bluuebunny/crossref_metadata_2025 huggingface dataset:
Emergency Department Performance Measures Updates: Proceedings of the 2014 Emergency Department Benchmarking Alliance Consensus Summit
Authors: Wiler Jennifer L. , Welch Shari , Pines Jesse , Schuur Jeremiah , Jouriles Nick , Stone‐Griffith Suzanne
Published: April 2015

Objectives

The objective was to review and update key definitions and metrics for emergency department (ED) performance and operations.

Methods

Forty‐five emergency medicine leaders convened for the Third Performance Measures and Benchmarking Summit held in Las Vegas, February 21–22, 2014. Prior to arrival, attendees were assigned to workgroups to review, revise, and update the definitions and vocabulary being used to communicate about ED performance and operations. They were provided with the prior definitions of those consensus summits that were published in 2006 and 2010. Other published definitions from key stakeholders in emergency medicine and health care were also reviewed and circulated. At the summit, key terminology and metrics were discussed and debated. Workgroups communicated online, via teleconference, and finally in a face‐to‐face meeting to reach consensus regarding their recommendations. Recommendations were then posted and open to a 30‐day comment period. Participants then reanalyzed the recommendations, and modifications were made based on consensus.

Results

A comprehensive dictionary of ED terminology related to ED performance and operation was developed. This article includes definitions of operating characteristics and internal and external factors relevant to the stratification and categorization of EDs. Time stamps, time intervals, and measures of utilization were defined. Definitions of processes and staffing measures are also presented. Definitions were harmonized with performance measures put forth by the Centers for Medicare and Medicaid Services (CMS) for consistency.

Conclusions

Standardized definitions are necessary to improve the comparability of EDs nationally for operations research and practice. More importantly, clear precise definitions describing ED operations are needed for incentive‐based pay‐for‐performance models like those developed by CMS. This document provides a common language for front‐line practitioners, managers, health policymakers, and researchers.
Impact of irradiation and immunosuppressive agents on immune system homeostasis in rhesus macaques
Authors: Meyer C , Walker J , Dewane J , Engelmann F , Laub W , Pillai S , Thomas Charles R , Messaoudi I
Published: April 2015

In this study we examined the effects of non-myeloablative total body irradiation (TBI) in combination with immunosuppressive chemotherapy on immune homeostasis in rhesus macaques. Our results show that the administration of cyclosporin A or tacrolimus without radiotherapy did not result in lymphopenia. The addition of TBI to the regimen resulted in lymphopenia as well as alterations in the memory/naive ratio following reconstitution of lymphocyte populations. Dendritic cell (DC) numbers in whole blood were largely unaffected, while the monocyte population was altered by immunosuppressive treatment. Irradiation also resulted in increased levels of circulating cytokines and chemokines that correlated with T cell proliferative bursts and with the shift towards memory T cells. We also report that anti-thymocyte globulin (ATG) treatment and CD3 immunotoxin administration resulted in a selective and rapid depletion of naive CD4 and CD8 T cells and increased frequency of memory T cells. We also examined the impact of these treatments on reactivation of latent simian varicella virus (SVV) infection as a model of varicella zoster virus (VZV) infection of humans. None of the treatments resulted in overt SVV reactivation; however, select animals had transient increases in SVV-specific T cell responses following immunosuppression, suggestive of subclinical reactivation. Overall, we provide detailed observations into immune modulation by TBI and chemotherapeutic agents in rhesus macaques, an important research model of human disease.
Ecological consequences of contrasting dispersal syndromes in New World Ephedra: higher rates of niche evolution related to dispersal ability
Authors: Loera Israel , Ickert‐Bond Stefanie M. , Sosa Victoria
Published: April 2015

In this study we selected the New World species of Ephedra to understand the ecological consequences of different dispersal syndromes. The twenty‐three species of Ephedra in the New World have a disjunct distribution in North and South American arid and semi‐arid habitats, exhibiting three dispersal syndromes related to dispersal by birds, wind and rodents. Using DNA sequence data we inferred phylogenetic relationships and lineage divergence times, and used these estimates to test different ecological assumptions. Using comparative methods we tested for correlations between dispersal syndromes and a set of ecological variables (niche breadth, niche evolution, distributional ranges and niche position). We found that speciation events in the New World coincided with the expansion of arid habitats in this region. We suggest that the bird dispersal syndrome is related with higher rates of climatic niche evolution for all variables used, including aridity index, mean annual temperature and mean annual precipitation. Distribution ranges were correlated with niche breadth, they were however not significantly different between dispersal syndromes. Species inhabiting the extremely arid regions on niche axes had narrower niche breadths. We conclude that species whose seeds are dispersed by birds have colonized a broader set of habitats and that those with wind and rodent dispersal syndromes might have promoted the colonization of more arid environments.
A new bacterial disease observed on Quercus myrsinifolia
Authors: Ishihara M. , Takikawa Y. , Akiba M. , Kawabe Y.
Published: April 2015

