bluuebunny/crossref_metadata_2025 huggingface dataset:
Vancomycin-resistance Enterococcal Colonization in Hospitalized Patients in Relation to Antibiotic Usage in a Tertiary Care Hospital of North India
Authors: Banerjee Tuhina , Anupurba Shampa , Filgona Joel , Singh Dinesh K
Published: August 2015

Background: Alarming rise of vancomycin-resistant enterococci (VRE) is a global cause of concern. Several factors have been held responsible for such rise, of which antibiotic usage is a prominent one.

Objectives: This study was undertaken to determine the intestinal VRE colonization rate amongst hospitalized patients in relation to use of various antibiotics in the Intensive Care Unit (ICU) of a tertiary care university hospital, India.

Materials and Methods: Stool samples were collected weekly from all the patients in the adult ICU for a period of 6 months and processed for isolation and phenotypic and genotypic characterization of VRE isolates. Patient and treatment details were noted and cases (those with VRE in stool) and controls (those without VRE in stool) were compared statistically. Further, a multivariate analysis was done to identify those antibiotics as independent risk factors for VRE colonization.

Results: VRE colonization was found in 34.56% (28/81) of the patients studied, with the majority 75% (21/28) carrying the vanA gene. The cases had significantly more (P < 0.05) duration of hospital stay and antibiotic exposure. Intake of metronidazole, vancomycin, and piperacillin-tazobactam were identified as significant risk factors both in univariate and multivariate analysis.

Conclusion: A potential reservoir of VRE was thus revealed even in low VRE prevalence setting. Based on this high colonization status, restriction of empirical antibiotic use, reviewing of the ongoing antibiotic policy, and active VRE surveillance as an integral part of infection control strategy were suggested.
Prevalence of Mupirocin Resistance Among Staphylococci, its Clinical Significance and Relationship to Clinical Use
Authors: Rudresh Manohar Shoorashetty , Ravi Giriyapur Siddappa , Motagi Aravind , Alex Ann Mary , Sandhya Parthasarathi , Navaneeth Bangalore Viswanath
Published: August 2015

Introduction: Mupirocin competitively inhibits bacterial isoleucyl transfer-RNA synthetase and inhibit bacterial protein synthesis. Widespread usage and over the counter availability of the drug has resulted in resistance among Staphylococcus species.

Objectives: This study aimed to determine the overall prevalence of mupirocin resistance among staphylococci. Correlate clinical significance of mupirocin resistance and its relationship to clinical use.

Methods: Consecutive, nonrepetitive, clinical isolates of Staphylococcus aureus (n = 98), and coagulase-negative staphylococci (CoNS) (n = 45) from skin and soft-tissue infections between January 2014 and June 2014 were studied. Antibiotic susceptibility testing was done according to Clinical and Laboratory Standards Institute guidelines. Low- and high-level mupirocin resistance was screened by using 5 μg and 200 μg discs respectively and confirmed by agar dilution. Annual consumption of mupirocin was studied and correlated with resistance.

Results: High-level mupirocin resistance was found in 8.2% S. aureus and 15.6% of CoNS, while low-level mupirocin resistance was found in 17% S. aureus and 8.9% CoNS. High-level mupirocin resistance was more common in methicillin-sensitive S. aureus isolates when compared with methicillin-resistant S. aureus isolates (P < 0.05). Mupirocin resistant S. epidermidis were associated with methicillin resistance and constitutive clindamycin resistance.

Conclusion: High prevalence of mupirocin resistance was found in the present study. Increased prevalence of mupirocin resistance among community-acquired staphylococci demands the judicious use of the drug in the community.
Renal Abscess Caused by Salmonella Typhi
Authors: Kaur Amarjeet , Sarma Smita , Kumar Navin , Sengupta Sharmila
Published: August 2015

Salmonella typhi is a true pathogen, which is capable of causing both intestinal and extraintestinal infections. Unusual presentations of Salmonella should always be kept in mind as this organism can cause disease in almost any organ of the body. S. typhi has been reported to cause the life-threatening infections such as meningitis, endocarditis, myocarditis, empyema, and hepatic abscess. Renal involvement by S. typhi is a relatively rare presentation. We report a case of renal abscess caused by S. typhi in an afebrile, 10-year-old child who did not have any clinical history of enteric fever. To our knowledge, this is the first reported case of isolation of S. typhi from the renal abscess, and interestingly this isolate was found to be resistant to quinolones.
Achromobacter Xylosoxidans Bloodstream Infection in Elderly Patient with Hepatocellular Carcinoma: Case Report and Review of Literature
Authors: Raghuraman Kausalya , Ahmed Nishat H , Baruah Frincy K , Grover Rajesh K
Published: August 2015

Achromobacter xylosoxidans is a nonfermentative Gram-negative organism, known to cause opportunistic infection in humans. We report a case of septicemia in a 76-year-old male patient with underlying hepatocellular carcinoma due to A. xylosoxidans, which showed a different antimicrobial susceptibility pattern from what is usually reported. From aerobic blood culture of the patient, A. xylosoxidans was isolated which was found to be sensitive to amoxicillin-clavulanic acid, piperacillin-tazobactam, ceftazidime, cefoperazone-sulbactam, meropenem, minocycline, tigecycline, and trimethoprim/sulfamethoxazole. The patient recovered with amoxicillin-clavulanic acid treatment, which was given empirically to the patient. The present case highlights the possible role of amoxicillin-clavulanic acid for treatment of bloodstream infection with A. xylosoxidans.
Perinatal Autopsy Findings in a Case of De Novo Hypohidrotic Ectodermal Dysplasia
Authors: Chikkannaiah Panduranga , Nagaraju Smitha , Kangle Rajit , Gosavi Mansi
Published: August 2015

