bluuebunny/crossref_metadata_2025 huggingface dataset:
Detection of pneumothoraces in patients with multiple blunt trauma: use and limitations of eFAST
Authors: Sauter Thomas C , Hoess Simon , Lehmann Beat , Exadaktylos Aristomenis K , Haider Dominik G
Published: May 2017

Background

Extended focused assessment with sonography for trauma (eFAST) has been shown to have moderate sensitivity for detection of pneumothorax in trauma. Little is known about the location or size of missed pneumothoraces or clinical predictors of pneumothoraces in patients with false-negative eFAST.

Methods

This retrospective cross-sectional study includes all patients with multiple blunt trauma diagnosed with pneumothorax who underwent both eFAST and CT performed in the ED of a level 1 trauma centre in Switzerland between 1 June 2012 and 30 September 2014. Sensitivity of eFAST for pneumothorax was determined using CT as the gold standard. Demographic and clinical characteristics of those who had a pneumothorax detected by eFAST and those who did not were compared using the Mann-Whitney U or Pearson’s χ2tests. Univariate binary logistic regression models were used to identify predictors for pneumothoraces in patients with negative eFAST examination.

Results

The study included 109 patients. Overall sensitivity for pneumothorax on eFAST was 0.59 and 0.81 for pneumothoraces requiring treatment. Compared with those detected by eFAST, missed pneumothoraces were less likely to be ventral (30 (47.6%) vs 4 (9.3%), p <0.001) and more likely to be apical and basal (7 (11.1%) vs 15 (34.9%), p=0.003; 11 (17.5%) vs 18 (41.9%), p=0.008, respectively). The missed pneumothoraces were smaller than the detected pneumothoraces (left side: 30.7±17.4 vs 12.1±13.9 mm; right side: 30.2±10.1 vs 6.9±10.2 mm, both p <0.001). No clinical variables were identified which predicted pneumothoraces in falsely negative eFAST. Among those pneumothoraces missed by eFAST, 30% required tube thoracostomy compared with 88.9% of those detected with eFAST.

Conclusion

In our study, pneumothoraces missed by eFAST were smaller and in atypical locations compared with those detected by eFAST and needed thoracic drainage less often.
Chronic obstructive pulmonary disease in Scottish military veterans
Authors: Bergman Beverly P , Mackay D F , Pell J P
Published: May 2017

Introduction

Smoking is a major risk factor for chronic obstructive pulmonary disease (COPD). Serving military personnel have previously been shown to be more likely to smoke, and to smoke more heavily, than civilians, but there is no clear consensus as to whether in later life, as veterans, they experience a higher prevalence and mortality from COPD than do non-veterans. We examined the risk of COPD in Scottish veterans and assessed the impact of changes in military smoking.

Methods

Retrospective 30-year cohort study of 56 205 veterans born 1945–1985, and 172 741 people with no record of military service, matched for age, sex and area of residence, using Cox proportional hazard models to examine the association between veteran status, birth cohort, length of service and risk of COPD resulting in hospitalisation or death.

Results

There were 1966 (3.52%) cases of COPD meeting the definition in veterans, compared with 5434 (3.19%) in non-veterans. The difference was statistically significant (p=0.001) in the unadjusted model although it became non-significant after adjusting for deprivation. The highest risk was seen in the oldest (1945–1949) birth cohort and in veterans with the shortest service (Early Service Leavers). The risk was significantly reduced in veterans born from 1960, and in those with over 12 years' service.

Conclusions

Our findings are consistent with falling rates of military smoking since the 1960s, and with the reduction in smoking with longer service. The oldest veterans, and those with the shortest service, are least likely to have benefited from this, as reflected in their higher risk for COPD.
Resistance to RET-Inhibition in RET-Rearranged NSCLC Is Mediated By Reactivation of RAS/MAPK Signaling
Authors: Nelson-Taylor Sarah K. , Le Anh T. , Yoo Minjae , Schubert Laura , Mishall Katie M. , Doak Andrea , Varella-Garcia Marileila , Tan Aik-Choon , Doebele Robert C.
Published: May 2017

Oncogenic rearrangements in RET are present in 1%–2% of lung adenocarcinoma patients. Ponatinib is a multi-kinase inhibitor with low-nanomolar potency against the RET kinase domain. Here, we demonstrate that ponatinib exhibits potent antiproliferative activity in RET fusion–positive LC-2/ad lung adenocarcinoma cells and inhibits phosphorylation of the RET fusion protein and signaling through ERK1/2 and AKT. Using distinct dose escalation strategies, two ponatinib-resistant LC-2/ad cell lines, PR1 and PR2, were derived. PR1 and PR2 cell lines retained expression, but not phosphorylation of the RET fusion and lacked evidence of a resistance mutation in the RET kinase domain. Both resistant lines retained activation of the MAPK pathway. Next-generation RNA sequencing revealed an oncogenic NRAS p.Q61K mutation in the PR1 cell. PR1 cell proliferation was preferentially sensitive to siRNA knockdown of NRAS compared with knockdown of RET, more sensitive to MEK inhibition than the parental line, and NRAS dependence was maintained in the absence of chronic RET inhibition. Expression of NRAS p.Q61K in RET fusion expressing TPC1 cells conferred resistance to ponatinib. PR2 cells exhibited increased expression of EGFR and AXL. EGFR inhibition decreased cell proliferation and phosphorylation of ERK1/2 and AKT in PR2 cells, but not LC-2/ad cells. Although AXL inhibition enhanced PR2 sensitivity to afatinib, it was unable to decrease cell proliferation by itself. Thus, EGFR and AXL cooperatively rescued signaling from RET inhibition in the PR2 cells. Collectively, these findings demonstrate that resistance to ponatinib in RET-rearranged lung adenocarcinoma is mediated by bypass signaling mechanisms that result in restored RAS/MAPK activation. Mol Cancer Ther; 16(8); 1623–33. ©2017 AACR.
Increased Thromboembolic Events With Dabigatran Compared With Vitamin K Antagonism in Left Ventricular Assist Device Patients
Authors: Andreas Martin , Moayedifar Roxana , Wieselthaler Georg , Wolzt Michael , Riebandt Julia , Haberl Thomas , Angleitner Philipp , Schlöglhofer Thomas , Wiedemann Dominik , Schima Heinrich , Laufer Guenther , Zimpfer Daniel
Published: May 2017

