bluuebunny/crossref_metadata_2025 huggingface dataset:
OH density optimization in atmospheric-pressure plasma jet by using multiple ring electrodes
Authors: Yue Y. , Pei X. , Lu X.
Published: January 2016

OH radical is one of the important reactive species generated by non-equilibrium atmospheric-pressure plasma jets, which is believed to play an important role in plasma medicine applications such as cancer therapy, wound healing and sterilization. In this study, a method to increase OH density is proposed. By using multiple pairs of ring electrodes, we generate 3–5 times more OH radicals than in the common device which uses only one high-voltage ring electrode. Discharge imaging shows that the plasma plume with only one ring electrode is longer and its emission intensity is higher than those with multiple pairs of ring electrodes. Further studies indicate that the distribution of OH radicals is significantly influenced by the gas flow rate. At higher gas flow rates, the OH peak concentration is detected further away from the nozzle, and the position of the peak OH concentration correlates with the product of the gas flow velocity and the pulse duration. As observed from the emission spectra, multiple electrodes only enhance the plasma inside the tube rather than the plasma plume in the surrounding air. These results suggest that the OH radicals are mainly generated inside the tube and then delivered to the outer plasma plume region by the gas flow.
Identifying the factors that affect the job satisfaction of early career Notre Dame graduate physiotherapists
Authors: Bacopanos Eleni , Edgar Susan
Published: January 2016

Objective Previous studies have highlighted the short career intentions and high attrition rates of physiotherapists from the profession. The aim of the present study was to examine the job satisfaction and attrition rates of early career physiotherapists graduating from one Western Australian university. Methods A self-administered online survey was conducted of 157 Notre Dame physiotherapy graduates (2006–2012), incorporating a job satisfaction rating scale. Results Results showed that lowered job satisfaction was related to working in the cardiorespiratory area of physiotherapy and working in multiple jobs since graduation. The majority of graduates did not predict a long-term career in physiotherapy, highlighting a lack of career progression and limited scope of practice as influential factors. Conclusions Job satisfaction in early career physiotherapists varies across different clinical areas of practice related to several factors, including challenge and flexibility. New roles in the profession, including extended scope roles, may impact on the future job satisfaction of physiotherapists. Further studies are needed to explore the effect of these roles on workforce trends, including attrition rates. What is known about the topic? Physiotherapists predict careers of 10 years or less on entry into the profession. No previous studies have explored the individual factors influencing job satisfaction in early career physiotherapists across different clinical settings. What does this paper add? This study highlights specific factors influencing the job satisfaction of early career physiotherapists, including clinical area of practice. Physiotherapists working in the cardiorespiratory area were less satisfied, as were physiotherapists undertaking multiple positions since graduation. What are the implications for practitioners? This study informs employers and workforce planners on the factors affecting job satisfaction in early career physiotherapists. In addition, knowledge of issues affecting job satisfaction in the early career stage may assist educational institutions in their preparation of graduates for the future health workforce.
Does place of service matter? A utilisation and cost analysis of sexually transmissible infection testing from 2012 claims data
Authors: Owusu-Edusei Kwame , Patel Chirag G. , Gift Thomas L.
Published: January 2016

Background In this study, a previous study on the utilisation and cost of sexually transmissible infection (STI) tests was augmented by focusing on outpatient place of service for the most utilised tests. Methods: Claims for eight STI tests [chlamydia, gonorrhoea, hepatitis B virus (HBV), HIV, human papillomavirus (HPV), herpes simplex virus type 2 (HSV2), syphilis and trichomoniasis] using the most utilised current procedural terminology (CPT) code for each STI from the 2012 MarketScan outpatient table were extracted. The volume and costs by gender and place of service were then summarised. Finally, semi-log regression analyses were used to further examine and compare costs. Results: Females had a higher number of test claims than males in all places of service for each STI. Together, claims from ‘Independent Laboratories’, ‘Office’ and ‘Outpatient hospital’ accounted for over 93% of all the test claims. The cost of tests were slightly (<5%) different between males and females for most places of service. Except for the estimated average cost for ‘Outpatient hospital’, the estimated average costs for the other categories were significantly lower (15–80%, P < 0.01) than the estimated average cost for ‘Emergency Room – Hospital’ for all the STIs. Among the predominant service venues, test costs from ‘Independent Laboratory’ and ‘Office’ were 30% to 69% lower (P < 0.01) than those from ‘Outpatient Hospital’. Conclusions: Even though the results from this study are not generalisable, our study shows that almost all STI tests from outpatient claims data were performed in three service venues with considerable cost variations.
Workfare Revisited
Authors: Paz-Fuchs Amir , Eleveld Anja
Published: January 2016

This paper explores and problematizes the exclusion of workfare participants from the scope of employment legislation, offering an opportunity to revisit the scope of the labour protection. As the UK and the Netherlands have been at the forefront of the European activation turn that catalysed the introduction of workfare programmes in European welfare states, the first part of the paper maps the employment protection of workfare participants in these two countries. In the second part of the paper we critically assess the reasons why employment status or, at least, employment protection regardless of status, is not granted to workfare participants and to other persons who are fulfilling financial non-rewarding (at least for the worker herself) ‘work’, such as volunteer workers or persons who have been found guilty of an offence and are sentenced to community service. On the basis of our analysis we suggest to expand labour protection to workfare participants, with or without granting them worker status.
Cosmic flows and the expansion of the local Universe from non-linear phase–space reconstructions
Authors: Heß Steffen , Kitaura Francisco-Shu
Published: January 2016

