old steers (Bos taurus, Aberdeen Angus) and the annual grass Lolium multiflorum, infected or not by Epichloë occultans to evaluate preference and to identify the underlying tolerance mechanisms. The first experiment evaluated steer preference for L. multiflorum cultivated in plots with three endophyte infection frequencies (low, medium and high), and investigated the role of canopy structure and plant nutritional traits on preference. The second experiment evaluated preference for chopped grass, offered in individual trays with contrasting infection frequencies (low and high), to discard possible effects associated with canopy structure and to focus on nutritional traits. The third experiment was performed with a tray + basket design that separated visual and olfactory stimuli from nutritional traits. High endophyte infection frequencies reduced consistently animal preference, even after short (~10 min) feeding events. However, we did not find significant evidence of plant structural, nutritional, visual or olfactory traits. Our results discarded several potential mechanisms; therefore, the dissuasive effect of fungal endophytes on animal consumption might be related to other mechanisms, including, likely, alkaloids and changes on grass metabolome.
Marijuana commercialization and adolescent substance treatment outcomes in Colorado
Authors: LeNoue Sean R. , Salomonsen‐Sautel Stacy , Min Sung‐Joon , Thurstone Christian
Published: October 2017

Background and Objectives

In Colorado, marijuana was legalized for medical use in 2000, commercialized in 2009, and approved for recreational purposes in 2012. Little is known about the association between recent policy changes and adolescent substance treatment outcomes measured by urine drug screens (UDS). This study addressed this research gap.

Methods

Participants were youth (N = 523) aged 11–19 years who were enrolled in an outpatient motivational interviewing (MI)/cognitive behavioral therapy (CBT) plus contingency management (CM) in Denver, Colorado from October 2007 to June 2014. The measures included UDS collected during weekly treatment sessions and sent to a commercial laboratory for quantitative analysis of tetrahydrocannabinol (THC)/Creatinine (Cr). Linear regression models and logistic regression models using a Generalized Estimating Equations (GEE) approach for repeated measures were completed to answer the study aims.

Results

Males, but not females, had a marginally significant increasing trend over time in monthly average THC/Cr (β = 1.99, p = 0.046). There was a significant increasing trend over time (per 30 days) in the odds of having a negative UDS within 6 sessions (OR = 1.02, 95%CI = 1.003–1.04, p = 0.006).

Conclusions and Scientific Significance

Based on these data, substance treatment outcomes from MI and CBT are mixed, but overall treatment appears to remain effective in a state with legalized marijuana. (Am J Addict 2017;26:802–806)
High‐risk squamous cell carcinoma masquerading as dense inflammation on Mohs frozen sections
Authors: Leow Liang Joo
Published: October 2017

High‐risk squamous cell carcinoma (SCC) can present a unique challenge in Mohs surgery. This case report describes how high‐risk SCC may masquerade as only a dense inflammation on frozen sections. This feature should raise the index of suspicion for hidden SCC and be a routine indication for further processing by paraffin sections and immunohistochemistry.
Sentinel lymph node biopsy status is not the most powerful predictor of prognosis in cutaneous melanoma
Authors: Zagarella Samuel , Lee Stephen , Heenan Peter
Published: October 2017

Sentinel lymph node (SLN) status has been advocated in several recently published articles as the single most valuable prognostic marker for melanoma, and of greater prognostic importance than more established parameters such as Breslow thickness. A careful examination of the evidence for these claims, however, indicates that they are not substantiated by the available data, are somewhat misleading and suggest misinterpretation of the statistical analysis of the papers to which they refer. We will examine the basis for these claims and show why they are invalid.
Sea Power in the 21st Century: Challenges and Opportunities for the Philippine Navy
Authors: Despi Dianne Faye Co
Published: October 2017

Situated at the heart of the Asia‐Pacific, the Philippines is a maritime nation with tremendous potential to be a major player in the region. Its geostrategic location allows for the country to be a premier logistics hub and a nexus for maritime cooperation in the region. As part of the Association of Southeast Asian Nations (ASEAN), there is a need for the Philippines to assume a more assertive position in contributing to regional security and stability. Thus, the need for a strong navy with capabilities across the whole spectrum of operations becomes more apparent in order to address the rise of diverse security concerns. This article seeks to provide a general overview of the Mahanian sea power concept applied to the Philippine experience, and using Booth's concept of the trinity of naval roles, elucidate the Philippine Navy's diversifying roles in pursuit of national and regional security in light of the ASEAN's increasing role in international affairs.
Great Power Dynamics and the Waning of ASEAN Centrality in Regional Security
Authors: Kraft Herman Joseph S.
Published: October 2017

