bluuebunny/crossref_metadata_2025 huggingface dataset:
The feminisation of contraceptive use: Australian women’s accounts of accessing contraception
Authors: Wigginton Britta , Harris Melissa L. , Loxton Deborah , Herbert Danielle , Lucke Jayne
Published: December 2014

The oral contraceptive pill remains the most widely used contraceptive method. We consider The Pill’s depiction as variously revolutionary and liberating, oppressive for women, and more recently, a ‘lifestyle drug’. Drawing on discourses of (hetero)sex, heterosexuality and gender performance, we discuss how contraceptive use has been feminised and consider the current gap in understanding how women negotiate their positioning as responsible for contraception. To begin to fill this gap, we conducted a thematic discourse analysis using 75 free-text responses (to a general question in a wider contraceptive survey) to explore how women account for their agency and responsibility in discussions of accessing contraception. We identified two themes: responsibility for education and information and ‘finding contraceptive fit’. Women’s discussions of responsibility for education and information highlight the need for transparency from educational bodies, which are positioned as lacking in their delivery of contraceptive information. Women describe “finding contraceptive fit” as an embodied process of experimentation with contraception to ultimately find one with minimal negative side effects. We situate our findings within critiques of the gendered nature and production of health, conceptualising contraceptive use as a distinctly feminine practice, which promotes self-surveillance and embodied awareness.
Mistress Joyce Jeffreys and her physician, Dr Bridstock Harford (1607–1695)
Authors: Connor Henry
Published: December 2014

The notebooks of Joyce Jeffreys, a wealthy Hereford businesswoman in the mid-17th century, provide information about the medicines she purchased and the fees she paid to her medical advisors. Her physician, Dr Bridstock Harford, was a successful doctor but a troublesome neighbour, who was often the subject of litigation. As an ardent parliamentarian, he held public offices during the Commonwealth. Later his opinions mellowed and he ended his days as a loyal subject of the king and a benefactor to his city.
Genotyping of Canine parvovirus in western Mexico
Authors: Pedroza-Roldán César , Páez-Magallan Varinia , Charles-Niño Claudia , Elizondo-Quiroga Darwin , Leonel De Cervantes-Mireles Raúl , López-Amezcua Mario Alberto
Published: December 2014

Canine parvovirus (CPV) is one of the most common infectious agents related to high morbidity rates in dogs. In addition, the virus is associated with severe gastroenteritis, diarrhea, and vomiting, resulting in high death rates, especially in puppies and nonvaccinated dogs. To date, there are 3 variants of the virus (CPV-2a, CPV-2b, and CPV-2c) circulating worldwide. In Mexico, reports describing the viral variants circulating in dog populations are lacking. In response to this deficiency, a total of 41 fecal samples of suspected dogs were collected from October 2013 through April 2014 in the Veterinary Hospital of the University of Guadalajara in western Mexico. From these, 24 samples resulted positive by polymerase chain reaction, and the viral variant was determined by restriction fragment length polymorphism. Five positive diagnosed samples were selected for partial sequencing of the vp2 gene and codon analysis. The results demonstrated that the current dominant viral variant in Mexico is CPV-2c. The current study describes the genotyping of CPV strains, providing valuable evidence of the dominant frequency of this virus in a dog population from western Mexico.
Cluster of cases of massive hemorrhage associated with anticoagulant detection in race horses
Authors: Carvallo Francisco R. , Poppenga Robert , Kinde Hailu , Diab Santiago S. , Nyaoke Akinyi C. , Hill Ashley E. , Arthur Rick M. , Uzal Francisco A.
Published: December 2014

Five horses originating from 4 different California race tracks were submitted to the California Animal Health and Food Safety Laboratory for necropsy and diagnostic workup. The 5 horses had a history of sudden collapse and death during exercise. In all of them, massive hemoperitoneum and hemorrhages in other cavities or organs were observed. The liver from these 5 animals and from 27 horses that had been euthanized due to catastrophic leg injuries (controls) were subjected to a rodenticide anticoagulant screen. Traces of brodifacoum, diphacinone, or bromadiolone were detected in the 5 horses with massive bleeding (5/5), and no traces of rodenticides were detected in control horses (0/27). Other frequent causes of massive hemorrhages in horses were ruled out in 4 of the cases; one of the horses had a pelvic fracture. Although only traces of anticoagulants were found in the livers of these horses and the role of these substances in the massive bleeding remains uncertain, it is speculated that exercise-related increases in blood pressure may have reduced the threshold for toxicity of these anticoagulants.
Hematological values for adult eastern Hermann’s tortoise (Testudo hermanni boettgeri) in semi-natural conditions
Authors: Bielli Mattia , Nardini Giordano , Di Girolamo Nicola , Savarino Paolo
Published: December 2014