Background—

Left ventricular assist device–supported patients are usually anticoagulated with a combination of aspirin and vitamin K antagonists. Long-term vitamin K antagonist therapy can be complicated by unstable international normalized ratio values and patient-related compliance problems. Therefore, direct thrombin inhibitors may represent an alternative to vitamin K antagonists.

Methods and Results—

Thirty HeartWare ventricular assist device patients with stable renal function were planned for this prospective, randomized, open-label, single-center study. Patients were randomized to receive either phenprocoumon or dabigatran in addition to aspirin for long-term anticoagulation. Treatment duration was scheduled for 1 year and stopped after observation of a primary end point. Dabigatran dose was 110 and 75 mg BID in patients with normal or impaired renal function (glomerular filtration rate >80 mL/min or between 80 and 30 mL/min, respectively). The study was stopped prematurely for safety reasons after 16 patients (61±8 years, 1 female) were randomized. Thromboembolic events occurred in 4 subjects receiving dabigatran (50%) and in 1 receiving phenprocoumon (13%;
P
=0.28). No major bleeding was recorded, and no patient died during the study. Median time to treatment termination was significantly shorter in dabigatran patients (8.5 versus 12.0 months;
P
=0.015).

Conclusions—

Thromboembolic events on dabigatran led to early termination of a randomized controlled trial of dabigatran versus phenprocoumon in left ventricular assist device patients.

Clinical Trial Registration—

https://www.clinicaltrials.gov
. Unique identifier: NCT02872649.
Outcomes After Decompression of the Right Ventricle in Infants With Pulmonary Atresia With Intact Ventricular Septum Are Associated With Degree of Tricuspid Regurgitation
Authors: Petit Christopher J. , Glatz Andrew C. , Qureshi Athar M. , Sachdeva Ritu , Maskatia Shiraz A. , Justino Henri , Goldberg David J. , Mozumdar Namrita , Whiteside Wendy , Rogers Lindsay S. , Nicholson George T. , McCracken Courtney , Kelleman Mike , Goldstein Bryan H.
Published: May 2017

Background—

Outcomes after right ventricle (RV) decompression in infants with pulmonary atresia with intact ventricular septum vary widely. Descriptions of outcomes are limited to small single-center studies.

Methods and Results—

Neonates undergoing RV decompression for pulmonary atresia with intact ventricular septum were included from 4 pediatric centers. Primary end point was reintervention post-RV decompression; secondary end points included circulation type at latest follow-up. Ninety-nine patients (71 with pulmonary atresia with intact ventricular septum and 28 with virtual atresia) underwent RV decompression at median 3 (25th–75th, 2–5) days of age. Seventy-one patients (72%) underwent at least 1 reintervention after decompression. Median duration of follow-up was 3 years (range, 1–10). Freedom from reintervention was 51% at 1 month and 23% at 3 years. In multivariable analysis, reintervention was associated with virtual atresia (hazard ratio [HR], 0.51; 95% confidence interval [CI], 0.28–091;
P
=0.027), smaller RV length (HR, 0.94; 95% CI, 0.89–0.99;
P
=0.027), and ≤mild tricuspid regurgitation (TR; HR, 3.58; 95% CI, 2.04–6.30;
P
<0.001). Patients undergoing surgical shunt or ductal stent were less likely to have virtual atresia (HR, 0.36; 95% CI, 0.15–0.85;
P
=0.02) and more likely to have higher RV end-diastolic pressure (HR, 1.07; 95% CI, 1.00–1.15;
P
=0.057) and ≤mild TR (HR, 3.50; 95% CI, 1.75–7.0;
P
<0.001). Number of reinterventions was associated with ≤mild TR (rate ratio, 1.87; 95% CI, 1.23–2.87;
P
=0.0037). Multivariable analysis indicated that <2-ventricle circulation status was associated with ≤mild TR (odds ratio, 18.6; 95% CI, 5.3–65.2;
P
<0.001) and lower RV area (odds ratio, 0.81; 95% CI, 0.72–0.91;
P
<0.001).

