bluuebunny/crossref_metadata_2025 huggingface dataset:
Chronic inflammatory pain induced GABAergic synaptic plasticity in the adult mouse anterior cingulate cortex
Authors: Koga Kohei , Shimoyama Shuji , Yamada Akihiro , Furukawa Tomonori , Nikaido Yoshikazu , Furue Hidemasa , Nakamura Kazuhiko , Ueno Shinya
Published: June 2018

Background

Chronic pain is a persistent unpleasant sensation that produces pathological synaptic plasticity in the central nervous system. Both human imaging study and animal studies consistently demonstrate that the anterior cingulate cortex is a critical cortical area for nociceptive and chronic pain processing. Thus far, the mechanisms of excitatory synaptic transmission and plasticity have been well characterized in the anterior cingulate cortex for various models of chronic pain. By contrast, the potential contribution of inhibitory synaptic transmission in the anterior cingulate cortex, in models of chronic pain, is not fully understood.

Methods

Chronic inflammation was induced by complete Freund adjuvant into the adult mice left hindpaw. We performed in vitro whole-cell patch-clamp recordings from layer II/III pyramidal neurons in two to three days after the complete Freund adjuvant injection and examined if the model could cause plastic changes, including transient and tonic type A γ-aminobutyric acid (GABAA) receptor-mediated inhibitory synaptic transmission, in the anterior cingulate cortex. We analyzed miniature/spontaneous inhibitory postsynaptic currents, GABAA receptor-mediated tonic currents, and evoked inhibitory postsynaptic currents. Finally, we studied if GABAergic transmission-related proteins in the presynapse and postsynapse of the anterior cingulate cortex were altered.

Results

The complete Freund adjuvant model reduced the frequency of both miniature and spontaneous inhibitory postsynaptic currents compared with control group. By contrast, the average amplitude of these currents was not changed between two groups. Additionally, the complete Freund adjuvant model did not change GABAA receptor-mediated tonic currents nor the set of evoked inhibitory postsynaptic currents when compared with control group. Importantly, protein expression of vesicular GABA transporter was reduced within the presynpase of the anterior cingulate cortex in complete Freund adjuvant model. In contrast, the complete Freund adjuvant model did not change the protein levels of GABAA receptors subunits such as α1, α5, β2, γ2, and δ.

Conclusion

Our results suggest that the induction phase of inflammatory pain involves spontaneous GABAergic plasticity at presynaptic terminals of the anterior cingulate cortex.
Children with post-stroke epilepsy have poorer outcomes one year after stroke
Authors: Fox Christine K , Jordan Lori C , Beslow Lauren A , Armstrong Jennifer , Mackay Mark T , deVeber Gabrielle
Published: June 2018

Background

Epilepsy is a common complication of pediatric stroke.

Aim

In this study, we aim to measure the association between epilepsy and neurologic outcome after childhood arterial ischemic stroke.

Methods

Prospective cohort study of children (29 days–19 years) enrolled after an acute arterial ischemic stroke at 21 international pediatric stroke centers and followed to identify epilepsy. One year post-stroke, outcomes were scored using the examination-based Pediatric Stroke Outcome Measure (range = 0–10); higher values reflect greater disability. Ordinal logistic regression was used to measure the association of Pediatric Stroke Outcome Measure scores (categorized as 0–1, 1.5–3, 3.5–6, 6.5–10) with epilepsy.

Results

Investigators enrolled 86 children (median age = 6.1 years, interquartile range (IQR) = 1.4–12.2 years) with acute stroke. At 1 year, 18/80 (23%) remained on an anticonvulsant including 8/80 (10%) with epilepsy. Among the 70 with Pediatric Stroke Outcome Measure scored, the median was 0.5 (IQR = 0–1.5) for children without epilepsy ( n = 63), and 6 (IQR = 0.5–10) for children with epilepsy ( n = 7). In univariable analyses, poorer 1-year outcome was associated with middle cerebral artery stroke, cortical infarcts, hemorrhagic transformation, hospital disposition not to home, and epilepsy. In multivariable analysis, middle cerebral artery stroke (odds ratio (OR) = 4.9, 95% confidence intervals (CI) = 1.1–21.3) and epilepsy (OR = 24.1, CI = 1.5–380) remained associated with poorer outcome.

Conclusions

Children who developed epilepsy during the first year post-stroke had poorer neurologic outcomes than those without epilepsy.
Meeting report: 30th International Conference on Antiviral Research, in Atlanta, GA, USA
Authors: Vere Hodge R Anthony
Published: June 2018

The 30th International Conference on Antiviral Research was held in Atlanta, GA, USA, from 21 to 25 May 2017. Each year, the International Society for Antiviral Research (ISAR) presents three major awards, this year to Mike Sofia (Elion award), David Chu (Holý award) and Maaike Everts (Prusoff award). Also this year, the inaugural ISAR Women in Science award lecture was presented by Priscilla Yang. For several years, International Conference on Antiviral Research (ICAR) has included at least one Keynote lecture, this year there were four. Although there are accounts of only these eight lectures, they reflect the diversity that is characteristic of ICAR – employment (academia, industry, public health), type of research (virus biology, potential antiviral targets, antiviral drugs, research organisation) and a range of viruses. For example, the viruses included were hepatitis C virus and hepatitis B virus (Mike Sofia), HIV and hepatitis B virus (David Chu), multiple antiviral projects (Maaike Everts), dengue (Priscilla Yang), rhinovirus C (Ann Palmenberg), polio (Mark Pallansch), HIV (Eric Hunter) and Zika virus (Pei-Yong Shi). This report ends with my personal comments giving examples in which this diversity can bring benefits. The 31st ICAR will be in Porto, Portugal, 11–15 June 2018.
Amlodipine-induced angioedema: An unusual complication of a common medication
Authors: Kuruvilla Merin E. , Sanan Neha
Published: June 2018