Hermann’s tortoise ( Testudo hermanni) is considered near threatened in the wild but, by contrast, it is one of the most popular pet tortoises in Europe. Scant data is reported in the veterinary literature on hematological values for T. hermanni and, to our knowledge, none focused on the subspecies boettgeri (eastern Hermann’s tortoise). Published reports are based on small sample populations, and confusion arises when comparing the sampling sites, the anticoagulants, and the counting methods used. The purpose of the current study was to establish the normal mean values and reference intervals for the main hematological parameters for captive adult T. hermanni boettgeri and to evaluate the reliability of a semiautomated blood analyzer for red blood cell count and hematocrit determination. Blood values were determined in 23 adult tortoises using a Neubauer chamber with Natt and Herrick solution; red blood cells and hematocrit were also measured using a semiautomated blood analyzer. Statistical analysis included descriptive statistics, differences between sexes, and agreement between the counting methods. Reference intervals were calculated with the robust method. Wilcoxon signed rank test with continuity correction was used to investigate differences between sexes, and Bland–Altman analysis was performed to compare manual versus semiautomated values. Red blood cells, hematocrit, and hemoglobin determinations were significantly higher in males than in females. White blood cell counts did not show any sex variability. The agreement of manual versus semiautomated determination was considered acceptable for clinical use.
Planning for Enjoyment in the General Music Classroom
Authors: Koops Lisa Huisman , Keppen Heidi
Published: December 2014

Enjoyment is an important but often overlooked element in the music classroom. In this article, we review research literature related to enjoyment in musical interactions and discuss the role of enjoyment in the general music classroom. Drawing on research literature, our experience as general music teachers, and our research on enjoyment during musical play, we make recommendations for teachers interested in enhancing enjoyment in their classrooms. We include a teacher reflection template and an enjoyable elements guide to assist teachers in applying these ideas in the classroom.
Dynamic homeostasis in packet switching networks
Authors: Oka Mizuki , Abe Hirotake , Ikegami Takashi
Published: December 2014

In this study, we investigate the adaptation and robustness of a packet switching network (PSN), the fundamental architecture of the Internet. We claim that the adaptation introduced by a transmission control protocol congestion control mechanism is interpretable as the self-organization of complex itinerant behavior among many quasi-attracting states. To discuss this argument quantitatively, we study the adaptation of the Internet by simulating a PSN using ns-2. Our hypothesis is that the robustness and fragility of the Internet can be attributed to the inherent dynamics of the PSN feedback mechanism called the congestion window size, or cwnd. By varying the data input into the PSN system, we demonstrate the possible self-organization of attractors in cwnd temporal dynamics and discuss the adaptability and robustness of PSNs. The present study provides an example of Ashby’s Law of Requisite Variety in action.
Laboratory Assessment of the Anticoagulant Activity of Dabigatran
Authors: Kyriakou Elias , Ikonomidis Ignatios , Stylos Dimitrios , Bonovas Stefanos , Papadakis Ioannis , Nikolopoulos Georgios K. , Kokoris Styliani , Kalantzis Dimitrios , Economopoulou Christine , Kopterides Petros , Lekakis John , Tsantes Argirios E.
Published: December 2014

Background:

Our aim was to identify laboratory assays in order to assess the anticoagulant effects of dabigatran etexilate (DE).

Methods:

Twenty patients with nonvalvular atrial fibrillation treated on DE (110 mg per os twice daily) and 20 on acenocoumarol were studied. Conventional coagulation tests, endogenous thrombin potential (ETP), thromboelastometry (ROTEM), epinephrine-induced light transmission aggregometry (LTA), and Hemoclot Thrombin Inhibitors (HTI) were performed in all patients.

Results:

In ROTEM analysis, the lysis index at 60 minutes was significantly lower in patients receiving DE ( P = .011). In LTA, patients on DE showed decreased aggregation compared to those on acenocoumarol, marginally insignificant ( P = .068). Regarding ETP, acenocoumarol affected thrombin generation more than dabigatran (area under the curve [AUC], P < .001), while statistically significant associations were detected between dabigatran levels, as determined by the HTI assay, and almost all parameters of ETP assay (AUC, P < .001).