In this work, we investigate the impact of cosmic flows and density perturbations on Hubble constant H0 measurements using non-linear phase–space reconstructions of the Local Universe (LU). In particular, we rely on a set of 25 precise constrained N-body simulations based on Bayesian initial conditions reconstructions of the LU using the Two-Micron Redshift Survey galaxy sample within distances of about 90  h−1 Mpc. These have been randomly extended up to volumes enclosing distances of 360  h−1 Mpc with augmented Lagrangian perturbation theory (750 simulations in total), accounting in this way for gravitational mode coupling from larger scales, correcting for periodic boundary effects, and estimating systematics of missing attractors (σlarge = 134  s−1 km). We report on Local Group (LG) speed reconstructions, which for the first time are compatible with those derived from cosmic microwave background-dipole measurements: |vLG| = 685 ± 137  s−1 km. The direction (l, b) = (260$_{.}^{\circ}$5 ± 13$_{.}^{\circ}$3, 39$_{.}^{\circ}$1 ± 10$_{.}^{\circ}$4) is found to be compatible with the observations after considering the variance of large scales. Considering this effect of large scales, our local bulk flow estimations assuming a Λ cold dark matter model are compatible with the most recent estimates based on velocity data derived from the Tully–Fisher relation. We focus on low-redshift supernova measurements out to 0.01 < z < 0.025, which have been found to disagree with probes at larger distances. Our analysis indicates that there are two effects related to cosmic variance contributing to this tension. The first one is caused by the anisotropic distribution of supernovae, which aligns with the velocity dipole and hence induces a systematic boost in H0. The second one is due to the inhomogeneous matter fluctuations in the LU. In particular, a divergent region surrounding the Virgo Supercluster is responsible for an additional positive bias in H0. Taking these effects into account yields a correction of ΔH0 = -1.76 ± 0.21  s− 1 km Mpc− 1, thereby reducing the tension between local probes and more distant probes. Effectively H0 is lower by about 2 per cent.
CO(J = 3–2) on-the-fly mapping of the nearby spiral galaxies NGC 628 and NGC 7793: Spatially resolved CO(J = 3–2) star-formation law
Authors: Muraoka Kazuyuki , Takeda Miho , Yanagitani Kazuki , Kaneko Hiroyuki , Nakanishi Kouichiro , Kuno Nario , Sorai Kazuo , Tosaki Tomoka , Kohno Kotaro
Published: January 2016

We present the results of CO(J = 3–2) on-the-fly mappings of two nearby non-barred spiral galaxies, NGC 628 and NGC 7793, with the Atacama Submillimeter Telescope Experiment at an effective angular resolution of 25″. We successfully obtained global distributions of CO(J = 3–2) emission over the entire disks at a sub-kpc resolution for both galaxies. We examined the spatially resolved (sub-kpc) relationship between CO(J = 3–2) luminosities ($L^{\prime }_{\rm CO(3-2)}$) and infrared (IR) luminosities (LIR) for NGC 628, NGC 7793, and M 83, and compared it with global luminosities of a JCMT (James Clerk Maxwell Telescope) Nearby Galaxy Legacy Survey sample. We found a striking linear $L^{\prime }_{\rm CO(3-2)}$–LIR correlation over the four orders of magnitude, and the correlation is consistent even with that for ultraluminous IR galaxies and submillimeter-selected galaxies. In addition, we examined the spatially resolved relationship between CO(J = 3–2) intensities (ICO(3–2)) and extinction-corrected star formation rates (SFRs) for NGC 628, NGC 7793, and M 83, and compared it with that for Giant Molecular Clouds in M 33 and 14 nearby galaxy centers. We found a linear ICO(3–2)–SFR correlation with ∼1 dex scatter. We conclude that the CO(J = 3–2) star-formation law (i.e., linear $L^{\prime }_{\rm CO(3-2)}$–LIR and ICO(3–2)–SFR correlations) is universally applicable to various types and spatial scales of galaxies; from spatially resolved nearby galaxy disks to distant IR-luminous galaxies, within ∼1 dex scatter.
Inferior Vena Cava Ultrasonography before General Anesthesia Can Predict Hypotension after Induction
Authors: Zhang Jie , Critchley Lester Augustus Hall
Published: January 2016

AbstractAbstract

The authors have shown that preoperative ultrasound of the inferior vena cava can be used to predict significant hypotension after anesthetic induction. The findings expand the potential clinical utility of ultrasound in the perioperative period.

Background

Hypotension is a common side effect of general anesthesia induction, and when severe, it is related to adverse outcomes. Ultrasonography of inferior vena cava (IVC) is a reliable indicator of intravascular volume status. This study investigated whether preoperative ultrasound IVC measurements could predict hypotension after induction of anesthesia.

Methods

One hundred four adult patients, conforming to American Society of Anesthesiologists physical status I to III, scheduled for elective surgery after general anesthesia were recruited. Maximum IVC diameter (dIVCmax) and collapsibility index (CI) were measured preoperatively. Before induction, mean blood pressure (MBP) was recorded. After induction, MBP was recorded for 10 min after intubation. Hypotension was defined as greater than 30% decrease in MBP from baseline or MBP less than 60 mmHg. Receiver operating characteristic curve analysis with gray zone approach and regression analyses were used.