Hypersensitivity reactions to dihydropyridine calcium channel blockers (CCB) are exceedingly rare, although sporadic reports of isolated angioedema seem to be gradually increasing in frequency. We present a case of angioedema likely triggered by amlodipine.
Autonomic nervous system dysfunction and sinonasal symptoms
Authors: Yao Alexander , Wilson Janet A. , Ball Stephen L.
Published: June 2018

Background

The autonomic nervous system (ANS) richly innervates the nose and paranasal sinuses, and has a significant role in lower airway diseases, e.g., asthma. Nonetheless, its contribution to sinonasal symptoms is poorly understood. This review aimed to explore the complex relationship between the ANS and sinonasal symptoms, with reference to systemic diseases and triggers of ANS dysfunction.

Methods

A review of articles published in English was conducted by searching medical literature databases with the key words “autonomic nervous system” and (“sinusitis” or “nose” or “otolaryngology”). All identified abstracts were reviewed, and, from these, relevant published whole articles were selected.

Results

The ANS has a significant role in the pathophysiologic mechanisms that produce sinonasal symptoms. There was limited evidence that describes the relationship of the ANS in sinonasal disease with systemic conditions, e.g. hypertension. There was some evidence to support mechanisms related to physical and psychological stressors in this relationship.

Conclusion

The role of ANS dysfunction in sinonasal disease is highly complex. The ANS sits within a web of multiple factors, including personality and psychological distress, that contribute to sinonasal symptoms. Further research will help to clarify the etiology of ANS dysfunction and its contribution to common systemic conditions.
Electronic Health Records and Evidence-Based Practice: Solving the Little-Data Problem
Authors: Flach John M. , Schanely Phil , Kuenneke Luke , Chidoro Bennett , Mubaslat Jad , Howard Brandon
Published: June 2018

There is great excitement in the healthcare field about the prospects of digital medicine and the associated availability of Big Data for supporting new discoveries that lead to improved healthcare. However, less attention has been devoted to the problem of using the power of digital systems (e.g., EHRs) for communicating the results from these discoveries to practicing clinical healthcare workers. This is the Little Data Problem. This paper discusses how the frameworks of CSE and UXD are helping designers to address the Little Data Problem. The focus is on designing software and interfaces that function as cognitive tools improving situation awareness and supporting sensemaking. Work to develop an app to help people assess cardiovascular health is described as a concrete example of how CSE and UXD principles are being applied to design technologies that support evidence-based clinical practice.
Optimizing EMR User Experience: A Human Factors Approach to Hardware Assessment and Design for Inpatient and Emergency Units
Authors: Dulude Catherine , Trudel Chantal , King W. James , Macaulay Karen , Gillert Jennifer , Czunyi Leilla , Hafezi Sanaz
Published: June 2018

Many factors contribute to the successful implementation and adoption of electronic medical records (EMRs). Easy access to the EMR, where and when required by clinicians, is a key component of adoption and end-user satisfaction with the system. A pediatric hospital implementing an integrated EMR used multiple methods within an iterative human-centered design (HCD) framework to develop hardware and access solutions supporting future EMR workflows in Inpatient and Emergency Departments. Context of use analysis, participatory design methods, preliminary analysis of evaluative simulations and tacit knowledge of the project team led to the development of guiding principles for hardware implementation and solutions supporting just-in-time documentation within the constraints of existing facility design.
Use Preferences for Continuous Cardiac and Respiratory Monitoring Systems in Hospitals: A Survey of Patients and Family Caregivers
Authors: Patterson Emily S. , Hritz Chris , Gebru Liya , Patel Kashvi , Yamokoski Todd , Moffatt-Bruce Susan D.
Published: June 2018

The overarching objective of this research is to reduce the burden of ‘alert fatigue’ on patients and family caregivers who stay overnight in hospitals on units that provide continuous monitoring of cardiac and respiratory systems. When a patient develops respiratory compromise on the medical-surgical units of the hospital, the mortality rate is 29 times higher. Alarms require nurses to quickly respond, even when it is likely a false alarm. An anonymous survey was distributed to patients and family caregivers with 72 responses. Alarm sounds were judged most helpful to detect a high heart rate or unusual rhythm, and less helpful to detect a patient exiting from bed. The expectation was for an immediate response to an alarm, and that it would be annoying to have an alarm go off for hours. There was strong agreement with wanting alarm sounds to go to the nurse, but not be heard in the hospital room by patients or caregivers. Implications of these findings are discussed.
Biomechanical Characterization of the Hand Touch Corrective Behavior in the Frail Elderly During Bed Egress
Authors: Taylor Dorothy , Merryweather Andrew , Morse Jan
Published: June 2018