This is the first report of a new bacterial disease occurring on Quercus myrsinifolia in the nurseries of the Kyushu district in Japan. The main symptoms are shoot and twig blight, which begins with black necrotic lesions. In addition, unclear blackish discolorations, bacterial ooze and water‐soaked lesions were observed as early symptoms, and spindle‐shaped cankers and stem cankers with irregular surface were observed as secondary symptoms. The blight symptoms observed on the current‐year shoots were first observed during the rainy season and continued until autumn (June–October). In summer, the symptoms were pronounced. A yellowish bacterium was consistently isolated from the affected shoots of Q. myrsinifolia, and on inoculation into healthy trees, it caused the same symptoms, which were more severe after wound inoculation than after non‐wound inoculation. Wound inoculation also caused the disease symptoms on Quercus spp., Fagus crenata and Lithocarpus glaber, but not on several other species of Fagaceae. The causal bacterium was identified as Xanthomonas arboricola based on its morphological, cultural and biochemical characteristics and genetic sequence analysis of 16S rDNA, 16S‐23S spacer regions and gyrB. To our knowledge, there are no previous records of xanthomonads causing shoot blight on fagaceous plants like Q. myrsinifolia. Therefore, we postulate that the shoot blight of Q. myrsinifolia is a new bacterial disease. We propose the name of the disease to be ‘bacterial shoot blight’ based on its main symptoms.
All‐cause mortality following a cancer diagnosis amongst multiple sclerosis patients: a Swedish population‐based cohort study
Authors: Roshanisefat H. , Bahmanyar S. , Hillert J. , Olsson T. , Montgomery S.
Published: April 2015

Background and purpose

A reduced cancer risk amongst patients with multiple sclerosis (MS) has been reported. Theoretically, this could represent a genuine reduction in risk or, alternatively, ‘diagnostic neglect’, where cancer is undiagnosed when symptoms are misattributed to MS.

Objective

Assess all‐cause mortality risk following a cancer diagnosis in patients with MS compared with a cohort without MS.

Patients

A cohort of MS patients (n = 19 364) and a cohort of the general population (n = 192 519) were extracted from national Swedish registers from 1969 to 2005. All‐cause mortality after cancer in MS was compared with the general population. Poisson regression analysis was conducted in the MS and non‐MS cohorts separately. The models were adjusted for follow‐up duration, year at entry, sex, region and socioeconomic index. The two cohorts were combined and differences in mortality risk were assessed using interaction testing.

Results

The adjusted relative risk (and 95% confidence interval) for all‐cause mortality following a cancer diagnosis in MS patients (compared with MS patients without cancer) is 3.06 (2.86–3.27; n = 1768) and amongst those without MS 5.73 (5.62–5.85; n = 24 965). This lower magnitude mortality risk in the MS patients was confirmed by multiplicative interaction testing (P < 0.001).

Conclusions

A consistent pattern of lower magnitude of all‐cause mortality risk following cancer in MS patients for a range of organ‐specific cancer types was found. It suggests that cancer diagnoses tend not to be delayed in MS and diagnostic neglect is unlikely to account for the reduced cancer risk associated with MS. The lower magnitude cancer risk in MS may be due to disease‐associated characteristics or exposures.
German Language Adaptation of the Headache Management Self‐Efficacy Scale (HMSE‐G) and Development of a New Short Form (HMSE‐G‐SF)
Authors: Graef Julia E. , Rief Winfried , French Douglas J. , Nilges Paul , Nestoriuc Yvonne
Published: April 2015

Objective

This study aims to develop and validate a German version of French and colleagues’ Headache Management Self‐efficacy Scale and to construct an abbreviated form for use in behavioral headache research. Furthermore, the contribution of headache‐specific self‐efficacy to pain‐related disability in German chronic headache sufferers was examined.

Background

Headache‐specific self‐efficacy refers to an individuals’ confidence that they can engage in behaviors to either prevent headache episodes or to manage headache‐related pain and disability. Self‐efficacy beliefs have been shown repeatedly to be positively associated with psychological well‐being, effective coping, and enhanced treatment outcomes.

Methods

A cross‐sectional sample of 304 individuals diagnosed with either migraine, chronic tension‐type headache, or a combination of 2 or more headache disorders completed the German Headache Management Self‐efficacy Scale and questionnaires assessing headache activity, pain‐related coping, general self‐efficacy, depression, and anxiety. Responsiveness of the scale was analyzed in a longitudinal subsample of 32 inpatients undergoing headache treatment. Finally, a short form was constructed and evaluated regarding psychometric properties.

Results

The German Headache Management Self‐efficacy Scale showed good reliability (Cronbach's α = 0.87) as did the 6‐item short form (Cronbach's α = 0.72). In the longitudinal sample, both versions showed a good ability to change over time (SRM= 0.52‐1.16). Chronic headache patients with higher levels of self‐efficacy reported lower levels of disability (r = −0.26 to −0.31). Multiple regression analyses revealed headache intensity and headache‐specific self‐efficacy as strongest predictors of headache‐related disability (βself‐efficacy = −0.21, βintensity = 0.26).