The regional security architecture in Southeast Asia, arguably even within the broader East Asian region, has largely revolved in the last 25 years around the viability of the Association of Southeast Asian Nations (ASEAN) as the driving force behind Southeast Asian (and East Asian) regionalism. Multilateral institutional arrangements established since 1994 had the ASEAN states as their core component, and the “ASEAN way” of conducting foreign affairs as their normative guide. These arrangements were seen as being a critical aspect of maintaining peaceful relations in the region in the face of long standing disputes and historical suspicions. This state of affairs, underpinned by ASEAN's ability to provide the basis for managing regional relations, has now begun to unravel with the intensifying strategic competition between China and the United States. Is the ASEAN‐driven multilateral security architecture sustainable in the face of intensifying great power competition?
Evolving Philippines‐U.S.‐China Strategic Triangle: International and Domestic Drivers
Authors: Heydarian Richard Javad
Published: October 2017

The triangular relations among three states—the Philippines, the United States, and the People's Republic of China—are governed by structural balance of power factors, “pragmatic opportunism” on the part of the superpowers, and the threat and opportunity perceptions of individual Philippine administrations. Recent years have seen Manila dramatically oscillating between the extremes of engagement and deterrence toward China, and dependence on, and independence from, the United States. In particular, while the Benigno Aquino III administration (2010–2016) adopted soft counterbalancing against China and heavily relied on American military support, the succeeding Rodrigo Duterte administration, in contrast, distanced itself from America in favor of deeper engagement with China. The seemingly erratic swings in the pendulum of Manila's foreign policy is a telltale sign of the dilemma of small power politics as well as the tempestuous nature of Philippine domestic politics.
Early discharge and post‐discharge outcomes in patients undergoing radical cystectomy for bladder cancer
Authors: Xia Leilei , Taylor Benjamin L. , Newton Andrew D. , Malhotra Aseem , Pulido Jose E. , Strother Marshall C. , Guzzo Thomas J.
Published: October 2017

Objective

To assess whether discharging patients early after radical cystectomy (RC) is associated with an increased risk of readmission and post‐discharge complications.

Materials and Methods

The National Surgical Quality Improvement Program database was queried to identify patients who underwent an elective RC from 2012 to 2015. Patients were stratified into two groups: those with a length of hospital stay (LOS) of 4–5 days (early‐discharge group) and those with an LOS of 6–9 days (routine‐discharge group). We used multivariable logistic regression analyses to assess the impact of early discharge on 30‐day readmission and post‐discharge complication rates. Sensitivity analyses and subgroup analyses were performed to validate the robustness of our primary analyses.

Results

A total of 3 311 patients were included. Unadjusted outcomes comparison showed no difference in readmission rate (21.6% vs 23.0%) or post‐discharge complication rate (17.7% vs 19.6%) between the early‐discharge and the routine‐discharge group. Multivariable logistic regression also showed that early discharge was not associated with increased odds of readmission (odds ratio [OR] 1.00, 95% confidence interval [CI] 0.82–1.22; P = 1.000) or post‐discharge complications (OR 0.95, 95% CI 0.77–1.17; P = 0.616). Two‐step sensitivity analyses (excluding patients with LOS of 8–9 days, followed by patients with any pre‐discharge adverse event) validated the robustness of our primary analyses. Subgroup analyses also yielded similar results in all subgroups except for the subgroup of patients aged ≥85 years.

Conclusions

Early discharge after RC was not associated with increased readmissions or post‐discharge complications. Future prospective studies, with defined peri‐operative care pathways, are needed to identify potential components that may enable hospitals to discharge patients early without compromising post‐discharge outcomes.
Oxidative stress and its possible relation to lower urinary tract functional pathology
Authors: Andersson Karl‐Erik
Published: October 2017

Oxidative stress is considered to reflect an imbalance between the systemic manifestation of reactive oxygen and nitrogen species (RONS) and a biological system's ability to readily detoxify the reactive intermediates or to repair the resulting damage. RONS are not only harmful agents that cause oxidative damage in pathologies; they also have important roles as regulatory agents in a range of biological phenomena. They are normally generated as by‐products of oxygen metabolism; however, environmental stressors (i.e., ultraviolet radiation, ionizing radiations, pollutants, heavy metal, and xenobiotics) contribute to greatly increase RONS production. Several antioxidants have been exploited in recent years for their actual or supposed beneficial effect against oxidative stress, but to date, none has been approved for any indication because they have not met the criteria of efficacy for drug approval. The present review discusses the concept of oxidative stress, how to measure it, how to prevent it, and its occurrence in different organ systems with special reference to the lower urinary tract.
Identifying candidates for super‐extended staging pelvic lymph node dissection among patients with high‐risk prostate cancer
Authors: Gandaglia Giorgio , Zaffuto Emanuele , Fossati Nicola , Bandini Marco , Suardi Nazareno , Mazzone Elio , Dell'Oglio Paolo , Stabile Armando , Freschi Massimo , Montorsi Francesco , Briganti Alberto
Published: October 2017

Objectives

To assess if the preoperative lymph node invasion (LNI) risk could be used to tailor the extent of pelvic lymph node dissection (PLND) according to individual profile in patients with prostate cancer (PCa) undergoing radical prostatectomy (RP), and to identify those who would benefit from the removal of the common iliac and pre‐sacral nodes.