Falls are the leading cause of fatal and non-fatal injuries among the elderly in the United States and throughout the world. Many studies have been done over the last few decades in an attempt to better understand how to prevent falls among the elderly population. Unfortunately, most of these studies are conducted by simulating falls in a laboratory with healthy adults which has been shown to be quite different from a real world fall. This pilot study defines corrective behaviors implemented by the elderly to maintain balance and looks specifically at measures of stability when the hand touch corrective behavior is used. These measures include base of support area, proximity of center of mass to base of support perimeter, time for center of mass to contact base of support perimeter, and jerk of the center of mass of the torso. Initial findings indicate that the hand touch corrective behavior is used to both maintain and regain stability. It is anticipated that, with the evaluation of the remaining trials, a model of fall-initiation of the frail elderly will be developed to provide key biomechanical stability measures for use as a proxy for a fall in laboratory studies, as well as to provide new insights in fall interventions.
A 3-State Analysis of Black–White Disparities in Diabetes Hospitalizations Among Medicaid Beneficiaries
Authors: Mkanta William N. , Reece Michelle C. , Alamri Abeer D. , Ezekekwu Emmanuel U. , Potluri Aishwarya , Chumbler Neale R.
Published: June 2018

Introduction:

Although diabetes is one of the leading chronic disease in the country, efforts in primary care and patient self-care management could prevent most of the diabetes-related hospitalizations and produce cost savings and improvements in quality of life. We used information from Medicaid beneficiaries in 3 states to predict racial differences in diabetes hospitalizations and demonstrate how they vary across states.

Methods:

We conducted a cross-sectional study to examine differences between black and white patients with diabetes hospitalizations. Information was obtained from the Medicaid Analytic eXtract files. We used multiple logistic regression models to assess the significance of the differences.

Results:

Analysis included 10 073 adult Medicaid recipients from the states of Mississippi (51%), Georgia (35%), and Michigan (14%). Blacks were more likely to experience longer hospital stays in Georgia (odds ratio [OR] = 1.040; 95% confidence interval [CI]: 1.03-1.06) and Mississippi (OR = 1.048; 95% CI: 1.03-1.07). A majority of patients in both groups were likely to be discharged to their homes for self-care. Black patients had lower odds of repeated stays in Georgia (OR = 0.670; 95% CI: 0.54-0.84), but higher odds in Michigan (OR = 1.580; 95% CI: 1.12-2.24). Similar differences occurred when patients were matched by age and sex. Blacks had lower odds of qualifying for dual Medicare–Medicaid enrollment benefit in Georgia and Mississippi.

Conclusion:

Racial differences in diabetes-related hospitalizations reflect possible inefficiencies in the process of care. Identification of race-specific factors for hospitalizations and implementation of primary care strategies that support effective self-management skills would aid in reducing diabetes hospitalizations and related disparities.
Techno-economic rationalities as a political practice in urban environmental politics in China
Authors: Westman Linda K , Castán Broto Vanesa
Published: June 2018

This article argues that techno-economic rationalities dominate urban environmental policy interventions and sustainability discourses in China. This is so despite recent trends toward diversification of actors and participatory approaches in environmental governance. The paper is based on material collected through interviews with public officials, urban planners, researchers, companies, and nongovernmental organizations working with sustainability issues in cities in China. Our empirical material shows that diversification of actors does not translate into a diversification of policy discourses. Instead, groups with technical expertise or economic resources dominate processes of environmental governance. To explain this tendency, we draw on insights from theories of technocracy. We argue that the concept of techno-economic rationalities explains why considerable leverage over sustainability-related policy decisions is created for non-state actors with access to technical expertise or economic resources, while groups who lack such resources are permanently excluded. In the case of China, this means systematically overlooking social and environmental priorities, which may cement nondemocratic decision making and increase social tensions.
Low-dose cytarabine to prevent myeloid leukemia in children with Down syndrome: TMD Prevention 2007 study
Authors: Flasinski Marius , Scheibke Kira , Zimmermann Martin , Creutzig Ursula , Reinhardt Katarina , Verwer Femke , de Haas Valerie , van der Velden Vincent H. J. , von Neuhoff Christine , Zwaan C. Michel , Reinhardt Dirk , Klusmann Jan-Henning
Published: June 2018

Key Points

Low-dose cytarabine treatment reduced mortality in symptomatic TMD patients compared with the historical control. An MRD monitoring–based low-dose cytarabine treatment does not prevent progression from preleukemic TMD to ML-DS.
Elastic wave-equation datuming
Authors: Gong Xufei , Du Qizhen , Zhao Qiang , Sun Pengyuan , Zhang Jianlei , Tian Zhenping
Published: June 2018

Wave-equation datuming (WED) techniques have demonstrated superiority when waves occur on the acquisition surface nonvertically, and traditional static corrections based on the time shift become inaccurate. Meanwhile, as for multicomponent data, those scalar techniques can hardly maintain the vector characteristics for the following multicomponent data processing flows. Considering this, we have developed an elastic-wave datuming approach to handle the static corrections for multicomponent data. Different from those existing scalar WED techniques, the multicomponent data are first decomposed into multicomponent P- and S-wave data. Then, the decomposed data are transformed into the [Formula: see text]-[Formula: see text] domain, and they are extrapolated from the acquisition surface to the datum using the one-way elastic-wave continuation. Finally, the datumed multicomponent data are reconstructed at the output datum by adding up the datumed P- and S-wave data. This elastic WED can guarantee that the same wave modes on different components are equally datumed, and the data remain multicomponent so that they are still applicable to multicomponent-joint processing techniques. Finally, several test examples involved in this paper have proved our method’s effectiveness in multicomponent data datuming application.
Numerical analysis of local strain measurements in fluid-saturated rock samples submitted to forced oscillations
Authors: Chapman Samuel , Quintal Beatriz
Published: June 2018

