bluuebunny/crossref_metadata_2025 huggingface dataset:
To Report or Not to Report: Emergency Services Response to Elder Abuse
Authors: Jones Jeffrey S. , Walker George , Krohmer Jon R.
Published: July 2016

Purpose:

Prehospital emergency medical services (EMS) personnel, as initial responders to calls for assistance, are in an ideal position to identify abused or neglected elderly. A survey of prehospital personnel in Michigan was conducted to determine the scope of this problem, levels of awareness, and willingness to report cases of elder abuse.

Methods:

The study population was a random sample of 500 prehospital personnel throughout one state. A blinded, self-administered survey was completed by emergency medical technicians (EMTs) and paramedics outlining their practice characteristics, prevalence of abuse in their community, and training available specific to elder abuse. Attitudes concerning the understanding and reporting of geriatric abuse were measured using a Likert-type scale.

Results:

A total of 156 surveys (31%) was completed; 68% of the respondents were paramedics. Respondents had an average of 8.7 years (range: 9 months-30 years) of prehospital emergency-care experience, and evaluated an average of 11 patients (range: 1–59) older than 65 years of age each week. Seventy-eight percent had seen a suspected case of elder abuse or negligence during their careers; 68% had seen a case during the past 12 months (mean: 2.3 cases/yr; range: 0–24 cases/yr). However, surveyed personnel reported only 27% of suspected cases to authorities last year (mean: 0.62 cases/yr). Reasons for not reporting included 1) unsure which authorities take reports; 2) unclear definitions; 3) unaware of mandatory reporting laws; and 4) lack of anonymity. Ninety-five percent of respondents stated that training related to elder abuse was not available through their EMS agency.

Conclusion:

Paramedics and EMTs lack complete understanding of their role in the identification and reporting of elder abuse. This information should be emphasized during EMS training and reinforced through continuing education.
A Comparative Analysis of the Emergency Medical Services and Rescue Responses to Eight Airliner Crashes in the United States, 1987–1991
Authors: Anderson Paul B.
Published: July 2016

Introduction:

Crashes involving commercial airliners stress emergency medical services (EMS) and rescue operations to performance far in excess of everyday activities, and special adaptations of everyday responses need to be implemented. Fortunately, these events are infrequent and usually do not occur more than once in any location. The responses that occur must be highly coordinated and efficient. Little is known about the responses to such events. This study examines the EMS and rescue responses associated with eight recent crashes involving commercial airliners in the United States.

Objective:

To identify common factors for which alterations in responses may enhance the survival and decrease the morbidity to victims involved in commercial aviation crashes.

Study population:

Eight commercial airliner crashes in the United States from 1987 through 1991.

Methods:

Case review using: 1) press and media accounts; 2) U.S. National Transportation and Safety Board testimony and reports; and 3) structured interviews with airport, fire, EMS, and hospital personnel. Data were collated and common factors identified for the cases. Findings are classified into: 1) conditions at the crash sites; 2) initial responses; 3) scene management; 4) scene status; 5) patient transport; 6) hospital responses; and 7) preplanning exercises.

Results:

Common factors that impaired responses for which some remediation is possible include: 1) new methods for training including computerized simulations; 2) improvements in rescue-extrication equipment and supplies; 3) stored caches of EMS equipment and supplies at airports; 4) ambulance transport capabilities; and 5) augmentation of patient transport capabilities.

Conclusions:

Many lessons can be learned through structured studies of commercial aircraft crashes. These findings suggest that simple and relatively inexpensive modifications may enhance all levels of emergency response to such events.
On-line Medical Direction: A Prospective Study
Authors: Wuerz Richard C. , Swope Gregory E. , Holliman C. James , Miguel Gaspar Vazquez-de
Published: July 2016

Objectives:

To determine the frequency with which physician, on-line medical direction (OLMD) [direct medical control] of prehospital care results in orders, to describe the nature of these orders, and to measure OLMD time intervals.

Methods:

Blinded, prospective study.

Setting:

A university hospital base-station resource center.

Participants:

Ten emergency physicians, 50 advanced life support providers.

Interventions:

Prehospital treatment was directed by both standing orders and OLMD physician orders. Independent observers recorded event times and the characteristics of OLMD.

Results:

Physician orders were given in 47 (19%) of the 245 study cases, and covered a variety of interventions, including many already authorized by standing orders. Mean OLMD radio time was four minutes (245 ± 216 seconds [sec]), and time from beginning of OLMD to hospital arrival averaged 12 minutes (718 ± 439 sec). Mean transport time in this system was 13 minutes.

Conclusion:

Despite detailed standing orders, OLMD results in orders for clinical interventions in 19% of cases. On-line medical direction requires about four minutes of physician time per call. This constituted about one-third of the potential field treatment time interval in this system. Thus, OLMD appears to play an important role in providing quality prehospital care.
Safe Out-of-Hospital Treatment of Chest Pain Without Direct Medical Control
Authors: McErlean Mara , Raccio-Robak Nancy , Bartfield Joel M. , Hermes Daniel
Published: July 2016

Introduction:

The use of direct medical control (DMC) in the out-of-hospital setting often is beneficial, but has the disadvantage of consuming emergency medical services (EMS) resources.

Hypothesis:

Uncomplicated, nontrauma, adult patients with chest pain can be treated safely and transported by paramedics without DMC.

