bluuebunny/crossref_metadata_2025 huggingface dataset:
Splice variants as novel targets in pancreatic ductal adenocarcinoma
Authors: Wang Jun , Dumartin Laurent , Mafficini Andrea , Ulug Pinar , Sangaralingam Ajanthah , Alamiry Namaa Audi , Radon Tomasz P. , Salvia Roberto , Lawlor Rita T. , Lemoine Nicholas R. , Scarpa Aldo , Chelala Claude , Crnogorac-Jurcevic Tatjana
Published: June 2017

Despite a wealth of genomic information, a comprehensive alternative splicing (AS) analysis of pancreatic ductal adenocarcinoma (PDAC) has not been performed yet. In the present study, we assessed whole exome-based transcriptome and AS profiles of 43 pancreas tissues using Affymetrix exon array. The AS analysis of PDAC indicated on average two AS probe-sets (ranging from 1–28) in 1,354 significantly identified protein-coding genes, with skipped exon and alternative first exon being the most frequently utilised. In addition to overrepresented extracellular matrix (ECM)-receptor interaction and focal adhesion that were also seen in transcriptome differential expression (DE) analysis, Fc gamma receptor-mediated phagocytosis and axon guidance AS genes were also highly represented. Of note, the highest numbers of AS probe-sets were found in collagen genes, which encode the characteristically abundant stroma seen in PDAC. We also describe a set of 37 ‘hypersensitive’ genes which were frequently targeted by somatic mutations, copy number alterations, DE and AS, indicating their propensity for multidimensional regulation. We provide the most comprehensive overview of the AS landscape in PDAC with underlying changes in the spliceosomal machinery. We also collate a set of AS and DE genes encoding cell surface proteins, which present promising diagnostic and therapeutic targets in PDAC.
Activity-independent targeting of mTOR to lysosomes in primary osteoclasts
Authors: Wang Andrew , Carraro-Lacroix Luciene R. , Owen Celeste , Gao Bowen , Corey Paul N. , Tyrrell Pascal , Brumell John H. , Voronov Irina
Published: June 2017

Mammalian target of rapamycin (mTOR) is activated by numerous stimuli, including amino acids and growth factors. This kinase is part of the mTOR complex 1 (mTORC1) which regulates cell proliferation, differentiation, and autophagy. Active mTORC1 is located on lysosomes and has been reported to disassociate from the lysosomal surface in the absence of amino acids. Furthermore, mTORC1 activity has been linked to the vacuolar H+-ATPases (V-ATPases), the proton pumps responsible for lysosomal acidification; however, the exact role of the V-ATPases in mTORC1 signaling is not known. To elucidate the mechanisms involved in mTORC1 regulation by the V-ATPases, we used primary osteoclasts derived from mice carrying a point (R740S) mutation in the a3 subunit of the V-ATPase. In these cells, the mutant protein is expressed but the pump is not functional, resulting in higher lysosomal pH. By analyzing mTOR activation, mTOR/lysosome co-localization, and lysosomal positioning using confocal microscopy, fractionation, and ultrapure lysosomal purification methods, we demonstrate that in primary osteoclasts, mTOR is localized on the lysosomal surface even when mTOR activity is inhibited. Our findings reveal that mTOR targeting to the lysosome in osteoclasts is activity-independent, and that its disassociation from the lysosome during starvation is not universal.
Regional brain functions in the resting state indicative of potential differences between depression and chronic pain
Authors: Yoshino Atsuo , Okamoto Yasumasa , Doi Mitsuru , Otsuru Naofumi , Okada Go , Takamura Masahiro , Ichikawa Naho , Yokoyama Satoshi , Yamashita Hidehisa , Yamawaki Shigeto
Published: June 2017

Complex relationships between depression and chronic pain have been reported in previous studies. However, only a few neuroimaging studies have investigated similarities and differences in neural systems underlying them. We examined the brain functions in the resting state of 43 patients with depression, 41 patients with chronic pain (somatoform pain disorder) and 41 healthy controls, by using regional homogeneity (ReHo) and functional connectivity analysis. Depressive symptoms were assessed by using the Beck Depression Inventory-Second Edition (BDI-II). ReHo values for the dorsolateral prefrontal cortex (DLPFC) significantly decreased for chronic pain patients, and functional connectivity between the DLPFC and thalamus decreased only for these patients. These findings are indicative of distinct brain functions related to depression and chronic pain. Understanding these differences would further elucidate the pathophysiology of these conditions.
Synthesis and characterization of ultralong SiC nanowires with unique optical properties, excellent thermal stability and flexible nanomechanical properties
Authors: Hu Ping , Dong Shun , Zhang Xinghong , Gui Kaixuan , Chen Guiqing , Hu Ze
Published: June 2017