Ectodermal dysplasia are group of inherited disorders involving the developmental defects of ectodermal structures like hair, teeth, nails, sweat glands, and others. X-linked recessive inheritance is most common. Here we describe perinatal autopsy findings in a case of de novo ectodermal dysplasia in a female fetus. To the best of our knowledge, this is the first fetal autopsy description in a case of ectodermal dysplasia.
Automatic volcanic ash detection from MODIS observations using a back-propagation neural network
Authors: Gray T. M. , Bennartz R.
Published: August 2015

Abstract. Due to the climate effects and aviation threats of volcanic eruptions, it is important to accurately locate ash in the atmosphere. This study aims to explore the accuracy and reliability of training a neural network to identify cases of ash using observations from the Moderate Resolution Imaging Spectroradiometer (MODIS). Satellite images were obtained for the following eruptions: Kasatochi, Aleutian Islands, 2008; Okmok, Aleutian Islands, 2008; Grímsvötn, northeastern Iceland, 2011; Chaiteìn, southern Chile, 2008; Puyehue-Cordoìn Caulle, central Chile, 2011; Sangeang Api, Indonesia, 2014; and Kelut, Indonesia, 2014. The Hybrid Single Particle Lagrangian Integrated Trajectory Model (HYSPLIT) was used to obtain ash concentrations for the same archived eruptions. Two back-propagation neural networks were then trained using brightness temperature differences as inputs obtained via the following band combinations: 12-11, 11-8.6, 11-7.3, and 11 μm. Using the ash concentrations determined via HYSPLIT, flags were created to differentiate between ash (1) and no ash (0) and SO2-rich ash (1) and no SO2-rich ash (0) and used as output. When neural network output was compared to the test dataset, 93 % of pixels containing ash were correctly identified and 7 % were missed. Nearly 100 % of pixels containing SO2-rich ash were correctly identified. The optimal thresholds, determined using Heidke skill scores, for ash retrieval and SO2-rich ash retrieval were 0.48 and 0.47, respectively. The networks show significantly less accuracy in the presence of high water vapor, liquid water, ice, or dust concentrations. Significant errors are also observed at the edge of the MODIS swath.
Evaluation of an operational ocean model configuration at 1/12° spatial resolution for the Indonesian seas – Part 1: Ocean physics
Authors: Tranchant B. , Reffray G. , Greiner E. , Nugroho D. , Koch-Larrouy A. , Gaspar P.
Published: August 2015

Abstract. INDO12, a 1/12° regional version of the NEMO physical ocean model covering the whole Indonesian EEZ has been developed and is now running every week in the framework of the INDESO project (Infrastructure Development of Space Oceanography) implemented by the Indonesian Ministry of Marine Affairs and Fisheries. The initial hydrographic conditions as well as open boundary conditions are derived from the operational global ocean forecasting system at 1/4° operated by Mercator Ocean. Atmospheric forcing fields (3 hourly ECMWF analyses) are used to force the regional model. INDO12 is also forced by tidal currents and elevations, and by the inverse barometer effect. The turbulent mixing induced by internal tides is taken into account through a specific parameterization. In this study we evaluate the model skill through comparisons with various datasets including outputs of the parent model, climatologies, in situ temperature and salinity measurements, and satellite data. The simulated and altimeter-derived Eddy Kinetic Energy fields display similar patterns and confirm that tides are a dominant forcing in the area. The volume transport of the Indonesian ThroughFlow is in good agreement with the INSTANT current meter estimates while the transport through Luzon Strait is, on average, westward but probably too weak. Significant water mass transformation occurs along the main routes of the Indonesian Throughflow (ITF) and compares well with observations. Vertical mixing is able to erode the South and North Pacific subtropical waters salinity maximum as seen in TS diagrams. Compared to satellite data, surface salinity and temperature fields display marked biases in the South China Sea. Altogether, INDO12 proves to be able to provide a very realistic simulation of the ocean circulation and water mass transformation through the Indonesian Archipelago. A few weaknesses are also detected. Work is on-going to reduce or eliminate these problems in the second INDO12 version.
Hydroelastic analysis of ice shelves under long wave excitation
Authors: Papathanasiou T. K. , Karperaki A. E. , Theotokoglou E. E. , Belibassakis K. A.
Published: August 2015

Abstract. The transient hydroelastic response of an ice shelf under long wave excitation is analysed by means of the finite element method. The simple model, presented in this work, is used for the simulation of the generated kinematic and stress fields in an ice shelf, when the latter interacts with a tsunami wave. The ice shelf, being of large length compared to its thickness, is modelled as an elastic Euler-Bernoulli beam, constrained at the grounding line. The hydrodynamic field is represented by the linearised shallow water equations. The numerical solution is based on the development of a special hydroelastic finite element for the system of governing of equations. Motivated by the 2011 Sulzberger Ice Shelf (SIS) calving event and its correlation with the Honshu Tsunami, the SIS stable configuration is studied. The extreme values of the bending moment distribution in both space and time are examined. Finally, the location of these extrema is investigated for different values of ice shelf thickness and tsunami wave length.
A numerical study of the early stages of a tropical cyclogenesis in relation to the MJO
Authors: Guerbette J. , Plu M. , Barthe C. , Mahfouf J.-F.
Published: August 2015