Results

IVC scanning was unsuccessful in 13.5% of patients. Data from 90 patients were analyzed. After induction, 42 patients developed hypotension. Areas (95% confidence interval) under the curves were 0.90 (0.82 to 0.95) for CI and 0.76 (0.66 to 0.84) for dIVCmax. The optimal cutoff values were 43% for CI and 1.8 cm for dIVCmax. The gray zone for CI was 38 to 43% and included 12% of patients and that for dIVCmax was 1.5 to 2.1 cm and included 59% of patients. After adjusting for other factors, it was found that CI was an independent predictor of hypotension with the odds ratio of 1.17 (1.09 to 1.26). CI was also positively associated with a percentage decrease in MBP (regression coefficient = 0.27).

Conclusions

Preoperative ultrasound IVC CI measurement was a reliable predictor of hypotension after induction of general anesthesia, wherein CI greater than 43% was the threshold.
Anesthetic Care for Orthopedic Patients
Authors: Memtsoudis Stavros G. , Poeran Jashvant , Zubizarreta Nicole , Rasul Rehana , Opperer Mathias , Mazumdar Madhu
Published: January 2016

AbstractAbstract

In a review of more than 1 million hip and knee arthroplasty procedures in the Premier Perspective database, use of neuraxial anesthesia was considerably less (odds ratio [OR], 0.35) in teaching versus nonteaching hospitals and moderately less for black patients (OR, 0.88), those on Medicaid (OR, 0.78), and those without insurance (OR, 0.89).

Background

Differences in health care represent a major health policy issue. Despite increasing evidence on the mediating role of anesthesia type used for surgery on perioperative outcome, there is a lack of data on potential care differences in this field. The authors aimed to determine whether anesthesia practice (use of neuraxial anesthesia [NA] or peripheral nerve block [PNB]) differs by patient and hospital factors.

Methods

The authors extracted data on n = 1,062,152 hip and knee arthroplasty procedures from the Premier Perspective database (2006 to 2013). Multilevel multivariable logistic regression models measured associations (odds ratios [ORs] and 95% CIs) between patient/hospital factors and NA or PNB use.

Results

Of all patients, 22.2% (n = 236,083) received NA and 17.9% (n = 189,732) received PNB. Lower adjusted odds for receiving NA were seen for black patients (OR, 0.88; 95% CI, 0.86 to 0.91) and those on Medicaid (OR, 0.78; 95% CI, 0.74 to 0.82) or without insurance (OR, 0.89; 95% CI, 0.81 to 0.98). Furthermore, teaching hospitals (compared with nonteaching hospitals) had lower adjusted odds for NA utilization (OR, 0.35; 95% CI, 0.14 to 0.89). Although generally similar patterns were seen for PNB utilization, the main difference was that particularly Hispanic patients were less likely to receive PNB compared with white patients (OR, 0.60; 95% CI, 0.56 to 0.65). Sensitivity analyses generally validated our results.

Conclusions

Significant differences exist in the provision of regional anesthetic care with factors such as race and insurance type being important determinants of anesthetic practice. Further and in-depth research is needed to fully assess the background of these differences.
Aggressive Extraocular Sebaceous Carcinoma of the Scalp Involving the Brain in a Patient With Muir–Torre Syndrome
Authors: Hadravsky Ladislav , Kazakov Dmitry V. , Stehlik Jan , Michal Michal , Curik Romuald , Krupa Petr , Skalova Alena , Kacerovska Denisa
Published: January 2016

This article reports an unusual case of aggressive extraocular sebaceous carcinoma located on the scalp with subsequent usurpation of the bone and penetrating through the bone and meninges to the brain in a 56-year-old man affected by Muir–Torre syndrome. Microscopically, the sebaceous neoplasm was located in the middle to deep dermis without any connection to the epidermis and showed a multinodular growth with neoplastic nodules with a central comedo-type necrosis separated from each other by fibrovascular stroma. The nodules were composed of varying proportions of mature sebaceous cells and atypical basaloid cells with high degree of atypia, including high nuclear/cytoplasmic ratio, nuclear pleomorphism, macronucleoli, atypical mitoses, and necrosis. The neoplasm was totally removed. Histopathological examinations of the recurrent lesion showed identical morphological features and, in addition, signs of the tumors growing through the periosteum were noted. In the final excision specimen, both the dura mater and the brain tissue were infiltrated by the sebaceous carcinoma. The diagnosis of Muir–Torre syndrome was confirmed by molecular genetic investigation that revealed an identical germline mutation in MSH2 gene in several family members, some of whom had colorectal tumors.
Neuropathic pain: an updated grading system for research and clinical practice
Authors: Finnerup Nanna B. , Haroutounian Simon , Kamerman Peter , Baron Ralf , Bennett David L.H. , Bouhassira Didier , Cruccu Giorgio , Freeman Roy , Hansson Per , Nurmikko Turo , Raja Srinivasa N. , Rice Andrew S.C. , Serra Jordi , Smith Blair H. , Treede Rolf-Detlef , Jensen Troels S.
Published: January 2016