The forced oscillation method is used to experimentally study the viscoelastic behavior of fluid-saturated rocks at seismic frequencies by measuring their dynamic stress-strain response. The strain on a sample can be measured locally with strain gauges or on the entire sample, here referred to as bulk strain, with a displacement transducer. The local response can vary greatly from the bulk because of heterogeneities in the rock, which can be structural in nature, for example, fractures, or they can arise from partial fluid saturation. Comparing the results from experimental setups that measure strains by different methods can therefore become problematic, and setups that exclusively measure local strains can be inadequate for performing certain experiments. To better understand these limitations, we numerically simulate forced oscillation tests on models representative of laboratory samples, using Biot’s quasistatic equations for poroelastic media. The main objective is to analyze the discrepancies that can arise between local and bulk measurements, with a specific focus on the frequency-dependent attenuation and the Young’s modulus dispersion. We find that, for a fully water-saturated sample having a single fracture and for a partially saturated sample, the local responses deviate significantly from the bulk responses. In addition, the average of three local measurements along a sample allows for approximating the bulk response for the case of a partially water-saturated sample having a homogeneous solid frame. Such an average is not sufficient for the fractured sample. In summary, the averaging of local strain measurements can provide a partial solution to accurately characterize the dynamic stress-strain response of the sample in certain cases, but in other cases, it can lead to results that strongly deviate from the bulk measurements. We advocate for experimental setups to be built to measure the bulk strain on rock samples or modified to include this measurement in addition to local ones.
Evaluating the effect of Brainfood groups for people with mild cognitive impairment and mild dementia: preliminary mixed-methodology study
Authors: Hassan Saba , Aguirre Elisa , Betz Anna , Robertson Sarah , Sankhla Deepak , Cooper Claudia
Published: June 2018

Background

Brainfood is a 5-week group intervention for people with mild cognitive impairment and mild dementia, promoting cognitive health through a Mediterranean-style diet, exercise, mindfulness and health self-management.

Aims

To evaluate Brainfood acceptability and the feasibility of conducting a randomised controlled trial; in a single group study in two National Health Service (NHS) memory services.

Method

Participants self-completed quantitative and semi-structured questionnaires. Recruitment, attendance and outcome completion were the primary outcomes.

Results

In total, 30 of 59 people invited to Brainfood attended; of the 26 (87%) who completed baseline measures: 25 (96%) completed post-intervention quantitative measures, 16 (67%) qualitative questions and 21 (81%) attended ≥3/5 sessions. Compared with baseline, participants reported significantly higher quality of life, Mediterranean diet adherence and exercising more, up to 2 months after the groups. Participants valued the groups and felt enabled to improve their well-being.

Conclusions

Brainfood was acceptable and feasible to implement in an NHS setting.

Declaration of interest

A.B. and C.C. developed Brainfood – they hold a creative commons license for the manual and make it available to use for free to all. The manual evolves iteratively, but the manual used in this research study is provided in an online supplement.
Text Messaging in Oncology: A Review of the Landscape
Authors: Mougalian Sarah S. , Gross Cary P. , Hall E. Kevin
Published: June 2018

Text messaging via short messaging service (SMS) is a common route of communication in the United States and offers many advantages to improve health care delivery compared with other forms of mHealth. Text messaging is easy to use, is convenient, is more likely to be viewed than e-mail, and can be tailored to an individual recipient’s needs. Despite evidence that patients with cancer desire more mobile-based communication, there are few examples of successful text messaging interventions in the literature. This narrative review examines the current landscape of SMS-based interventions across the continuum of cancer care, including addressing behavioral change, attendance to screening and follow-up appointments, adherence to treatment, and assessment of symptoms and quality of life. Finally, we explore some of the barriers to implementation of a successful text messaging intervention.
Managing Cancer and Living Meaningfully (CALM): A Randomized Controlled Trial of a Psychological Intervention for Patients With Advanced Cancer
Authors: Rodin Gary , Lo Christopher , Rydall Anne , Shnall Joanna , Malfitano Carmine , Chiu Aubrey , Panday Tania , Watt Sarah , An Ekaterina , Nissim Rinat , Li Madeline , Zimmermann Camilla , Hales Sarah
Published: June 2018

Purpose

Individuals with advanced cancer experience substantial distress in response to disease burden and impending mortality. Managing Cancer And Living Meaningfully (CALM) is a novel, brief, manualized psychotherapeutic intervention intended to treat and prevent depression and end-of-life distress in patients with advanced cancer. We conducted a randomized controlled trial to compare CALM with usual care (UC) in this population.

Methods

Patients with advanced cancer were recruited from outpatient oncology clinics at a comprehensive cancer center into an unblinded randomized controlled trial. Permuted block randomization stratified by Patient Health Questionnaire-9 depression score allocated participants to CALM plus UC or to UC alone. Assessments of depressive symptoms (primary outcome), death-related distress, and other secondary outcomes were conducted at baseline, 3 months (primary end point), and 6 months (trial end point). Analyses were by intention to treat. Analysis of covariance was used to test for outcome differences between groups at follow-up, controlling for baseline. Mixed-model results are reported.

Results

Participants (n = 305) were recruited between February 3, 2012, and March 4, 2016, and randomly assigned to CALM (n = 151) or UC (n = 154). CALM participants reported less-severe depressive symptoms than UC participants at 3 months (Δ = 1.09; P = .04; Cohen’s d = 0.23; 95% CI, 0.04 to 2.13) and at 6 months (Δ = 1.29; P = .02; d = 0.29; 95% CI, 0.24 to 2.35). Significant findings for greater end-of-life preparation at 6 months also favored CALM versus UC. No adverse effects were identified.