Abstract. The role of an active phase of the Madden–Julian Oscillation (MJO) on the evolution of a mesoscale convective systems (MCS) leading to a tropical depression is investigated in the South-West Indian Ocean during the Dynamics of the Madden–Julian Oscillation (DYNAMO) field experiment, with a numerical limited-area atmospheric model. A mesoscale vortex is followed in the low-troposphere from the initiation of the active MJO phase. It is shown that the interaction of the vortex with the Equatorial jet associated with the MJO plays an important role on the vortex development. As the vortex encounters the southern part of the low-level jet, it undergoes intensification that is explained by the barotropic conversion of kinetic energy from the low-level jet to the vortex.
VAIKŲ KVĖPAVIMO SISTEMOS RODIKLIŲ FUNKCINIŲ RYŠIŲ ĮVERTINIMAS PRIKLAUSOMAI NUO LYTIES
Authors: Pereckienė Rimantė , Astrauskienė Audronė , Zachovajevienė Brigita , Zachovajevas Pavelas
Published: August 2015

Research aim was to identify functional relationships of the respiratory system for different gender childrens. There took part in research the children, which parents where informed about execution procedure and the parents accepted using of research results. Persons for research were detected according following criterions: age 7-8 years old, no motoric development problems, no infections invasions, ability for free physical action and freedom for activity after school time, no additional sporting after school time, no problems in case of breath and breath channels muscules. There were evaluated living capacity of lungs using pyrometer. Maximal exhalation speed measured using pneumotachometer. Power of breath muscules measured maximal inhalation (PImax) and exhalation (PEmax) pressure using pneumotonometer. The measurement device Micro Medical RPM used for maximal breath pressure measurement in this research. There were detected, that 39% of girls living capacity of lungs is normal limits, the rest 61% proportions are: 28% girls have less living capacity of lungs than the norms, and 33% have bigger than the norms are (p<0,05). Data of boys during living capacity of lungs evaluation and comparing it to the norms have the following results: 17% have living capacity of lungs below norms, and it is the smallest part in this research. Data according norms limits are 42%, and results, what exceed‘s the norms, are 43% (p<0,05). Conclusion. The boys usually have living capacity of lungs, maximal exhalation flow speed, maximal inhalation and exhalation pressure above norms and higher than that indexes of girls are. There exist functional relationships between functional indexes: if one of indexes is higher, other indexes increase in it‘s values too.
DNR METILINIMO POKYČIAI PERIFERINIO KRAUJO LEUKOCITUOSE PACIENTAMS, SERGANTIEMS SKRANDŽIO VĖŽIU
Authors: Daukša Albertas , Gulbinas Antanas , Kazlauskaitė Aurelija , Oldenburg Johannes , El-Maarri Osman
Published: August 2015

Gastric cancers are usually diagnosed at an advanced stage in the progression of the disease, thus reducing the survival chances of the patients. Non-invasive early detection would greatly enhance therapy and survival rates. For this aim, we investigated tumor suppressor genes CDKN2A/p16, RARBeta, TNFRSF10C, APC, ACIN1, DAPK1, 3OST2, BCL2 and CD44 for methylation changes in peripheral blood leukocytes of gastric cancer patients. This study shows that methylation changes in peripheral blood leukocyte DNA could provide a promising method for the early detection of gastric cancer. However, larger studies are essential to explore the clinical usefulness of a peripheral blood leukocyte DNA methylation based tests for non-invasive early detection of gastric cancer.
PACIENTŲ POŽIŪRIS Į ANESTEZIJOS METODĄ IR JO PASIRINKIMO MOTYVAI
Authors: Birutė Dagnė , Bukauskas Tomas , Macas Andrius
Published: August 2015

Patients often have preconceptions about their planned procedures, therefore they have their own opinion about different types of anesthesia. We conducted a prospective questionnaire survey of surgical patients with the aim to investigate patients‘ attitudes to different methods of anesthesia (patients had to agree or not with some statements about types of anesthesia) and find out the reasons for their choices and what general characteristics (age, sex, education, previous anesthesia, etc.) could lead to their choice. I-III ASA class patients undergoing elective surgery were asked to answer the questionnaire of 25 questions - 21 questions before and 4 after surgery. Patients were visited preoperative day and the second day after surgery. The survey involved 101 patients. The results suggest that the proposed type of anesthesia depends on the operation type. The patient‘s choice of anesthesia is not led by their sex, age, education, previous operations, unpleasant sensations in the previous operations. Patients also tend to congregate anesthesiologist recommended anesthesia. According to the findings, we can conclude that the anesthesiologist’s proposed anesthesia type patients accepted as the best and it formed patients‘ opinion about the different types of anesthesia.http://dx.doi.org/10.5200/sm-hs.2013.048
COUNSELLING OF PREGNANT WOMEN AT THE PHARMACY ABOUT RATIONAL USE OF MEDICINAL SUBSTANCES: ASSOCIATION WITH AGE AND EDUCATION OF PHARMACY SPECIALISTS
Authors: Grincevičienė Švitrigailė
Published: August 2015