Conclusion:

The role of ETP in estimating anticoagulant activity of dabigatran possibly requires further research.
Evaluating Lease-Purchase Financing for Professional Sports Facilities
Authors: Propheter Geoffrey , Hatch Megan E.
Published: December 2014

In 2012, the city of Seattle, Washington, entered into a public–private partnership (P3) whose goal was the construction and operation of a new sports arena. The cornerstone of the P3 was a unique lease-purchase financing (LPF) agreement markedly different from lease-purchase contracts that governments typically use for acquiring capital goods. This article has a twofold objective. First, it details Seattle’s agreement and contrasts it with other relevant P3s. Second, it identifies a number of potential sources of additional public costs and risks overlooked in the subsidy debate. Because it offers local governments and franchise owners a number of benefits, it is anticipated that Seattle’s lease-purchase model will be used by other municipalities in the future. This case study can be used in future LPF subsidy debates to improve public-sector outcomes.
Comparisons of Intelligence and Behavior in Children With Fetal Alcohol Spectrum Disorder and ADHD
Authors: Raldiris Tarah L. , Bowers Thomas G. , Towsey Carla
Published: December 2014

Objective: Children with fetal alcohol spectrum disorder (FASD) can easily be misdiagnosed as having ADHD. Method: A total of 164 children were compared on cognitive and behavioral measures for four groups of children: FASD, ADHD, FASD + ADHD, and other neuropsychological disorders. Results: The ADHD group was not significantly different from the “other diagnosis” group on any of the measurements. The children with FASD were found to perform significantly worse than ADHD on externalizing problems, Full-Scale IQ, and indices of Verbal Comprehension, Perceptual Reasoning, and Working Memory. The comorbid FASD + ADHD group was significantly weaker than ADHD on verbal comprehension measures. The FASD children demonstrated significantly higher levels of atypicality and aggression relative to ADHD, and the FASD + ADHD group demonstrated significantly higher levels of hyperactivity and withdrawal relative to ADHD. Conclusion: These results indicate that children with FASD display a differential behavioral and cognitive profile that is significantly poorer than children with ADHD and other types of neuropsychological disorders.
Priming for Social Activities
Authors: Gengoux Grace W.
Published: December 2014

This study examined whether brief priming sessions (i.e., previewing activities with an adult ahead of time) would increase the rate of initiations made by children with autism to peers in inclusive settings. A multiple baseline across participants design assessed changes in rate of initiations, as well as statements reflecting target child competence and positive affect. Following priming, all four participants with autism demonstrated increased rates of peer initiations, and they generalized these gains to unprimed activities. Children with autism and peers also verbalized statements reflecting the competence of the child with autism and exhibited stable or improved levels of positive affect. Results are discussed in terms of theoretical and practical implications for future research and clinical care.
Occlusion and malocclusion in the cat
Authors: Milella Lisa
Published: December 2014

Practical relevance:

Malocclusion affecting cats, and treatment thereof, has not been widely described in the veterinary literature, yet is a condition seen in a growing number of breeds, often causing pain and discomfort to the patient. Recognising the problem, and certainly whether it is a hereditary problem (eg, a skeletal malocclusion), is important for the longer term health of pedigree breeds.

Clinical challenges:

If there is a malocclusion, the mouth may be painful and a thorough occlusal assessment of the conscious patient may be difficult. Occlusal assessment should always be accompanied by a thorough oral examination and, where necessary, further investigation under general anaesthesia, including dental radiography. Recognising what is normal, and what is not, can be challenging; so, too, can be determining the correct time to intervene.

Audience:

This article is intended to help fill the gap in dental education regarding the range of developmental and acquired malocclusions seen in cats. Treatment options are also briefly reviewed.

Evidence base:

The guidance contained in this article is based on a combination of the published literature, the author’s personal experience and that of colleagues.
Tooth resorption in cats
Authors: Gorrel Cecilia
Published: December 2014

Practical relevance:

Tooth resorption is common in the domestic cat and the incidence has been reported to increase with increasing age. Cats with clinically missing teeth have also been found to be more likely to have tooth resorption. All types of teeth in the feline dentition may be affected, but lesions seem to be more common in certain teeth.

Clinical challenges:

Tooth resorption can be difficult to detect, with cats often masking signs of oral discomfort or pain. Routine radiography is required for timely diagnosis, as clinical (visual and tactile) methods only detect late-stage lesions – that is, when they become evident in the crown. The aetiology of many tooth resorptions is not clear. A large number of lesions appear to be idiopathic and, to date, there is no known treatment that prevents the development and/or progression of this category of tooth resorption. Tooth extraction is the gold standard treatment but teeth with resorptive lesions are notoriously difficult to extract and coronal amputation is often indicated. Determining the best treatment option in an individual case again relies on radiography.

Audience:

This review is aimed at feline and general practitioners, as well as veterinarians with expertise in dentistry.