Conclusion

Findings suggest that CALM is an effective intervention that provides a systematic approach to alleviating depressive symptoms in patients with advanced cancer and addresses the predictable challenges these patients face.
Hypothalamic–Pituitary and Growth Disorders in Survivors of Childhood Cancer: An Endocrine Society* Clinical Practice Guideline
Authors: Sklar Charles A , Antal Zoltan , Chemaitilly Wassim , Cohen Laurie E , Follin Cecilia , Meacham Lillian R , Murad M Hassan
Published: June 2018

Objective

To formulate clinical practice guidelines for the endocrine treatment of hypothalamic–pituitary and growth disorders in survivors of childhood cancer.

Participants

An Endocrine Society–appointed guideline writing committee of six medical experts and a methodologist.

Conclusions

Due to remarkable improvements in childhood cancer treatment and supportive care during the past several decades, 5-year survival rates for childhood cancer currently are >80%. However, by virtue of their disease and its treatments, childhood cancer survivors are at increased risk for a wide range of serious health conditions, including disorders of the endocrine system. Recent data indicate that 40% to 50% of survivors will develop an endocrine disorder during their lifetime. Risk factors for endocrine complications include both host (e.g., age, sex) and treatment factors (e.g., radiation). Radiation exposure to key endocrine organs (e.g., hypothalamus, pituitary, thyroid, and gonads) places cancer survivors at the highest risk of developing an endocrine abnormality over time; these endocrinopathies can develop decades following cancer treatment, underscoring the importance of lifelong surveillance. The following guideline addresses the diagnosis and treatment of hypothalamic–pituitary and growth disorders commonly encountered in childhood cancer survivors.
Prospective Observational Investigation of Capnography and Pulse Oximetry Monitoring After Cesarean Delivery With Intrathecal Morphine
Authors: Weiniger Carolyn F. , Akdagli Seden , Turvall Elliot , Deutsch Lisa , Carvalho Brendan
Published: June 2018

BACKGROUND:

Intrathecal morphine provides excellent analgesia after cesarean delivery; however, respiratory events such as apnea, bradypnea, and hypoxemia have been reported. The primary study aim was to estimate the number of apneas per subject, termed “apnea alert events” (AAEs) defined by no breath for 30–120 seconds, using continuous capnography in women who underwent cesarean delivery.

METHODS:

We performed a prospective, observational study with institutional review board approval of women who underwent cesarean delivery with spinal anesthesia containing 150-µg intrathecal morphine. A STOP-Bang obstructive sleep apnea assessment was administered to all women. Women were requested to use continuous capnography and pulse oximetry for 24 hours after cesarean delivery. Nasal sampling cannula measured end-tidal carbon dioxide (Etco
2) and respiratory rate (RR), and oxygen saturation (Spo
2) as measured by pulse oximetry. Capnography data were defined as “valid” when Etco
2 >10 mm Hg, RR >5 breaths per minute (bpm), Spo
2 >70%, or during apnea (AAE) defined as “no breath” (Etco
2, <5 mm Hg) for 30–120 seconds. Individual respiratory variable alerts were 10-second means of Etco
2 <10 mm Hg, RR <8 bpm, and Spo
2 <94%. Nurse observations of RR (hourly and blinded to capnography) are reported.

RESULTS:

We recruited 80 women, mean (standard deviation [SD]) 35 (5) years, 47% body mass index >30 kg/m2/weight >90 kg, and 11% with suspected obstructive sleep apnea (known or STOP-Bang score >3). The duration of normal capnography and pulse oximetry data was mean (SD) (range) 8:28 (7:51) (0:00–22:32) and 15:08 (6:42) (1:31–23:07) hours:minutes, respectively; 6 women did not use the capnography. There were 198 AAEs, mean (SD) duration 57 (27) seconds experienced by 39/74 (53%) women, median (95% confidence interval for median) (range) 1 (0–1) (0–29) per subject. Observation of RR by nurses was ≥14 bpm at all time-points for all women, r = 0.05 between capnography and nurse RR (95% confidence interval, −0.04 to 0.14). There were no clinically relevant adverse events for any woman. Sixty-five women (82%) had complaints with the capnography device, including itchy nose, nausea, interference with nursing baby, and overall inconvenience.

CONCLUSIONS:

We report 198 AAEs detected by capnography among women who underwent cesarean delivery after receiving intrathecal morphine. These apneas were not confirmed by the intermittent hourly nursing observations. Absence of observer verification precludes distinction between real, albeit nonclinically significant alerts with capnography versus false apneas. Discomfort with the nasal sampling cannula and frequent alerts may impact capnography application after cesarean delivery. No clinically relevant adverse events occurred.
Monitoring Depth of Hypnosis: Mid-Latency Auditory Evoked Potentials Derived aepEX in Children Receiving Desflurane-Remifentanil Anesthesia
Authors: Cheung Yuen M. , Scoones Gail P. , Stolker Robert Jan , Weber Frank
Published: June 2018

BACKGROUND:

The aepEXplus monitoring system, which uses mid-latency auditory evoked potentials to measure depth of hypnosis, was evaluated in pediatric patients receiving desflurane-remifentanil anesthesia.