Pharmacy specialists are responsible for counsel ling about rational use of medicinal substance in so ciety, but not all of them provide advice for the pa tients. So the aim of this study was to analyze the association between counselling of pregnant wom en at Lithuanian pharmacies about rational use of medicinal substances and pharmacy specialist’s age and educational background. Methods. Random sample of Lithuanian pharmacy specialists (N = 440) was anonymously questioned during the period of March-October, 2012. “FIP reference paper on the effective utilization of pharmacists in improving maternal, newborn and child health” was used for the development of questions about the counselling of pregnant women about rational use of medicinal substances. Results. The odds ratio of more frequent counselling was higher in the case of millennial generation comparing with baby boomers (OR = 3.521 (CI 95% = 6.135 – 2.020)). Higher proportion of pharmacists, compared to pharmacy technicians (p< 0.05), were counselling about rational use of synthetized medicinal substances and non-pharmacological alternatives (millennial generation) and almost all topics of rational use of medicinal substances (baby boomers). Conclusions. Age was associated with the frequency of counselling about rational use of medicinal substances. Age and educational background was associated with counselling topics during pregnancy.
KARDIOVASKULINĖS SISTEMOS BIOLOGINIS LAIKRODIS: KOKS CIRKADINIŲ RITMŲ VAIDMUO ŪMINIO MIOKARDO INFARKTO PATOGENEZĖJE?
Authors: Šerpytis Pranas , Misiūra Jonas , Berūkštis Egidijus , Pelanytė Simona
Published: August 2015

Aim of study: to analyse data of initial or re-hospitalizations in Vilnius University Hospital Santariskes Clinic Cardiologic Reanimation and Intensive Care unit due to acute myocardial infarction during the period from 2000 to 2010 year in order to identify, whether the desynchronization of circadian rhythms contributes toward acute myocardial infarction pathogenesis. Materials and methods: the study comprised clinical cases of 15333 patients. Median age was 66 ± 1,5 years. The inclusion criteria were: hospitalization in Vilnius University Hospital Cardiologic Reanimation and Intensive Care unit with diagnosis of the acute myocardial infarction during the period from 2000 – 01 – 01 to 2010 – 12 – 31. There were estimated 11 – years period total hospitalization rate at different four time intervals: 00:00 - 05:59 h; 06:00 - 11:59 h; 12:00 - 17:59 h; 18:00 - 23:59 h. Results: the annual tendency dominated in female‘s and male‘s with acute myocardial infarction – about 3,2 times more patients hospitalized from 06:00 h till 17:59 h, compared to 18:00 - 05:59 h interval data. Conclusions: the acute myocardial infarction pathogenesis mechanism is influenced by the diurnal variantions of the darkness – light phase, with increased risk of this pathology during the 06:00 – 17:59 h period.
PRAKTINIO MOKYMO IR MENTORYSTĖS VAIDMUO UGDANT PACIENTŲ SAUGOS GEBĖJIMUS: SLAUGOS STUDIJŲ ATVEJIS
Authors: Paulikienė Simona
Published: August 2015

Patient safety represents a global public health problem. WHO Patient Safety estimates that millions of patients worldwide suffer disabling injuries or death every year due to unsafe medical practices and care. Patient safety competencies are important in professional practice, so true to install and integrate the patient safety in curriculum training of health care professionals. Mentoring and practical training is also particularly relevant to patient safety education. Research aim - expose role of practical training in developing patient safety competencies of nursing students’. The study involved general practice nursing degree program students (N = 276) of two Lithuanian colleges. The study was conducted using a questionnaire of Health Professional Education in Patient Safety Survey and questionnaire prepared by researcher of this study. Nursing students evaluated obtained competencies of patient safety during the theoretical lessons and practice, expressed their views about the activities of the mentor. The results revealed that the nursing students in practical training in comparison with theoretical lessons acquire fewer patient safety competencies of risk management, communication with patients, understanding of environmental factors, culture of safety, working in teams. During practical training students insufficiently acquire competencies of patient safety. Mentoring is important in developing patient safety competencies of nursing students’ during practical training.
Trade between Kashmir and Central Asia via Traditional Corridors of Ladakh
Authors: Sheikh Ab. Hamid
Published: August 2015

Kashmir valley with great geo-strategic significance, was an economic hub, connecting Indian sub-continent with Central Asia and rest of the world, since ancient times. However, this exchanging center lost it relevance with the Partition of Indian sub-continent in 1947, ‘Greater Jammu & Kashmir’ was divided into Azad Jammu Kashmir administered by Pakistan and Jammu and Kashmir Administered by India and the State moved from main to margin as all the routes were closed for trade and traffic including Zojila Pass. Indian Administer Kashmir (J&K) became wholly and solely dependent on Jawahar Tunnel for import and export. The people of J&K still remain behind curtain for number of days due to climatic hazards, communal and political tension, in the age of globalization, modernization and regional integration. The author attempted to put forth historical significance and arguments for reviving traditional corridors via Ladakh on sound basis rather than making revival of ancient trade outlets subservient to peace and drug mafia. 
A Mad Art, My Masters:
Authors: Geddes Louise
Published: August 2015