Evidence base:

The author draws on the published literature and her clinical experience and own research to review current thinking about the epidemiology, aetiology and pathogenesis of tooth resorptions, and to offer advice on diagnosis and treatment options.
Pulse pressure does not predict the response of diabetic nephropathy to glucose-lowering therapy
Authors: Nakhjavani Manouchehr , Nargesi Arash Aghajani , Heidari Behnam , Ghazizadeh Zaniar , Larry Mehrdad , Esteghamati Alireza
Published: December 2014

We aimed to study whether pulse pressure (PP) predicts the response of diabetic nephropathy to glucose-lowering treatment. Patients with uncontrolled type 2 diabetes were followed for decrease in albuminuria after insulin/oral-hypoglycemic treatment. A total of 143 patients were followed for a median time of 10.5 months in a cohort study. Fasting blood sugar and HbA1C significantly decreased, while systolic, diastolic and pulse pressures remained constant during intervention. Median albuminuria decreased from 18.4 mg/day [10–40] to 16.4 mg/day [9–28] at the end of study (p-value < 0.005). The number of patients with normo/micro/macro-albuminuria changed from 98/36/9 to 108/31/4 (p-value < 0.001). No significant difference in baseline PP (47.5 ±1.61 vs. 45.9 ±1.81 mmHg; p-value = 0.51) or final PP (47.0 ±2.41 vs. 49.4 ±2.38 mmHg; p-value = 0.47) existed between those with decreased and increased albuminuria. PP was not a significant predictor of albuminuria changes in receiver operating characteristic curve (p-value = 0.77) and regression (p-value = 0.98) analyses. Benefits of glycemic control in diabetic nephropathy are independent of PP.
Thermal and mechanical behavior of innovative melt-blown fabrics based on polyamide nanocomposites
Authors: Dorigato Andrea , Brugnara Marco , Giacomelli Gianmarco , Fambri Luca , Pegoretti Alessandro
Published: December 2014

A commercial organo-modified clay (OMC) was added to a polyamide 6 (PA6) matrix at various concentrations during the polymerization stage or by melt compounding in a twin-screw extruder, and the resulting pellets were used for the production of depth filters in the shape of cylindrical nonwoven webs through a melt-blown process. The processability of the investigated materials was significantly affected by nanofiller introduction. Differential scanning calorimetry revealed that OMCs play a nucleating effect on the crystallization of the polyamide matrix, with a remarkable increase in the crystallization temperature on cooling from the melt. Consequently, a parameter related to the filtering performances of the web, such as the pressure drop (Δ P) evaluated on cylindrical filters, decreased with the increase in die-to-collector distance in a more pronounced way for nanocomposite nonwovens. This behavior was related to the significant decrease of the connecting points in the networks due to the rapid cooling of the filaments on the collecting mandrel. Compressive mechanical tests evidenced how organoclay addition led to a remarkable increase of the rigidity of the web, when the data were compared at the same Δ P value, irrespectively from the preparation technique.
Can interactive educational technologies support the link between ultrasound theory and practice via feedback mechanisms?
Authors: Dickson Diane
Published: December 2014

Linking theory to practice is an area of concern for ultrasound students, clinical mentors and academic staff. The link between theory and practice requires a robust clinical mentorship scheme in addition to careful curricula design considerations to improve student outcomes. The introduction of interactive technology in education provides ripe opportunity to improve feedback to students to support the link between theory and practice. A series of three interactive learning and teaching activities were designed and delivered to a PostGraduate Ultrasound cohort, after which, evaluation was performed to answer the research question: Which interactive technologies support the link between theory and practice through improved feedback mechanisms? An action research methodology was adopted involving an enquiry based literature review, planning, design and action process. Data were collected following action of three interactive teaching and learning sessions within the Medical Ultrasound cohort of 2013/2014 at Glasgow Caledonian University via a paper based questionnaire. A 100% response rate was achieved ( n = 14). All three interactive learning and teaching sessions were considered with 100% highest point agreement to support the link between ultrasound theory and practice via feedback. Students found all three designed and facilitated sessions valuable and relevant to their learning, which in turn provided positive experiences which were perceived to support the link between theory and practice through feedback. These activities can be considered valuable in Postgraduate Ultrasound education.
Food choice by people with intellectual disabilities at day centres
Authors: Cartwright Luke , Reid Marie , Hammersley Richard , Blackburn Chrissie , Glover Lesley
Published: December 2014