Patients and Methods

A total of 471 patients with high‐risk PCa treated with RP and a super‐extended PLND that included the removal of the pre‐sacral and common iliac nodes between 2006 and 2016 were identified. The risk of LNI was calculated according to the Briganti nomogram. Multivariable logistic regression analyses assessed the association between LNI risk and involvement of the common iliac and pre‐sacral regions. The risk of positive common iliac and pre‐sacral nodes was plotted over the LNI risk using the LOWESS‐smoothed fit curve.

Results

The median preoperative LNI risk was 25.5%. The median number of nodes removed was 23, and 171 (36.3%) patients had LNI. Overall, 61 (13.0%) and 28 patients (5.9%), respectively, had positive common iliac and pre‐sacral nodes alone or in combination with other sites. The LNI risk was associated with the involvement of the common iliac and pre‐sacral regions (all P < 0.001). The proportion of patients with positive common iliac and pre‐sacral nodes progressively increased according to the LNI risk. The adoption of a 30% threshold would result in avoiding the removal of the common iliac and pre‐sacral nodes in >60% cases, with a risk of missing LNI in these regions of <5%.

Conclusions

Fewer than 5% of patients with an LNI risk of <30% harbour positive common iliac and pre‐sacral nodes. A super‐extended PLND that includes the dissection of these regions should be considered exclusively in patients with an LNI risk ≥30%.
“They're Colonizing My Neighborhood”: (Perceptions of) Social Mix in Canada
Authors: Bucerius Sandra M. , Thompson Sara K. , Berardi Luca
Published: October 2017

In recent years, urban neighborhoods in many Western nations have undergone neighborhood restructuring initiatives, especially in public housing developments. Regent Park, Canada's oldest and largest public housing development, is a neighborhood currently undergoing ‘neighborhood revitalization’ based on the social mix model. One tenet of this model is the idea that original public housing residents are benefiting from interactions with middle class residents. Based on qualitative interviews and ethnographic observations with original housing residents as well as new middle–class homeowners, we examine whether cross–class interactions actually occur “on the ground” in Regent Park. By examining an iteration of the model that differs with respect to the direction of resident movement—that is, the revitalization of Regent Park involves more advantaged residents buying into the once low–income neighborhood, as opposed to providing lower–income residents with housing vouchers to move out of the community (and into more affluent neighborhoods across the city)—our study provides a unique contribution to the existing research on social mix. In particular, our research examines whether the direction of this resident movement has any distinct or demonstrable impact on: (1) the daily perceptions, attitudes, and actions of original and new residents, and (2) the nature of cross–class interactions. Second, unlike the vast majority of studies done in Europe and the United States, which are conducted “postrevitalization,” we examine the effects of neighborhood revitalization as the process unfolds.
Adaptive social impact management for conservation and environmental management
Authors: Kaplan‐Hallam Maery , Bennett Nathan J.
Published: October 2017

Concerns about the social consequences of conservation have spurred increased attention the monitoring and evaluation of the social impacts of conservation projects. This has resulted in a growing body of research that demonstrates how conservation can produce both positive and negative social, economic, cultural, health, and governance consequences for local communities. Yet, the results of social monitoring efforts are seldom applied to adaptively manage conservation projects. Greater attention is needed to incorporating the results of social impact assessments in long‐term conservation management to minimize negative social consequences and maximize social benefits. We bring together insights from social impact assessment, adaptive management, social learning, knowledge coproduction, cross‐scale governance, and environmental planning to propose a definition and framework for adaptive social impact management (ASIM). We define ASIM as the cyclical process of monitoring and adaptively managing social impacts over the life‐span of an initiative through the 4 stages of profiling, learning, planning, and implementing. We outline 14 steps associated with the 4 stages of the ASIM cycle and provide guidance and potential methods for social‐indicator development, predictive assessments of social impacts, monitoring and evaluation, communication of results, and identification and prioritization of management responses. Successful ASIM will be aided by engaging with best practices – including local engagement and collaboration in the process, transparent communication of results to stakeholders, collective deliberation on and choice of interventions, documentation of shared learning at the site level, and the scaling up of insights to inform higher‐level conservation policies‐to increase accountability, trust, and perceived legitimacy among stakeholders. The ASIM process is broadly applicable to conservation, environmental management, and development initiatives at various scales and in different contexts.
Myxofibrosarcoma of unusual sites
Authors: Tjarks B. Joel , Ko Jennifer S. , Billings Steven D.
Published: October 2017

Background

Myxofibrosarcoma classically presents as a painless mass in the proximal extremities. Cutaneous myxofibrosarcomas arising in the head and neck and distal extremities are extremely uncommon. We present a series of 6 cases of myxofibrosarcoma presenting in the head and neck and acral locations.