Methods:

Retrospective chart review of all nontrauma, adult patients with chest pain treated in a combined rural and suburban EMS system during a 2-year period (December 1990 through November 1992) was conducted. Before November 1991, DMC was mandatory for all patients with chest pain. Beginning 01 November 1991, if a patient had resolution of pain either spontaneously, with administration of oxygen, or after a single dose of nitroglycerin, DMC was at the discretion of the paramedic. Using the above criteria for inclusion, three study groups were defined: Group 1, before protocol change; Group 2, after protocol change without DMC; and Group 3, after protocol change when physician contact was obtained, but not required. These groups were compared for the following parameters: 1) scene time; 2) time to administration of first dose of nitroglycerin; 3) time interval between measurement of vital signs; 4) oxygen use; 5) intravenous access; and 6) electrocardiographic monitoring. Continuous and categorical variables were analyzed by multivariate and univariate analysis of variance and chi-square tests, respectively.

Results:

Of 308 nontrauma, adult patients with chest pain, 71 met inclusion criteria in Group 1, 40 in Group 2, and 34 in Group 3. No statistically significant differences were identified in any of the study parameters.

Conclusion:

Adult patients with chest pain who have no other symptoms or complicating conditions can be treated appropriately by paramedics without DMC.
Early Predictors of Sepsis in the Motor-Vehicle Crash Trauma Victim
Authors: Previdi Jeanette K. , Cayten C. Gene , Byrne Daniel W.
Published: July 2016

Introduction:

Sepsis is a major cause of late morbidity and mortality in the victim of trauma. Currently, there is no method that is clinically practical and accurate for predicting the occurrence of sepsis in trauma victims.

Methods:

Data were collected on 3,759 motor-vehicle crash victims from 16 hospitals during a 4 1/2 year period. Retrospective analysis was done to examine the relationship of patient and injury factors known within the first 24 hours of admission on the development of sepsis.

Results:

Sepsis developed in 154 patients (4.1%) who had a mortality rate of 17.5% Significant early predictors of sepsis included: 1) certain pre-existing conditions; 2) blood transfusion required; 3) seven or more injuries; 4) Glasgow Coma Scale score <10 and hypertension; 5) major blood vessel injury; 6) head trauma; 7) internal injury of the chest or abdomen; 8) spinal-cord injury; and 9) certain fracture types.

Conclusions:

These predictors might help target high-risk patients and, thus, promote earlier and more effective treatment for those patients.
Anaphylactoid Reaction to Adenosine
Authors: Fata John G. , Roth Ronald N. , Carpenter Linda
Published: July 2016

Adenosine (Adenocard) is an endogenous purine nucleoside that has been approved recently for intravenous treatment of paroxysmal supraventricular tachycardia. With a serum half-life of 10 seconds, reported side effects including facial flushing, dyspnea, and chest pressure are common, but very transient. An elderly woman who received adenosine for paroxysmal supraventricular tachycardia had a prolonged anaphylactoid reaction that required pharmacological treatment. This is the first reported case of prolonged anaphylactoid reaction to adenosine.
Into the Fray: Integration of Emergency Medical Services and Special Weapons and Tactics (SWAT) Teams
Authors: Jones Jeffrey S. , Reese Kevin , Kenepp Greg , Krohmer Jon
Published: July 2016

Introduction:

The purpose of this study was to determine current experience and training of emergency medical support personnel for special weapons and tactics (SWAT) teams in North America.

Methods:

This cross-sectional, epidemiologic survey was sent to SWAT unit commanders from the 200 largest metropolitan areas. Questions included basic demographics, specialized training of emergency medical services (EMS) personnel, and where such personnel are deployed during tactical operations. Unit commanders also were asked to estimate the number and type of injuries sustained during tactical operations and to list any recommendations to improve the EMS response.

Results:

A total of 150 surveys was completed, for a response rate of 75%. The most common medical support (69%) was a civilian ambulance on standby at a predesignated location. Ninety-four percent of these prehospital care providers had no specialized training, and could not enter an area that was not secured tactically. Police officers with first aid or EMT training comprised the next largest group of medical support. Overall, 31% of SWAT commanders depended on remote EMS dispatch by radio to the scene when injuries occurred. Thirty-eight percent of respondents reported a significant injury had occurred during their tactical operations within the past 24 months. Common injuries included gunshot wounds, chemical exposure, and fractures. However, 78% (117/150) of respondents did not have a medical director, and 23% (35/150) of teams did not have an EMS preplan or protocol.

Conclusion:

The results suggest a need for established EMS protocols, medical direction, and specialized tactical medical training, especially in large metropolitan areas.
A Comparison of EMS Continuing Education for Paramedics in the United States
Authors: Herman Linda L. , Willoughby Paula J. , Koenigsberg Max D. , Ward Sharon , McDonald Cary C.
Published: July 2016

Objective:

To determine characteristics of continuing education programs for paramedics in large metropolitan areas, and to make recommendations for changes in the Chicago Emergency Medical Services (EMS) system.

Design:

A survey of 95 metropolitan areas from each state in the United States.

Participants:

EMS medical directors, coordinators, and administrators.