Conclusions—

Patients with pulmonary atresia with intact ventricular septum deemed suitable for RV decompression have a high reintervention burden although most achieve 2-ventricle circulation. TR ≤mild at baseline is strongly associated with reintervention and <2-ventricle circulation at medium-term follow-up. Degree of baseline TR may be an important marker of long-term outcomes in this population.
Legacy Effect of Coronary Perforation Complicating Percutaneous Coronary Intervention for Chronic Total Occlusive Disease
Authors: Kinnaird Tim , Anderson Richard , Ossei-Gerning Nicholas , Cockburn James , Sirker Alex , Ludman Peter , deBelder Mark , Walsh Simon , Smith Elliot , Hanratty Colm , Spratt James , Strange Julian , Hildick-Smith David , Mamas Mamas A.
Published: May 2017

Background—

Coronary perforation (CP) during chronic total occlusion percutaneous coronary intervention for stable angina (CTO-PCI) is a rare but serious event. The evidence base is limited, and the long-term effects are unclear. Using a national PCI database, the incidence, predictors, and outcomes of CP during CTO-PCI were defined.

Methods and Results—

Data analyzed from the British Cardiovascular Intervention Society data set on all CTO-PCI procedures performed in England and Wales between 2006 and 2013. Multivariate logistic regressions and propensity scores were used to identify predictors of CP and its association with outcomes. A total of 376 CP were recorded from 26 807 CTO-PCI interventions (incidence of 1.40%) with an increase in frequency during the study period (
P
=0.012). Patient-related factors associated with an increased risk of CP were age and female sex. Procedural factors indicative of complex CTO intervention strongly related to an increased risk of CP with a close relationship between the number of complex strategies used and CP evident (
P
=0.008 for trend). Tamponade occurred in 16.6% and emergency surgery in 3.4% of cases. Adverse outcomes were frequent in those patients with perforation including bleeding, transfusion, myocardial infarction, and death. A legacy effect of perforation on mortality was evident, with an odds ratio for 12-month mortality of 1.60 for perforation survivors compared with matched nonperforation survivors without a CP (
P
<0.0001).

Conclusions—

Many of the factors associated with an increased risk of CP were related to CTO complexity. Perforation was associated with adverse outcomes, with a legacy effect on later mortality after CP also observed.
Co-Constructing Identities, Literacies, and Contexts: Sustaining Critical Meta-Awareness With/in Urban Communities
Authors: Caraballo Limarys , Souto-Manning Mariana
Published: May 2017

Mariana Souto-Manning calls for educational researchers to move beyond traditional/oppressive forms of research toward frameworks and methods that center the concerns of participants. Such critical research represents attempts to honor and support participants’ cultures, knowledge, and emerging identities in diverse urban educational contexts, building upon a legacy of culturally responsive research that incites scholars, researchers, and educators to develop and support culturally sustaining pedagogies. The authors in this special issue respond to Souto-Manning’s and Paris’ calls for empirical studies that analyze humanizing and transformative pedagogies to sustain the cultures, languages, and literacies of diverse peoples.
The Five Stages of Prisoner Reentry: Toward a Process Theory
Authors: Durnescu Ioan
Published: May 2017

This article is based on an ethnographic study involving 58 Roma and Romanian participants who were released from Jilava Prion in Romania between January and July 2015. The methodology involved interviews, observation, questionnaires, and photovoice. The findings seem to suggest that most of the factors associated with desistance and reentry in the literature are relevant to the ex-prisoner’s experiences. The main contribution of this article is the observation that these factors come into play at different times and in different stages of the reentry process. Five reentry stages were identified in this study: prerelease-anticipation, recovery and reunion, activation, consolidation, and relapse. The aim of the article is to describe this reentry process as the participants experienced it. Theoretical and practice implications are discussed.
The involvement of people with Parkinson’s in designing a study of the lived experience of anxiety
Authors: Lovegrove Christopher J , Bannigan Katrina , Cheeseman Debbie , Latour Jos M
Published: May 2017

Introduction

Anxiety is a common non-motor symptom of Parkinson’s and is an important consideration for occupational therapists working with this population. Little is known about how people with Parkinson’s experience anxiety. A pragmatic inquiry framework and inductive approach were used to perform a patient and public consultation round to inform future occupational therapy research exploring anxiety in people with Parkinson’s.

Method

Seven telephone and two Skype interviews were conducted with people with Parkinson’s, who were accessed and recruited through the charity Parkinson’s UK. They were selected on the basis of their previous experience and training to participate in a consultation exercise. Thematic analysis was used to develop codes using an inductive approach.

Findings

Three key themes emerged: experiences of anxiety in Parkinson’s; coping with anxiety in Parkinson’s; and considerations for future research. These include timing with regards to medication ‘wearing-off’ phenomena, easy access to medications, and providing a safe, sensitive research environment. Occupational therapists need to take these findings into account when designing intervention studies.

Conclusion

This patient and public involvement consultation round proved valuable and the participants’ contributions will directly improve the design of future occupational therapy research exploring the lived experience of anxiety for people with Parkinson’s.
Cost-sensitive design of error correcting output codes
Authors: Xue Aijun , Wang Xiaodan
Published: May 2017

Many real world applications involve multiclass cost-sensitive learning problems. However, some well-worked binary cost-sensitive learning algorithms cannot be extended into multiclass cost-sensitive learning directly. It is meaningful to decompose the complex multiclass cost-sensitive classification problem into a series of binary cost-sensitive classification problems. So, in this paper we propose an alternative and efficient decomposition framework, using the original error correcting output codes. The main problem in our framework is how to evaluate the binary costs for each binary cost-sensitive base classifier. To solve this problem, we proposed to compute the expected misclassification costs starting from the given multiclass cost matrix. Furthermore, the general formulations to compute the binary costs are given. Experimental results on several synthetic and UCI datasets show that our method can obtain comparable performance in comparison with the state-of-the-art methods.
The economic crisis and changes in work–family arrangements in six European countries
Authors: Dotti Sani Giulia Maria
Published: May 2017