METHODS:

Seventy-five patients, 1–18 years of age (stratified for age; 1–3, 3–6, 6–18 years, for subgroup analyses), were included in this prospective observational study. The aepEX and the bispectral index (BIS) were recorded simultaneously, the latter serving as a reference. The ability of the aepEX to detect different levels of consciousness, defined according to the University of Michigan Sedation Scale, investigated using prediction probability (Pk), and receiver operating characteristic (ROC) analysis, served as the primary outcome parameter. As a secondary outcome parameter, the relationship between end-tidal desflurane and the aepEX and BIS values were calculated by fitting in a nonlinear regression model.

RESULTS:

ThePkvalues for the aepEX and the BIS were, respectively, .68 (95% CI, 0.53–0.82) and .85 (95% CI, 0.73–0.96;P= .02). The aepEX and the BIS had an area under the ROC curve of, respectively, 0.89 (95% CI, 0.80–0.95) and 0.76 (95% CI, 0.68–0.84;P= .04). The maximized sensitivity and specificity were, respectively, 81% (95% CI, 61%–93%) and 86% (95% CI, 74%–94%) for the aepEX at a cutoff value of >52, and 69% (95% CI, 56%–81%) and 70% (95% CI, 57%–81%) for the BIS at a cutoff value of >65. The age-corrected end-tidal desflurane concentration associated with an index value of 50 (EC50) was 0.59 minimum alveolar concentration (interquartile range: 0.38–0.85) and 0.58 minimum alveolar concentration (interquartile range: 0.41–0.70) for, respectively, the aepEX and BIS (P= .69). Age-group analysis showed no evidence of a difference regarding the area under the ROC curve or EC50.

CONCLUSIONS:

The aepEX can reliably differentiate between a conscious and an unconscious state in pediatric patients receiving desflurane-remifentanil anesthesia.
Practice of Ultrasound-Guided Palpation of Neck Landmarks Improves Accuracy of External Palpation of the Cricothyroid Membrane
Authors: You-Ten Kong Eric , Wong David T. , Ye Xiang Y. , Arzola Cristian , Zand Atoosa , Siddiqui Naveed
Published: June 2018

BACKGROUND:

Ultrasonography can accurately identify the cricothyroid membrane; however, its impact on the subsequent accuracy of external palpation is not known. In this study, we tested the ability of anesthesia participants to identify the midpoint of the cricothyroid membrane using external palpation with and without ultrasound (US)-guided practice.

METHODS:

Following institutional ethics approval and informed consent, anesthesia participants consisting of anesthesia residents, fellows, and practicing anesthesia assistants underwent didactic teaching on neck landmarks. The participants were then randomized to practice palpation of neck landmarks with US guidance (US group) or without ultrasonography (non-US [NUS] group). After the practice session, each participant identified the cricothyroid membrane using external palpation on the neck of 10 volunteers and marked the anticipated entry point for device insertion (palpation point [PT]). The midpoint of the cricothyroid membrane of each volunteer had been premarked with invisible ink using ultrasonography (US point) by a separate member of the research team. The primary outcome was the accuracy rate defined as the percentage of the attempts with the distance ≤5 mm measured from the PT to US point for the participant. The primary outcome was compared between NUS and US groups using Wilcoxon rank sum test. A mixed-effect logistic regression or mixed-effect linear model was also conducted for outcomes accounting for the clustering and adjusting for potential confounders.

RESULTS:

Fifteen anesthesia participants were randomized to US (n = 8) and NUS (n = 7) groups. A total of 80 and 61 attempts were performed by the US and NUS groups, respectively. The median accuracy rate in the US group was higher than the NUS group (65% vs 30%;P= .025), and the median PT-US distance in the US group was shorter than in the NUS group (4.0 vs 8.0 mm;P= .04). The adjusted mean PT-US distance in the US group was shorter compared to the NUS group (adjusted mean [95% CI], 3.6 [2.9–4.6] vs 6.8 [5.2–8.9] mm;P< .001).

CONCLUSIONS:

Anesthesia participants exposed to practice with US-guided palpation of the cricothyroid membrane location were better able to identify the cricothyroid membrane using only blind palpation than participants without US-guided practice. Practice with US-guided palpation of neck landmarks improves subsequent blind localization of the cricothyroid membrane using palpation alone.
Metabolic traits of cancer stem cells
Authors: Peixoto Joana , Lima Jorge
Published: June 2018

Cancer stem cells are a subpopulation of cells within a tumour believed to confer resistance to standard cancer therapies. Although many studies have addressed the specific mechanisms of tumour recurrence driven by cancer stem cells, cellular metabolism is an often-neglected attribute. The metabolic features of cancer stem cells are still poorly understood, and they thus constitute a promising field in cancer research. The findings published so far point to a distinct metabolic phenotype in cancer stem cells, which might depend on the cancer type, the model system used or even the experimental design, and several controversies still need to be tackled. This Review describes the metabolic phenotype of cancer stem cells by addressing the main metabolic traits in different tumours, including glycolysis and oxidative, glutamine, fatty acid and amino acid metabolism. In the context of these pathways, we also mention the specific alterations in metabolic enzymes and metabolite levels that have a role in the regulation of cancer stemness. Determining the role of metabolism in supporting resistance to therapy driven by cancer stem cells can raise the opportunity for novel therapeutic targets, which might not only eliminate this resistant population, but, more importantly, eradicate the whole tumour in a relapse-free scenario.
GESTÃO DE RECURSOS RELACIONAIS PARA O DESENVOLVIMENTO DE INOVAÇÕES SOCIAIS EM LIVING LABS: O CASO DO HABITAT LIVING LAB DE VITÓRIA, ES - BRASIL
Authors: Silva Silvio Bitencourt da , Bitencourt Claudia Cristina
Published: June 2018