Conclusions

Both the 25‐item version and the 6‐item version appear to be valid, reliable measures of self‐efficacy beliefs. These scales will allow clinicians to identify headache sufferers with low levels of headache‐specific self‐efficacy with the goal of enhancing this expectancy for improvement. The new short form can help accomplish this goal without adding significantly to the burden of the self‐report assessment batteries used in clinical settings.
Dependency and Emancipation in the Debt‐Economy: Care‐Ethical Critique of Contractarian Conceptions of the Debtor–Creditor Relation
Authors: Thorgeirsdottir Sigridur
Published: April 2015

The fight for emancipation takes place on different levels, and one of them is the level of contemporary financial capitalism as debt‐economy. Debt can be a major tool of control and exploitation in that it produces subordinate subjects situated in exchange relations of debt and credit. Recent work on financial debt and the debt‐economy has, however, not taken gender adequately into account in philosophical definitions of indebted subjects. Gender analysis discloses how the debtor–creditor relationship is based on a contractarian idea of the indebted subject as an autonomous moral agent (Pateman and Mills 2007), and on a masculine, that is, a‐relational understanding of what counts as debt and what does not in the contemporary debt‐economy. In contrast to atomistic notions of the subject in liberal, contractarian theories (deriving from Locke and Hobbes), relational notions of the subject as advanced in care ethics are a better point of departure for capturing the interdependence of subjects within a debt‐economy as a core feature of a nonsustainable monetary system. On the basis of such analysis, care ethics also offers means for imagining ways of emancipation from private and public problem credit in order to make financial systems more sustainable and more just.
Risk of urethral stricture recurrence increases over time after urethroplasty
Authors: Han Justin S , Liu Joceline , Hofer Matthias D , Fuchs Amanda , Chi Amanda , Stein Daniel , Dielubanza Elodi , Ballek Nathaniel , Gonzalez Chris M
Published: April 2015

Objective

To report a single institutional experience with urethroplasty outcomes and success rates at long‐term follow up.

Methods

A retrospective review was carried out of all urethroplasties performed by a single surgeon from 2000 to 2010. A total of 347 patients underwent urethroplasty during this time period, of which 227 had minimum 1‐year follow‐up data available. Demographic, clinical, pathological and outcome data were reviewed. Recurrence was defined by patient reported urinary symptoms or need for subsequent intervention. Statistical analyses were carried out using SPSS statistical software.

Results

A total of 26% of all patients had a recurrence at a mean follow up of 62 months (range 13–147 months). The recurrence rate after anastomotic urethroplasty was 18%, as compared with 31% after substitution urethroplasty. Mean time to recurrence was 34 months (range 5–87). On univariate analysis, use of abdominal skin graft, history of prior urethroplasty, lichen sclerosus and length of follow up were statistically significant predictors of recurrence. On multivariate analysis, only history of prior urethroplasty and length of follow‐up time exceeding 48 months were statistically significant predictors of recurrence.

Conclusions

Urethroplasty for urethral stricture is the most durable treatment modality, regardless of surgical approach. However, there is an ongoing risk of recurrence with the passage of time. Patients should be counseled appropriately on the potential for late recurrence of stricture disease after urethroplasty.
Use of romiplostim in patients with chronic idiopathic thrombocytopenic purpura during perioperative period
Authors: Ramakrishna R. , Rehman A. , Ramakrishna S. , Alexander W. , Yeo W. W.
Published: April 2015

Introduction

In patients with chronic idiopathic thrombocytopenic purpura (cITP), the platelet count tends to be quite variable and, in the majority of cases, specific therapy is not warranted on a regular basis. However, patients with low platelet count (<30 nL) or with bleeding complications would require therapy, such as prednisolone, intravenous immunoglobulin infusions, splenectomy and/or immunosuppression. Romiplostim, a thrombopoietin agonist, has also proven to be useful in improving platelet counts. cITP can be associated with bleeding complications perioperatively. As such, a higher platelet count is warranted (approximately 80 nL), particularly for invasive surgeries, such as orthopaedic surgery, cardio‐thoracic surgery, head and neck surgery and abdominal surgery, where risk of bleeding is quite high already.

Aim

The aim of this study is to evaluate the safety and efficacy of short‐term use of romiplostim, perioperatively.

Methods

Patients with chronic ITP requiring major surgical interventions were enrolled in the study. Patients with malignancies or myelodysplastic syndromes, major bleeding disorders, under 18 years of age or pregnancy were excluded.

Conclusion

This study has shown that the use of romiplostim is safe and effective in improving platelet counts preoperatively and that this could achieve excellent haemostasis, with no associated bleeding complications or rebound thrombocytopenia. A larger study involving multiple centres is required to verify these findings.
Newborn Body Perception: Sensitivity to Spatial Congruency
Authors: Filippetti Maria Laura , Orioli Giulia , Johnson Mark H. , Farroni Teresa
Published: April 2015

Studies on adults have demonstrated that the perception our own body can be manipulated by varying both temporal and spatial properties of multisensory information. While human newborns are capable of detecting the temporal synchrony of visuo‐tactile body‐related cues, it remains unknown whether they also utilise spatial information for body perception. Twenty newborns were presented with a video of an infant's face touched with a paintbrush, while their own face was touched either in the spatially congruent, or an incongruent, location. We found that newborns show a visual preference for spatially congruent synchronous events, supporting the view that newborns have a rudimentary sense of their own body.
Sex‐specific food intake in whiting Merlangius merlangus
Authors: Lauerburg R. A. M. , Keyl F. , Kotterba P. , Floeter J. , Temming A.
Published: April 2015