Results:

The survey population included 56 respondents. Within this group, 23% were from areas of 1 million people or more, 61% in areas with populations of 100,000 to 1 million and 16% from areas populated by < 100,000 people. Several system types were represented in the survey. In the systems surveyed, 98% mandate didactic continuing education requirements. Clinical continuing education was required by 34% of the systems. Ten systems (18%) awarded continuing education hours for documented in-field experience. This method did not have a specific structure by the majority of users. Both written and skills testing were used by most EMS systems to evaluate paramedic competency. No statistically significant differences (p >0.05) could be found among population subgroups or EMS system types when evaluating the use of these various methods.

Conclusion:

EMS systems primarily use didactic sessions to meet their continuing education requirements. Nearly half of the systems requiring clinical continuing education use in-field credit to fulfill these requirements. In-field credit systems are poorly developed to date. This mechanism may be an effective alternative to usual clinical experiences for paramedics and deserves further investigation.
Emerging Issues and Future Needs in Humanitarian Assistance
Authors: VanRooyen Michael J. , Hansch Steven , Curtis Donna , Burnham Gilbert
Published: July 2016

During the past two decades, there has been tremendous investment in the ability to intervene in disaster settings, and significant barriers remain to providing appropriate services to populations affected by natural and manmade calamities. Many of the barriers to providing effective assistance exist within the NGO community, and illustrate emerging needs for international agencies. These emerging needs include improving methods of recipient participation to promote the local health system, developing improved methods for quality assurance, enhancing options for personnel development, and addressing long-term needs of reconstruction and rehabilitation. Relief agencies face challenges on all levels to develop sound practices in providing humanitarian assistance that can lead to long-term benefits to populations affected by disaster.
Physicians and International Humanitarian Law in Complex Emergencies: Controversies and Future Opportunities
Authors: Hoffman Michael H.
Published: July 2016

This paper describes the areas in which the Geneva Conventions no longer are adequate as a source of legal description or prescription for the challenges faced by physicians working in complex emergencies. It covers the conceptual pitfalls facing the medical profession in connection with humanitarian interventions, which often are conventional military operations, but are not recognized as such because they may vary in some respects from more familiar forms of interstate conflict. Emerging categories of combatants who pose a major threat during complex emergencies also are identified.

Opportunities to meet these challenges with the tools and culture of medicine are explored, and are proposed to the medical community as an opportunity for leadership. The paper proposes that new, epidemiological standards should be developed in order to identify the outbreak of armed conflicts and the trigger points for application of international humanitarian law. Such could replace the political model that presently underlies international humanitarian law. It also argues that international humanitarian law is not the starting point for application of humanitarian standards in war zones, but rather is built upon a peacetime medical culture that must be replicated in complex emergencies as a precursor to effective application of the law.
Communicating Across Cultures: Improving Translation to Improve Complex Emergency Program Effectiveness
Authors: Bolton Paul A. , Weiss William M.
Published: July 2016

Translation is a vital activity in Complex Emergencies (CEs) in which the responders and the affected populations do not share the same language or culture. This particularly applies to CEs in developing countries in which a lack of local resources usually results in the importation of foreign aid workers. This paper describes many of the common issues surrounding translation that can affect CE response effectiveness, issues that frequently are not appreciated by aid workers, including clinicians. The authors describe how these issues can arise, their effects, and outline approaches to addressing them.
Cardiopulmonary Resuscitation (CPR) Basic and Advanced Life Support (BLS, ALS) Self-Training Systems (STS) for Paramedical and Medical Personnel
Authors: Scott M. , Safar P. , Berkebile P. , Sladen A. , McClintock J. , Hritz R. , Lepley E.
Published: July 2016

Resuscitation and acute respiratory care must be taught to all personnel involved in the management of everyday emergencies and mass casualties. Personnel range from the lay public to physician specialists. In deciding who should be taught what and how one must consider the limitations of learning ability of trainees and of resources. Mouth-to-mouth ventilation can be learned by laymen merely from viewing pictures, but better with manikin practice to perfection. CPR steps A-B-C can be effectively taught to non-physicians including laymen with instructor-coached manikin practice to perfection. but also with self-practice coached by audiotape, and to some extent even by frequent film viewing only without manikin practice. In 1972, A. Laerdal invented a CPR steps A-B-C self-training system consisting of a recording manikin, flipcharts and the coaching audiotape. We added a demonstration film to be shown before manikin practice.
Mobile Intensive Care Units
Authors: Dick Wolfgang F.
Published: July 2016

Mobile intensive care units (MICU) will take care of all real emergency patients with presumed or proven disturbances of vital functions. These vehicles are equipped according to standardized criteria, and usually stationed at emergency hospitals. MICU's are accompanied by one rescue assistant, one emergency medical technician (EMT) and one physician.

Eighty-five to 90% of the total number of emergency calls were primary emergency calls, where the emergency patient had to be treated at the scene; 10% to possibly 20% were emergency patients who had already received treatment by medical or paramedical personnel.
The Rendezvous System Using Emergency Doctors' Vehicles in the Federal Republic of Germany (FRG)
Authors: Sefrin P.
Published: July 2016

In the Federal Republic of Germany, 1.2 million people per year get into a life-threatening situation from which they can be saved only by immediate medical assistance. Progress in intensive care therapy and the improved organization of rescue services have led to a greater number of doctors being available for first aid at the scene of the accident. The creation of an emergency medical service was designed to ensure medical treatment of emergency patients by medically qualified personnel. The Emergency Medical Service is defined as an organization within the framework of rescue services providing care for emergency patients. The emergency physician is trained and equipped particularly to recognize and treat life-threatening conditions. Through the rescue service, the physician can be taken to the scene of the accident by the quickest and shortest way. For this need, two systems have become established in the Federal Republic of Germany.
An Economic Professional Rescue Organization for Civil Disasters with Mass Casualties
Authors: Reich Hanns
Published: July 2016

The newspapers present almost daily reports on great accidents some place on earth. However, on a national basis, catastrophes occur at rare intervals. There is hardly anywhere a professional rescue personnel which is ready for major accidents with mass casualties because of underutilization and for financial reasons.