Several-millimeter long SiC nanowires (NWs) with unique optical properties, excellent thermal stability and flexible nanomechanical properties were synthesized using a simple method with silicon and phenolic resin as the raw materials. The SiC NWs displayed special optical properties that were attributed to their large size and Al-doping. They displayed broad green emission at 527.8 nm (2.35 eV) and purple emission concentrated at 438.9 nm (2.83 eV), in contrast to the other results, and the synthesized SiC NWs could also remain relatively stable in air up to 1000 °C indicating excellent thermal stability. The Young’s moduli of the SiC NWs with a wide range of NW diameters (215–400 nm) were measured using anin situnanoindentation method with a hybrid scanning electron microscopy/scanning probe microscopy (SEM/SPM) system for the first time. The results suggested that the values of the Young’s modulus of the SiC NWs showed no clear size dependence, and the corresponding Young’s moduli of the SiC NWs with diameters of 215 nm, 320 nm, and 400 nm were approximately 559.1 GPa, 540.0 GPa and 576.5 GPa, respectively. These findings provide value and guidance for studying and understanding the properties of SiC nanomaterials and for expanding their possible applications.
Generation and characterisation of a stable nickel(ii)-aminoxyl radical complex
Authors: Parrot Arnaud , Morimoto Yuma , Paria Sayantan , Sugimoto Hideki , Fujieda Nobutaka , Itoh Shinobu
Published: June 2017

A stable nickel(ii)-aminoxyl radical complex was generated by the reaction of a nickel(ii) complex and m-chloroperoxybenzoic acid.
A flexible 1,2-cis α-glycosylation strategy based on in situ adduct transformation
Authors: Hu Jhe-Cyuan , Feng Ai-Fen Wendy , Chang Bo-Yao , Lin Chun-Hung , Mong Kwok-Kong Tony
Published: June 2017

Towards a universal 1,2-cis α-glycosylation strategy using the joined forces of formamide and iodide nucleophile additives.
A theoretical study on the mechanism of ruthenium(ii)-catalyzed phosphoryl-directed ortho-selective C–H bond activations: the phosphoryl hydroxy group triggered Ru(ii)/Ru(0) catalytic cycle
Authors: Chen Peng , Sun Ying , Wu Yile , Liu Liu Leo , Zhu Jun , Zhao Yufen
Published: June 2017

A theoretical study on the mechanism of ruthenium(ii)-catalyzed phosphoryl-directed ortho-selective C–H bond activations has been reported.
Emulsion-based systems for fabrication of electrospun nanofibers: food, pharmaceutical and biomedical applications
Authors: Nikmaram Nooshin , Roohinejad Shahin , Hashemi Sara , Koubaa Mohamed , Barba Francisco J. , Abbaspourrad Alireza , Greiner Ralf
Published: June 2017

Encapsulation of bioactive materials and drugs using the emulsion electrospinning method.
Cation substitution induced novel gehlenite Ca2GaAlSiO7:Eu2+/Ce3+phosphor with green/blue emission for UV-WLEDs
Authors: Jiao Mengmeng , Xu Qinfeng , Yang Chuanlu , You Hongpeng
Published: June 2017

We have investigated the structure and luminescence properties of a novel and efficient Ca2GaAlSiO7:Eu2+/Ce3+phosphor obtained by cation substitution for UV-WLEDs.
The structure, electrical properties and chemical stability of porous Nb-doped SrTiO3– experimental and theoretical studies
Authors: Drożdż Ewa , Koleżyński Andrzej
Published: June 2017

This work fills the significant gap in literature on chemical stability, electrical properties and electronic structure of Nb-doped SrTiO3system.
The potential of non-aqueous redox flow batteries as fast-charging capable energy storage solutions: demonstration with an iron–chromium acetylacetonate chemistry
Authors: Bamgbopa Musbaudeen O. , Shao-Horn Yang , Almheiri Saif
Published: June 2017

We report a fast-charging iron–chromium non-aqueous redox flow battery that combines the fast kinetics of the single iron(iii) acetylacetonate redox couple on the positive side with the fastest of the chromium(iii) acetylacetonate redox couple on the negative side.
An alkaline electro-activated Fe–Ni phosphide nanoparticle-stack array for high-performance oxygen evolution under alkaline and neutral conditions
Authors: Zhang Bowei , Lui Yu Hui , Zhou Lin , Tang Xiaohui , Hu Shan
Published: June 2017

Fe–Ni hydroxide nanosheets were converted to Fe–Ni phosphide nanoparticle-stack array by low-temperature phosphorization to promote surface area and further improve oxygen evolution reaction activities.
Grain size optimization for high-performance polycrystalline SnSe thermoelectrics
Authors: Peng Kunling , Wu Hong , Yan YanCi , Guo Lijie , Wang Guoyu , Lu Xu , Zhou Xiaoyuan
Published: June 2017

Grain size significantly affects the thermoelectric performance, the thickness of oxidized/amorphous layer and the stability of SnSe polycrystals. As a result, sample Sn0.97Na0.03Se with average grain size around 4 μm achieves a high thermoelectric performance and stability in the whole measured temperature range.
Nanomaterial-based cancer immunotherapy
Authors: Luo Lijia , Shu Rui , Wu Aiguo
Published: June 2017

This review focuses on summarizing the existing work about nanomaterial-based cancer immunotherapy in detail.
Novel water insoluble (NaxAg2−x)MoO4(0 ≤ x ≤ 2) microwave dielectric ceramics with spinel structure sintered at 410 degrees
Authors: Zhou Di , Li Jing , Pang Li-Xia , Wang Da-Wei , Reaney Ian M.
Published: June 2017

A novel series of spinel structured ultra-low temperature co-fired microwave dielectric (Na,Ag)MoO4ceramics were studied in detail. The (Na1.2Ag0.8)MoO4ceramic can be well sintered at 410 °C with a permittivity ∼8.1, a quality factor (Qf) ∼44 800 GHz and grain size 1–5 μm.
Quasi‐synchronisation of fractional‐order memristor‐based neural networks with parameter mismatches
Authors: Huang Xia , Fan Yingjie , Jia Jia , Wang Zhen , Li Yuxia
Published: June 2017