In this study, the topic of sexual growth dimorphism in whiting Merlangius merlangus is examined. To understand the magnitude and underlying mechanisms, North Sea International Bottom Trawl Survey (IBTS) data and two additional datasets from the third quarter of 2007 and the first quarter of 2012 were analysed. Merlangius merlangus displays distinct differences in growth parameters between males and females, with females reaching a higher asymptotic length (L∞) than males. To identify the mechanisms which lead to higher growth in females, the quantity and the quality of the diet of M. merlangus in the North Sea were investigated to compare the sex‐specific energy uptake levels. The diet composition did not differ between the sexes, but females had higher stomach content masses than males of the same total length (LT), and showed lower proportions of empty stomachs. Moreover, female M. merlangus had higher liver and empty stomach masses compared with males of the same size, which indicates additional sex‐specific differences in the metabolic costs and energy allocation patterns. Finally, interannual differences were found in the stomach contents, the share of empty stomachs and liver masses of M. merlangus in the North Sea.
Development of a PCR Assay for Rapid Detection of Cronobacter sakazakii from Powdered Infant Formula Using a Target Sequence Identified by Comparative Genomic Analysis
Authors: Chen Wanyi , Yu Shuijing , Ren Jing , Shi Chunlei , Hang Feng , Guo Benheng
Published: April 2015

The occurrence of outbreaks of Cronobacter sakazakii causing necrotizing meningitis in China highlights the need for strain characterization of this pathogenic species. In this study, SMM system was utilized to mine for new molecular markers of C. sakazakii. One C. sakazakii‐specific CDS (>ref|NC_009778.1|:c1077329‐1076055) with a length of 1,275 bp was used to design a primer set. A PCR assay was developed and optimized to detect C. sakazakii. The PCR assay amplified a 498 bp DNA product from all 43 C. sakazakii strains tested but not from 30 other bacteria strains. The detection limit was 7.11 pg/PCR (equivalent 1,422 genomic copies) when the genomic DNA of C. sakazakii ATCC 29544 was 10‐fold diluted. Three powdered infant formulas from different commercial brands were inoculated with the strain ATCC 29544 at the level of 56 cells contamination, and the target fragments (498 bp) were produced after samples were enriched for 6 h at 37C.Thirty food samples were detected simultaneously by this PCR assay and the conventional method, and a coincident detecting result was found between the PCR assay and the conventional method. This method provides a useful tool for rapid identification of C. sakazakii in food and environmental matrices.

Practical Applications

The gold standard based on the FDA‐recommended methods for isolation and identification of Cronobacter sakazakii from powdered infant formula is time consuming and labor intensive. A PCR assay has been established to detect C. sakazakii. This method provides a useful tool for rapid and accurate identification of C. sakazakii in food when a large number of food samples need to be rapidly isolated and identified.
Overactivation of NR2B‐containing NMDA receptors through entorhinal–hippocampal connection initiates accumulation of hyperphosphorylated tau in rat hippocampus after transient middle cerebral artery occlusion
Authors: Xu Cheng‐Shi , Liu An‐Chun , Chen Juan , Pan Zhi‐Yong , Wan Qi , Li Zhi‐Qiang , Wang Ze‐Fen
Published: April 2015

Middle cerebral artery occlusion (MCAO) induces secondary damages in the hippocampus that is remote from primary ischemic regions. Tau hyperphosphorylation is an important risk for neurodegenerative diseases. Increased tau phosphorylation has been identified in ischemic cortex, but little is known regarding the changes in the hippocampus. We showed that unilateral transient MCAO induced accumulation of hyperphosphorylated tau and concurrent dephosphorylation of glycogen synthase kinase‐3β at Ser 9 in the ipsilateral hippocampus. These MCAO‐induced changes were not reproduced when glutamatergic inputs from the entorhinal cortex to the hippocampus were transected; however, the changes were mimicked by intrahippocampal N‐methyl‐d‐aspartate (NMDA) administration. Inhibition of NMDA receptor (NMDAR) subunit NR2B, but not NR2A activity in the hippocampus attenuated the accumulation of hyperphosphorylated tau and spatial cognitive impairment in MCAO rats. Together, our data suggest that overactivation of NR2B‐containing NMDARs through entorhinal–hippocampal connection plays an important role in the accumulation of hyperphosphorylated tau in the hippocampus following MCAO. Glycogen synthase kinase‐3β is an important protein kinase involved in NMDARs‐mediated tau hyperphosphorylation. This study indicates that early inhibition of NR2B‐containing NMDARs may represent a potential strategy to prevent or delay the occurrence of post‐stroke dementia.

image

Middle cerebral artery occlusion induces secondary damage in the hippocampus that is remote from primary ischemic regions. We propose that excessive activation of NR2B‐containing NMDA receptors through entorhinal–hippocampal connection initiated the accumulation of hyperphosphorylated tau in the hippocampus, which subsequently induced cognitive deficit. This study provides new insights into the prospects of NR2B inhibition in stoke therapy.
The UN Convention on the Rights of Persons with Disabilities: Implementing a Paradigm Shift
Authors: Mittler Peter
Published: April 2015