The redefinition of neuropathic pain as “pain arising as a direct consequence of a lesion or disease affecting the somatosensory system,” which was suggested by the International Association for the Study of Pain (IASP) Special Interest Group on Neuropathic Pain (NeuPSIG) in 2008, has been widely accepted. In contrast, the proposed grading system of possible, probable, and definite neuropathic pain from 2008 has been used to a lesser extent. Here, we report a citation analysis of the original NeuPSIG grading paper of 2008, followed by an analysis of its use by an expert panel and recommendations for an improved grading system. As of February, 2015, 608 eligible articles in Scopus cited the paper, 414 of which cited the neuropathic pain definition. Of 220 clinical studies citing the paper, 56 had used the grading system. The percentage using the grading system increased from 5% in 2009 to 30% in 2014. Obstacles to a wider use of the grading system were identified, including (1) questions about the relative significance of confirmatory tests, (2) the role of screening tools, and (3) uncertainties about what is considered a neuroanatomically plausible pain distribution. Here, we present a revised grading system with an adjusted order, better reflecting clinical practice, improvements in the specifications, and a word of caution that even the “definite” level of neuropathic pain does not always indicate causality. In addition, we add a table illustrating the area of pain and sensory abnormalities in common neuropathic pain conditions and propose areas for further research.
In Vitro Validation of a Multiscale Patient-Specific Norwood Palliation Model
Authors: Hang Tianqi , Giardini Alessandro , Biglino Giovanni , Conover Timothy , Figliola Richard S.
Published: January 2016

In Norwood physiology, shunt size and the occurrence of coarctation can affect hemodynamics significantly. The aim of the study was to validate an in vitro model of the Norwood circulation against clinical measurements for patients presenting differing aortic morphologies. The mock circulatory system used coupled a lumped parameter network of the neonatal Norwood circulation with modified Blalock–Taussig (mBT) shunt with a three-dimensional aorta model. Five postoperative aortic arch anatomies of differing morphologies were reconstructed from imaging data, and the system was tuned to patient-specific clinical values. Experimentally measured flow rates and pressures were compared with clinical measurements. Time-based experimental and clinical pressure and flow signals within the aorta and pulmonary circulation branches agreed closely (0.72 < R2 < 0.95) for the five patients, whereas mean values within the systemic and pulmonary branches showed no significant differences (95% confidence interval). We validated an experimental multiscale model of the Norwood circulation with mBT shunt by showing it capable of reproducing clinical pressure and flow rates at various positions of the circulation with very good fidelity across a range of patient physiologies and morphologies. The multiscale aspect of the model provides a means to study variables in isolation with their effects both locally and at the system level. The model serves as a tool to further the understanding of the complex physiology of single-ventricle circulation.
Sirt1-Positive Lymphocytes in Acute Cellular Cardiac Allograft Rejection: Contributor to Pathogenesis and a Therapeutic Target
Authors: Welsh Kerry J. , Zhao Bihong , Buja L. Maximilian , Brown Robert E.
Published: January 2016

Cardiac allograft rejection remains a problem, despite advances with immunosuppressants. Understanding the mechanisms behind rejection is essential for developing targeted therapies. The goal of this investigation is to explore Sirtuin 1 (Sirt1) as a therapeutic target for cardiac allograft rejection. Thirteen endomyocardial biopsy specimens with acute cellular rejection (grade 2R or 3R) were selected. CD3, CD4, CD8, CD20, CD68, T-cell intracytoplasmic antigen (TIA-1), and Sirt1 expressions were determined by immunohistochemical stains. Comparison of Sirt1 expression was made with 10 cases of grade 0R and grade 1R. Quantitative image analysis was performed. There were 2 cases of grade 3R and 11 cases of grade 2R acute cellular rejection. Sirtuin 1 expression was present in the majority of mononuclear cells (median percentage, 73.5; interquartile range, 51.2–100%); staining was also observed in cardiomyocytes. Twelve of the 13 cases (92.3%) had an elevated CD8/FoxP3 ratio, coinciding with acute cellular rejection. Sirtuin 1 expression in the nuclei of FoxP3+ cells can lead to deacetylation and inactivation of FoxP3 rendering the T-suppressor cells inactive and promoting acute cellular rejection. The use of a Sirt1 inhibitor may be a therapeutic option in expanding the functionality of the FoxP3+ T-suppressor cells and moderating the severity of such rejection.
Retrospective Observational Review of Percutaneous Cannulation for Extracorporeal Membrane Oxygenation
Authors: Burns Janis , Cooper Eve , Salt Gavin , Gillon Stuart , Camporota Luigi , Daly Kathleen , Barrett Nicholas A.
Published: January 2016

Cannulation is a potentially complex event in the conduct of venovenous extracorporeal membrane oxygenation (VV-ECMO) for patients with severe respiratory failure. The purpose of this article is to describe our approach to cannulation and its complications. A single-center, retrospective, observational cohort, electronic note review study of patients commenced on VV-ECMO for severe respiratory failure. We identified 348 cannulae placed in 179 patients commenced on VV-ECMO from December 2011 to March 2015. All cannulations were successful. There were no deaths related to cannulation, and complications included one arterial injury, one cardiac tamponade, two cases of venous insufficiency, and five cannula site infections. Percutaneous cannulation for VV-ECMO can be achieved with a high degree of success and low complication rate by intensivists using ultrasound and fluoroscopic guidance.
Systemic Thrombolysis Versus Device Exchange for Pump Thrombosis Management: A Single-Center Experience
Authors: Oezpeker Cenk , Zittermann Armin , Ensminger Stephan , Kizner Lukas , Koster Andreas , Sayin Ali , Schoenbrodt Michael , Milting Hendrik , Gummert Jan F. , Morshuis Michiel
Published: January 2016