O presente estudo investiga como são geridos os recursos relacionais para o desenvolvimento de inovações sociais em Living Labs. Trata-se de uma pesquisa qualitativa caracterizada como estudo de caso cuja unidade de análise se refere às ações gerenciais tomadas pelos orquestradores para facilitar a gestão dos recursos relacionais no Living Lab Habitat, único membro ativo da European Network of Living. Gera como principal implicação da teoria existente a criação de conhecimento no âmbito da VBR que permite a identificação de ações para facilitar a gestão de recursos relacionais: gestão de parceiros; gestão da estrutura e de colaboração; e gestão do modo de relacionamento. Em termos gerenciais, possibilita aos responsáveis por Living Labs e/ou outras redes de inovação voltadas para o desenvolvimento de inovações sociais a algumas das “melhores práticas” para a gestão de relações colaborativas em redes de inovação para construir resultados na esfera social, em que alguns recursos suplementares são acessados, como o conhecimento.
A TECNOLOGIA DE GESTÃO E O HOLOCAUSTO: É POSSÍVEL “HACKEAR” ISSO?
Authors: Silva Orlando Gomes da
Published: June 2018

Neste ensaio, discutimos a condição, vista por Bauman pelas lentes do Holocausto, do que ainda se apresenta como lógica dominante das tecnologias de gestão disseminadas na formação em Administração no Brasil. Mostra-se que, além das graduações enviesadas por uma racionalidade questionável, há um imaginário que condiciona a percepção geral e afeta as possibilidades emancipatórias dos estudantes. Contextualiza-se, assim, o que o Holocausto pode representar em termos da tecnologia de gestão; aborda- se uma orientação epistemológica a ser assimilada como ponto de partida nos desenvolvimentos em torno de racionalidades alternativas e, com um exemplo de protagonismo de estudantes de Administração na Internet, situa-se uma distinção entre mídia social e mídia tática, de modo a falar sobre possíveis hackings nesse campo. Conclui-se enfatizando a possibilidade do estudo/atuação das/com tecnologias online a partir da distinção entre modelo de negócio e prática política.
ΕΠΙ ΜΙΑΣ ΝΟΣΟΥ ΤΩΝ ΑΙΓΩΝ ΟΦΕΙΛΟΜΕΝΗΣ ΕΙΣ ΙΟΝ ΔΙΗΘΗΤΟΝ, ΚΑΛΛΙΕΡΓΗΣΙΜΟΝ ΚΑΙ ΟΡΑΤΟΝ
Authors: ΔΕΜΠΟΝΕΡΑΣ Γ.
Published: June 2018

NO ABSTRACT AVAILABLE
H ΧΡΗΣΙΣ TΩN ΔΙΗΘΗΜΕΝΩΝ ΥΠΕΡΙΩΔΩΝ ΑΚΤΙΝΩΝ EN ΤΗ ΚΡΕΩΣΚΟΠΙΑ
Authors: ΚΑΡΒΟΥΝΑΡΗΣ Π. Α.
Published: June 2018

NO ABSTRACT AVAILABLE
Recent advances in the management of systemic lupus erythematosus
Authors: Sciascia Savino , Radin Massimo , Roccatello Dario , Sanna Giovanni , Bertolaccini Maria Laura
Published: June 2018

Systemic lupus erythematosus (SLE) is a chronic autoimmune disease presenting highly heterogeneous clinical manifestations and multi-systemic involvement. Patients are susceptible to relapse­ and remission, thus making management challenging. Moreover, a considerable number of side effects may occur with conventional therapies; therefore, there is clearly a need for new therapeutic strategies. Since the pathogenesis of SLE is highly complex, it is far from being fully understood. However, greater understanding of the pathways and of the cellular and molecular mediators involved in SLE is being achieved. Emerging evidence has allowed the development of new biological therapeutic options targeting crucial molecular mediators involved in the pathogenesis of SLE. This literature review analyzes the availability of biological and target-directed treatments, phase II and III trials, and new therapies that are being developed for the treatment of SLE.
Recent advances in understanding and managing diverticulitis
Authors: Severi Carola , Carabotti Marilia , Cicenia Alessia , Pallotta Lucia , Annibale Bruno
Published: June 2018

In the past few decades, the increasing socioeconomic burden of acute diverticulitis (AD) has become evident, and with the growth of the population age, this significant economic impact will likely continue to rise. Furthermore, recent evidence showed an increased rate of hospital admissions especially evident among women and younger individuals. The natural history and pathophysiology of this clinical condition is still to be fully defined, and efforts continue to be made in the identification of risk factors and the establishment of relative preventive strategies. The actual therapeutic strategies aimed to modulate gut microbiota, such as rifaximin or probiotics, or to reduce mucosal inflammation, such as mesalazine, present a relatively poor efficacy for both the prevention of the first AD episode (primary prevention) and its recurrence (secondary prevention). In the last few years, the main goal achieved has been in the management of AD in that uncomplicated AD can, to a larger extent, be managed in an outpatient setting with no or little supportive therapy, a strategy that will certainly impact on the health costs of this disease. The problem of AD recurrence remains a topic of debate.