Recently, critics have approached the cultural appropriation of “not-Shakespearean texts, arguing that the Jacobean revivals of the 1980s and 1990s “are as conservative as their Shakespearean counterparts” (Aebischer 282), due to their emphasis on historical continuity and coherence. However, the drama produced in the 1970s and 1980s asserted a new theatrical aesthetic that demands that the audience recognize its own complicity in perpetuating the myth of historical continuum through the stylistic assertion of disunity. Instead of employing a ‘usable history,’ the playwrights of this era created a ‘usable culture’ that used literature as historicity in order to highlight the inefficiency of both as a means of mediating the present. Barrie Keeffe's play, A Mad World My Masters, under the guise of Jacobean nostalgia, confronts the implications of the emergent Conservative cultural dictate that assumes governmental responsibility for defining and maintaining “the good standards and best things” (Thatcher) of postwar England—a missive that repeatedly conflated the form of outrage with the “good” art that should contain such protest. Keeffe challenges the audience's cultural expectations by putting the worst of Thatcher's “scroungers” onstage and demands that the audience recognized its complicity in the emergent fraudulent meritocracy that characterized political reform.
Filming Shakespeare's Rome:
Authors: Flaherty Jennifer
Published: August 2015

Despite dramatically different approaches to mise-en-scène, Julie Taymor's Titus (1999) and Ralph Fiennes's Coriolanus (2011) both use Rome in a way reminiscent of what Susan Bennett and Pascale Aebischer term the ‘contemporary Jacobean.’ The films locate the violence, pain, and politics of the Shakespearean texts simultaneously in an ancient past and a vaguely timeless present, creating a preposterous contemporary Rome. In Taymor's Titus, even scenes filmed off-location are designed to play to audiences’ preconceived notions of Rome through references to history, literature, and pop culture. While the production is site-specific, the time period is both universal and conflated; every historical or fictional Rome seems to exist in the same moment in the film. Fiennes establishes a Rome that is more time-specific by making costumes and setting distinctly contemporary, but the site of the Roman setting becomes universal, suggesting that the Rome of Shakespeare's Coriolanus can be anywhere and everywhere. The disordered Romes presented by Taymor and Fiennes suggest that Shakespeare can be understood through a reading of contemporary warfare, and contemporary civil strife can be understood and even predicted through Shakespeare's Rome. This cyclical reading of human brutality establishes both films as nostalgic readings of Shakespearean texts.
International arrivals forecasting for Australian airports and the impact of tourism marketing expenditure
Authors: Tsui Wai Hong Kan , Balli Faruk
Published: August 2015

An airport’s international passenger arrivals are susceptible to exogenous and endogenous factors (such as economic conditions, flight services, fluctuations and shocks). Accurate and reliable airport passenger demand forecasts are imperative for policymaking and planning by airport and airline management as well as by tourism authorities and operators. This article employs the Box–Jenkins SARIMA, SARIMAX and SARIMAX/EGARCH volatility models to forecast international passenger arrivals for the eight key Australian airports (Adelaide, Brisbane, Cairns, Darwin, Gold Coast, Melbourne, Perth and Sydney). Monthly international tourist arrivals between January 2006 and September 2012 are used for the empirical analysis. All the forecasting models are highly accurate with the lower values of mean absolute percentage error, mean absolute error and root mean squared error. The findings suggest that the international passenger arrivals of Australian airports are affected by positive and negative shocks and tourism marketing expenditure is also a significant factor influencing the majority of Australian airports’ international passenger arrivals.
Transoral Robotic Surgery in Oropharyngeal Carcinoma
Authors: Helman Samuel N. , Schwedhelm Thomas , Kadakia Sameep , Wang Yanhua , Schiff Bradley A. , Smith Richard V.
Published: August 2015

Context

The incidence of oropharyngeal squamous cell carcinoma has increased during the past decade and is related primarily to the human papillomavirus. This change in etiology, from tobacco and alcohol to human papillomavirus, has resulted in improved survival for the disease. In the United States, open resection had largely been replaced by concurrent chemotherapy and/or radiotherapy by the early 2000s. The advent of transoral surgery has led to an increase in surgery as the primary treatment for both early- and advanced-stage oropharyngeal squamous cell carcinoma because it has potential advantages over open surgery and nonsurgical modalities.

Objective

To provide an overview of transoral robotic surgery for oropharyngeal squamous cell carcinoma and contrast it with other surgical and nonsurgical modalities.

Data Sources

Articles from 2000 to 2014 were accessioned on PubMed and reviewed for utility by the primary authors.

Conclusions

Transoral surgery has become more commonly used as a minimally invasive approach to treat oropharyngeal tumors. Other strategies, including radiation, chemotherapy with radiation, and open surgery, are still important treatment approaches. The treatment options for an individual patient rely on multiple factors, including the tumor location and size, features of the tumor, and patient comorbidities. The continued study of these techniques is important to match the patient with the most appropriate treatment.
New Markers for Separating Benign From Malignant Mesothelial Proliferations: Are We There Yet?
Authors: Churg Andrew , Sheffield Brandon S. , Galateau-Salle Francoise
Published: August 2015

The separation of benign from malignant mesothelial proliferations is crucial to patient care but is frequently morphologically difficult.Context.—

To briefly review adjunctive tests claimed to be useful in this setting and to examine in detail 2 new tests: p16 fluorescence in situ hybridization (FISH) and BRCA1-associated protein 1 (BAP1) immunohistochemistry.Objective.—