That means that at major accidents with mass casualties, the need for rescue personnel and equipment usually exceeds the daily professional readiness for rescue services, and the required manpower and equipment in sufficient numbers are seldom available to handle such big accidents. Voluntary lief organizations will then lend a hand, but they mostly consist of helpers who are neither educated nor trained for such difficult rescue work.
The Burn Disaster at Los Alfaques, Spain, 1978
Authors: Blomberg Rune , Arturson Gösta , Brandsjö Kaare
Published: July 2016

On July 11, 1978, a truck with a tank loaded with liquid propylene crashed into a camping ground, Los Alfaques, on the Eastern coast of Spain, giving rise to a Boiling Liquid Expanding Vapour Explosion (BLEVE) with a large number of casualties. The Swedish Organizing Committee for Disaster Medicine initiated a study of the events by sending the authors to Spain to make all possible observations at the scene. We were in the camp 48 hours after the explosion.

The Camp

The camping ground Los Alfaques is situated about 190 kilometers south of Barcelona and 165 kilometers north of Valenica. There are hospitals of varying sizes on the route to these big cities, both of which have large hospitals equipped with burn units of high standards, Francisco Franco Hospital in Barcelona and La Fe Hospital in Valencia.
16. First Responder Defibrillation Does Not Increase Survival from Sudden Cardiac Death in a Two-Tiered Urban-Suburban EMS System
Authors: Sweeney Thomas A. , Runge Jeffrey W. , Gibbs Michael A. , Carter Janet M. , Schafermeyer Robert W. , Norton James A.
Published: July 2016

Purpose: The use of automatic external defibrillators (AED) by emergency medical service (EMS) first responders (FR) is widely advocated based largely on reports from one metropolitan area, but widespread impact on survival remains unproven. We hypothesized that the addition of AEDs to an EMS system with short FR and prolonged paramedic response times (4 vs. 10 minutes) would improve survival from sudden cardiac death.

Methods: Prospective, controlled, crossover study (AED vs. no AED) of consecutive cardiac arrests managed by 24 FR fire companies from 1992–1995 in a city of 440,000. Patients were stratified by the Utstein criteria. Primary end-point was survival to hospital discharge among patients with bystander witnessed arrests of cardiac etiology. Power was set at 0.8 to detect a 10% difference in survival.

Results: A total of 627 patients were studied. Groups were comparable for age, gender, history of myocardial infarction, congestive heart failure or diabetes, arrest at home, bystander CPR, and ventricular fibrillation (VF) as initial rhythm.
08. Missed Diagnosis of Pneumothorax During Aeromedical Transport
Authors: Thomas SH , DeVellis P , Harrison T , Wedel SK
Published: July 2016

Purpose: Difficulties with physical assessment inherent to the helicopter environment have led to suggestion that aeromedical crews may be unable to identify hemo- or pneumothorax (HTX/PTX) while in-flight. This study was conducted to determine the frequency of missed HTX/PTX in trauma patients undergoing air transport.

Methods: One year (1994) of an air medical service's trauma transports to a Level I trauma center were analyzed to identify patients undergoing tube thoracostomy (TT) within 2 hours of trauma center arrival. Patients who had received intra-transport needle thoracostomy were excluded. Records were reviewed to determine how HTX/PTX was diagnosed at the trauma center.

Results: Only 11 patients who had not received aeromedical needle decompression underwent TT at the receiving center. Two of the 11 were trauma arrests and received TT as part of thoracotomy, without air or blood return on TT. None of the remaining 9 patients had TT on clinical suspicion alone. Four had normal physical examination and underwent TT after chest X-ray (CXR). Remaining patients had no HTX/PTX clues on exam or CXR; one had a small HTX identified on chest computed tomography and the other four received intra-operative TT because of rib fractures in the setting of multisystem trauma.
What is the evidence that point sources of anthropogenic effluent increase antibiotic resistance in the environment? Protocol for a systematic review
Authors: Williams-Nguyen Jessica , Bueno Irene , Sargeant Jan M. , Nault André J. , Singer Randall S.
Published: July 2016

Herein we describe a protocol for a systematic review of the evidence on whether point sources of anthropogenic effluent are associated with an increase in antibiotic resistance in the adjacent environment. The review question was based on the Population, Exposure, Comparator, Outcome, Study Design (PECOS) framework as follows: Is the prevalence or concentration of antibiotic resistant bacteria or resistance genes (O) in soil, water, air or free-living wildlife (P) higher in close proximity to, or downstream from, known or suspected sources of anthropogenic effluent (E) compared to areas more distant from or upstream from these sources (C)? A comprehensive search strategy was created to capture all relevant, published literature. Criteria for two stages of eligibility screening were developed to exclude publications that were not relevant to the question, and determine if the study used a design that permitted estimation of an association between a source and levels of resistance. A decision matrix was created for assessment of risk of bias to internal validity due to sample selection bias, information bias, and confounding. The goal of this protocol is to provide a method for determining the state of knowledge about the effect of point sources on antibiotic resistance in the environment.
Where literature is scarce: observations and lessons learnt from four systematic reviews of zoonoses in African countries
Authors: Alonso Silvia , Lindahl Johanna , Roesel Kristina , Traore Sylvain Gnamien , Yobouet Bassa Antoine , Ndour Andrée Prisca Ndjoug , Carron Maud , Grace Delia
Published: July 2016