This study addresses the problem of quasi‐synchronisation of fractional‐order memristor‐based neural networks (FMNNs) with time delay in the presence of parameter mismatches. Under the framework of fractional‐order differential inclusions and set‐valued maps, quasi‐synchronisation of delayed FMNNs is discussed and quasi‐synchronisation criteria are established by means of constructing suitable Lyapunov function, together with introducing some fractional‐order differential inequalities. A new lemma on the estimate of Mittag–Leffler function is derived first, which extends the application of Mittag–Leffler function and plays a key role in the estimate of synchronisation error bound. Then, linear state feedback combined with delayed state feedback control law is designed, which guarantees that for a predetermined synchronisation error bound, quasi‐synchronisation of two FMNNs with mismatched parameters will be achieved provided that the feedback gains satisfy the newly‐proposed criteria. The obtained results extend and improve some previous published works on synchronisation of FMNNs. Finally, two numerical examples are given to demonstrate the effectiveness of the obtained results.
Steady‐state analysis of high‐voltage gain multiple series Z‐source inverter
Authors: Babaei Ebrahim , Shokati Asl Elias
Published: June 2017

In this study, a new topology for multiple series Z‐source inverter is proposed. The proposed topology only with one dc power source can generate output voltage higher than the conventional converter. This inverter has low voltage stress on capacitors and common ground between the input source and inverter. Also, the proposed topology with soft‐start strategy has inherent ability to reduce inrush‐current at start‐up. First, different operating modes of the proposed inverter are investigated. Then, the voltage and current of elements and also voltage gain of the inverter are extracted. The comparison results of the proposed and conventional topologies show the advantages of the proposed topology. To verify the correctness operation of the proposed topology, the simulation and experimental results are used.
Bond graph modelling of chemoelectrical energy transduction
Authors: Gawthrop Peter J. , Siekmann Ivo , Kameneva Tatiana , Saha Susmita , Ibbotson Michael R. , Crampin Edmund J.
Published: June 2017

Energy‐based bond graph modelling of biomolecular systems is extended to include chemoelectrical transduction thus enabling integrated thermodynamically compliant modelling of chemoelectrical systems in general and excitable membranes in particular. Our general approach is illustrated by recreating a well‐known model of an excitable membrane. This model is used to investigate the energy consumed during a membrane action potential thus contributing to the current debate on the trade‐off between the speed of an action potential event and energy consumption. The influx of is often taken as a proxy for energy consumption; in contrast, this study presents an energy‐based model of action potentials. As the energy‐based approach avoids the assumptions underlying the proxy approach it can be directly used to compute energy consumption in both healthy and diseased neurons. These results are illustrated by comparing the energy consumption of healthy and degenerative retinal ganglion cells using both simulated and in vitro data.
Deutscher Pflegekongress 2017: Hilft bessere Bezahlung gegen den Pflegemangel?
Authors: Hillebrand Thomas
Published: June 2017

Diese „Gretchenfrage“ wird auf dem Deutschen Pflegekongress äußerst kontrovers diskutiert werden. Aber auch sonst ist das Kongressprogramm prall gefüllt – z. B. auch mit allen Themen, die sich die Bundesregierung in den letzten Jahren bezüglich der Pflege vorgenommen hatte.
cdgw Feiert Seinen 10. Geburtstag: Im Business Club trifft sich die Branche
Authors: Emmrich Michael
Published: June 2017

Einen Club für die Gesundheitsbranche zu etablieren – diese Idee stammt von Gunter Murzin, ehemaliger Herausgeber und Gründer der kma. Und er ließ nicht locker, bis aus seiner Vision Realität wurde. Gemeinsam mit Andreas Bernshausen und Dr. Michael Emmrich von der Kommunikations- und Marketingagentur embe consult realisierte er seinen Traum: Dieses Jahr feiert der cdgw seinen zehnten Geburtstag.
2. Fachmesse Krankenhaus Technologie: „Unsere Messe ist die Plattform für alle Berufsgruppen im Krankenhaus“
Authors: Kohrs Jens
Published: June 2017

Nach der erfolgreichen Premiere im vergangenen Jahr verspricht die 2. Fachmesse Krankenhaus Technologie zahlreiche Neuerungen. Im Interview erklären die FKT-Präsidenten Horst Träger und Wolfgang Siewert, warum es sich lohnt, am 28. und 29. Juni in den Gelsenkirchener Wissenschaftspark zu kommen.
Cheek and Chin Implants to Enhance Facelift Results
Authors: Patel Sagar , Kridel Russell
Published: June 2017

The traditional rhytidectomy addresses facial and neck aging as it relates to soft tissue laxity. The modern volumetric facelift provides optimal results by addressing not only skin laxity but also the loss of volume secondary to tissue atrophy and bony resorption. While multiple techniques including fat grafting, dermal fillers, and tissue resuspension are used to correct the tissue loss, alloplastic midface augmentation remains the most permanent method. In our practice we often address midface cheek hollowness or atrophy with the placement of submalar implants at the time of rhytidectomy. In addition to midface volumetric rejuvenation, alloplastic chin implantation can help strengthen and further define a retrusive chin and weak jawline. In this article we discuss technique, indications, and benefits of performing alloplastic augmentation as an adjunct to rhytidectomy.
V-Y Advancement Flap for Defects of the Lid–Cheek Junction
Authors: Quatrano Nicola , Stevenson Mary , Sclafani Anthony , Carucci John
Published: June 2017