Literature review with emphasis on p16 FISH and BAP1 immunohistochemistry.Design.—

Glucose transporter-1, p53, insulin-like growth factor 2 messenger RNA–binding protein 3 (IMP-3), desmin, and epithelial membrane antigen have all been claimed to mark either benign or malignant mesothelial processes, but in practice they at best provide statistical differences in large series of cases, without being useful in an individual case. Homozygous deletion of p16 by FISH or loss of BAP1 has only been reported in malignant mesotheliomas and not in benign mesothelial proliferations. BAP1 appears to be lost more frequently in epithelial than mixed or sarcomatous mesotheliomas. Homozygous deletion of p16 by FISH is seen in pleural epithelial, mixed, and sarcomatous mesotheliomas, but it is much less frequent in peritoneal mesothelioma. The major drawback to both these tests is limited sensitivity; moreover, failure to find p16 deletion or BAP1 loss does not make a mesothelial process benign.Results.—

In the context of a mesothelial proliferation, the finding of homozygous deletion of p16 by FISH or loss of BAP1 by immunohistochemistry is, thus far, 100% specific for malignant mesothelioma. The limited sensitivity of each test may be improved to some extent by running both tests.Conclusions.—
Moral Dilemmas and Existential Issues Encountered Both in Psychotherapy and Philosophical Counseling Practices
Authors: Popescu Beatrice A.
Published: August 2015

This paper stems from clinical observations and empirical data collected in the therapy room over six years. It investigates the relationship between psychotherapy and philosophical counseling, proposing an integrative model of counseling. During cognitive behavior therapy sessions with clients who turn to therapy in order to solve their clinical issues, the author noticed that behind most of the invalidating symptoms classified by the DSM-5 as depression, anxiety, hypochondriac and phobic complaints, usually lies a lack of existential meaning or existential scope and clients are also tormented by moral dilemmas. Following the anamnestic interview and the psychological evaluation, rarely the depression or anxiety diagnosed on Axis I is purely just a sum of invalidating symptoms, which may disappear if treated symptomatically. When applying the Sentence Completion Test, an 80 items test of psychodynamic origin and high-face validity, most of the clients report an entire plethora of conscious or unconscious motivations, distorted cognitions or irrational thinking but also grave existential themes such as scope or meaning of life, professional identity, fear of death, solitude and loneliness, freedom of choice and liberty. Same issues are approached in the philosophical counseling practice, but no systematic research has been done yet in the field. Future research and investigation is needed in order to assess the importance of moral dilemmas and existential issues in both practices.
Romantic Relationship Length and its Perceived Quality: Mediating Role of Facebook-Related Conflict
Authors: Rahaman H. M. Saidur
Published: August 2015

The purpose of this study was to investigate how Facebook use is leading to negative relationship outcomes such as cheating and breakup by assessing users’ perceived relationship qualities. It was hypothesized that Facebook-related conflict will be negatively related with users’ relationship length and will also be negatively related with their perceived relationship satisfaction, commitment, and love. Facebook-related conflict further mediates the relationship between relationship length and perceived relationship satisfaction, commitment, and love. Self-report data were gathered from participants (N = 101) in an online survey by employing standard questionnaires. A set of regression and mediation analyses confirmed all the hypotheses of the study. That is, Facebook-related conflict mediates the relationship between relationship length and perceived relationship satisfaction, commitment, and love. Moreover, the magnitude of mediation was highest for relationship satisfaction. Implications for future research and contributions are discussed.
In Vivo Effects of Mesenchymal Stromal Cells in Two Patients With Severe Acute Respiratory Distress Syndrome
Authors: Simonson Oscar E. , Mougiakakos Dimitrios , Heldring Nina , Bassi Giulio , Johansson Henrik J. , Dalén Magnus , Jitschin Regina , Rodin Sergey , Corbascio Matthias , El Andaloussi Samir , Wiklander Oscar P.B. , Nordin Joel Z. , Skog Johan , Romain Charlotte , Koestler Tina , Hellgren-Johansson Laila , Schiller Petter , Joachimsson Per-Olof , Hägglund Hans , Mattsson Mattias , Lehtiö Janne , Faridani Omid R. , Sandberg Rickard , Korsgren Olle , Krampera Mauro , Weiss Daniel J. , Grinnemo Karl-Henrik , Le Blanc Katarina
Published: August 2015

Mesenchymal stromal cells (MSCs) have been investigated as a treatment for various inflammatory diseases because of their immunomodulatory and reparative properties. However, many basic questions concerning their mechanisms of action after systemic infusion remain unanswered. We performed a detailed analysis of the immunomodulatory properties and proteomic profile of MSCs systemically administered to two patients with severe refractory acute respiratory distress syndrome (ARDS) on a compassionate use basis and attempted to correlate these with in vivo anti-inflammatory actions. Both patients received 2 × 106 cells per kilogram, and each subsequently improved with resolution of respiratory, hemodynamic, and multiorgan failure. In parallel, a decrease was seen in multiple pulmonary and systemic markers of inflammation, including epithelial apoptosis, alveolar-capillary fluid leakage, and proinflammatory cytokines, microRNAs, and chemokines. In vitro studies of the MSCs demonstrated a broad anti-inflammatory capacity, including suppression of T-cell responses and induction of regulatory phenotypes in T cells, monocytes, and neutrophils. Some of these in vitro potency assessments correlated with, and were relevant to, the observed in vivo actions. These experiences highlight both the mechanistic information that can be gained from clinical experience and the value of correlating in vitro potency assessments with clinical effects. The findings also suggest, but do not prove, a beneficial effect of lung protective strategies using adoptively transferred MSCs in ARDS. Appropriate randomized clinical trials are required to further assess any potential clinical efficacy and investigate the effects on in vivo inflammation.