The success of a systematic review depends on the availability, accessibility and quality of literature related to the review question. This paper presents the literature found in four systematic reviews conducted for a selection of zoonotic hazards in four livestock value chains in Africa, as well as setting out the challenges in conducting the reviews. The protocol was designed following international standards, and addressed four questions around prevalence, risk factors, control options and impact of various hazards and populations. Searches were conducted in four online databases. Articles were screened for relevance, and quality was assessed before data extraction. Literature on zoonotic hazards was in general scarce and access to full articles was limited. Overall, 25–40% of papers were considered poor quality. The diversity of approaches and designs in the studies compromised the ability to generate summarized estimates. We found that the emphasis of veterinary research has been on livestock problems rather than public health issues, although this seems to be shifting in the last decade; we also found there are limited studies on impact and control. While increasing literature is being published around zoonoses in Africa, this is still inadequate to appropriately inform policy and guide research efforts.
My Brother's Keeper? Religious Cues and Support for Foreign Military Intervention
Authors: Wu Joshua Su-Ya , Knuppe Austin J.
Published: July 2016

Americans are reluctant to support foreign military intervention. However, if victims of violence are identified as Christians, support for intervention is higher. We term this a “Brother's Keeper” effect as Americans, especially more religious Americans, will support intervention that aids co-religionists. To test our argument, we use a survey experiment that randomly assigns respondents to varying accounts of violence in the Central African Republic. Respondents who read Christians are the victims of violence are more supportive of military intervention compared to respondents who read vignettes that do not identify the religious identities of victims. Moreover, these Brother's Keeper effects are stronger among more religious respondents. We also find even stronger effects when extrapolating results as a population effect with survey weights. Our findings reveal that labeling otherwise unknown foreign actors as Christian have significant effects on support for foreign military intervention.
Results of bypass graft surgery after prior angioplasty in critical limb ischaemia treatment
Authors: Cury Marcus Vinícius Martins , Brochado-Neto Francisco Cardoso , Matielo Marcelo Fernando , de Athayde Soares Rafael , Sarpe Anna Karina Paiva , Sacilotto Roberto
Published: July 2016

Abstract. Background: The aim of this study was to determine the outcomes of primary bypass graft surgery (BGS) compared to BGS after failed angioplasty (PTA). Patients and methods: Between January 2007 and January 2014, we performed 136 BGSs exclusively for the treatment of critical limb ischaemia. Two cohorts were identified: 1) primary BGS (n = 102; group I), and 2) BGS after prior PTA (n = 34; group II). Data were analysed retrospectively and the primary endpoints were the rates of secondary patency, amputation-free survival, freedom from major adverse outcomes (graft occlusion, amputation, or death), and overall survival, which were assessed with the Kaplan-Meier method. Results: Both groups were comparable with a predominance of Rutherford’s category 5 ischaemic lesions (73.3 %). Most patients had extensive TASC D athe-rosclerotic disease (83.6 %), and the main conduit was the greater saphenous vein (58.1 %). The mean follow-up time was 36.2 months. The 3-year secondary patency rates were better for group I (64.3 % vs 49.6 %; P = 0.04). During the same period, the amputation-free survival rates were similar between the groups (77.4 % vs 74.5 %; P = 0.59). For multivariate Cox regression analysis, BGS after prior PTA was the only factor associated with re-intervention for limb salvage (hazard ratio = 2.39; CI 95 % = 1.19 - 4.80; P = 0.02). At the 3-year point, there were no differences in the overall survival rates (72.6 % vs 70 %; P = 0.97), but the proportion of patients without adverse outcomes was higher in group I (37.3 % vs 13.4 %; P = 0.007). Conclusions: Although secondary patency was better after primary BGS, the amputation-free and overall survival rates support the use of BGS after prior PTA.
A toolkit of thread-based microfluidics, sensors, and electronics for 3D tissue embedding for medical diagnostics
Authors: Mostafalu Pooria , Akbari Mohsen , Alberti Kyle A. , Xu Qiaobing , Khademhosseini Ali , Sonkusale Sameer R.
Published: July 2016

Threads, traditionally used in the apparel industry, have recently emerged as a promising material for the creation of tissue constructs and biomedical implants for organ replacement and repair. The wicking property and flexibility of threads also make them promising candidates for the creation of three-dimensional (3D) microfluidic circuits. In this paper, we report on thread-based microfluidic networks that interface intimately with biological tissues in three dimensions. We have also developed a suite of physical and chemical sensors integrated with microfluidic networks to monitor physiochemical tissue properties, all made from thread, for direct integration with tissues toward the realization of a thread-based diagnostic device (TDD) platform. The physical and chemical sensors are fabricated from nanomaterial-infused conductive threads and are connected to electronic circuitry using thread-based flexible interconnects for readout, signal conditioning, and wireless transmission. To demonstrate the suite of integrated sensors, we utilized TDD platforms to measure strain, as well as gastric and subcutaneous pH in vitro and in vivo.
Dynamic reconfiguration of the default mode network during narrative comprehension
Authors: Simony Erez , Honey Christopher J , Chen Janice , Lositsky Olga , Yeshurun Yaara , Wiesel Ami , Hasson Uri
Published: July 2016