People with intellectual disabilities experience a range of health inequalities. It is important to investigate possible contributory factors that may lead to these inequalities. This qualitative study identified some difficulties for healthy eating in day centres. (1) Service users and their family carers were aware of healthy food choices but framed these as diets for weight loss rather than as everyday eating. (2) Paid carers and managers regarded the principle of service user autonomy and choice as paramount, which meant that they felt limited in their capacity to influence food choices, which they attributed to the home environment. (3) Carers used food as a treat, a reward and for social bonding with service users. (4) Service users’ food choices modelled other service users’ and carers’ choices at the time. It is suggested that healthy eating should be made more of a priority in day care, with a view to promoting exemplarily behaviour that might influence food choice at home.
Unfree Labour under Capitalism: A Contradiction in (Useful) Terms
Authors: Rao J. Mohan
Published: December 2014

Is free labour under capitalism a contradiction in terms? Two aspects of this long-debated question are considered. One is the divide between the libertarian insistence on individual freedom and the socialist contention of proletarian class unfreedom. Is there a viewpoint free of judgments or valuations as to what is or is not interesting or valuable about any given view of freedom? We argue that the Rawlsian original position defines a value-free benchmark of maximal freedom from which the degree of unfreedom under any set of social rules can be assessed. While negative individual freedom and class unfreedom are not incompatible, ‘free labour under capitalism’ has got to be a contradiction in terms. But capitalism classically defined is production by doubly ‘free’ labour which sharply distinguishes it from forms of ‘unfree’ labour that constitute its pre-history. This raises both conceptual and substantive empirical questions defining the second divide we consider, between Marx’s view linking capitalism and free labour and its detractors. Our contention is that keeping capitalism and unfree labour properly apart is a practical imperative of the continued use of these historically fruitful categories even if, as a corollary, ‘unfree labour under capitalism’ must seem a contradiction in terms.
Discontents and Resistance of ‘Unverified’ Ex-combatants and Challenges to their Rehabilitation in Nepal
Authors: Subedi D.B.
Published: December 2014

Economic rehabilitation of ex-combatants, which plays a salient role in transforming ex-combatants into civilians, is a highly context-specific transformative process often taking place in post-conflict peace building. Its context-specific nature means that every rehabilitation programme is considerably different from the other. On one hand, there is a lack of understanding of the micro–macro factors and dynamics that affect the process and outcome of a rehabilitation programme; on the other hand, there is also a lack of an analytical framework that can be applied to assess the effectiveness of rehabilitation programmes. This article develops a four dimensional analytical framework which is applied to study the economic rehabilitation of verified minors and late recruits Maoist ex-combatants in Nepal. The framework is based on the data collected in eight districts of Nepal.
In Defense of Intellectual Autonomy: A Response to Hendricks
Authors: Moyo Sam , Jha Praveen , Yeros Paris
Published: December 2014

This article is a response to Fred Hendricks’ critique of our most recent statement on the classical and contemporary agrarian questions. The critique, we believe, is a gross misunderstanding of our position on a variety of issues, including populism, nationalism, the character of the peasantry and industrialization. In defence of our intellectual integrity and autonomy, we restate here our basic positions and outline the trajectory of our collective research projects, in the hope that our positions are put into better perspective.
Nickel and silver coated nano-SiO2 with excellent conductivity and permeability
Authors: Li X F. , Chang Z Z. , Zhang Y S. , Gao G X.
Published: December 2014

Considering the importance of electromagnetic shielding fillers in the advanced electromagnetic shielding material and the shortcomings of the current fillers in electrical and magnetic conductivity properties, a facile two-step electroless plating process, including coating nickel layer onto nano-SiO2 followed by coating another Ag layer onto SiO2/Ni obtained, was developed to fabricate electromagnetic shielding fillers in this study. The effects of SiO2 loadings on the thickness, density, magnetic permeability and electric conductivity of as obtained SiO2/Ni/Ag fillers have been investigated completely. The results indicated the thickness of Ni and Ag layer could be finely tuned by changing the content of SiO2 and SiO2/Ni during electroless plating processes. The optimised SiO2/Ni/Ag nanocomposites demonstrate high magnetic permeability and excellent electrical conductivity with 1·60×10−5 H m and 1·82×10−5 Ω m respectively. This method provides a facile and low cost strategy to fabricate nano-fillers for the polymer based electromagnetic shielding composite materials.
Modifying the Rizzoli foot model to improve the diagnosis of pes‐planus: application to kinematics of feet in teenagers
Authors: Portinaro Nicola , Leardini Alberto , Panou Artemisia , Monzani Valerio , Caravaggi Paolo
Published: December 2014

Background

A number of multi‐segment foot protocols have been proposed to obtain measurements of clinical value. In the clinical assessment of foot pathologies and deformities, such as in the pes‐planus, the frontal‐plane alignment of the calcaneus and the dynamic properties of the medial longitudinal arch are critical parameters though often neglected by the majority of foot protocols. The aim of the present work is to modify an established foot protocol to obtain static and kinematic measures more consistent with corresponding clinical observations. Moreover, while many papers have reported kinematic data from varying populations, few investigations have focussed on young participants from same‐age cohorts.