Significance

This article describes the cases of two patients with severe refractory adult respiratory syndrome (ARDS) who failed to improve after both standard life support measures, including mechanical ventilation, and additional measures, including extracorporeal ventilation (i.e., in a heart-lung machine). Unlike acute forms of ARDS (such in the current NIH-sponsored study of mesenchymal stromal cells in ARDS), recovery does not generally occur in such patients.
2005 Donor Eligibility Requirements: Unintended Consequences for Stem Cell Development
Authors: Couture Larry A. , Carpenter Melissa K.
Published: August 2015

Several human embryonic stem cell (hESC)-derived cell therapeutics have entered clinical testing and more are in various stages of preclinical development. The U.S. Food and Drug Administration (FDA) regulates these products under existing regulations and has stated that these products do not constitute a new class of biologic. However, as human tissue, hESCs are subject to regulations that were developed before hESCs were first described. The regulations have not been revised since 2005, well before the first hESC-derived product entered clinical studies. The current regulations require donors of hESCs to be tested in the same manner as donors of tissues intended for transplantation. However, because hESC-derived cell products are more than minimally manipulated, they are also subject to the same end-of-production release testing as most other biologic agents. In effect, this makes hESC products subject to redundant testing. No other biologic is subject to a similar testing requirement. Furthermore, the regulations that require donor testing are specifically applicable to hESC cells harvested from donors after a date in 2005. It is unclear which regulations cover hESCs harvested before 2005. Ambiguity in the guidelines and redundant testing requirements have unintentionally created a burdensome regulatory paradigm for these products and reluctance on the part of developers to invest in these promising therapeutics. We propose a simple solution that would address FDA safety concerns, eliminate regulatory uncertainty and risk, and provide flexibility for the FDA in the regulation of hESC-derived cell therapies.

Significance

Regulatory ambiguity concerning donor eligibility screening and testing requirements for human embryonic stem cell lines, in particular those lines created before 2005, are causing significant concern for drug developers. Technically, most of these lines fail to meet eligibility under U.S. Food and Drug Administration (FDA) rules for product licensure, and many developers are unaware that FDA approval to begin trials under an exemption is not an assurance that the FDA will grant licensure of the product. This Perspective outlines the ambiguity and the problem it has caused and proposes a workable solution. The intent is to generate stakeholder and FDA discussion on this issue.
De anjos a mulheres: ideologias e valores na formação de enfermeiras
Authors: Passos Elizete
Published: August 2015

A autora identifica os valores que têm definido a enfermagem como uma prática abnegada, de submissão e doação. Para entender este ponto central, ela retoma algumas questões clássicas que perpassam a enfermagem em geral, focando em experiências vividas na Escola de Enfermagem da UFBA (EEUFBA) ao longo de seus 50 anos de existência. Interessada em entender as relações de poder instituídas no campo da enfermagem, Elizete Passos tomou a perspectiva de Gênero para analisar o modo como esta área é vista como um trabalho essencialmente feminino.
Seismic anisotropy in the lowermost mantle near the Perm Anomaly
Authors: Long Maureen D. , Lynner Colton
Published: August 2015

The lower mantle is dominated by two large structures with anomalously low shear wave velocities, known as Large Low‐Shear Velocity Provinces (LLSVPs). Several studies have documented evidence for strong seismic anisotropy at the base of the mantle near the edges of the African LLSVP. Recent work has identified a smaller structure with similar low‐shear wave velocities beneath Eurasia, dubbed the Perm Anomaly. Here we probe lowermost mantle anisotropy near the Perm Anomaly using the differential splitting of SKS and SKKS phases measured at stations in Europe. We find evidence for lowermost mantle anisotropy in the vicinity of the Perm Anomaly, with geographic trends hinting at lateral variations in anisotropy across the boundaries of the Perm Anomaly as well as across a previously unsampled portion of the African LLSVP border. Our observations suggest that deformation is concentrated at the boundaries of both the Perm Anomaly and the African LLSVP.
Late Cretaceous back‐arc extension and arc system evolution in the Gangdese area, southern Tibet: Geochronological, petrological, and Sr‐Nd‐Hf‐O isotopic evidence from Dagze diabases
Authors: Ma Lin , Wang Qiang , Wyman Derek A. , Jiang Zi‐Qi , Wu Fu‐Yuan , Li Xian‐Hua , Yang Jin‐Hui , Gou Guo‐Ning , Guo Hai‐Feng
Published: August 2015