The aim of this review is to present updated evidence on AD epidemiology and relative open clinical questions and to analyze in detail predisposing and protective factors with an attempt to integrate their possible modes of action into the several pathogenic mechanisms that have been suggested to contribute to this multifactorial disease. A unifying hypothesis dealing with the colonic luminal and extra-luminal microenvironments separately is provided. Finally, evidence-based changes in therapeutic management will be summarized. Because of an ascertained multifactorial pathogenesis of uncomplicated and complicated AD, it is probable that a single ‘causa prima’ will not be identifiable, and a better stratification of patients could allow one to pursue tailored therapeutic algorithm strategies.
Benefits of reversible contraception
Authors: Kopp Kallner Helena
Published: June 2018

Long-acting reversible contraception—intrauterine devices and contraceptive implants—offers the highest protection against unintended pregnancies. In addition, the use of reversible hormonal contraception has added health benefits for women in both the short and the long term. This review will give an overview of the benefits of reversible contraception as well as an evidence-based recommendation on how it should be used to benefit women the most.
Norwegian e-Infrastructure for Life Sciences (NeLS)
Authors: Tekle Kidane M. , Gundersen Sveinung , Klepper Kjetil , Bongo Lars Ailo , Raknes Inge Alexander , Li Xiaxi , Zhang Wei , Andreetta Christian , Mulugeta Teshome Dagne , Kalaš Matúš , Rye Morten B. , Hjerde Erik , Antony Samy Jeevan Karloss , Fornous Ghislain , Azab Abdulrahman , Våge Dag Inge , Hovig Eivind , Willassen Nils Peder , Drabløs Finn , Nygård Ståle , Petersen Kjell , Jonassen Inge
Published: June 2018

The Norwegian e-Infrastructure for Life Sciences (NeLS) has been developed by ELIXIR Norway to provide its users with a system enabling data storage, sharing, and analysis in a project-oriented fashion. The system is available through easy-to-use web interfaces, including the Galaxy workbench for data analysis and workflow execution. Users confident with a command-line interface and programming may also access it through Secure Shell (SSH) and application programming interfaces (APIs). 

NeLS has been in production since 2015, with training and support provided by the help desk of ELIXIR Norway. Through collaboration with NorSeq, the national consortium for high-throughput sequencing, an integrated service is offered so that sequencing data generated in a research project is provided to the involved researchers through NeLS. Sensitive data, such as individual genomic sequencing data, are handled using the TSD (Services for Sensitive Data) platform provided by Sigma2 and the University of Oslo. NeLS integrates national e-infrastructure storage and computing resources, and is also integrated with the SEEK platform in order to store large data files produced by experiments described in SEEK.  

In this article, we outline the architecture of NeLS and discuss possible directions for further development.
CLASSIFICATION OF FODDER MASSES APPLIED TO ITS HYDRO-MECHANICS
Authors: Асадуллин Наиль , Asadullin Nail
Published: June 2018

The current stage in the development of agricultural production in livestock is characterized by the extensive use of pipeline transport to move the forage masses, which are related to non-Newtonian fluids. Production experience and scientific work on the study of hydrotransport systems showed that this method of transportation is the most economical and promising, it has high reliability of structural elements, improves sanitary and hygienic working conditions and makes it possible to fully automate the transportation process. The complex nature of the transportation of mixtures has not allowed to create a unified theory of hydrodynamic calculation of their parameters to date, therefore, various models are used for theoretical investigation of the nature of motion. To select a particular model, it is always important to correctly classify viscous semiliquid media with respect to hydrodynamics. Therefore, the article did not set out the specific goal of choosing a method for studying non-Newtonian systems, but solved the problem of their classification by known defining characteristics. The proposed classification does not pretend to be exhaustive in terms of the physical and chemical nature of the fluid, especially their combinations, but it covers almost all the anomalous phenomena that occur in the fluid during its transportation and helps to select a quantitative method for calculating the transporting fluid. The classification of non-Newtonian fluids with respect to their hydromechanics is based on the dependence of the shear stress on the shear gradient. For this dependence, each type of liquid is considered. The developed classification scheme further promotes a more complete account of the rheological properties of high-viscosity liquids during their transportation through pipes and facilitates the development of quantitative calculation methods.
PROSPECTS OF IMPROVING THE EFFICIENCY OF HOP CULTIVATION CLUSTER OF THE CHUVASH REPUBLIC
Authors: Захаров Анатолий , Zaharov Anatoliy , Макушев Андрей , Makushev Andrey , Васильева Алена , Vasil'eva Alena , Кириллова Ксения , Kirillova Kseniya
Published: June 2018

The article is devoted to the problems of hop production, both at the world level and in some regions of the Russian Federation. A comprehensive analysis of hop production development for 1971-2017 was carried out. Attention is focused on the fact that in the Chuvash Republic for the period under study, the production of hop has decreased many times, while the pre-reform period of the republic produced up to 90% of the total volume produced in the whole in the Russian Federation. The creation of a cluster is an effective tool for solving the tasks of the industry development. The study of hop-growing in the Chuvash Republic, based on cluster analysis, will reveal factors and conditions for increasing its effectiveness. If in 1990 hops were cultivated on an area of 2.6 thousand hectares, the yield per hectare in the republic averaged 10.8 centners per hectare, the gross harvest was 2.8 thousand tons, and in 2017 in agricultural organizations with fructifying The area of 96 hectares was harvested at 16.2 centner per hectare, the gross harvest was 155.5 tons.
We propose a model of the structure of the hop-growing cluster of the Chuvash Republic. In the hopper cluster, enterprises of various types could enter in accordance with their functional role. The basis of the hop-growing cluster of the Chuvash Republic will be formed by branch enterprises. In their structure we propose to include: agricultural enterprises engaged in the production of hops, processing hops, consumers of hops - breweries. In the structure of the hop-growing cluster, enterprises that service industries and infrastructures will function.