We report a series of 10 patients who underwent inferolaterally based V-Y advancement flaps for reconstruction of defects involving the lower eyelid and infraorbital cheek junction. Defects ranged from 1.7 to 2.9 cm in largest diameter, and patients ranged from 59 to 84 years of age. All patients had excellent functional and cosmetic outcomes without subsequent surgical or laser revision. There were no instances of flap necrosis, hematoma, or ectropion. Vertically oriented V-Y flaps are often underused in this setting largely due to the perceived increase risk of ectropion. We describe a modification of the flap with lateral orientation that both diminishes the downward tension vector, which threatens ectropion, and conceals incision scars within resting tension lines, providing superior functional and aesthetic outcomes. Our series demonstrates that a properly designed and well-executed inferiorly based V-Y advancement flap can be used as a safe reconstructive modality for defects involving the lid–cheek junction.
Cone Beam CT of Trauma of Small Bones and Joints
Authors: Desimpel Julie , Vanhoenacker Filip
Published: June 2017

Evaluation of trauma of small bones or joints is traditionally done by conventional radiographs (CRs). Although multidetector computed tomography (MDCT) has a better sensitivity than CR in fracture detection and evaluation of complex fractures, high doses of radiation prevent systematic use of MDCT in fracture evaluation. Cone beam computed tomography (CBCT) combines a high spatial resolution and relatively low radiation dose and is therefore a very valuable technique to evaluate trauma of small bones and joints in patients with negative or doubtful radiographs and a high clinical suspicion for fractures or when complex fractures are suspected. CBCT may also be useful for the evaluation of chronic trauma or follow-up of fractures.
Emergency and Trauma Imaging of the Thoracolumbar Spine
Authors: Moutinho Ricardo , Tyrrell Prudencia , Cassar-Pullicino Victor
Published: June 2017

Spine trauma is a devastating event with high morbidity and mortality and many additional medical, psychological, social, and financial consequences for patients, their families, and society. The thoracolumbar spine represents the most common area fractured in the spine. Morphology, extent, and the location of fracture lines are important determinants of stability, which is the core issue in the assessment of vertebral injuries, dictating conservative or surgical treatment. After hospital admission and clinical stabilization, patients with potential spine trauma are screened radiologically. Imaging analysis is based on radiographs, computed tomography, and magnetic resonance imaging. Understanding these three tools is essential to get a clear picture of the extent of any vertebral fracture. A multidisciplinary team should provide assessment, treatment, and education to patients with a spinal injury to achieve a treatment tailored for each patient. Thoracolumbar trauma focusing on spinal biomechanics, stability, imaging modalities, morphology patterns, classifications, and treatment are discussed and reviewed.
Emergency and Trauma of the Ankle
Authors: Bruno Federico , Arrigoni Francesco , Splendiani Alessandra , Di Cesare Ernesto , Zappia Marcello , Guglielmi Giuseppe , Masciocchi Carlo , Barile Antonio
Published: June 2017

Ankle injuries are very common among patients presenting to emergency departments, affecting patients of both sexes at any age. Management of ankle injuries can be challenging for orthopedic surgeons, given the large range of osteochondral, tendinous, and capsuloligamentous injuries that can occur. An accurate imaging evaluation is therefore of paramount importance to identify the degree and type of injury correctly and to direct the patient to the correct therapeutic management. Radiologic evaluation is the most appropriate initial imaging modality. Cross-sectional imaging (computed tomography, magnetic resonance imaging) has a secondary role in an emergency, primarily as a tool for preoperative planning and as a problem-solving technique in patients with suspected occult fractures or soft tissue injuries. We review the role of imaging in the evaluation of patients with ankle trauma and the main imaging findings occurring in such injuries.
Outrunning damage: Electrons vs X-rays—timescales and mechanisms
Authors: Spence John C. H.
Published: June 2017

Toward the end of his career, Zewail developed strong interest in fast electron spectroscopy and imaging, a field to which he made important contributions toward his aim of making molecular movies free of radiation damage. We therefore compare here the atomistic mechanisms leading to destruction of protein samples in diffract-and-destroy experiments for the cases of high-energy electron beam irradiation and X-ray laser pulses. The damage processes and their time-scales are compared and relevant elastic, inelastic, and photoelectron cross sections are given. Inelastic mean-free paths for ejected electrons at very low energies in insulators are compared with the bioparticle size. The dose rate and structural damage rate for electrons are found to be much lower, allowing longer pulses, reduced beam current, and Coulomb interactions for the formation of smaller probes. High-angle electron scattering from the nucleus, which has no parallel in the X-ray case, tracks the slowly moving nuclei during the explosion, just as the gain of the XFEL (X-ray free-electron laser) has no parallel in the electron case. Despite reduced damage and much larger elastic scattering cross sections in the electron case, leading to not dissimilar elastic scattering rates (when account is taken of the greatly increased incident XFEL fluence), progress for single-particle electron diffraction is seen to depend on the effort to reduce emittance growth due to Coulomb interactions, and so allow formation of intense sub-micron beams no larger than a virus.
δ-Doping of oxygen vacancies dictated by thermodynamics in epitaxial SrTiO3 films
Authors: Li Fengmiao , Yang Fang , Liang Yan , Li Shanming , Yang Zhenzhong , Zhang Qinghua , Li Wentao , Zhu Xuetao , Gu Lin , Zhang Jiandi , Plummer E. W. , Guo Jiandong
Published: June 2017