Over the past decades, there has been a substantial increase in female labour force participation, and the number of dual-earner and female-earner households has risen throughout western countries. However, the recent economic crisis has caused large losses in employment for both women and men, potentially yielding unexpected consequences for the evolution of work–family arrangements. This article carries out a comparative analysis of the relationship between the 2008/2009 economic crisis and work–family arrangements in Europe. Using data for six countries from the European Union Statistics on Income and Living Conditions, this article fills a gap in the literature by addressing three issues: (1) whether work–family arrangements have changed from before to after the beginning of the economic downturn in countries with different gender and welfare regimes (Germany, Greece, Spain, France, Sweden and the United Kingdom), (2) whether changes in work–family arrangements have occurred at different levels of the social strata and (3) whether couples have moved from dual-earner to male- or female-breadwinner. The results indicate changes in work–family arrangements in those countries worst hit by the economic crisis, Greece and Spain, where dual-earner and male-breadwinner households have decreased and no-earner and female-main-earner households have increased. Moreover, the results show that in these two countries, all social strata – proxied through women’s level of education – have been affected by the crisis. In contrast, only moderate changes in work–family arrangements among all women can be observed in countries less hit by the economic downturn. The findings for the two southern European countries are troubling, as the increases in no-earner and female-breadwinner households point to worsening economic conditions throughout the population and to a halt in the process that for several decades had been leading to more equality in the distribution of employment between genders.
Expanding Research on Corporate Corruption, Management, and Organizations
Authors: Zyglidopoulos Stelios , Hirsch Paul , Martin de Holan Pablo , Phillips Nelson
Published: May 2017

In this special issue introduction, we briefly describe a variety of research paths researchers have followed to study the multifaceted phenomenon of corruption. Furthermore, we classify the papers included in this special issue according to their contribution to these research paths and briefly preview them. Finally, drawing on these four research paths and the papers included in this special issue, we propose a six-item agenda for future research on corruption.
Ambient and soft play: Play, labour and the digital in everyday life
Authors: Hjorth Larissa
Published: May 2017

This is the editor’s introduction for the Special Issue on digital creativity, play and labour in everyday life (SIDigiplay).
Perpetual Inferiority: Whites’ Racial Ideology toward Latinos
Authors: Lacayo Celia Olivia
Published: May 2017

The author examines contemporary Latino racialization by focusing on whites’ attitudes toward Latinos. Drawing on 40 in-depth interviews with whites from Orange County, California, the findings show that this group of white Americans believes that Latino culture is deficient and inferior. Moreover, the respondents explicitly ascribe these problems to the group as a whole, regardless of national origin, citizenship status, or generation. The interviews reveal how whites construct Latinos as a racial group by explaining that Latinos pass down their “deficient” culture to the subsequent generation and thus are unable to change, adapt, and progress. In essence, whites perceive Latino cultural traits as fixed. By doing so, whites use cultural racism to function as biological racism. This reveals a racial ideology toward Latinos the author terms perpetual inferiority, which accounts for how whites construct Latinos as a nonwhite racial group that is unable to assimilate. This study demonstrates specifically how external ascription affects the racial formation process of Latinos and their position within the racial hierarchy.
Sweet and Sour: Social Networks and Inequality in a Chinese Restaurant
Authors: Hill Katherine Michelle
Published: May 2017

The author examines how immigrant networks and labor segmentation by race and gender facilitate inequality in immigrant-owned restaurants. The author conducted three months of participant observation at an immigrant-owned restaurant and supplemental interviews with 18 workers and owners at similar restaurants in Austin, Texas. Labor segmentation by gender and race resulted in varied degrees of wage inequality, surveillance, and exposure to hazardous working conditions. Also, although ethnic networks among workers offer benefits, embedded in these networks are unwritten rules of obligation, gift giving, and repayment. Shared ethnicity or identity as immigrants did not prevent immigrant owners from exploiting workers of the same ethnicity and other immigrant workers. Ultimately, the author argues that ethnic networks are embedded in the larger economy and context of racial-ethnic hierarchies. This research sheds light on everyday interactions among Asian immigrant restaurant owners and workers. The author highlights how an uncritical focus on the benefits of ethnic networks obscures constraints in social networks.
Structural Behavior of the Endothelial Glycocalyx Is Associated With Pathophysiologic Status in Septic Mice: An Integrated Approach to Analyzing the Behavior and Function of the Glycocalyx Using Both Electron and Fluorescence Intravital Microscopy
Authors: Kataoka Hanae , Ushiyama Akira , Akimoto Yoshihiro , Matsubara Sachie , Kawakami Hayato , Iijima Takehiko
Published: May 2017

BACKGROUND:

The endothelial surface layer (ESL) regulates vascular permeability to maintain fluid homeostasis. The glycocalyx (GCX), which has a complex and fragile ultrastructure, is an important component of the ESL. Abnormalities of the GCX have been hypothesized to trigger pathological hyperpermeability. Here, we report an integrated in vivo analysis of the morphological and functional properties of the GCX in a vital organ.

METHODS:

We examined the behavior of the ESL and GCX, using both electron microscopy (EM) and intravital microscopy (IVM). We also compared morphological changes in the ESL of mouse skin in a glycosidase-treated and control group. Combined approaches were also used to examine both morphology and function in a lipopolysaccharide-induced septic model and the pathophysiological features of leukocyte–endothelial interactions and in vivo vascular permeability.