Implementation of the United Nations' (UN) Convention on the Rights of Persons with Disabilities (CRPD), together with the new UN commitment to ensure the inclusion of people with disabilities in the post‐2015 Sustainable Development Goals (SDGs), should now be considered an overarching priority by organizations and individuals committed to improving the quality of life of people with disabilities. The CRPD is not merely the latest in a long line of UN declarations, but a potential catalyst for a radical reappraisal of policy and practice among governments and organizations of persons with disabilities (disabled persons organizations (DPOs)) and by service planners and providers, members of professional and voluntary organizations, the research community, and by society at large. The 152 governments that have ratified the CRPD have entered into a commitment in international law to submit detailed reports to the CRPD Committee of the UN human rights commission. Although some DPOs have made good use of their right of access to this Committee, there is cause of concern about resources available to others. The Committee's criticisms of the nature and quality of government implementation highlight the need for sustained and informed advocacy by civil society and the use of the Internet and social media to raise public awareness about the potential of the CRPD to benefit people with disabilities. The author posits that lack of data on persons with disabilities in many countries now presents the most serious obstacle to accountability and monitoring. It is suggested that scientific and professional bodies need to work more earnestly in partnership with DPOs in a combined effort to make a reality of the Convention and the emerging SDGs in a new dynamic of “research to practice.”
The Influence of Different Emulsifiers on the Physical and Textural Characteristics of Gluten‐Free Cheese Bread
Authors: López‐Tenorio Julián Alfredo , Rodríguez‐Sandoval Eduardo , Sepúlveda‐Valencia José Uriel
Published: April 2015

The aim of this study was to evaluate the effects of two emulsifiers, sodium stearoyl‐2‐lactylate (SSL) and diacetyl tartaric acid esters of mono and diglycerides (DATEM) on the physical and textural characteristics of gluten‐free (GF) cheese bread and the influence they have during storage. DATEM and SSL in percentages of 0.5 and 1.0 were added based on the amount of cheese in the formula. The dough behaved as a viscoelastic solid, adjusting itself to a model consisting of three Maxwell elements with a spring in parallel. The results indicate that emulsifiers had no significant effect on dough rheology. The emulsifiers affected the physical and textural characteristics of GF cheese bread. The height, diameter and specific volume of the samples decreased with higher concentrations of emulsifiers in the formula, while the yield and crumb hardness increased. Crust fracture and crumb hardness of samples increased during storage, thus the emulsifiers did not control product aging.

Practical Applications

Large‐scale production and the rise in consumers that demand good‐quality GF products have brought about the need to use food additives, such as emulsifiers, which are used as antiaging agents in bakery products by increasing their shelf life. Few studies have been carried out into the use of emulsifiers in GF products. For this reason, it is considered of great importance to evaluate the effect that these additives have on GF cheese bread, which is made by blending mainly sour cassava starch, water or milk, cheese, salt, sugar and fat. This product has a large market in South America and could be an alternative for celiac patients in that region.
Early Tumor Response to Intraarterial or Intravenous Administration of Carboplatin to Treat Naturally Occurring Lower Urinary Tract Carcinoma in Dogs
Authors: Culp W.T.N. , Weisse C. , Berent A.C. , Reetz J.A. , Krick E.L. , Jackson D.E. , Kass P.H. , Clifford C.A. , Sorenmo K.U.
Published: April 2015

Background

Survival times and tumor responses associated with malignant neoplasia of the lower urinary tract are poor despite the vast array of current treatments. Therefore, the evaluation of alternative treatments, such as intraarterial administration of chemotherapy (IAC) should be considered.

Objective

To describe a technique for superselective catheterization for IAC and to evaluate initial tumor response by ultrasonography after both IAC and intravenous administration of chemotherapy (IVC).

Animals

Client‐owned dogs with lower urinary tract neoplasia treated with either IVC (n = 15) or IAC (n = 11).

Methods

Retrospective study. An arterial approach via the carotid or femoral artery was utilized to obtain superselective access and administer chemotherapy in the IAC cases. Medical record review was performed, data were recorded, and recorded variables were evaluated statistically.

Results

Intraarterial chemotherapy was successfully administered in all cases. There was a significantly greater decrease in longest unidimensional measurement in the IAC group as compared to the IVC group (P = .013). The IAC group was also significantly more likely to have a tumor response as assessed by modified RECIST guidelines (P = .049). Dogs in the IAC group were significantly less likely to develop anemia (P = .001), lethargy (P = .010) and anorexia (P = .024).

Conclusion and Clinical Importance

This study demonstrated the feasibility and efficacy of performing IAC for lower urinary tract neoplasia. Further investigation is necessary as the follow‐up time was short and the impact on long‐term outcome and survival was not determined.
Pharmacotherapy of vestibular and cerebellar disorders and downbeat nystagmus: translational and back‐translational research
Authors: Strupp Michael , Zwergal Andreas , Feil Katharina , Bremova Tatiana , Brandt Thomas
Published: April 2015