Methods

A 6‐camera motion capture system was employed to track the shank, rear‐, mid‐ and fore‐foot segments in the left and right leg of 10 children (13.1 ± 0.8 years) during gait. Three markers were attached to each segment thus allowing for triplanar motion of five joints to be described according to the Rizzoli Foot Model. An additional marker was attached to the posterior bottom of the calcaneus to enhance measurement of frontal‐plane orientation. Description of the medial longitudinal arch angle was redefined to be more consistent with rearfoot orientation and to common clinical assessments. A novel 3‐marker description of the hallux segment was implemented to improve robustness in calculating 1st metatarso‐phalangeal joint rotations.

Results

Foot segments kinematics showed good inter‐ participant repeatability and overall consistency with previous similar reports. 15 out of 20 feet showed neutral or slightly valgus orientation of the calcaneus. Relatively large medial longitudinal arch angles (mean 186 ± 16 deg) were found in the present young population. Both measurements were reasonably in accordance with the relevant clinical observations of these feet.

Conclusions

Modifications to a widely used multisegmental foot kinematic model were implemented to improve robustness and consistency with relevant clinical observations. A detailed description of foot joints motion during barefoot walking in a population of 13‐year old children with apparent flat feet has been presented, which may provide useful information to investigate the development of gait in children and the diagnosis of flexible flat foot.
Percutaneous and surgical tracheostomy in critically ill adult patients: a meta-analysis
Authors: Putensen Christian , Theuerkauf Nils , Guenther Ulf , Vargas Maria , Pelosi Paolo
Published: December 2014

Introduction

The aim of this study was to conduct a meta-analysis to determine whether percutaneous tracheostomy (PT) techniques are advantageous over surgical tracheostomy (ST), and if one PT technique is superior to the others.

Methods

Computerized databases (1966 to 2013) were searched for randomized controlled trials (RCTs) reporting complications as predefined endpoints and comparing PT and ST and among the different PT techniques in mechanically ventilated adult critically ill patients. Odds ratios (OR) and mean differences (MD) with 95% confidence interval (CI), and I2 values were estimated.

Results

Fourteen RCTs tested PT techniques versus ST in 973 patients. PT techniques were performed faster (MD, −13.06 minutes (95% CI, −19.37 to −6.76 (P <0.0001)); I2 = 97% (P <0.00001)) and reduced odds for stoma inflammation (OR, 0.38 (95% CI, 0.19 to 0.76 (P = 0.006)); I2 = 2% (P = 0.36)), and infection (OR, 0.22 (95% CI, 0.11 to 0.41 (P <0.00001)); I2 = 0% (P = 0.54)), but increased odds for procedural technical difficulties (OR, 4.58 (95% CI, 2.21 to 9.47 (P <0.0001)); I2 = 0% (P = 0.63)). PT techniques reduced odds for postprocedural major bleeding (OR, 0.39 (95% CI, 0.15 to 0.97 (P = 0.04)); I2 = 0% (P = 0.69)), but not when a single RCT using translaryngeal tracheostomy was excluded (OR, 0.58 (95% CI, 0.21 to 1.63 (P = 0.30)); I2 = 0% (P = 0.89)). Eight RCTs compared different PT techniques in 700 patients. Multiple (MDT) and single step (SSDT) dilatator techniques are associated with the lowest odds for difficult dilatation or cannula insertion (OR, 0.30 (95% CI, 0.12 to 0.80 (P = 0.02)); I2 = 56% (P = 0.03)) and major intraprocedural bleeding (OR, 0.29 (95% CI, 0.10 to 0.85 (P = 0.02)); I2 = 0% (P = 0.72)), compared to the guide wire dilatation forceps technique.

Conclusion

In critically ill adult patients, PT techniques can be performed faster and reduce stoma inflammation and infection but are associated with increased technical difficulties when compared to ST. Among PT techniques, MDT and SSDT were associated with the lowest intraprocedural risks and seem to be preferable.
The efficacy and safety of plasma exchange in patients with sepsis and septic shock: a systematic review and meta-analysis
Authors: Rimmer Emily , Houston Brett L , Kumar Anand , Abou-Setta Ahmed M , Friesen Carol , Marshall John C , Rock Gail , Turgeon Alexis F , Cook Deborah J , Houston Donald S , Zarychanski Ryan
Published: December 2014

Introduction

Sepsis and septic shock are leading causes of intensive care unit (ICU) mortality. They are characterized by excessive inflammation, upregulation of procoagulant proteins and depletion of natural anticoagulants. Plasma exchange has the potential to improve survival in sepsis by removing inflammatory cytokines and restoring deficient plasma proteins. The objective of this study is to evaluate the efficacy and safety of plasma exchange in patients with sepsis.