In patients with left ventricular assist device (LVAD) implants, pump thrombosis is a potential life-threatening complication. In a retrospective data analysis, we compared clinical outcomes in 50 patients with HeartWare (HW) or HeartMate II implants undergoing device exchange (DEx; n = 21) or systemic thrombolysis (STL; n = 29) for pump thrombosis. Primary end-point was survival up to 90 days postintervention. Secondary end-points were the need for blood products postintervention, duration of intensive care unit stay, in-hospital stay, 90 day and 2 year therapy failure (the need for additional surgical or nonsurgical intervention because of pump thrombosis), and 2 year survival. Ninety-day survival was 89.3% in the STL group and 91.0% in the DEx group (p = 0.901). Compared with the DEx group, the average use of different blood products was lower (p < 0.001), and duration of intensive care unit stay and in-hospital stay tended to be shorter in the STL group (p values = 0.086 and 0.048, respectively). However, 90 day freedom from therapy failure was significantly lower in the STL group than in the DEx exchange group (p = 0.027) and so was 2 year freedom from therapy failure (p = 0.006). Two-year survival was comparable between groups (p = 0.267). Our data indicate that STL can be considered as a therapeutic option in LVAD patients with pump thrombosis.
Automated Rotational Percussion Bed and Bronchoscopy Improves Respiratory Mechanics and Oxygenation in ARDS Patients Supported with Extracorporeal Membrane Oxygenation
Authors: Sharma Nirmal S. , Wille Keith M. , Bellot S. Christopher , Diaz-Guzman Enrique
Published: January 2016

Extracorporeal membrane oxygenation (ECMO) has been used to provide “lung rest” through the use of low tidal volume (6 ml/kg) and ultralow tidal volume (<6 ml/kg) ventilation in acute respiratory distress syndrome (ARDS). Low and ultralow tidal volume ventilation can result in low dynamic respiratory compliance and potentially increased retention of airway secretions. We present our experience using automated rotational percussion beds (ARPBs) and bronchoscopy in four ARDS patients to manage increased pulmonary secretions. These beds performed automated side-to-side tilt maneuver and intermittent chest wall percussion. Their use resulted in substantial reduction in peak and plateau pressures in two patients on volume control ventilation, while the driving pressures (inspiratory pressure) to attain the desired tidal volumes in patients on pressure control ventilation also decreased. In addition, mean partial pressure of oxygen in arterial blood (PaO2)/fraction of inspired oxygen (FiO2) ratio (109 pre-ARPB vs. 157 post-ARPB), positive end-expiratory pressure (10 cm H2O vs. 8 cm H2O), and FiO2 (0.88 vs. 0.52) improved after initiation of ARPB. The improvements in the respiratory mechanics and oxygenation helped us to initiate early ECMO weaning. Based on our experience, the use of chest physiotherapy, frequent body repositioning, and bronchoscopy may be helpful in the management of pulmonary secretions in patients supported with ECMO.
Total Artificial Heart, Augmented by Venovenous Extracorporeal Membrane Oxygenation
Authors: Lick Scott D. , Tran Phat L. , Kazui Toshinobu , Smith Richard G. , Khalpey Zain I.
Published: January 2016

Shortly after SynCardia total artificial heart (TAH) implant, venovenous extracorporeal membrane oxygenation (ECMO) via a 31 Fr Avalon cannula was used for profound hypoxic lung dysfunction. Immediately after starting ECMO, TAH flow increased by 1.5–2.0 L/min, presumably because of augmented TAH filling by the ECMO jet.
Percutaneous Right Ventricular Assist Device Support in a Patient Supported by an LVAD
Authors: Morgan Jeffrey A. , O’Neill William W.
Published: January 2016

Right ventricular failure requiring short-term mechanical support is a relatively common complication after left ventricular assist device (LVAD) implantation. Removal of the temporary right ventricular assist device (RVAD) generally requires a reoperative sternotomy. In this report, we describe an innovative percutaneous approach for placing an RVAD at the time of LVAD implantation using the Impella RP (Abiomed Inc.) that does not require reoperation for removal, as the Impella RP can be removed at the patient’s bedside.
OBESICA study: relationship between BMI and acute heart failure outcome
Authors: Miró Òscar , A. Rizzi Miguel , Herrero Pablo , Jacob Javier , Martín-Sánchez Francisco J. , Gil Víctor , Alquezar Aitor , Escoda Rosa , Llorens Pere
Published: January 2016

Objective

The objective of this study was to investigate the relationship between BMI and outcome of acute heart failure (AHF).

Methods

We carried out a secondary analysis of the Epidemiology of Acute Heart Failure in Emergency department Registry (prospective, multicenter registry following a cohort of AHF patients from 34 Spanish emergency departments). Follow-up was at 3 months and 1 year after enrolment over the telephone and included medical history review. We analyzed revisits to the emergency department and death in relation to BMI. Significant differences were analyzed using proportional risk models including data on demographic variables, basal status, the acute episode, and patient outcome.