There are currently eight groups of drugs for the pharmacotherapy of vertigo, nystagmus, and cerebellar disorders: antiemetics; anti‐inflammatories, antimenieres, and antimigraineous medications; antidepressants, anticonvulsants, aminopyridines, and acetyl‐dl‐leucine (“the eight A's”). In acute unilateral vestibulopathy, corticosteroids improve the recovery of peripheral vestibular function, but there is not sufficient current evidence for a general recommendation. There is also insufficient evidence that 48 or 144 mg/day betahistine has an effect in Ménière's disease. Therefore, higher dosages are currently recommended; in animal studies, it was shown that betahistine increases cochlear blood flow. In vestibular paroxysmia, oxcarbazepine was effective (one yet not randomized controlled trial (RCT)). Aminopyridines are recommended for the treatment of downbeat nystagmus (two RCTs) and episodic ataxia type 2 (EA2, one RCT). There are so far no RCTs on vestibular migraine, so currently no treatment can be recommended. Acetyl‐dl‐leucine improves cerebellar ataxia (three observational studies); it also accelerates central compensation in an animal model of acute unilateral lesion, but RCTs were negative. There are ongoing RCTs on vestibular paroxysmia with carbamazepine (VESPA), acute unilateral vestibulopathy with betahistine (BETAVEST), vestibular migraine with metoprolol (PROVEMIG), benign paroxysmal positional vertigo with vitamin D (VitD@BPPV), EA2 with 4‐aminopyridine versus acetazolamide (EAT‐2‐TREAT), and cerebellar ataxias with acetyl‐dl‐leucine (ALCAT).
Fentanyl with ropivacaine infusion for postoperative pain relief in infants and children. Kinetics of epidural fentanyl
Authors: Karas‐Trzeciak Magdalena , Grabowski Tomasz , Woloszczuk‐Gebicka Bogumila , Borucka Beata
Published: April 2015

Objectives

The aim of the study was to evaluate pharmacokinetics of fentanyl administered as continuous epidural infusion with 0.2% ropivacaine for postoperative pain relief in infants and toddlers, and older children undergoing major abdominal and urological procedures.

Methods

Thirteen infants and toddlers (median age 14 [range 3–36] months, 11 [5–17] kg, Group I) and 11 children (68 [45–131] months, 21 [16–52] kg, Group II) participated in the study. Epidural catheter was placed under general anesthesia in the L1–L2, L2–L3, or L3–L4 epidural space and threaded up to 4 cm into the epidural space. Bolus dose of 0.2% ropivacaine, 0.5 ml·kg−1 and fentanyl, 2 μg·kg−1 was given, then followed by continuous infusion of 0.2% ropivacaine, 0.15 ml·kg−1·h−1 with fentanyl 1.12 μg·kg−1·h−1. In the postoperative period, fentanyl dose was reduced to 0.375 μg·kg−1·h−1.

Results

With this dosing regimen, fentanyl concentration in plasma was within the range of analgesic concentrations, and did not exceed 1.0 ng·ml−1. After discontinuation of epidural infusion, pharmacokinetics of fentanyl was complicated by a slight increase in plasma concentration during the elimination phase. Both elimination half‐life of fentanyl (t1/2,MRT) and mean residence time (MRT) were much longer than those observed after single IV bolus dose, and longer in Group I than in Group II (t1/2MRT 15.9 [3.6–31.5] h vs 8.0 [7.1–13.3] h, P < 0.05, MRTstop‐last 22.9 [5.1–45.5] h vs 11.5 [10.2–19.1] h, P < 0.05). Therefore, monitoring of vital signs seems warranted for several hours after the termination of the epidural infusion because risk of respiratory depression may persist, especially in the younger age group.
Ground
Authors: Raven Michael J.
Published: April 2015

This essay focuses on a recently prominent notion of (metaphysical) ground which is distinctive for how it links metaphysics to explanation. Ground is supposed to serve both as the common factor in diverse in virtue of questions as well as the structuring relation in the project of explaining how some phenomena are “built” from more fundamental phenomena. My aim is to provide an opinionated synopsis of this notion of ground without engaging with others. Ground, so understood, generally resists illumination by appeal to more familiar models of explanation. Nevertheless, its distinctive explanatory and metaphysical aspects guide us on characterizing its explanatory logic and its metaphysical features. Some issues concerning the meta‐question of what (if anything) grounds ground are explored, as well as some recent skeptical challenges to ground.
Classical Chinese Logic
Authors: Rošker Jana S.
Published: April 2015

The present article provides an introduction to classical Chinese logic, a term which refers to ancient discourses that were developed before the arrival of significant external influences and which flourished in China until the first unification of China, during the Qin Dynasty (221 BC). Taking as its premise that logic implies both universal and culturally conditioned elements, the author describes the historical background of Chinese logic, the main schools of Chinese logical thought, the current state of research in this area and the crucial concepts and methods applied in classical Chinese logic. The close link between Chinese logic and the Chinese language is also stressed.
Antidiabetic Therapy in End‐Stage Renal Disease
Authors: Boyle Suzanne M. , Simon Barbara , Kobrin Sidney M.
Published: April 2015

There has been substantial growth in the variety of available antidiabetic agents during the last decade and a half. The role of these newer agents in patients with diabetes and end‐stage renal disease (ESRD) population, and their relative benefits and risks in this population compared to patients without ESRD are not yet clear. This stems from the altered state of glucose homeostasis in ESRD, which places patients at high risk for hypoglycemia and, in certain situations, hyperglycemia. In addition, there is a dearth of evidence to support a benefit of tight glycemic control on either micro‐ or macrovascular outcomes in ESRD patients; furthermore, the metrics by which glycemic control is conventionally measured are less valid in ESRD. In this review, we will discuss noninsulin and insulin‐based therapies as well as unique challenges, contraindications, advantages, and disadvantages to their use in ESRD. We will also review issues pertinent to both hemodialysis (HD) and peritoneal dialysis (PD) patients.
Unionism, Loyalism, and the Ulster‐Scots Ethnolinguistic ‘Revival’
Authors: Gardner Peter Robert
Published: April 2015