Methods

Archives were searched using the term “myxofibrosarcoma” over a 6‐year period (2009‐2015). The clinicopathologic features of myxofibrosarcoma were recorded. Cases in the head and neck or acral locations were retrieved. When available, the patient's medical records were reviewed.

Results

Ninety‐five cases of myxofibrosarcoma were identified over a 6‐year period. Six patients were identified with myxofibrosarcoma arising in the head (n = 4, M:F 3:1), hand (n = 1, F) and foot (n = 1, F). Each had typical features of myxofibrosarcoma. Two of the tumors on the head were high‐grade and had multiple recurrences, while the remaining 2 were intermediate grade. Both acral tumors were intermediate grade and 1 recurred locally within a year of diagnosis.

Conclusions

Myxofibrosarcoma may rarely involve the head and neck and acral locations, and presentation in these sites is a potential source of diagnostic difficulty. Recognition of the characteristic histologic features of myxofibrosarcoma in conjunction with judicial use of immunohistochemical stains should allow for accurate diagnosis.
Living with disasters: social capital for disaster governance
Authors: Melo Zurita Maria de Lourdes , Cook Brian , Thomsen Dana C. , Munro Paul G. , Smith Timothy F. , Gallina John
Published: October 2017

This paper explores how social networks and bonds within and across organisations shape disaster operations and strategies. Local government disaster training exercises serve as a window through which to view these relations, and ‘social capital’ is used as an analytic for making sense of the human relations at the core of disaster management operations. These elements help to expose and substantiate the often intangible relations that compose the culture that exists, and that is shaped by preparations for disasters. The study reveals how this social capital has been generated through personal interactions, which are shared among disaster managers across different organisations and across ‘levels’ within those organisations. Recognition of these ‘group resources’ has significant implications for disaster management in which conducive social relations have become paramount. The paper concludes that socio‐cultural relations, as well as a people‐centred approach to preparations, appear to be effective means of readying for, and ultimately responding to, disasters.
Congenital anomalies and cerebral palsy: cause or comorbidity?
Authors: Williams Jane
Published: October 2017

This commentary is on the original article by Jystad et al. on pages 1174–1180 of this issue.
Reflections on the usefulness of the term ‘health‐related quality of life’
Authors: Ronen Gabriel M
Published: October 2017

This commentary is on the original article by Wei et al. on pages 1152–1157 of this issue.
TRUST, RECIPROCITY, AND RULES
Authors: Rietz Thomas A. , Schniter Eric , Sheremeta Roman M. , Shields Timothy W.
Published: October 2017

Many economic interactions rely on trust and trust violations can have serious economic consequences. Simple minimum standard rules are attractive because they prevent egregious trust violations. However, they may undermine more trusting and reciprocal (trustworthy) behavior that otherwise would have occurred, leading to worse outcomes. In an experimental trust game, we test the efficacy of exogenously imposed minimum standard rules. Rules damage trust and reciprocity, reducing economic welfare. While sufficiently restrictive rules restore welfare, trust and reciprocity never return. Results indicate that participants are concerned about payoffs while also using the game to learn about trust and trustworthiness of others. (JEL C72, C90, D63, D64, L51)
Effective education and communication strategies to promote environmental engagement
Authors: Zaval Lisa , Cornwell James F. M.
Published: October 2017

Communicators of climate science seek ways to better educate and motivate individuals to personally commit to sustainable, energy‐saving activities. However, critical psychological and social barriers to conservation make this task challenging. Behavioural scientists are well aware of the difficulties that individuals and groups have in responding effectively to information surrounding climate change and have used these insights to develop a number of techniques to aid in persuading people of the importance of the issue and motivating adaptive behavioural responses. This article consolidates research findings from behavioural economics, decision science, and social psychology to explore key insights and evidence around effective climate change education strategies aimed at enhancing conservation behaviours, including analyses of cognitive bias, social influences, values, and communication strategies. In addition, we note international, academic‐private partnerships that have used interventions suggested by behavioural science to dramatic effects. We conclude by addressing implications for policymakers.
Transporters of Trypanosoma brucei—phylogeny, physiology, pharmacology
Authors: Schmidt Remo S. , Macêdo Juan P. , Steinmann Michael E. , Salgado Amaia González , Bütikofer Peter , Sigel Erwin , Rentsch Doris , Mäser Pascal
Published: October 2017