Homoepitaxial SrTiO3(110) film is grown by molecular beam epitaxy in ultra-high vacuum with oxygen diffusing from substrate as the only oxidant. The resulted oxygen vacancies (VOs) are found to be spatially confined within few subsurface layers only, forming a quasi-two-dimensional doped region with a tunable high concentration. Such a δ-function distribution of VOs is essentially determined by the thermodynamics associated with the surface reconstruction, and facilitated by the relatively high growth temperature. Our results demonstrate that it is feasible to tune VOs distribution at the atomic scale by controlling the lattice structure of oxide surfaces.
Knowledge of mood in internal and external interface contexts in Spanish heritage speakers in the Netherlands
Authors: Osch Brechje van , Hulk Aafke , Sleeman Petra , Aalberse Suzanne
Published: June 2017

This study investigates Spanish heritage speakers in the Netherlands on their judgments of Spanish mood in a syntactic context and in two interface contexts: the internal interface between syntax and semantics and the external interface between syntax and pragmatics. The strong version of the Interface Hypothesis predicts most vulnerability in the external interface context, and least in the syntactic context. The results of a scalar acceptability judgment task provide support for this hypothesis. We furthermore discuss other possibly relevant factors such as cross-linguistic influence, the default status of the indicative, order of L1 acquisition and variability and frequency in monolingual Spanish.
The Compounding Parameter and L2 acquisition
Authors: Marcelino Marcello
Published: June 2017

This chapter investigates the L2 acquisition of the cluster of structures related to the positive setting of the Compounding Parameter (TCP: nominal compounding (N+N), resultative structures (RS), verb+particle constructions (V+PRT), double object constructions (DOC), and preposition stranding (PrepStr)) in the development of the interlanguage of Brazilian learners of English. Since Brazilian Portuguese (BP) has the negative setting of TCP, the possible acquisition of the cluster in this context may serve as evidence for poverty of the stimulus effects in L2 acquisition. Two groups of Brazilian learners of English, one intermediate and one advanced, were tested and compared. The results suggest that the acquisition of [+]TCP-related cluster of structures by the advanced group as well as their developing knowledge by the intermediate group might be indicative of access to UG.
Recreating the image of Chan master Huineng
Authors: Yu Hailing , Wu Canzhong
Published: June 2017

The article is on the recreation of the image of Chan master Huineng in four English translations of thePlatform Sutrathrough the choice of personal pronouns. Adopting SysConc as analytical tool, the study looks at the use of personal pronouns and the image of Huineng recreated in each translation. InWong (1930a), the use ofwein combination withyoupresents Huineng as both friendly and authoritative; inHeng (1977b), Huineng tends to avoid personal pronouns and seems to be detached; inCleary (1998b), Huineng is more involved in the interaction and uses manyI’s as well asyou; inCheng (2011), Huineng speaks in an elegant way and uses genericoneas personal reference. It is argued that both the choices of personal pronouns and the images of Huineng recreated can be better understood in terms of the context of translation.
The Brophy Case: The use of Artificial Hydration and Nutrition
Authors: Boyle Philip , King Larry , O'Rourke Kevin
Published: June 2017

Case Study:

Paul Brophy, a 48-year old fireman living in Boston, married to Patricia Brophy for 27 years, suffered a subarachnoid hemorrhage as a result of a ruptured basilar tip aneurysm on March 22, 1983. In order to correct the aneurysm. Brophy underwent major surgery involving a right frontotemporal craniotomy and a clipping of the basilar tip aneurysm. Postoperatively, he never regained consciousness, and has remained in a persistent vegetative state. Subsequent to his surgery of April 6, 1983 and prior to his discharge on June 28, 1983, Brophy received multiple CT scans, which showed a complete infarction (destruction of tissue secondary to lack of blood flow) of his left posterior cerebral artery and infarction of the right temporal lobe of the brain. In January, 1985, Patricia Brophy, with the consent of the five Brophy children, all of whom are adults, petitioned to have all life sustaining treatment removed from her husband, including the discontinuation of all artificial nutrition and hydration.

What decision should the court make?
Legislating Pro-Life Principle: Victory without Compromise
Authors: Sadick Mary H.
Published: June 2017

A Panel Presentation to the 60th Annual Meeting of the National Federation of Catholic Physicians’ Guilds at Ann Arbor, Michigan, October 12, 1991.
Precipitation priority in 5083 Al-alloys containing small amounts of Cu or Zn
Authors: Chen Wei , Luo Binghui , Gao Yang , Bai Zhenhai , Jing Huibo , Zhao Jingwei
Published: June 2017

This study investigated the precipitation priority in Al–Mg alloys modified by the addition of 0.8 wt-% Cu or Zn, revealing that both these alloys exhibit increased hardness and decreased corrosion resistance. Scanning electron microscopy, transmission electron microscopy, and high-angle annular dark field imaging show that the precipitation priority changed the main second-phase particles of Cu- and Zn-containing alloys. Additionally, thermodynamic data of these phases were calculated using a semi-empirical model, showing good agreement with the experimental results.