Does the default mode network (DMN) reconfigure to encode information about the changing environment? This question has proven difficult, because patterns of functional connectivity reflect a mixture of stimulus-induced neural processes, intrinsic neural processes and non-neuronal noise. Here we introduce inter-subject functional correlation (ISFC), which isolates stimulus-dependent inter-regional correlations between brains exposed to the same stimulus. During fMRI, we had subjects listen to a real-life auditory narrative and to temporally scrambled versions of the narrative. We used ISFC to isolate correlation patterns within the DMN that were locked to the processing of each narrative segment and specific to its meaning within the narrative context. The momentary configurations of DMN ISFC were highly replicable across groups. Moreover, DMN coupling strength predicted memory of narrative segments. Thus, ISFC opens new avenues for linking brain network dynamics to stimulus features and behaviour.
Multi-omics landscapes of colorectal cancer subtypes discriminated by an individualized prognostic signature for 5-fluorouracil-based chemotherapy
Authors: Tong M , Zheng W , Li H , Li X , Ao L , Shen Y , Liang Q , Li J , Hong G , Yan H , Cai H , Li M , Guan Q , Guo Z
Published: July 2016

Until recently, few prognostic signatures for colorectal cancer (CRC) patients receiving 5-fluorouracil (5-FU)-based chemotherapy could be used in clinical practice. Here, using transcriptional profiles for a panel of cancer cell lines and three cohorts of CRC patients, we developed a prognostic signature based on within-sample relative expression orderings (REOs) of six gene pairs for stage II–III CRC patients receiving 5-FU-based chemotherapy. This REO-based signature had the unique advantage of being insensitive to experimental batch effects and free of the impractical data normalization requirement. After stratifying 184 CRC samples with multi-omics data from The Cancer Genome Atlas into two prognostic groups using the REO-based signature, we further revealed that patients with high recurrence risk were characterized by frequent gene copy number aberrations reducing 5-FU efficacy and DNA methylation aberrations inducing distinct transcriptional alternations to confer 5-FU resistance. In contrast, patients with low recurrence risk exhibited deficient mismatch repair and carried frequent gene mutations suppressing cell adhesion. These results reveal the multi-omics landscapes determining prognoses of stage II–III CRC patients receiving 5-FU-based chemotherapy.
High-throughput ab-initio dilute solute diffusion database
Authors: Wu Henry , Mayeshiba Tam , Morgan Dane
Published: July 2016

We demonstrate automated generation of diffusion databases from high-throughput density functional theory (DFT) calculations. A total of more than 230 dilute solute diffusion systems in Mg, Al, Cu, Ni, Pd, and Pt host lattices have been determined using multi-frequency diffusion models. We apply a correction method for solute diffusion in alloys using experimental and simulated values of host self-diffusivity. We find good agreement with experimental solute diffusion data, obtaining a weighted activation barrier RMS error of 0.176 eV when excluding magnetic solutes in non-magnetic alloys. The compiled database is the largest collection of consistently calculated ab-initio solute diffusion data in the world.
Development of a millimetrically scaled biodiesel transesterification device that relies on droplet-based co-axial fluidics
Authors: Yeh S. I. , Huang Y. C. , Cheng C. H. , Cheng C. M. , Yang J. T.
Published: July 2016

In this study, we investigated a fluidic system that adheres to new concepts of energy production. To improve efficiency, cost, and ease of manufacture, a millimetrically scaled device that employs a droplet-based co-axial fluidic system was devised to complete alkali-catalyzed transesterification for biodiesel production. The large surface-to-volume ratio of the droplet-based system, and the internal circulation induced inside the moving droplets, significantly enhanced the reaction rate of immiscible liquids used here – soybean oil and methanol. This device also decreased the molar ratio between methanol and oil to near the stoichiometric coefficients of a balanced chemical equation, which enhanced the total biodiesel volume produced, and decreased the costs of purification and recovery of excess methanol. In this work, the droplet-based co-axial fluidic system performed better than other methods of continuous-flow production. We achieved an efficiency that is much greater than that of reported systems. This study demonstrated the high potential of droplet-based fluidic chips for energy production. The small energy consumption and low cost of the highly purified biodiesel transesterification system described conforms to the requirements of distributed energy (inexpensive production on a moderate scale) in the world.
Recombinant herpes simplex virus type 1 strains with targeted mutations relevant for aciclovir susceptibility
Authors: Brunnemann Anne-Kathrin , Liermann Kristin , Deinhardt-Emmer Stefanie , Maschkowitz Gregor , Pohlmann Anja , Sodeik Beate , Fickenscher Helmut , Sauerbrei Andreas , Krumbholz Andi
Published: July 2016