RESULTS:

Using IVM, we identified an illuminated part of the ESL as the GCX and confirmed our observation using morphological and biochemical means. In septic mice, we found that the GCX was thinner than in nonseptic controls in both an EM image analysis (0.98 ± 2.08 nm vs 70.68 ± 36.36 nm, P< .001) and an IVM image analysis (0.36 ± 0.15 μm vs 1.07 ± 0.39 μm, P< .001). Under septic conditions, syndecan-1, a representative core protein of the GCX, was released into the blood serum at a higher rate in septic animals (7.33 ± 3.46 ng/mL) when compared with controls (below the limit of detection, P< .001). Significant increases in leukocyte–endothelial interactions, defined as the numbers of rolling or firm-sticking leukocytes, and molecular hyperpermeability to the interstitium were also observed after GCX shedding in vivo.

CONCLUSIONS:

Using IVM, we visualized an illuminated part of the ESL layer that was subsequently confirmed as the GCX using EM. Severe sepsis induced morphological degradation of the GCX, accompanied by shedding of the syndecan-1 core protein and an increase in leukocyte–endothelial interactions affecting the vascular permeability. Our in vivo model describes a new approach to deciphering the relationship between structural and functional behaviors of the GCX.
Tablet e-Logbooks: Four Thousand Clinical Cases and Complications e-Logged by 14 Nondoctor Anesthesia Providers in Nepal
Authors: Shah Shristi , Ross Oliver , Pickering Stephen , Knoble Stephen , Rai Indra
Published: May 2017

BACKGROUND:

To meet the need for essential surgery across rural Nepal, anesthesia at district level is delivered by nondoctor anesthetists. They require support to maintain confidence and competence, and upgraded professional registration to secure their status. To meet these needs, a distance-blended learning course was pioneered and delivered. A core course requirement was to log all clinical cases; these were logged on a new e-logbook.

METHODS:

Fourteen nondoctor anesthesia providers working in 12 different districts across Nepal were enrolled in the 1-year course. The course is based on self-completion on a tablet loaded with new learning modules, a resource library, and a case logbook. Continuous educational mentoring was provided by anesthesiologists by phone and email. The logbook included preanesthesia assessment and interventions, American Society of Anesthesiologists (ASA) grading, types of cases and anesthesia given, monitors used, complications, outcomes and free text remarks. Cases were uploaded monthly to a database, and mentors reviewed all logbook entries.

RESULTS:

The 14 nondoctor anesthesia providers were widely distributed across the country in district, zonal, community, and mission hospitals, and had different levels of clinical experience and caseloads. Logbooks and uploads were regularly completed without difficulty; 1% cases were entered incompletely with no case details provided. A total of 4143 cases were recorded. Annual caseload per nondoctor anesthesia provider ranged from 50 to 788, the majority of which were under spinal anesthesia; 34% of the total cases were cesarean deliveries, of which 99% received spinal anesthesia. Fifty gastrointestinal laparotomies (1% total) were recorded. Ninety-one percent of cases were ASA I, 0.8% ASA III/IV. Pulse oximetry was used in 98% of cases. Complications were recorded in 6% of cases; the most common were circulation problems (69%) including hypotension and occasional bradycardia after spinal anesthesia. Airway complications were usually under ketamine anesthesia requiring basic airway maneuvers; 4 difficult intubations were recorded under general anesthesia. Anesthesia outcomes were good with overall mortality of 0.1% (total 4 cases). Causes of death included severe preeclampsia, sepsis postlaparotomy, and patients with multiorgan failure for minor procedure.

CONCLUSIONS:

The tablet-based electronic anesthesia logbook was successfully used to record cases, complications, and outcomes across rural Nepal. The nondoctor anesthesia providers had trust and confidence in recording outcomes. It remains to be tested whether an e-logbook would be routinely completed outside of a specific training course. Such a logbook could be incorporated into all continuous professional development programs for rural nondoctor anesthetists.
Food for thought
Authors: Hayward Deborah
Published: May 2017

A report on the topics dished up at the 2017 BETA Feed Conference, by Deborah Hayward
Supplements for horses
Authors: Warren Helen
Published: May 2017

Dr Helen Warren, investigates whether horse owners really understand what and why they are feeding supplements to their horses and, how to make an informed choice
Hoof wall separation disease
Authors: Logie Sarah
Published: May 2017

Sarah Logie AWCF discusses this debilitating condition
Allergic reactions
Authors: Watson Rebecca
Published: May 2017

Rebecca Watson, MSc RVN discusses some of the more common triggers and symptoms
Charity helps to improve veterinary knowledge
Authors: Maguire Liam
Published: May 2017

Liam Maguire, World Horse Welfare director of international operations, explains how their veterinary training projects are helping working equids
No place for the rigid cervical collar in pre-hospital care
Authors: Rogers Leigh
Published: May 2017

The cervical collar was introduced to pre-hospital practice in 1967. It has been widely acknowledged that evidence supporting its use has been lacking, and that its use was therefore based upon hypothetical benefit. However, modern evidence challenges the very principle of immobilisations on which the collar's use was justified, and argues that the cervical collar is an ineffective immobilisation tool regardless. Cervical collars have always been thought to be a relatively harmless measure, and their precautionary use therefore encouraged in order to protect those few patients who have sustained an injury. Yet, there is an increasing volume of evidence to say that the application of cervical collars can be harmful to patients. An assessment of today's evidence justifies an immediate change of practice, and EMS providers across the world are adapting accordingly. The UK remains entrenched in rigid trauma protocol, which is not consistent with the principles of patient safety, evidence-based practice or the HCPC's Standards of Proficiency for Paramedics. Practice change is well overdue.
Appropriateness of action learning in the physical and virtual spaces: a discussion
Authors: Willis Sam , Prass Nicolas , Karstadt Lyn
Published: May 2017