This paper is part of a thematic issue on Light Alloys.
The 1955 Salk Polio Vaccine and the 1957-61 Niles Leukemia Cluster: A Flawed Investigation by the U.S. Public Health Service
Authors: Ratner Herbert
Published: June 2017

A 1963 U.S. Public Health Service study of the 1957-1961 leukemia cluster of eight children in Niles, IL, gave cursory attention to the possible role of the Salk polio vaccine in the etiology of the leukemia. Entitled “Leukemia among Children in a Suburban Community,” and published in the American Journal of Medicine, 34:796-812 June, 1963, the study was reprinted as a “Classic in Oncology” in CA — A Cancer Journal for Clinicians, 40, 1:27-50 Jan.-Feb., 1990. Focusing on the physical environment of the school and church community to which six of the children belonged, the study either overlooked or ignored the presence of live polio virus in the first two inoculations received by first and second graders in Chicago and its suburbs in the spring of 1955. Had the investigators considered the 1955 vaccine as a vector of the disease, their conclusions might have been other than to say the etiology of the leukemia cluster could not be determined.
Is There a Need for a Catholic Standard of Care?
Authors: Corcoran Gerald P.
Published: June 2017

This is the text of an address given to the Guild of St. Luke at their annual White Mass in Boston, November 3, 2000. Dr. Corcoran, a family practitioner from Needham, MA, was the president of the Boston Guild from 1990 to 2000.
Carbapenem-Resistant Enterobacteriaceae Infections: Results From a Retrospective Series and Implications for the Design of Prospective Clinical Trials
Authors: Alexander Elizabeth L. , Loutit Jeffery , Tumbarello Mario , Wunderink Richard , Felton Tim , Daikos George , Fusaro Karen , White Dan , Zhang Shu , Dudley Michael N.
Published: June 2017

Background

The increasing incidence of multidrug-resistant Gram negatives, such as carbapenem-resistant Enterobacteriaceae (CRE), has resulted in a critical need for new antimicrobials. Most studies of new antimicrobials have been performed in patients with nondrug-resistant pathogens. We performed a retrospective analysis of patients with CRE infections to inform the design of phase 3 clinical trials.

Methods

This was a retrospective study at 22 centers in 4 countries. Baseline data, treatment, and outcomes were collected in patients with complicated urinary tract infection (cUTI)/acute pyelonephritis (AP), hospital-acquired bacterial pneumonia (HABP), ventilator-associated bacterial pneumonia (VABP), and bacteremia due to CRE.

Results

Two hundred fifty-six cases of CRE infection were identified: 75 cUTI/AP, 21 HABP, 20 VABP, and 140 bacteremia. The patient population had significant comorbidities: 32.8% had chronic renal insufficiency, and 26.2% were immunocompromised. Illness severity at presentation was high: 29.3% presented with septic shock. Treatment regimens varied widely; however, a majority of patients received combination therapy. Outcomes were universally poor (28-day mortality was 28.1%) across all sites of infection, particularly in dialysis patients and those with sepsis.

Conclusions

The CRE infections occured in patients with substantial comorbidities and were associated with high mortality and low rates of clinical cure with available antibiotics. Patients with these comorbidities are often excluded from enrollment in clinical trials for registration of new drugs. These results led to changes in the inclusion/exclusion criteria of a phase 3 trial to better represent the patient population with CRE infections and enable enrollment. Observational studies may become increasingly important to guide clinical trial design, inform on the existing standard of care, and provide an external control for subsequent trials.
Methadone Management of Withdrawal Associated With Loperamide-related Opioid Use Disorder
Authors: Leo Raphael J. , Ghazi Muhammad A. , Jaziri Kelly S.
Published: June 2017

Loperamide hydrochloride is an over-the-counter anti-diarrheal agent, acting via mu-opioid receptor agonist effects in the intestinal myenteric plexus. Although preclinical investigations suggested that abuse liability associated with loperamide use is low, there are increasing numbers of cases reported to the US Food and Drug Administration, of abuse, dependence, and withdrawal associated with loperamide use. A case of a patient with opioid use disorder, that is, in the form of protracted loperamide excess use, requiring management of withdrawal with methadone is presented. Management of withdrawal from abrupt loperamide discontinuation has not been discussed in the literature. Long-term treatment issues are also described.
Cancer incidence estimation method: an Apulian experience
Authors: Nannavecchia Anna M. , Rashid Ivan , Cuccaro Francesco , Chieti Antonio , Bruno Danila , Burgio Lo Monaco Maria G. , Tanzarella Cinzia , Bisceglia Lucia
Published: June 2017

The Cancer Registry of Puglia (RTP) was instituted in 2008 as a regional population-based cancer registry. It consists of six sections (Foggia, Barletta-Andria-Tran, Bari, Brindisi, Lecce, and Taranto) and covers more than 4 000 000 inhabitants. At present, four of six sections have received accreditation by AIRTUM (53% of regional population). To point out possible regional geographic variability in cancer incidence and also to support health services planning, we developed an original estimation method to ensure a complete territorial coverage. Incidence data of the four accredited RTP sections for the shared incidence period 2006–2008, the 2001–2009 hospitalization regional data, and 2006–2009 mortality data were considered. To take into account specific health features of different provinces, we performed an estimate of cancer incidence rates of nonaccredited sections using a combination of accredited sections rates and a factor that combines mortality and hospitalization ratios available for all the sections. Finally, we validated the method and we applied it to estimate regional cancer rates as the population-weighted average of accredited sections and nonaccredited sections adjusted rates. The validation process shows that estimated rates are close to real incidence data. The most frequent neoplasms in Apulia are breast (direct standardized rates 96.8 per 100 000 inhabitants), colon–rectum (36.6), and thyroid cancer (25.3) in women and prostate (70.2), lung (68.4), and colon–rectum cancer (52.2) in men. This method could be useful to assess the cancer incidence when complete cancer registration data are not available, but hospitalization, mortality, and neighbouring incidence data are available.
Critical Care Nurses’ Suggestions to Improve End-of-Life Care Obstacles
Authors: Beckstrand Renea L. , Hadley Kacie Hart , Luthy Karlen E. , Macintosh Janelle L. B.
Published: June 2017