Trypanosoma brucei comprise the causative agents of sleeping sickness, T. b. gambiense and T. b. rhodesiense, as well as the livestock‐pathogenic T. b. brucei. The parasites are transmitted by the tsetse fly and occur exclusively in sub‐Saharan Africa. T. brucei are not only lethal pathogens but have also become model organisms for molecular parasitology. We focus here on membrane transport proteins of T. brucei, their contribution to homeostasis and metabolism in the context of a parasitic lifestyle, and their pharmacological role as potential drug targets or routes of drug entry. Transporters and channels in the plasma membrane are attractive drug targets as they are accessible from the outside. Alternatively, they can be exploited to selectively deliver harmful substances into the trypanosome's interior. Both approaches require the targeted transporter to be essential: in the first case to kill the trypanosome, in the second case to prevent drug resistance due to loss of the transporter. By combining functional and phylogenetic analyses, we were mining the T. brucei predicted proteome for transporters of pharmacological significance. Here, we review recent progress in the identification of transporters of lipid precursors, amino acid permeases and ion channels in T. brucei.
Evaluation of the functions of the temporary catheter with various tip types
Authors: Ogawa Tomonari , Sasaki Yusuke , Kanayama Yuki , Yasuda Kunihiko , Okada Yoshimi , Kogure Yuta , Sano Tatsuro , Hatano Minoru , Hara Hiroaki , Kanozawa Koichi , Hasegawa Hajime
Published: October 2017

Introduction: A temporary catheter (TC) is used short‐term and for emergencies. There are some cases when we cannot withdraw blood immediately after inserting the catheter in our patients. The reason is said to be the tips of the TC sticking to the vascular walls.

Objective: We evaluated examined 3 catheters with different tip shapes in a simulation circuit to assess the effect on the blood flow.

Methods: Water was circulated in the simulation circuit at 1 L/minute. Next, we inserted each TC into the model, and the TCs were connected to the dialysis circuit at 200 mL/minute. We put gold powder into the simulation circuit. We visually observed the movement of the gold power at the head of the catheter and measured the recirculation rate.

Result: The uplift type TC was able to perform blood removal and reinfusion with the least difficulties. All recirculation rates were less than 1%. The hindrance caused by hitting a vascular wall is believed to have been reduced.

Conclusion: With the manipulation of the catheter tip shapes, blood was able to circulate smoothly. We expect less blood clots and a decrease in sticking to the vascular wall. We plan to study these 3 catheters at clinical tests in the future.
A case of hypothermia on CRRT
Authors: Kaur Gurwant , Banoth Prameela , Yerram Preethi , Misra Madhukar
Published: October 2017

A 64‐year‐old Asian man, with past medical history of hypertension, hypothyroidism, and hyperlipidemia, presented with 3 days history of fever associated with cough and worsening shortness of breath. Subsequent clinical course was complicated by acute lung injury leading to acute respiratory distress syndrome requiring positive pressure ventilation, septic shock requiring inotropic support, and acute kidney injury requiring continuous renal replacement therapy (CRRT). On day 3 of CRRT, the patient developed significant hypothermia (temporal temperature 27.5°C), which was successfully managed. Continuous renal replacement therapy was subsequently discontinued as renal function recovered and the patient was discharged home after a prolonged hospital stay. He currently remains off dialysis and is being followed as an outpatient for chronic kidney disease. In this article, we examine various aspects of pathophysiology and management of hypothermia on CRRT and review relevant literature in this field.
Psychometric properties of the Parental Feeding Behaviours Questionnaire for Indonesian parents of young children
Authors: Lusmilasari Lely , Chaiyawat Waraporn , Rodcumdee Branom
Published: October 2017

Purpose

The objective of this study was to test the psychometric properties of the Parental Feeding Behaviours Questionnaire (PFBQ) to measure feeding behaviours of Indonesian parents of toddlers (young children).

Methods

A total of 696 parents of toddlers were obtained by convenience sampling during September 2013 to April 2014. To validate the PFBQ, confirmatory factor analysis and the contrasted group technique were conducted. Reliability of this instrument was examined by construct reliability and test‐retest reliability.

Results

Results showed that the regression coefficients of all 56 indicators were statistically significant (P < 0.001). The contrasted group technique showed significantly different parental feeding behaviours between parents of well‐nourished and malnourished toddlers (P = 0.047). The test‐retest reliability of the PFBQ was acceptable (Pearson correlation = 0.644), and the construct reliability ranged from 0.88 to 0.96.