Methods

We searched MEDLINE, EMBASE, CENTRAL, Scopus, reference lists of relevant articles, and grey literature for relevant citations. We included randomized controlled trials comparing plasma exchange or plasma filtration with usual care in critically ill patients with sepsis or septic shock. Two reviewers independently identified trials, extracted trial-level data and performed risk of bias assessments using the Cochrane Risk of Bias tool. The primary outcome was all-cause mortality reported at longest follow-up. Meta-analysis was performed using a random-effects model.

Results

Of 1,957 records identified, we included four unique trials enrolling a total of 194 patients (one enrolling adults only, two enrolling children only, one enrolling adults and children). The mean age of adult patients ranged from 38 to 53 years (n = 128) and the mean age of children ranged from 0.9 to 18 years (n = 66). All trials were at unclear to high risk of bias. The use of plasma exchange was not associated with a significant reduction in all-cause mortality (risk ratio (RR) 0.83, 95% confidence interval (CI) 0.45 to 1.52, I2 60%). In adults, plasma exchange was associated with reduced mortality (RR 0.63, 95% CI 0.42 to 0.96; I2 0%), but was not in children (RR 0.96, 95% CI 0.28 to 3.38; I2 60%). None of the trials reported ICU or hospital lengths of stay. Only one trial reported adverse events associated with plasma exchange including six episodes of hypotension and one allergic reaction to fresh frozen plasma.

Conclusions

Insufficient evidence exists to recommend plasma exchange as an adjunctive therapy for patients with sepsis or septic shock. Rigorous randomized controlled trials evaluating clinically relevant patient-centered outcomes are required to evaluate the impact of plasma exchange in this condition.
Fibroblast growth factor 23 in acute myocardial infarction complicated by cardiogenic shock: a biomarker substudy of the Intraaortic Balloon Pump in Cardiogenic Shock II (IABP-SHOCK II) trial
Authors: Fuernau Georg , Pöss Janine , Denks Daniel , Desch Steffen , Heine Gunnar H , Eitel Ingo , Seiler Sarah , de Waha Suzanne , Ewen Sebastian , Link Andreas , Schuler Gerhard , Adams Volker , Böhm Michael , Thiele Holger
Published: December 2014

Introduction

Cardiogenic shock (CS) is the leading cause of death in patients hospitalized with acute myocardial infarction (AMI). Biomarkers might help in risk stratification and understanding of pathophysiology. Preliminary data suggests that patients with CS face a profound increase in the osteocyte-derived hormone fibroblast growth factor 23 (FGF-23), which acts as a negative regulator of serum phosphate levels. The present study aimed to assess the predictive role of FGF-23 for clinical outcome in a large cohort of CS patients with and without renal dysfunction.

Methods

In the randomized Intraaortic Balloon Pump in Cardiogenic Shock II (IABP-SHOCK II) trial, 600 patients with CS complicating AMI were assigned to therapy with or without IABP. Our predefined biomarker substudy included 182 patients. Blood sampling was performed in a standardized procedure at three different time points (day 1 (day of admission), day 2 and day 3). Differences in outcome of patients with FGF-23 levels < and > median were compared by log-rank testing. Stepwise logistic regression modeling was performed to identify predictors of death at 30 days and Cox regression analysis for time to death during the first year.

Results

At all three time points, nonsurvivors had significantly higher FGF-23 levels compared to survivors (P <0.001 for all). Patients with FGF-23 levels above the median (395 RU/mL [interquartile range 102;2,395]) were characterized by an increased 30-day mortality and 1-year mortality. In multivariable analysis FGF-23 levels remained independent predictors for 30-day (odds ratio per 10log 1.80, 95% confidence interval (CI) 1.11 to 2.92; P = 0.02) and 1-year mortality (hazard ratio 1.50, 95% CI 1.11 to 2.04, P = 0.009). After stratifying the patients according to their baseline serum creatinine levels, the negative prognostic association of increased FGF-23 was only significant in those with serum creatinine greater than median.

Conclusions

In CS, high levels of FGF-23 are independently related to a poor clinical outcome. However, this prognostic association appears only to apply in patients with impaired renal function.