Paramedics are autonomous health professionals who must graduate into the workforce with complex problem-solving skills, an ability to exercise critical thinking, and clinical reasoning skills to challenging situations, if they are to practise safely. Face-to-face action learning (AL) has long been acknowledged for contributing to the development of such skills, by providing a platform for structured thinking, group working, and a tool for developing participant's ability to ask insightful questions ( Pedler et al, 2005 ) and more recently, action learning in the virtual space is becoming increasingly popular. Virtual action learning has emerged for reasons including globalisation, where the emergence of multi-national and dispersed students has become commonplace ( Dickenson et al, 2010 ) and advances in technology that have allowed more collaborative communication.

This discussion paper provides an introduction and background to action learning (AL), virtual action learning (VAL) and explores the appropriateness of these paradigms as a tool for embedding reflective practice and problem-solving skills among undergraduate student paramedics.
CattleReview
Authors: Barrett David C
Published: May 2017

Introduction:

This edition of Cattle Review considers papers on farmer and veterinary attitudes to disease prevention and medicine prescribing respectively, as well as the antimicrobial resistance risks of feeding waste milk to calves.
Research roundup: May 2017
Authors: Greener Mark
Published: May 2017

In brief

Long-term antibiotic use by adults seems to increase the risk of colorectal adenoma Taking antidepressants during pregnancy does not seem to increase the risk of autism and other neurodevelopmental disorders People with psoriasis may be at increased risk of uveitis
Statins: All you need to know
Authors: Rees Sharon
Published: May 2017

Despite quality and outcomes framework (QOF) targets and impressive research credentials, statins remain underused. Even in those on the medication, statins have failed to reach their full potential in preventing cardiovascular disease (CVD). The reasons for both appear to be multifactorial and probably include public perception, clinician reluctance to switch or up-titrate, as well as concordance issues.

This article aims to explain the reasons why statins are important in the adult population, and will provide the prescribing information to enable confident and informed choices to be made by patients and clinicians. The focus is on lipid-lowering drug actions in older adults, rather than on the multitude of potential therapeutic actions of statins, such as treatment of multiple sclerosis and cancer.
Drug action: The therapeutic effect
Authors: Robertson Deborah
Published: May 2017

In this article in the series of ‘bite sized’ pharmacology, we will look at the concept of drug action—the therapeutic effect of the medications we give. It is important that prescribers are aware of factors that can affect drug action and the time-to-onset, and subsequent duration of, the desired therapeutic effect. This article will look at factors that affect these two important areas of drug action. Knowledge of these factors can assist the prescriber when deciding on doses and dose schedules to ensure that patients receive their medications at the correct dosing, by the correct route and in the right formulation to ensure optimum therapeutic effect. It also helps the prescriber understand why dose adjustments are made or some drugs are avoided in patients with hepatic or renal impairment.
Food for thought
Authors: Cox Ella
Published: May 2017

Ella Cox examines the role of diet advice in the prevention and management of type 2 diabetes. She discusses the challenges as a non-medical prescriber working with people with obesity and diabetes and questions what can be done to help?
Supporting smokers to quit in general practice
Authors: Croghan Emma
Published: May 2017

Practice nurses can play an invaluable role in helping patients to stop smoking. Emma Croghan outlines smoking risks and different ways people can be helped to quit

Smoking tobacco is the single biggest preventable cause of mortality in England and Wales and is the cause of much ill-health with over 1.5 million people in England suffering from a smoking-related disease. This article provides an overview of smoking cessation training needs for practice nurses, information on carbon monoxide and advice on the different methods of cessation and relevant medication.
Research Roundup
Authors: Winter George
Published: May 2017

George Winter provides an overview of recently published articles that may be of interest to practice nurses. Should you wish to look at any of the papers in more detail, a full reference is provided.
Offenes Erzählen
Authors: Mothes Ulrike
Published: May 2017

Der Dokumentarfilm gilt in Indien als kommerziell schwer auswertbares Genre - und stellt dennoch ein Feld dar, in welchem Experimente entstehen können. Angesichts der gegenwärtigen gesellschaftlichen Umbrüche untersucht Ulrike Mothes den aktuellen indischen Dokumentarfilm hinsichtlich seiner filmästhetischen Form und betrachtet seine Positionierung zwischen lokalen und globalen Bezugnahmen, politischem Diskurs und kulturellem Ausdruck. Ihr besonderes Augenmerk liegt dabei auf der Beschreibung offener Erzählstrategien, welche die Annahme von Wahrheit als solcher hinterfragen und mehrere Deutungen eines Themas zulassen.
Landschaft und Atmosphäre
Authors: Ulber Marie
Published: May 2017