Here, we describe a novel reliable method to assess the significance of individual mutations within the thymidine kinase (TK) gene of herpes simplex virus type 1 (HSV-1) to nucleoside analogue resistance. Eleven defined single nucleotide polymorphisms that occur in the TK gene of clinical HSV-1 isolates and a fluorescence reporter were introduced into the HSV-1 strain 17+ that had been cloned into a bacterial artificial chromosome. The susceptibility of these different strains to aciclovir, penciclovir, brivudin, and foscarnet was determined with a modified cytopathic effect reduction assay. The strains were also tested for their aciclovir susceptibility by measuring the relative fluorescence intensity as an indicator for HSV-1 replication and by quantifying the virus yield. Our data indicate that the amino acid substitutions R41H, R106H, A118V, L139V, K219T, S276R, L298R, S345P, and V348I represent natural polymorphisms of the TK protein, whereas G61A and P84L mediate broad cross-resistance against aciclovir, penciclovir, brivudin, and susceptibility to foscarnet. This method allows the definition of the resistance genotype of otherwise unclear mutations in the TK gene of HSV-1. Thus, it provides a scientific basis for antiviral testing in clinical isolates of patients suffering from serious diseases and will facilitate testing of new antivirals against HSV-1.
Additive reductions in zebrafish PRPS1 activity result in a spectrum of deficiencies modeling several human PRPS1-associated diseases
Authors: Pei Wuhong , Xu Lisha , Varshney Gaurav K. , Carrington Blake , Bishop Kevin , Jones MaryPat , Huang Sunny C. , Idol Jennifer , Pretorius Pamela R. , Beirl Alisha , Schimmenti Lisa A. , Kindt Katie S. , Sood Raman , Burgess Shawn M.
Published: July 2016

Phosphoribosyl pyrophosphate synthetase-1 (PRPS1) is a key enzyme in nucleotide biosynthesis and mutations in PRPS1 are found in several human diseases including nonsyndromic sensorineural deafness, Charcot-Marie-Tooth disease-5 and Arts Syndrome. We utilized zebrafish as a model to confirm that mutations in PRPS1 result in phenotypic deficiencies in zebrafish similar to those in the associated human diseases. We found two paralogs in zebrafish, prps1a and prps1b and characterized each paralogous mutant individually as well as the double mutant fish. Zebrafish prps1a mutants and prps1a;prps1b double mutants showed similar morphological phenotypes with increasingly severe phenotypes as the number of mutant alleles increased. Phenotypes included smaller eyes and reduced hair cell numbers, consistent with the optic atrophy and hearing impairment observed in human patients. The double mutant also showed abnormal development of primary motor neurons, hair cell innervation and reduced leukocytes, consistent with the neuropathy and recurrent infection of the human patients possessing the most severe reductions of PRPS1 activity. Further analyses indicated the phenotypes were associated with a prolonged cell cycle likely resulting from reduced nucleotide synthesis and energy production in the mutant embryos. We further demonstrated the phenotypes were caused by delays in the tissues most highly expressing the prps1 genes.
The acquisition of Clostridium tyrobutyricum mutants with improved bioproduction under acidic conditions after two rounds of heavy-ion beam irradiation
Authors: Zhou Xiang , Yang Zhen , Jiang Ting-Ting , Wang Shu-Yang , Liang Jian-Ping , Lu Xi-Hong , Wang Liang
Published: July 2016

End-product inhibition is a key factor limiting the production of organic acid during fermentation. Two rounds of heavy-ion beam irradiation may be an inexpensive, indispensable and reliable approach to increase the production of butyric acid during industrial fermentation processes. However, studies of the application of heavy ion radiation for butyric acid fermentation engineering are lacking. In this study, a second 12C6+ heavy-ion irradiation-response curve is used to describe the effect of exposure to a given dose of heavy ions on mutant strains of Clostridium tyrobutyricum. Versatile statistical elements are introduced to characterize the mechanism and factors contributing to improved butyric acid production and enhanced acid tolerance in adapted mutant strains harvested from the fermentations. We characterized the physiological properties of the strains over a large pH value gradient, which revealed that the mutant strains obtained after a second round of radiation exposure were most resistant to harsh external pH values and were better able to tolerate external pH values between 4.5 and 5.0. A customized second round of heavy-ion beam irradiation may be invaluable in process engineering.
CD4+ and γδ T Cells are the main Producers of IL-22 and IL-17A in Lymphocytes from Mycobacterium bovis-infected Cattle
Authors: Steinbach Sabine , Vordermeier H. Martin , Jones Gareth J.
Published: July 2016

Gene transcription studies have identified dual roles for the cytokines IL-17A and IL-22 in bovine tuberculosis, where they show potential as both predictors of vaccine success and correlates of infection. To allow for a detailed investigation of the cell populations responsible for production of these cytokines, we have utilised a novel bovine IL-22 specific recombinant antibody for flow cytometry. Bovine tuberculin (PPDB) induced greater IL-22 and IL-17A production in Mycobacterium bovis (M. bovis)-infected cattle compared to non-infected controls, while PWM-induced cytokine levels were similar between the two groups. In M. bovis-infected animals, PPDB specific IL-22 and IL-17A responses were observed in both CD4+ T cell and γδ T cell populations. Although both cytokines were detected in both cell types, IL-22/IL-17A double producers were rare and confined mainly to the γδ T cell population. These results support previous gene transcription studies and extend the observation of increased IL-22 and IL-17A responses in M. bovis-infected animals to the level of protein production. We were also able to characterise the cell populations responsible for these disease-related cytokine responses. The data generated can be used to further our understanding of the immunopathology of bovine tuberculosis and to produce more sensitive and specific immune-diagnostic reagents.
The effects of poly(zwitterions)s versus poly(ethylene glycol) surface coatings on the biodistribution of protein nanoparticles
Authors: Wang Jing , Yuan Shanmei , Zhang Yajun , Wu Wei , Hu Yong , Jiang Xiqun
Published: July 2016