Results

We included 1562 patients: low weight 1.3%, normal weight 26.1%, overweight 45.3%, obese 24.3%, and morbidly obese 3.1%. BMI was inversely associated with mortality (P<0.001) but not with revisit (P=0.70). Compared with patients with normal weight, the proportional risk of death among patients with low weight was increased [hazard ratio (HR) 1.75, 95% confidence interval (CI) 0.95–3.23], being reduced in overweight, obese and morbidly obese patients (HR 0.72, 95% CI 0.59–0.89; HR 0.75, 95% CI 0.58–0.96; and HR 0.42, 95% CI 0.20–0.85, respectively). These differences disappeared after adjusting the model for confounding factors and other predictive variables of mortality.

Conclusion

BMI seems to be related to AHF and death, although this relationship disappeared on considering other prognostic factors and confounding variables. This finding limits the use of BMI by emergency physicians when estimating the risk of emergency department reconsultation or death in AHF patients.
Survey of Nursing Faculty Preparation for Teaching About Autism Spectrum Disorders
Authors: Gardner Marcia R. , Suplee Patricia Dunphy , Jerome-D’Emilia Bonnie
Published: January 2016

The prevalence of autism spectrum disorders (ASDs) has increased significantly in children and adults. Nursing faculty’s ability to teach students about best practices in their care across the lifespan is important. This study explored nurse educators’ perceived knowledge of, and levels of comfort in, their abilities to teach nursing students about nursing care of people with ASD. Strategies are proposed to incorporate competencies for care of people with ASD into nursing curricula.
Nursing Examinations
Authors: Palmer Janice L. , Bultas Margaret , Davis Renée L. , Schmuke Ashley D. , Fender Joshua B.
Published: January 2016

Academic integrity is a concern in higher education. The authors describe the findings of a nursing faculty task force developed with the goal of reducing incidents of cheating on classroom examinations in a school of nursing. Following a review of the literature, a modified Delphi technique was used to prioritize the suggested strategies into recommendations for faculty to follow. The findings and recommendations from the task force are presented and serve as a guide for nursing faculty in implementing measures to promote academic integrity during classroom examinations.
Lessons Learned From an International, Multisite Simulation Research Study
Authors: Foronda Cynthia , Alhusen Jeanne
Published: January 2016

The purpose of this article is to describe the process and lessons learned in conducting an international, multisite simulation research study. Key lessons include asking site leaders to complete human subjects training early, applying for a deferral agreement for multiple sites, standardization, seeking consultation, considering differences in simulation centers, and having a back-up plan if committed team members are unable to progress. Although challenging, this process yields many rewards and raises the state of the science to improve pedagogy and student learning outcomes.
O-GlcNAcylation of master growth repressor DELLA by SECRET AGENT modulates multiple signaling pathways inArabidopsis
Authors: Zentella Rodolfo , Hu Jianhong , Hsieh Wen-Ping , Matsumoto Peter A. , Dawdy Andrew , Barnhill Benjamin , Oldenhof Harriëtte , Hartweck Lynn M. , Maitra Sushmit , Thomas Stephen G. , Cockrell Shelley , Boyce Michael , Shabanowitz Jeffrey , Hunt Donald F. , Olszewski Neil E. , Sun Tai-ping
Published: January 2016

The DELLA family of transcription regulators functions as master growth repressors in plants by inhibiting phytohormone gibberellin (GA) signaling in response to developmental and environmental cues. DELLAs also play a central role in mediating cross-talk between GA and other signaling pathways via antagonistic direct interactions with key transcription factors. However, how these crucial protein–protein interactions can be dynamically regulated during plant development remains unclear. Here, we show that DELLAs are modified by theO-linkedN-acetylglucosamine (O-GlcNAc) transferase (OGT) SECRET AGENT (SEC) inArabidopsis.O-GlcNAcylation of the DELLA protein REPRESSOR OFga1-3(RGA) inhibits RGA binding to four of its interactors—PHYTOCHROME-INTERACTING FACTOR3 (PIF3), PIF4, JASMONATE-ZIM DOMAIN1, and BRASSINAZOLE-RESISTANT1 (BZR1)—that are key regulators in light, jasmonate, and brassinosteroid signaling pathways, respectively. Consistent with this, thesec-null mutant displayed reduced responses to GA and brassinosteroid and showed decreased expression of several common target genes of DELLAs, BZR1, and PIFs. Our results reveal a direct role of OGT in repressing DELLA activity and indicate thatO-GlcNAcylation of DELLAs provides a fine-tuning mechanism in coordinating multiple signaling activities during plant development.
Recovering and preventing loss of detailed memory: differential rates of forgetting for detail types in episodic memory
Authors: Sekeres Melanie J. , Bonasia Kyra , St-Laurent Marie , Pishdadian Sara , Winocur Gordon , Grady Cheryl , Moscovitch Morris
Published: January 2016