The Ulster‐Scots ethnolinguistic ‘revival’ in Northern Ireland has been appropriated, promoted, and internalized by many across the varieties of unionism and loyalism. Much of the academic literature on Ulster‐Scots has focused on political and cultural dimensions of the ‘revival’. This article analyses the written promotion of the Ulster‐Scots movement by those who purport to conceptualize it primarily in terms of a literary‐linguistic revival. Through a close textual analysis of the Ulster‐Scots Language Society's journal, Ullans, I investigate where this part of the Ulster‐Scots ‘revival’ fits in the nexus of unionism and loyalism. Although Ullans does contain markers of the ‘Protestant community’, in general its Ulster‐Scots narrative fails to conform to any specific form of unionist ideology. Rather, this victimhood narrative may be more mimetic towards Irish linguo‐cultural promotion, defence, and legitimization than a development of various strands of endogenous unionist ideology.
‘Two Ukraines’ Reconsidered: The End of Ukrainian Ambivalence?
Authors: Riabchuk Mykola
Published: April 2015

The 2014 Russo‐Ukrainian war, euphemistically called the ‘Ukraine crisis’, has largely confirmed, on certain accounts, a dramatic split of the country and people's loyalties between the proverbial ‘East’ and ‘West’, between the ‘Eurasian’ and ‘European’ ways of development epitomized by Russia and the European Union. By other accounts, however, it has proved that the Ukrainian nation is much more united than many experts and policymakers expected, and that the public support for the Russian invasion, beyond the occupied regions of Donbas and Crimea, is close to nil. This article does not deny that Ukraine is divided in many respects but argues that the main – and indeed the only important – divide is not between ethnic Russians and Ukrainians, or Russophones and Ukrainophones, or the ‘East’ and the ‘West’. The main fault line is ideological – between two different types of Ukrainian identity: non/anti‐Soviet and post/neo‐Soviet, ‘European’ and ‘East Slavonic’. All other factors, such as ethnicity, language, region, income, education, or age, correlate to a different degree with the main one. However divisive those factors might be, the external threat to the nation makes them largely irrelevant, bringing instead to the fore the crucial issue of values epitomized in two different types of Ukrainian identity.
Understanding Taliban Resurgence: Ethno‐Symbolism and Revolutionary Mobilization
Authors: Kamel Kareem
Published: April 2015

This article argues that the post‐2001 Taliban resurgence was due to their capacity to act as resourceful ethnic entrepreneurs through selective usage of dominant Pashtun and Islamic mythomoteurs in the process of symbolic cultivation. Through comparative historical analysis and an ethno‐symbolist theoretical framework, it shows that the main identity determinants informing the movement's behaviour have played a fundamental role in the process of revolutionary mobilization. With Afghanistan as their territorial referent, the ideological lenses of Pashtun nationalism and Islamism, coupled with their situational ‘village’ lens, have been used interchangeably by the Taliban to shed light on specific symbolic resources for successful resistance.
Clustered Survival Data with Left‐truncation
Authors: Eriksson Frank , Martinussen Torben , Scheike Thomas H.
Published: April 2015

Left‐truncation occurs frequently in survival studies, and it is well known how to deal with this for univariate survival times. However, there are few results on how to estimate dependence parameters and regression effects in semiparametric models for clustered survival data with delayed entry. Surprisingly, existing methods only deal with special cases. In this paper, we clarify different kinds of left‐truncation and suggest estimators for semiparametric survival models under specific truncation schemes. The large‐sample properties of the estimators are established. Small‐sample properties are investigated via simulation studies, and the suggested estimators are used in a study of prostate cancer based on the Finnish twin cohort where a twin pair is included only if both twins were alive in 1974.
Cytokinin is required for escape but not release from auxin mediated apical dominance
Authors: Müller Dörte , Waldie Tanya , Miyawaki Kaori , To Jennifer P.C. , Melnyk Charles W. , Kieber Joseph J. , Kakimoto Tatsuo , Leyser Ottoline
Published: April 2015

Auxin produced by an active primary shoot apex is transported down the main stem and inhibits the growth of the axillary buds below it, contributing to apical dominance. Here we use Arabidopsis thaliana cytokinin (CK) biosynthetic and signalling mutants to probe the role of CK in this process. It is well established that bud outgrowth is promoted by CK, and that CK synthesis is inhibited by auxin, leading to the hypothesis that release from apical dominance relies on an increased supply of CK to buds. Our data confirm that decapitation induces the expression of at least one ISOPENTENYLTRANSFERASE (IPT) CK biosynthetic gene in the stem. We further show that transcript abundance of a clade of the CK‐responsive type‐A Arabidopsis response regulator (ARR) genes increases in buds following CK supply, and that, contrary to their typical action as inhibitors of CK signalling, these genes are required for CK‐mediated bud activation. However, analysis of the relevant arr and ipt multiple mutants demonstrates that defects in bud CK response do not affect auxin‐mediated bud inhibition, and increased IPT transcript levels are not needed for bud release following decapitation. Instead, our data suggest that CK acts to overcome auxin‐mediated bud inhibition, allowing buds to escape apical dominance under favourable conditions, such as high nitrate availability.
The Establishment of the Colombian Integrated Program for Antimicrobial Resistance Surveillance (COIPARS): A Pilot Project on Poultry Farms, Slaughterhouses and Retail Market
Authors: Donado‐Godoy P. , Castellanos R. , León M. , Arevalo A. , Clavijo V. , Bernal J. , León D. , Tafur M. A. , Byrne B. A. , Smith W. A. , Perez‐Gutierrez E.
Published: April 2015