Conclusions

The PFBQ is a valid and reliable instrument; however, more studies are required to identify acceptable tools to measure more culturally diverse range of parental feeding behaviours.
Migration strategies of the Baltic dunlin: rapid jump migration in the autumn but slower skipping type spring migration
Authors: Pakanen Veli‐Matti , Jaakkonen Tuomo , Saarinen Joni , Rönkä Nelli , Thomson Robert L. , Koivula Kari
Published: October 2017

Migration during spring is usually faster than during autumn because of competition for breeding territories. In some cases, however, the costs and benefits associated with the environment can lead to slower spring migration, but examples are quite rare. We compared seasonal migration strategies of the endangered Baltic population of the dunlinCalidris alpina schinziiusing light‐level geolocator data from 26 individuals breeding in Finland. Autumn migration was faster, with individuals showing a ‘jump’ and ‘skipping’ migration strategy characterised by fewer stationary periods, shorter total stopping time and faster flight. Spring migration was slower, with individuals using a ‘skipping’ strategy. The duration of migration was longer for early departing birds during spring but not during autumn suggesting that early spring migrants are prevented from arriving to the breeding areas or that fueling conditions are worse on the stopover sites for early arriving individuals. Dunlins showed high migratory connectivity. All individuals had one long staging at the Wadden Sea in the autumn after which half of the individuals flew 4500 km non‐stop to Banc d’Arguin, Mauritania. The other half stopped briefly on the Atlantic coast on their way to Mauritania. One bird wintered on the coast of Portugal. Nine individuals that carried geolocators for two years were site faithful to their final non‐breeding sites. Based on the strategies during the non‐breeding period we identified, Baltic dunlin may be especially vulnerable to rapid environmental changes at the staging and non‐breeding areas. Consequently, the preservation of the identified non‐breeding areas is important for their conservation.
Accuracy of the pacemaker event recorder versus Holter‐ECG to detect both symptomatic and asymptomatic ventricular arrhythmias
Authors: Sampaio Stela Maria Vitorino , Craveiro Neyle Moara , Darrieux Francisco , de Oliveira Ítalo Martins , Scanavacca Mauricio , Hachul Denise
Published: October 2017

Background

Although new pacemakers can register cardiac rhythm, few studies were performed evaluating their accuracy in diagnosing ventricular arrhythmias (VA). This study aimed to assess the correlation and agreement between the pacemaker's monitor and the ambulatory Holter in detecting VA.

Methods and results

We studied 129 patients with pacemakers, mean age 68.6 ± 19.1 years, 54.8% female. Once Holter monitoring was connected, the pacemakers’ event counters were reset and clocks of both systems were synchronized to register electrocardiograms (ECG) simultaneously. Pacemakers were programmed to detect the lowest ventricular rate and lowest number of sequential beats allowed in their event monitors. After 72 hours, Holter and pacemakers records were analyzed. VA was defined in Holter and event monitor, respectively, as: isolated premature ventricular complexes: “PVC”; pairs: “couplets”; nonsustained ventricular tachycardia (NSVT): “triplets”—3 beats; “runs”—4–8 or > 8 beats, and high ventricular rates (“HVR”)—3–4 beats. Spearman correlations evaluated whether pacemaker and Holter identified the same parameters. Intraclass correlation coefficients (ICCs) and respective 95% confidence intervals were calculated to assess the concordance between methods. The agreement between both systems was low, except for “triplet” and three beats NSVT (ICC = 0.984). The correlation for more than 10 PVC/h was moderate (Kappa = 0.483). When the pacemaker was programmed to detect HVR sequences of three beats lower than 140 bpm (< 140/3), the correlation with NSVT was perfect (r = 1) and agreement was also quite high (ICC = 0.800).

Conclusions

Pacemakers' event monitors underestimate the occurrence of ventricular arrhythmias detected by Holter. Standardization of pacemakers’ algorithms is required before using this function for patients' clinical follow‐up.
Indirect osteoblast differentiation by liposomal clodronate
Authors: Okada Emi , Nakata Hidemi , Yamamoto Maiko , Kasugai Shohei , Kuroda Shinji
Published: October 2017

Bisphosphonates impair function of osteoclasts and prevent bone resorption, the mechanism of which has been studied extensively. However, the possible effects of bisphosphonates on chondroblast differentiation and calcium deposition by osteoblasts have only been demonstrated recently. Moreover, cells from monocytic lineage are capable of stimulating osteoblast proliferation. Hence, susceptibility of osteoblasts to various factors requires further investigation. A primary culture of bone marrow‐derived stromal cells was treated with liposomal clodronate (0.1, 0.5, or 1.0 mg/ml) or conditioned medium from liposomal clodronate. Liposomal clodronate (0.25 mg) was injected into mouse femur for in vivo experiments. The effects of liposomal clodronate were examined by alkaline phosphatase staining and/or activity assay, and real‐time RT‐PCR was used for studying the effect on osteogenic gene expression. Administration of liposomal clodronate to bone marrow‐derived mesenchymal stromal cell culture enhanced alkaline phosphatase activity and mRNA levels of Runx2 and Dlx5. In addition, conditioned medium from liposomal clodronate also stimulated osteogenic characteristics similar to those of observed in vitro, and the number of exosomes in the conditioned medium was highest when pre‐treated with liposomal clodronate. Western blot analysis revealed the presence of RANK proteins in exosomes collected from conditioned medium of liposomal clodronate. Identical observations were obtained in vivo, as liposomal clodronate‐injected mouse femur showed increased alkaline phosphatase activity and Runx2 and Dlx5 mRNA expressions, even though the numbers of monocytes and macrophages were reduced. In conclusion, osteoblast differentiation was promoted via soluble RANK‐containing exosomes in response to clodronates.
Silicon application promotes rice growth and negatively affects development of Spodoptera frugiperda (J. E. Smith)
Authors: Nascimento A. M. , Assis F. A. , Moraes J. C. , Souza B. H. S.
Published: October 2017