Background:

Critical-care nurses (CCNs) provide end-of-life (EOL) care on a daily basis as 1 in 5 patients dies while in intensive care units. Critical-care nurses overcome many obstacles to perform quality EOL care for dying patients.

Objectives:

The purposes of this study were to collect CCNs’ current suggestions for improving EOL care and determine if EOL care obstacles have changed by comparing results to data gathered in 1998.

Methods:

A 72-item questionnaire regarding EOL care perceptions was mailed to a national, geographically dispersed, random sample of 2000 members of the American Association of Critical-Care Nurses. One of 3 qualitative questions asked CCNs for suggestions to improve EOL care. Comparative obstacle size (quantitative) data were previously published.

Results:

Of the 509 returned questionnaires, 322 (63.3%) had 385 written suggestions for improving EOL care. Major themes identified were ensuring characteristics of a good death, improving physician communication with patients and families, adjusting nurse-to-patient ratios to 1:1, recognizing and avoiding futile care, increasing EOL education, physicians who are present and “on the same page,” not allowing families to override patients’ wishes, and the need for more support staff. When compared with data gathered 17 years previously, major themes remained the same but in a few cases changed in order and possible causation.

Conclusion:

Critical-care nurses’ suggestions were similar to those recommendations from 17 years ago. Although the order of importance changed minimally, the number of similar themes indicated that obstacles to providing EOL care to dying intensive care unit patients continue to exist over time.
Immunoassays for Measuring Serum Concentrations of Monoclonal Antibodies and Anti-biopharmaceutical Antibodies in Patients
Authors: Darrouzain François , Bian Sumin , Desvignes Céline , Bris Céline , Watier Hervé , Paintaud Gilles , de Vries Annick
Published: June 2017

Monoclonal antibodies (mAbs) may be used as biopharmaceuticals to treat various diseases, ranging from oncology to inflammatory and cardiovascular affections. Trustworthy analytical methods are necessary to study their pharmacokinetics, both during their development and in post-marketing studies. Because biopharmaceuticals are macromolecules, ligand-binding assays (both immunoassays and bioassays) are methods of choice to measure their concentrations. Immunoassays are based on the capture of biopharmaceuticals by their target, which may be a circulating or membrane antigen or by an antibody recognizing their structure. Bioassays measure the activity of the biopharmaceutical in a specific in vitro test. A number of techniques have been reported, but their limits of detection and quantification vary widely. Anti-drug antibodies (ADA) against biopharmaceuticals are often formed and sometimes interfere with clinical efficacy. Accurate and reliable detection of ADA is therefore necessary. Binding of ADA is dependent on affinity and avidity, which makes quantification challenging. In this review, we discuss the benefits and limitations of each method to determine mAb levels and carefully compare ADA assays.
Prolongation of Biologic Dosing Intervals in Patients With Stable Psoriasis: A Feasibility Study
Authors: van Bezooijen Ji S. , van Doorn Martijn B. A. , Schreurs Marco W. J. , Koch Birgit C. P. , te Velthuis Henk , Prens Errol P. , van Gelder Teun
Published: June 2017

Background:

Biologics are usually licensed according to the “one dose fits all” principle. It is therefore suspected that a significant number of patients with psoriasis are overtreated. However, evidence for successful dose reduction of biologics in psoriasis is scarce. The aim of this study was to investigate whether the dosing interval of 3 biologics, adalimumab, etanercept, or ustekinumab could be prolonged successfully in patients with plaque psoriasis.

Methods:

In a prospective exploratory cohort study, 59 patients with psoriasis on maintenance treatment with adalimumab, etanercept, or ustekinumab were included. After a run-in period of 6 weeks, the dosing interval of the biologics was prolonged according to a predefined schedule. Our primary objective was to determine the proportion of patients who could maintain a successful prolongation of the per label dosing interval. Secondary objectives were to evaluate the predictive value of baseline serum trough concentrations for successful dosing interval prolongation and to explore the feasibility of dosing interval prolongations in off-label-treated patients.

Results:

In the per label group, 7 out of 16 (44%) adalimumab patients, 5 out of 16 (31%) etanercept patients, and 2 out of 10 (20%) ustekinumab patients achieved a successful dosing interval prolongation. Baseline serum trough concentrations did not differ significantly between patients with successful dosing interval prolongation and failures. In the off-label group, prolongation in patients with already extended intervals was unsuccessful. For patients with shortened intervals, minor prolongation was successful in 3 out of 17 (17.6%) patients.

Conclusions:

Prolongation of the per label biologic dosing interval was feasible in approximately 30% of patients with psoriasis with stable minimal disease activity and can reduce costs in clinical practice. Baseline serum trough concentrations were not predictive for successful dosing interval prolongation.
Difficulties in Surgical Decision Making and Associated Factors Among Elective Surgical Patients in Taiwan
Authors: Lin Mei-Ling , Chen Ching-Huey
Published: June 2017

Background:

Respect for the autonomy of patients is essential in life-threatening medical decisions such as surgery. Even if a patient has the competency to make decisions, many obstacles exist that may influence his or her willingness to participate in the surgical decision-making process.