Atmosphären sind ein allgegenwärtiges und zugleich vielfach unterschätztes Phänomen der Wahrnehmung. Im Anschluss an Gernot Böhme und den Architekten Peter Zumthor wendet Marie Ulber das Atmosphärenkonzept auf die Landschaftsästhetik an und erweitert es für Umweltgestalter_innen. Ein eigens entwickeltes »System der Prägung« zeigt dabei die Zusammenhänge von Umgebungsqualitäten, Atmosphärencharakter und menschlichem Erleben auf. Die Atmosphären ausgewählter anthropogener Landschaften werden mittels künstlerischer Forschung übersetzt und anschließend verglichen. Mit der Verflechtung von Kunst und Wissenschaft erschließt die Studie wichtige Dimensionen der Atmosphären und weist die vielfältigen Korrelationen von Mensch und Umgebung nach.
Gender und Gaming
Authors: Hahn Sabine
Published: May 2017

Computerspiele sind aus medienökonomischer Sicht zwar längst ein Massenmedium, in der gesellschaftlichen Wahrnehmung werden sie jedoch tendenziell immer noch als Spielzeug vornehmlich für junge Männer wahrgenommen. Dabei liegt der Anteil derjenigen, die regelmäßig spielen, in Deutschland bei fast 50 Prozent der Bevölkerung - und hiervon sind wiederum ca. 45 Prozent Spielerinnen. Ausgehend von diesem Missverhältnis zwischen gesellschaftlicher Verbreitung und Wahrnehmung rückt Sabine Hahn einerseits aus kulturwissenschaftlicher Perspektive die Spielerinnen in den Fokus und wirft andererseits aus mediensoziologischer bzw. kommunikationswissenschaftlicher Perspektive einen Blick hinter die Kulissen der Games-Industrie.
Öffentliche Institutionen als weiße Räume?
Authors: Wagner Constantin
Published: May 2017

Welche Bedeutung hat die wahrgenommene »ethnische Zugehörigkeit« von Klient_innen und Patient_innen auf deren Behandlung in öffentlichen Institutionen? Am Beispiel eines schweizerischen Sozialamts untersucht Constantin Wagner, wie ethnisierende Kategorisierungen im Organisations- und Akteurshandeln praxisrelevant werden und rassismusreproduzierend wirken. Das Weißsein - also die eigene »ethnische Zugehörigkeit« - der fallführenden Sozialarbeiter_innen rückt dabei in den Fokus. Zudem wird die Frage von »Diversität« im Öffentlichen Dienst aus einer im Mainstream nicht vorhandenen macht- und rassismuskritischen Perspektive betrachtet.
Use of plant-derived products to control household and structural arthropod pests
Authors: Gahukar Ruparao
Published: May 2017

Plant extracts in water or chemical solvents; crude oil, essential oils and other allelochemicals of several plant species were tested at the laboratory as contact poison and/or fumigant. Most of them acted as repellent to insects and mites. Toxicity effect was dose-dependent and varied as per plant species and organism tested. In some instances, plant-derived products causing mortality were less effective than synthetic pesticides. However, considering possible environmental contamination of synthetics and the eventual toxicity to non-target organisms, plant-derived products against household and structural pests have been recommended by researchers. The major pest species with mode of actions of plant products and integrated strategies for effective, practical and ecofriendly pest control are discussed throughout this review.
Driving, not Losing, the Plot: Narrative Patterns in Implicit and Explicit Fictional Representations of Dementia
Authors: Völk Malte
Published: May 2017

This essay examines representations of dementia in literary works. It draws a distinction between those representations of dementia symptoms that can be understood as implicit and those that can be understood as explicit. Whereas implicit representations do not treat dementia as a distinct, clearly identified disorder, they nonetheless display a certain similarity to the explicitly medicalized discussion of dementia symptoms. This similarity lies in the fact that dementia symptoms are used to drive forward the narrative action. The essay traces this pattern by analysing different literary works with this feature in common and discusses the significance of this narrative’s dynamic potential for the plasticity of cultural narratives of dementia and old age.
On the statistical power of Baarda’s outlier test and some alternative
Authors: Lehmann R. , Voß-Böhme A.
Published: May 2017

Baarda’s outlier test is one of the best established theories in geodetic practice. The optimal test statistic of the local model test for a single outlier is known as the normalized residual. Also other model disturbances can be detected and identified with this test. It enjoys the property of being a uniformly most powerful invariant (UMPI) test, but is not a uniformly most powerful (UMP) test. In this contribution we will prove that in the class of test statistics following a common central or non-central χ2 distribution, Baarda’s solution is also uniformly most powerful, i.e. UMPχ2 for short. It turns out that UMPχ2 is identical to UMPI, such that this proof can be seen as another proof of the UMPI property of the test. We demonstrate by an example that by means of the Monte Carlo method it is even possible to construct test statistics, which are regionally more powerful than Baarda’s solution. They follow a so-called generalized χ2 distribution. Due to high computational costs we do not yet propose this as a ”new outlier detection method”, but only as a proof that it is in principle possible to outperform the statistical power of Baarda’s test.
Hydrographic survey of a south Florida canal using a hydrolite
Authors: Berber M. , Wright W.
Published: May 2017

In this study, a hydrographic map of a South Florida canal is prepared using RTK GPS (Real Time Kinematic Global Positioning System) measurements combined with a hydrolite (single beam echo sounder). RTK GPS measurements are made using both single RTK and Network RTK systems. Digital sounding measurements taken by hydrolite are compared to manual lead line measurements. Single RTK and Network RTK results differed in the order of tenth of a foot accuracy for horizontal coordinates and for height measurements variations can go up to several tenths. Sounding results indicate a best-fit trend line with a slope of 0.993, and an R squared value of 0.972, demonstrating that hydrolite measurements and manually collected depths at this site are well correlated.
The crystal structure of 1,2-bis[2-methyl-5-(3-cyanophenyl)-3-thienyl]-3,3,4,4,5,5-hexafluoro-cyclopent-1-ene, C29H16F6N2S2
Authors: Lei Luo-Na , Xu Wen-Yuan , Yi Jian-Min
Published: May 2017