Episodic memories undergo qualitative changes with time, but little is known about how different aspects of memory are affected. Different types of information in a memory, such as perceptual detail, and central themes, may be lost at different rates. In patients with medial temporal lobe damage, memory for perceptual details is severely impaired, while memory for central details is relatively spared. Given the sensitivity of memory to loss of details, the present study sought to investigate factors that mediate the forgetting of different types of information from naturalistic episodic memories in young healthy adults. The study investigated (1) time-dependent loss of “central” and “peripheral” details from episodic memories, (2) the effectiveness of cuing with reminders to reinstate memory details, and (3) the role of retrieval in preventing forgetting. Over the course of 7 d, memory for naturalistic events (film clips) underwent a time-dependent loss of peripheral details, while memory for central details (the core or gist of events) showed significantly less loss. Giving brief reminders of the clips just before retrieval reinstated memory for peripheral details, suggesting that loss of details is not always permanent, and may reflect both a storage and retrieval deficit. Furthermore, retrieving a memory shortly after it was encoded prevented loss of both central and peripheral details, thereby promoting retention over time. We consider the implications of these results for behavioral and neurobiological models of retention and forgetting.
Inhibition of different histone acetyltransferases (HATs) uncovers transcription-dependent and -independent acetylation-mediated mechanisms in memory formation
Authors: Merschbaecher Katja , Hatko Lucyna , Folz Jennifer , Mueller Uli
Published: January 2016

Acetylation of histones changes the efficiency of the transcription processes and thus contributes to the formation of long-term memory (LTM). In our comparative study, we used two inhibitors to characterize the contribution of different histone acetyl transferases (HATs) to appetitive associative learning in the honeybee. For one we applied garcinol, an inhibitor of the HATs of the p300 (EP300 binding protein)/CBP (CREB-binding protein) family, and the HATs of the PCAF (p300/CBP-associated factor) family. As comparative agent we applied C646, a specific inhibitor that selectively blocks HATS of the p300/CBP family. Immunochemical analysis reveals differences in histone H3 acetylation in the honeybee brain, in response to the injection of either C646 or garcinol. Behavioral assessment reveals that the two drugs cause memory impairment of different nature when injected after associative conditioning: processes disturbed by garcinol are annihilated by the established transcription blocker actinomycin D and thus seem to require transcription processes. Actions of C646 are unaltered by actinomycin D, and thus seem to be independent of transcription. The outcome of our different approaches as summarized suggests that distinct HATs contribute to different acetylation-mediated processes in memory formation. We further deduce that the acetylation-mediated processes in memory formation comprise transcription-dependent and transcription-independent mechanisms.
Basolateral amygdala projections to ventral hippocampus modulate the consolidation of footshock, but not contextual, learning in rats
Authors: Huff Mary L. , Emmons Eric B. , Narayanan Nandakumar S. , LaLumiere Ryan T.
Published: January 2016

The basolateral amygdala (BLA) modulates memory consolidation for a variety of types of learning, whereas other brain regions play more selective roles in specific kinds of learning suggesting a role for differential consolidation via distinct BLA pathways. The ventral hippocampus (VH), an efferent target of the BLA, has been suggested to selectively process emotion-related learning, yet whether the BLA → VH pathway modulates memory consolidation, and does so in a learning-specific manner, is unknown. To address this issue, the BLA of male Sprague-Dawley rats was bilaterally transduced to express either ChR2(E123A) or eArchT3.0. Fiber optic probes were implanted in the VH to provide illumination of BLA axons. Rats then underwent a modified contextual fear conditioning task permitting separation of context and footshock learning. On day 1, rats received 3 min of pre-exposure to the apparatus. On day 2, rats were placed into the apparatus, received an immediate footshock, and quickly removed. Retention was tested on day 4. Optical stimulation of the BLA → VH pathway following footshock, but not context, training using trains of 40-Hz light pulses enhanced retention. Continuous optical inhibition of this pathway for 15 min starting 25 min after footshock training impaired retention. These findings indicate that BLA → VH projections influence the consolidation for footshock, but not context, learning of a modified CFC task and provide direct evidence that BLA projections to other brain regions modulate memory consolidation selectively depending on the kind of learning involved.
Multifaceted ability of naturally occurring polyphenols against metastatic cancer
Authors: Zhou Qingyu , Bennett Lunawati L , Zhou Shufeng
Published: January 2016

Although cancer metastases are known to be the main cause of cancer‐related deaths, truly effective antimetastatic therapeutics remain scarce in clinical practice. Naturally occurring polyphenols are the most abundant antioxidants in human diets. Many of them possess chemopreventive and chemotherapeutic properties against various types of cancer. Recent advances in understanding the molecular pathways that mediate cancer development and progression have led to an increase of interest in preclinical investigations on the mechanisms underlying anticancer activity of polyphenols. In particular, an increasing number of preclinical studies using cultured cells and animal models have demonstrated the inhibitory effects of polyphenols on tumour cell invasion and metastasis, thereby highlighting the potential of polyphenols against metastatic cancer. This review specifically addresses growing evidence of the capability of polyphenols to impair the invasion and migration of tumour cells through a diverse set of mechanisms, including downregulation of expression of matrix metalloproteinases, modulation of regulators of epithelial‐mesenchymal transition, interference with Met signalling, inhibition of nuclear factor‐kappa B mediated transcription, and so on. Given that metastasis occurs through a multistep process in which each step is regulated by a complex network of signalling pathways, the multi‐function and multi‐target characteristics of polyphenols render those promising candidates for effective adjuvant therapy against metastatic cancer.
Law as Information in the Era of Data‐Driven Agency
Authors: Hildebrandt Mireille
Published: January 2016