Purpose:

The aim of this study was to explore the perceived difficulties in surgical decision making and related factors among elective surgical patients.

Methods:

This was a cross-sectional correlational study. A convenience sampling method was used to recruit patients from a medical center in southern Taiwan. Patients who had received elective surgery, were older than 20 years old, and were competent to make medical decisions were invited to participate. A structured questionnaire was developed by the researchers to collect demographic data, decision patterns, and perceived difficulties in surgical decision making. Acceptable validity and reliability of the questionnaire were confirmed before data collection.

Results:

Over 80% of the participants made the surgical decision by themselves or in collaboration with their family or physician. Less than 15% expected to make the surgical decision by themselves. Illness-related suffering was the greatest difficulty that participants faced. The patients who tended toward passive decision making faced greater difficulties in the dimensions of “do not understand information,” “physician’s lack of concern,” and “difficulty in freely communicating with the physician” than their active decision-making peers. Male participants reported having more difficulty in communicating with their physician than their female peers. Age, education, and marital status were not significantly associated with perceived difficulties in surgical decision making.

Conclusions:

Family participation in the medical decision-making process is expected by most patients. Although less than 20% of the participants in this study were categorized as passive decision makers, this group reported more difficulties than the active decision-making group. Healthcare professionals should be more active in communicating with patients who are largely silent during the decision-making process to elicit their preferences and needs with regard to surgical decisions.
Genetic Testing
Authors: Berdanier Carolyn D.
Published: June 2017

Deoxyribonucleic acid, the genetic material in the cell, provides a window into the reasons for human variability. The testing of this material can provide much information about one's genetic heritage and identity. If designed to examine a specific segment of the DNA, it can provide information about the genetic risk for developing diseases that have a genetic component. Kits that will provide an analysis of the DNA can be purchased. The results of some of these kits can be very informative, but the results of others must be viewed with considerable skepticism according to the FDA, FTC, and CDC. Depending on the purpose of the DNA analysis, the interpretation of the results can be quite challenging. There are many factors that influence whether a particular DNA fragment is expressed. This review discusses the use of the results of genetic testing. It also describes some of the factors that can influence the expression of one's genetic heritage.
Embracing a Plant-Based Diet
Authors: Pawlak Roman , Kolasa Kathryn M.
Published: June 2017

In this article, we present a case of a young health professional feeling peer pressured to become vegan. We discuss nutrient of concerns for individuals restricting or eliminating foods, especially animal food, from their diets.
“Attention Everyone, Time Out!”: Safety Attitudes and Checklist Practices in Anesthesiology in Germany. A Cross-Sectional Study
Authors: Neuhaus Christopher , Spies Aline , Wilk Henryk , Weigand Markus A. , Lichtenstern Christoph
Published: June 2017

Background

The use of perioperative checklists has generated a growing body of evidence pointing toward reduction of mortality and morbidity, improved compliance with guidelines, reduction of adverse events, and improvements in human factor–related areas. Usual quality management metrics generally fall short in assessing compliance with their perioperative application. Our study assessed application attitudes and compliance with safety measures centered around the World Health Organization (WHO) “Safe Surgery Saves Lives” campaign as perceived by anesthesia professionals in Germany.

Methods

Three hundred sixteen physicians and nurses participated in our cross-sectional survey, and 304 completed all 35 questions.

Results

Only 59.5% of participants had knowledge of the theoretical framework behind the WHO campaign. During the “sign-in,” patient ID and surgical site were checked in 99.6% and 95.1% as recommended by the WHO. Allergies were addressed by 89.2%, expected difficult airway by 65.7%, and the availability of blood products by 70.5%. A total of 84.9% of participants advocated for the time-out to include all persons present in the operating room, which was the case in 57.0%. A total of 40.8% stated that the time-out was only performed between anesthetist and surgeon; in 17.0% of cases, the patient was simultaneously draped and/or surgically scrubbed. No significant differences between hospital types were observed.

Conclusions

Our study paints a heterogeneous picture of the implementation, usage, and safety attitudes concerning the Safe Surgery Checklist as promoted by the WHO. The lack of standardized execution and team-mindedness can be taken as further evidence for the importance of interdisciplinary training focusing on human factors, communication, and collaboration rather than the mere implementation by decree.
Genetic Dissection of Heritable Traits in Yeast Using Bulk Segregant Analysis
Authors: Ehrenreich Ian M. , Magwene Paul M.
Published: June 2017

Bulk segregant analysis (BSA) is commonly used to determine the genetic basis of complex traits in yeast. This technique involves phenotyping progeny from a cross and then selectively genotyping pooled subsets of offspring with extreme phenotypes. Analysis of these genotype data can identify loci that show skewed allele frequencies in a group of phenotypically extreme individuals and that are likely to contribute to a trait. BSA can be applied to diverse strain crosses, including ones involving nonreference isolates. Further, given the high throughput of next-generation sequencing, it is possible to conduct many BSA experiments in parallel. Here, we present a BSA protocol for the generation of recombinant cross progeny. We then describe general BSA strategies for conducting phenotyping, causal loci detection, and candidate gene identification in a statistically powerful manner.