Zwitterionic poly(carboxybetaine) (PCB), poly(2-methacryloyloxyethyl phosphorylcholine) (PMPC) and nonionic poly(ethylene glycol) (PEG), which have similar degrees of polymerization, were grafted to branched polyethyleneimine (PEI) to generate PCB-grafted PEI (PEI-PCB), PMPC-grafted PEI (PEI-PMPC) and PEG-grafted PEI (PEI-PEG) copolymers, respectively.
Structure and electronic properties of bilayer graphene functionalized with half-sandwiched transition metal-cyclopentadienyl complexes
Authors: Yao Xiaojing , Zhang Xiuyun , Ye Xiaoshan , Wang Jinlan
Published: July 2016

The CpTM-functionalized bilayer graphene and the band gap opening of different systems.
A Cu(ii) MOF with a flexible bifunctionalised terpyridine as an efficient catalyst for the single-pot hydrocarboxylation of cyclohexane to carboxylic acid in water/ionic liquid medium
Authors: Paul Anup , Ribeiro Ana P. C. , Karmakar Anirban , Guedes da Silva M. Fátima C. , Pombeiro Armando J. L.
Published: July 2016

A bifunctionalised terpyridine based Cu(ii) MOF for efficient hydrocarboxylation of cyclohexane to cyclohexanecarboxylic acid in an ionic liquid medium.
Carbon-based two electron σ-donor ligands beyond classical N-heterocyclic carbenes
Authors: Ghadwal Rajendra S.
Published: July 2016

Recent advances in N-heterocyclic carbene-derived carbon-based two electron σ-donor ligands are presented in this perspective.
Development and characterization of muscle-based actuators for self-stabilizing swimming biorobots
Authors: Holley Merrel T. , Nagarajan Neerajha , Danielson Christian , Zorlutuna Pinar , Park Kidong
Published: July 2016

A self-stabilizing swimming biorobot, utilizing a fin-based propulsion, is developed. The biorobot is powered by a cardiomyocyte sheet on a thin PDMS cantilever and is able to maintain its submersion depth, pitch, and roll without external intervention.
Regulation of highly homologous major urinary proteins in house mice quantified with label-free proteomic methods
Authors: Enk Viktoria M. , Baumann Christian , Thoß Michaela , Luzynski Kenneth C. , Razzazi-Fazeli Ebrahim , Penn Dustin J.
Published: July 2016

We performed isoform-specific MUP quantification on MS1 and MS2 level in response to increased social interaction of male wild house mice by seminatural housing.
Application of independent component analysis, principal component regression and partial least squares methodologies for the simultaneous potentiometric titration of some amino acids
Authors: Hakan Aktaş A. , Göksu Karagöz Sermin
Published: July 2016

Potentiometric titration and chemometric methods were applied to the simultaneous determination of the four amino acids, alanine (ALA), phenylalanine (PHE), leucine (LEU) and lysine (LYS).
Boric acid functionalized ratiometric fluorescence probe for sensitive and on-site naked eye determination of dopamine based on two different kinds of quantum dots
Authors: Xu Yeqing , Wei Xiao , Li Hongji , Zheng Xudong , Lu Kai , Liu Xiqing , Wang Kun , Yan Yongsheng
Published: July 2016

A simple dual-emission probe based on 3-aminophenylboronic acid functionalized CdTe quantum dots (QDs) and carbon quantum dots (CQDs) was developed for the on-site naked eye detection of dopamine (DA).
Nitrogen-doped reduced graphene oxide and aniline based redox additive electrolyte for a flexible supercapacitor
Authors: Sankar K. Vijaya , Selvan R. Kalai , Vignesh R. Hari , Lee Y. S.
Published: July 2016

Nitrogen-doped reduced graphene oxide (N-rGO) with a flexible structure was prepared by simple hydrothermal method. The N-rGO flexible supercapacitor fabricated and improved the performance using aniline as redox additive.
One-pot hydrothermal synthesis of platinum nanoparticle-decorated three-dimensional nitrogen-doped graphene aerogel as a highly efficient electrocatalyst for methanol oxidation
Authors: Zhang Xuan , Hao Nan , Dong Xiaoya , Chen Saibo , Zhou Zhou , Zhang Ying , Wang Kun
Published: July 2016

Pt nanoparticle-decorated nitrogen-doped 3D graphene aerogel (PtNPs/3DNGA) composites were prepared through a one-pot hydrothermal approach and show superior catalytic activity in methanol oxidation.
Giant room temperature elastocaloric effect of PbTiO3 ferroelectric materials with 90° domain structure
Authors: Wang F. , Li B. , Ou Y. , Liu L. F. , Peng C. Z. , Wang Z. S. , Wang W.
Published: July 2016

The elastocaloric effect in PbTiO3 with 90° domain structure under the applied stress field at room temperature has been studied. A negative ΔTσ of −7.2 K can be obtained by controlled polarization switching under the applied stress fields.