Silicon (Si) has been reported to enhance plant resistance against biotic and abiotic stressors and also benefit plant growth. These effects are more pronounced in grass species, especially with soil‐applied Si. This study investigated the effects of Si application on rice resistance to Spodoptera frugiperda development and plant vegetative growth. Effects of Si on rice were assessed via soil and foliar applications and compared with untreated plants (control). Si was soil‐ and foliar‐applied as 1% silicic acid solution at a dosage equivalent to 1.4 t Si per ha. After application, leaf material was collected from Si‐treated and untreated plants and placed in Petri dishes with individual S. frugiperda neonate larvae, where development was followed to adult emergence and biological parameters recorded. Vegetative growth parameters recorded in rice plants were the height, chlorophyll content, fresh and dry weights of shoots, and shoot Si content. No effects of Si application were observed on the durations of larval and pupal stages, larval and pupal survival, and sex ratio of S. frugiperda. Insects fed leaves from Si‐treated plants exhibited lower leaf consumption, larval and pupal weights, longevity of males and females, number of eggs, and egg viability. The negative effects were correlated with higher rice Si content. Si application to rice increased plant height, chlorophyll content and dry weight. Our study demonstrates that foliar‐applied Si is as efficient as soil‐applied Si in negatively affecting S. frugiperda development and providing beneficial effects on rice plant growth.
Incidence of “Candidatus Liberibacter asiaticus” in a Florida population of Asian citrus psyllid
Authors: Hall D. G.
Published: October 2017

The incidence of a bacterium “Candidatus Liberibacter asiaticus” was assessed in a Florida population of Asian citrus psyllid, Diaphorina citri. The bacterium is the presumed causal agent of Asiatic huanglongbing, a serious citrus disease. Adult D. citri were periodically collected between May 2010 and September 2012 in a block of diseased trees located in east‐central Florida. The psyllids were individually subjected to molecular analyses (quantitative polymerase chain reaction assays using HLBaspr primers) to determine whether the bacterium was present and, if so, the population level of the pathogen based on qPCR cycle threshold (CT) values. Significantly greater percentages of females tested positive for the pathogen than males, but there were no significant differences between females and males with respect to population levels of the pathogen within the psyllids. No significant differences were found among the three D. citri colour morphs with respect to percentages of adults testing positive for the pathogen. Among 47 sample dates, a mean of 17.5% of adults per sample date tested positive (CT < 36) for the pathogen with a mean CT value of 31.1. The incidence of the pathogen was generally higher during late fall or early winter and often lower during mid‐ to late summer. There was a significant negative correlation between percentages of D. citri testing positive and air temperature. Increases in the incidence of the pathogen may not necessarily correspond to increases in transmission, as a number of factors both internal and external to D. citri can influence transmission. Transmission rates may be highest during periods when D. citri infestation levels are large, a high percentage of adults carry a high population of the pathogen in their salivary glands, and citrus flush is abundant.
A simple screening test to recognize fibromyalgia in primary care patients with chronic pain
Authors: Jones Kim D. , Aebischer Jonathan H. , St. John Amanda W. , Friend Ronald , Bennett Robert M.
Published: October 2017

Rationale, aims, and objectives

Primary care providers are increasingly expected to recognize and treat fibromyalgia (FM) without significant interaction with rheumatologists. The purpose of this study was to evaluate the potential usefulness of 3 simple measures (tenderness to digital pressure, BP cuff‐evoked pain, and a single patient question) as a screening test for possible FM in a patient with chronic pain.

Methods

A total of 352 patients (mean age 50 ± 16.3 years, 70% female) scheduled for routine examination in 2 primary care practices were studied. They were comprised of 52 patients (14.8%) who carried a chart diagnosis of FM, 108 (30.7%) with chronic pain but not FM, and 192 who had neither pain nor FM (54.5%). Subjects were assessed for tenderness to digital pressure at 10 locations, BP cuff‐evoked pain, and a single question, “I have a persistent deep aching over most of my body” (0–10).