Back‐arc extension and asthenosphere upwelling associated with oceanic lithospheric subduction affect the structure and thermal regime of the arc lithosphere, which often triggers widespread extension‐related mafic magmatism. Although it is commonly accepted that the Neo‐Tethyan oceanic lithosphere subducted beneath the southern Lhasa block, resulting in the well‐known Late Mesozoic Gangdese magmatic arc, the possible role of contemporary back‐arc extension and asthenosphere upwelling has been disputed due to a lack of evidence for extension‐related mafic magmatism. Here, we report detailed petrological, geochronological, geochemical, and Sr‐Nd‐Hf‐O isotopic data for the Dagze diabases located in the north of the Gangdese district, southern Lhasa block. The zircon U‐Pb analyses indicate that they were generated in the Late Cretaceous (ca. 92 Ma) instead of the Eocene (42–38 Ma) as previously believed. These mafic rocks are characterized by variable MgO (4.0–12.2 wt %) and Mg# (42 to 71) values combined with flat to slightly enriched ([La/Yb]N = 1.87–5.23) light rare earth elements (REEs) and relative flat heavy REEs ([Gd/Yb]N = 1.36–1.87) with negative Ta, Nb, and Ti anomalies (e.g., [Nb/La]PM = 0.16–0.51). They also have slightly variable εNd(t) (−1.25 to +4.71) and low initial 87Sr/86Sr (0.7045–0.7058) values with strong positive igneous zircon εHf(t) (+8.0 to +12.1) and low δ18O (5.31–6.12‰) values. The estimated primary melt compositions are similar to peridotite‐derived experimental melts. Given their high melting temperature (1332 to 1372°C) and hybrid geochemical characteristics, we propose that the Dagze mafic magmas likely represent mixtures of asthenospheric and enriched lithospheric mantle‐derived melts that underwent minor crustal assimilation and fractional crystallization of clinopyroxene. Taking into account the spatial and temporal distribution of Mesozoic mafic‐felsic magmatic rocks and regional paleomagnetic and basin data, we suggest that the Dagze mafic rocks resulted from asthenospheric upwelling associated with intracontinental back‐arc extension during the rollback of subducted Tethyan oceanic lithosphere in the Late Cretaceous.
A rapid estimation of near‐field tsunami runup
Authors: Riquelme Sebastián , Fuentes Mauricio , Hayes Gavin P. , Campos Jaime
Published: August 2015

Many efforts have been made to quickly estimate the maximum runup height of tsunamis associated with large earthquakes. This is a difficult task because of the time it takes to construct an accurate tsunami model using real‐time data from the source. It is possible to construct a database of potential seismic sources and their corresponding tsunami a priori. However, such models are generally based on uniform slip distributions and thus oversimplify the knowledge of the earthquake source. Here we show how to predict tsunami runup from any seismic source model using an analytic solution that is specifically designed for subduction zones with a well‐defined geometry, i.e., Chile, Japan, Nicaragua, and Alaska. The main idea of this work is to provide a tool for emergency response, trading off accuracy for speed. The solutions we present for large earthquakes appear promising. Here runup models are computed for the following: the 1992Mw 7.7 Nicaragua earthquake, the 2001Mw 8.4 Perú earthquake, the 2003Mw 8.3 Hokkaido earthquake, the 2007Mw 8.1 Perú earthquake, the 2010Mw 8.8 Maule earthquake, the 2011Mw 9.0 Tohoku earthquake, and the recent 2014Mw 8.2 Iquique earthquake. The maximum runup estimations are consistent with measurements made inland after each event, with a peak of 9 m for Nicaragua, 8 m for Perú (2001), 32 m for Maule, 41 m for Tohoku, and 4.1 m for Iquique. Considering recent advances made in the analysis of real‐time GPS data and the ability to rapidly resolve the finiteness of a large earthquake close to existing GPS networks, it will be possible in the near future to perform these calculations within the first minutes after the occurrence of similar events. Thus, such calculations will provide faster runup information than is available from existing uniform‐slip seismic source databases or past events of premodeled seismic sources.
Trajectory modeling of modern dust transport to the Southern Ocean and Antarctica
Authors: Neff Peter D. , Bertler Nancy A. N.
Published: August 2015

Aerosol deposition over the Southern Ocean and Antarctica has the potential to alter marine productivity and thus ocean carbon uptake while also impacting radiative balance due to scattering and absorption from atmospheric particulates. Quantification of modern emission, transport, and deposition of terrestrial dust and other airborne material from Southern Hemisphere sources is challenging due to low emission levels and poor detection from remote sensing platforms. Here forward trajectory modeling is used to explore atmospheric transport, independent of deposition processes, from 1979 to 2013. Trajectories are initiated from known arid dust source areas in South America (Patagonia), Australia, and southern Africa, with detailed consideration of New Zealand as a potential source. Results suggest that Patagonian and New Zealand dust and other aerosol emissions share strong atmospheric transport during all seasons, allowing even potentially small New Zealand emissions to contribute significantly to Southern Ocean and Antarctic aerosol loading. We find that atmospheric transport controlling distribution of dust and other aerosols shows distinct spatial variability. New Zealand and Patagonia rapidly contribute a high proportion of trajectories to West Antarctica, while in interior East Antarctica, source contributions are limited and highly mixed. The sensitivity of existing deep ice core sites to modern atmospheric transport is discussed. Finally, interannual variability of poleward trajectory extension over the Pacific and Atlantic sectors of the Southern Ocean highlights the association of both tropical Pacific sea‐surface temperature and high‐latitude wind variability (e.g., the Southern Annular Mode) with transport of dust and other aerosols to the Southern Ocean and Antarctica.