C29H16F6N2S2, monoclinic, C2/c, a = 18.910(3) Å, b = 8.5720(14) Å, c = 16.757(3) Å, β = 100.474(2)°, V = 2670.9(7) Å3, Z = 4, R
gt(F) = 0.0825 , wR
ref(F
2) = 0.1833 , T = 296(2) K.
Crystal structure of 1,1-bis(η
5-adamantylcyclopentadienyl)-3-phenyl-2-trimethylsilyl-2,3-dihydroisotitanazole, C42H55NSiTi
Authors: Manßen Manfred , Schmidtmann Marc , Beckhaus Rüdiger
Published: May 2017

C42H55NSiTi, triclinic, P1̅ (no. 2), a = 9.2556(4) Å, b = 12.5048(5) Å, c = 15.7350(7) Å, α = 69.6151(13)°, β = 85.3502(14)°, γ = 83.8861(14)°, V = 1695.51(13) Å3, Z = 2, R
gt(F) = 0.0334, wR
ref(F
2) = 0.0885, T = 100(2) K.
Transposon‐driven transcription is a conserved feature of vertebrate spermatogenesis and transcript evolution
Authors: Davis Matthew P , Carrieri Claudia , Saini Harpreet K , van Dongen Stijn , Leonardi Tommaso , Bussotti Giovanni , Monahan Jack M , Auchynnikava Tania , Bitetti Angelo , Rappsilber Juri , Allshire Robin C , Shkumatava Alena , O'Carroll Dónal , Enright Anton J
Published: May 2017

Spermatogenesis is associated with major and unique changes to chromosomes and chromatin. Here, we sought to understand the impact of these changes on spermatogenic transcriptomes. We show that long terminal repeats (LTRs) of specific mouse endogenous retroviruses (ERVs) drive the expression of many long non‐coding transcripts (lncRNA). This process occurs post‐mitotically predominantly in spermatocytes and round spermatids. We demonstrate that this transposon‐driven lncRNA expression is a conserved feature of vertebrate spermatogenesis. We propose that transposon promoters are a mechanism by which the genome can explore novel transcriptional substrates, increasing evolutionary plasticity and allowing for the genesis of novel coding and non‐coding genes. Accordingly, we show that a small fraction of these novel ERV‐driven transcripts encode short open reading frames that produce detectable peptides. Finally, we find that distinct ERV elements from the same subfamilies act as differentially activated promoters in a tissue‐specific context. In summary, we demonstrate that LTRs can act as tissue‐specific promoters and contribute to post‐mitotic spermatogenic transcriptome diversity.
ZBTB48 is both a vertebrate telomere‐binding protein and a transcriptional activator
Authors: Jahn Arne , Rane Grishma , Paszkowski‐Rogacz Maciej , Sayols Sergi , Bluhm Alina , Han Chung‐Ting , Draškovič Irena , Londoño‐Vallejo José Arturo , Kumar Alan Prem , Buchholz Frank , Butter Falk , Kappei Dennis
Published: May 2017

Telomeres constitute the ends of linear chromosomes and together with the shelterin complex form a structure essential for genome maintenance and stability. In addition to the constitutive binding of the shelterin complex, other direct, yet more transient interactions are mediated by the CST complex and HOT1/HMBOX1, while subtelomeric variant repeats are recognized by NR2C/F transcription factors. Recently, the Kruppel‐like zinc finger protein ZBTB48/HKR3/TZAP has been described as a novel telomere‐associated factor in the vertebrate lineage. Here, we show that ZBTB48 binds directly both to telomeric and to subtelomeric variant repeat sequences. ZBTB48 is found at telomeres of human cancer cells regardless of the mode of telomere maintenance and it acts as a negative regulator of telomere length. In addition to its telomeric function, we demonstrate through a combination of RNAseq, ChIPseq and expression proteomics experiments that ZBTB48 acts as a transcriptional activator on a small set of target genes, including mitochondrial fission process 1 (MTFP1). This discovery places ZBTB48 at the interface of telomere length regulation, transcriptional control and mitochondrial metabolism.
TZAP‐ing telomeres down to size
Authors: Garcia‐Exposito Laura , O'Sullivan Roderick J
Published: May 2017

The phenomenon of gradual telomere shortening has become a paradigm for how we understand the biology of aging and cancer. Cell proliferation is accompanied by cumulative telomere loss, and the aged cell either senesces, dies or transforms toward cancer. This transformation requires the activation of telomere elongation mechanisms in order to restore telomere length such that cell death or senescence programs are not induced. Most of the time, this occurs through telomerase reactivation. In other rare cases, the Alternative lengthening of telomeres (ALT) pathway hijacks DNA recombination‐associated mechanisms to hyperextend telomeres, often to more than 50 kb. Why telomere length is restricted and what sets their maximal length has been a long‐standing puzzle in cell biology. Two recent studies published in this issue of EMBO Reports [1] and recently in Science [2] sought to address this important question. Both built on omics approaches that identified ZBTB48 as a potential telomere‐associated protein and reveal it to be a critical regulator of telomere length homeostasis by the telomere trimming mechanism. These discoveries provide fundamental insights for our understanding of telomere trimming and how it impacts telomere integrity in stem and cancer cells.