Results

FM patients endorsed the single deep ache question substantially more than those with chronic pain but without FM (7.4 ± 2.9 vs 3.2 ± 3.4; P < .0001) and exhibited greater bilateral digital evoked tenderness (6.1 ± 3.1 vs 2.4 ± 2.4, P < 0.0001), and BP‐evoked pressure pain (132.6 mmHg ±45.5 vs 169.2 mmHg ±48.0, P < 0.0001). However, on multivariate logistic regressions, the BP cuff‐evoked pain became non‐significant. On further analyses, a useful screening test was provided by: (1) pain on pinching the Achilles tendon at 4 kg/pressure over 4 seconds, and (2) and positive endorsement of the question “I have a persistent deep aching over most of my body”.

Conclusion

These results suggest that 2 tests, taking less than 1 minute, can indicate a probable diagnosis of FM in a chronic pain patient. In the case of a positive screen, a follow‐up examination is required for confirmation or refutation.
Histopathological and ultrastructural assessment of two mugilid species infected with myxozoans and helminths
Authors: Sayyaf Dezfuli B , Castaldelli G , Giari L
Published: October 2017

The histopathology and ultrastructure of the intestine of mullets,Liza ramadaandLiza saliens, from Comacchio lagoons (northern Italy) naturally infected with myxozoans and helminths were investigated and described. Sixty‐two (80.5%) of 77 mullets harboured one or more of the following parasites species:Myxobolus mugchelo(Myxozoa),Neoechinorhynchus agilis(Acanthocephala),Haplosplanchnus pachysomusandDicrogaster contractus(Digenea). Co‐occurrence of helminths with myxozoans was common. The main damage caused by digeneans was destruction of the mucosal epithelium of the villi, necrosis and degeneration of intestinal epithelial cells. More severe intestinal damage was caused by acanthocephalans which reach the submucosa layer with their proboscis. At the site of helminths infection, several mast cells (MCs), rodlet cells (RCs), mucous cells and few neutrophils and macrophages were observed in the epithelium.RCs and mucous cells exhibited discharge activity in close vicinity to the worm's tegument.M. mugcheloconspicuous plasmodia were encysted mainly in muscle and submucosa layers of the intestine. Indeed, spores ofM. mugchelowere documented within the epithelial cells of host intestine and in proximity toMCs. Degranulation of theMCs near the myxozoans was very frequent.
DNA vaccines for fish: Review and perspectives on correlates of protection
Authors: Dalmo R A
Published: October 2017

Recently in 2016, the European Medicines Agency (EMA) recommended granting a marketing authorization in the EU for “Clynav,” a DNA vaccine against salmon pancreas disease (salmonid alphavirus‐3). Generally, DNA vaccines induce both early and late immune responses in fish that may be protective against disease. Several transcriptomic approaches have been performed to map immunome profiles following DNA vaccination, but the precise immune mechanism(s) that is responsible for protection is not known, although reasonable suggestions have been made. The current review includes an overview on main transcriptomic findings from microarray experiments after DNA vaccination against VHSV, IHNV, HIRRV and IPNV—with considerations of what can be considered as correlates of protection (CoP) or merely a surrogate of protection. Identification and use of correlates of protection (COPs) may be a strategic tool for accelerated and targeted vaccine design, testing and licensure. General rules on what can be considered as CoPs can be extracted from past knowledge on protective immune responses following vaccination that induced protection. Lastly, there will be an overview on non‐viral molecular adjuvants that have been exploited to obtain higher vaccine potencies and efficacies.
Antimicrobial susceptibility of Flavobacterium psychrophilum isolates from the United Kingdom
Authors: Ngo T P H , Smith P , Bartie K L , Thompson K D , Verner‐Jeffreys D W , Hoare R , Adams A
Published: October 2017

Routine application of antimicrobials is the current treatment of choice for rainbow trout fry syndrome (RTFS) or bacterial coldwater disease (BCWD) caused by Flavobacterium psychrophilum. In this study, the antimicrobial susceptibilities of 133 F. psychrophilum isolates, 118 of which were from the UK, were evaluated by broth microdilution and disc diffusion methods following VET04‐A2 and VET03‐A guidelines of Clinical and Laboratory Standards Institute (CLSI), respectively. Isolates were categorized as wild type (fully susceptible, WT) or non‐wild type (NWT) using normalized resistance interpretation (NRI)‐determined cut‐off values (COWT). Broth microdilution testing showed that only 12% of UK isolates were WT to oxolinic acid (MIC COWT ≤ 0.25 mg/L) and 42% were WT for oxytetracycline (MIC COWT ≤ 0.25 mg/L). In contrast, all the isolates tested were WT (MIC COWT ≤ 2 mg/L) for florfenicol, the main antimicrobial for RTFS control in the UK. Disc diffusion‐based COWT values were ≥51 mm for 10 μg amoxicillin, ≥44 mm for 30 μg florfenicol, ≥30 mm for 2 μg oxolinic acid and ≥51 mm for 30 μg oxytetracycline. There was a high categorical agreement between the classifications of the isolates by two testing methods for florfenicol (100%), oxytetracycline (93%) and oxolinic acid (99%).