The development of antimicrobial resistance among bacteria (AMR) is currently one of the world's most pressing public health problems. The use of antimicrobial agents in humans and animals has resulted in AMR which has narrowed the potential use of antibiotics for the treatment of infections in humans. To monitor AMR and to develop control measures, some countries, such as the USA, Canada and Denmark, have established national integrated surveillance systems (FDA, , CIPARS, 2007, DANMAP,2002). The components of these programs monitor changes in susceptibility/resistance to antimicrobial agents of selected zoonotic pathogens and commensal organisms recovered from animals, retail meats and humans. The rapid development of Colombia's animal production industry has raised food safety issues including the emergence of antibiotic resistance. The Colombian Integrated Surveillance Program for Antimicrobial Resistance (COIPARS) was established as a pilot project to monitor AMR on poultry farms, slaughter houses and retail markets.
A Technique for Quantifying Wrist Motion Using Four-Dimensional Computed Tomography: Approach and Validation
Authors: Zhao Kristin , Breighner Ryan , Holmes David , Leng Shuai , McCollough Cynthia , An Kai-Nan
Published: April 2015

Accurate quantification of subtle wrist motion changes resulting from ligament injuries is crucial for diagnosis and prescription of the most effective interventions for preventing progression to osteoarthritis. Current imaging techniques are unable to detect injuries reliably and are static in nature, thereby capturing bone position information rather than motion which is indicative of ligament injury. A recently developed technique, 4D (three dimensions + time) computed tomography (CT) enables three-dimensional volume sequences to be obtained during wrist motion. The next step in successful clinical implementation of the tool is quantification and validation of imaging biomarkers obtained from the four-dimensional computed tomography (4DCT) image sequences. Measures of bone motion and joint proximities are obtained by: segmenting bone volumes in each frame of the dynamic sequence, registering their positions relative to a known static posture, and generating surface polygonal meshes from which minimum distance (proximity) measures can be quantified. Method accuracy was assessed during in vitro simulated wrist movement by comparing a fiducial bead-based determination of bone orientation to a bone-based approach. The reported errors for the 4DCT technique were: 0.00–0.68 deg in rotation; 0.02–0.30 mm in translation. Results are on the order of the reported accuracy of other image-based kinematic techniques.
Characterization of Mechanical Properties of Tissue Scaffolds by Phase Contrast Imaging and Finite Element Modeling
Authors: Bawolin Nahshon K. , Dolovich Allan T. , Chen Daniel X. B. , Zhang Chris W. J.
Published: April 2015

In tissue engineering, the cell and scaffold approach has shown promise as a treatment to regenerate diseased and/or damaged tissue. In this treatment, an artificial construct (scaffold) is seeded with cells, which organize and proliferate into new tissue. The scaffold itself biodegrades with time, leaving behind only newly formed tissue. The degradation qualities of the scaffold are critical during the treatment period, since the change in the mechanical properties of the scaffold with time can influence cell behavior. To observe in time the scaffold's mechanical properties, a straightforward method is to deform the scaffold and then characterize scaffold deflection accordingly. However, experimentally observing the scaffold deflection is challenging. This paper presents a novel study on characterization of mechanical properties of scaffolds by phase contrast imaging and finite element modeling, which specifically includes scaffold fabrication, scaffold imaging, image analysis, and finite elements (FEs) modeling of the scaffold mechanical properties. The innovation of the work rests on the use of in-line phase contrast X-ray imaging at 20 KeV to characterize tissue scaffold deformation caused by ultrasound radiation forces and the use of the Fourier transform to identify movement. Once deformation has been determined experimentally, it is then compared with the predictions given by the forward solution of a finite element model. A consideration of the number of separate loading conditions necessary to uniquely identify the material properties of transversely isotropic and fully orthotropic scaffolds is also presented, along with the use of an FE as a form of regularization.
A Cruise Gas Turbine for Naval Ships
Authors: Johnson H. E.
Published: April 2015

An introduction and brief history lead into the selection of the Tyne by the British Royal Navy for the cruise role in future all-gas-turbine powered ships. The engine redesign, modular approach to the installation, and development and shore trial programs are described, with problems experienced and their solutions. The power plant is now in full production, and an uprating program is progressing to increase the power output by some 25 percent.
Continuously Variable Transmissions for Single-Shaft, Turbine Powered Vehicles
Authors: Kraus C. E. , Gres M. E.
Published: April 2015

The concept, principle of operation, and pertinent characteristics of a continuously variable traction drive transmission are described. The performance, both of a single-shaft powered passenger vehicle and a similarly powered bus/truck, using this type of transmission is presented. Although the traction drive is limited to a 9:1 speed/torque ratio range, various gearing arrangements in combination with the traction drive, which permit the transmission to achieve speed/torque ratio ranges up to 31:1, are discussed, the advantages and disadvantages and appropriate applications of these combinations for single-shaft turbine powered vehicles are discussed. The status of development and results of tests and analyses, which define the efficiencies, life, and capacity of the drives that support the use of this type of transmission for vehicle application, are presented.