This contribution introduces the mathematical theory of information that ‘informs’ computer systems, the internet and all that has been built upon it. The aim of the author is to invite lawyers to reconsider the grammar and alphabet of modern positive law and of the Rule of Law, in the face of the alternative grammar and alphabet of a data‐driven society. Instead of either embracing or rejecting the technological transitions that reconfigure the operations of the law, this article argues that lawyers should collaborate with the computer scientists that engineer and design the affordances of our new onlife world. This is crucial if we want to sustain democratic participation in law‐making, contestability of legal effect and transparency of how citizens may be manipulated by the invisible computational backbone of our rapidly and radically changing world.
Is there an EU Copyright Jurisprudence? An Empirical Analysis of the Workings of the European Court of Justice
Authors: Favale Marcella , Kretschmer Martin , Torremans Paul C.
Published: January 2016

The Court of Justice of the European Union has seen a dramatic and controversial increase in copyright cases during the last decade. This study investigates empirically two claims: (i) that the Court has failed to develop a coherent copyright jurisprudence (lacking domain expertise, copyright specific reasoning, and predictability); (ii) that the Court has pursued an activist, harmonising agenda (resorting to teleological interpretation of European law). We analyse the allocation of copyright and database right cases by Chambers of the Court, Advocate General (AG) and Reporting Judge, and investigate the biographical background of the Judges and AGs sitting. We trace patterns of reasoning in the Court's approach through quantitative content analysis. Legal topoi that are employed in the opinions and decisions are linked to the outcomes of each case.
Something Old, Something New: Recasting the European Insolvency Regulation
Authors: McCormack Gerard
Published: January 2016

This paper critically evaluates the recasting of the European Insolvency Regulation ‐ Regulation (EU) 2015/848 ‐ in the context of the EU Europe 2020 growth strategy. According to the Council of Ministers, through the protection of creditors and the survival of business, the new legislation should contribute to the preservation of employment in these challenging times. The paper argues that worthwhile improvements have been made by extending the scope of the regulation; clarifying and confirming contentious areas of interpretation; smoothing the inter‐relationship between main and secondary insolvency proceedings and improving information flows. But the overall effect is to enhance complexity. The recast Regulation carries the whiff of political compromise and, at times, seems to point in different directions at the same time.
Black Spiders Weaving Webs: The Constitutional Implications of Executive Veto of Tribunal Determinations
Authors: Craig Robert
Published: January 2016

In R (Evans) v Attorney General, the Supreme Court quashed the Attorney General's statutory veto of the Upper Tribunal's original determination made under freedom of information legislation. The Upper Tribunal had held that so‐called ‘advocacy’ memos should be published after a full hearing on the merits. The Supreme Court split five to two, with the lead judgment of Lord Neuberger using constitutional rather than administrative language and focusing on the rule of law. This note raises four objections to the lead judgment. First, it argues that the Upper Tribunal was acting in an executive not judicial capacity and the veto was not therefore a breach of the rule of law. Secondly it suggests the veto clause is best understood as a variant Henry VIII clause. Thirdly, it suggests Lord Neuberger's judgment is founded on a paradox. Finally, it argues that the judgment undermines parliamentary sovereignty. Future implications are then considered.
Late spontaneous resolution of persistent molar pregnancy
Authors: Taylor F , Short D , Harvey R , Winter MC , Tidy J , Hancock BW , Savage PM , Sarwar N , Seckl MJ , Coleman RE
Published: January 2016

Objective

To determine the outcome of women with persistently raised but falling human chorionic gonadotrophin (hCG) levels 6 months after surgical evacuation of a molar pregnancy.

Design

An 11‐year retrospective review.

Setting

The United Kingdom supra‐regional trophoblastic disease treatment centres at Weston Park Hospital (Sheffield) and Charing Cross Hospital (London).

Population

Women with raised but falling serum human chorionic gonadotrophin (hCG) levels 6 months after evacuation of a molar pregnancy.

Methods

Retrospective case note review of eligible women identified by the electronic databases held at each supra‐regional centre.

Main outcome measures

The proportion of women that attain normal hCG levels spontaneously without chemotherapy. In addition, rates of gestational trophoblastic neoplasia (GTN), drug resistance, disease relapse and overall survival are reported.

Results

Thirty‐five women with molar pregnancy and raised but falling serum hCG levels continued surveillance 6 months after evacuation. Levels of hCG in 30 of the patients (86%) fell to normal levels spontaneously. One woman defaulted follow up prior to hCG normalisation (3%) and the remaining four women (11%) were treated with chemotherapy due to a plateau or rise in serum hCG levels indicating GTN. All treated women were successfully salvaged by either first (n = 1) or second line (n = 2) chemotherapy or found to have persistently raised low level hCG of uncertain clinical relevance (n = 1). No women developed relapsed disease and overall survival was 100%.

Conclusions

Women with a molar pregnancy and a raised but falling hCG level beyond 6 months from uterine evacuation can be safely observed with regular hCG monitoring and can usually avoid potentially toxic chemotherapy.

Tweetable abstract

Women with treated molar pregnancy may avoid chemotherapy if 6‐month hCG levels are raised but falling.