Trial registration

ClinicalTrials.gov NCT00491036. Registered 22 June 2007.
Paraoxonase-1 gene Q192R and L55M polymorphisms and risk of cardiovascular disease in Egyptian patients with type 2 diabetes mellitus
Authors: El-Lebedy Dalia , Kafoury Mona , Abd-El Haleem Dalia , Ibrahim Alshaymaa , Awadallah Eman , Ashmawy Ingy
Published: December 2014

Background

Increased oxidative stress or an impaired antioxidant defense mechanism may play a crucial role in the onset and progression of atherosclerosis. Recently, Paraoxonase −1 (PON1) which accounts for most of the antioxidant effect of high density lipoprotein (HDL) cholesterol has been presented as a potential therapeutic agent against atherosclerosis development. Allele frequencies for PON1 gene that influence enzyme concentration as well as activity differ greatly among ethnic groups and data from several studies showed ethnic variations in the interpretation of cardiovascular disease (CVD) associated with PON1 polymorphisms. In this work, we investigated PON1 Q192R and L55M polymorphisms in Egyptian patients with type 2 diabetes mellitus (T2DM) and its association with CVD.

Methods

The study included 184 subjects classified into 3 groups; T2DM, T2DM + CVD, and healthy controls. PON1 polymorphisms were genotyped by real-time PCR and PON1 concentration was assayed in serum by ELISA (enzyme linked immunesorbent assay).

Results

Genotype and allele frequencies of Q192R were significantly different between controls and diabetic patients. Frequency of QQ genotype was significantly higher in healthy controls, while QR and RR genotypes were significantly higher in diabetic patients (p = 0.02). Frequency of 55LL and LM genotypes were significantly higher in patients than in controls (p = 0.009). Q192R polymorphism associated with CVD in our diabetic patients (p = 0.01) and with low serum PON1 concentration (p = 0.04). Multiple logistic regression analysis revealed significant correlations between 192R and other independent CVD risk factors.

Conclusion

PON1 192R and 55 L alleles are associated with T2DM. Q192R polymorphism is associated with CVD and lower serum enzyme concentration and might represents a novel risk factor for CVD in Egyptian patients with T2DM.
Edge enhancement of magnetic data using fractional-order-derivative filters
Authors: Arısoy Muzaffer Özgü , Dikmen Ünal
Published: December 2014

Edge enhancement and detection techniques are fundamental operations in magnetic data interpretation. Many techniques for edge enhancement have been developed, some based on profile data and others designed for grid-based data sets. Methods that are traditionally applied to magnetic data, such as total horizontal derivative (THD) and analytic signal (AS), require the computation of integer-order horizontal and vertical derivatives of the magnetic data. However, if the data set contains features with a large variation in amplitude, then the features with small amplitudes may be difficult to outline. In addition, because most edge enhancement and detection filters are derivative-based filters, they also amplify high-frequency noise content in the data. As a result, the accuracy of derivative-based filters is restricted to data of high quality. We suggested the modification of the THD and AS filters by combining the amplitude spectra of fractional-order-derivative filters with ad hoc phase spectra, particularly designed for edge detection in magnetic data. We revealed the capability of the proposed algorithm on synthetic magnetic data and on aeromagnetic data from Turkey. Compared with the traditional use of THD and AS (with integer-order derivatives), we developed the method based on fractional-order derivatives that produced more effective results in terms of suppressing noise and delineating the edges of deep sources.
Leptin Normalizes Photic Synchronization in Male ob/ob Mice, via Indirect Effects on the Suprachiasmatic Nucleus
Authors: Grosbellet Edith , Gourmelen Sylviane , Pévet Paul , Criscuolo François , Challet Etienne
Published: December 2014

Mounting evidence indicates a strong link between metabolic diseases and circadian dysfunctions. The metabolic hormone leptin, substantially increased in dietary obesity, displays chronobiotic properties. Here we investigated whether leptin is involved in the alteration of timing associated with obesity, via direct or indirect effects on the suprachiasmatic nucleus (SCN), the site of the master clock. Photic synchronization was studied in obese ob/ob mice (deficient in leptin), either injected or not with high doses of recombinant murine leptin (5 mg/kg). This was performed first at a behavioral level, by shifting the light-dark cycle and inducing phase shifts by 30-minute light pulses and then at molecular levels (c-FOS and P-ERK1/2). Moreover, to characterize the targets mediating the chronomodulatory effects of leptin, we studied the induction of phosphorylated signal transducer and activator of transcription 3 (P-STAT3) in the SCN and in different structures projecting to the SCN, including the medial hypothalamus. Ob/ob mice showed altered photic synchronization, including augmented light-induced phase delays. Acute leptin treatment normalized the photic responses of the SCN at both the behavioral and molecular levels (decrease of light-induced c-FOS). Leptin-induced P-STAT3 was modulated by light in the arcuate nucleus and both the ventromedial and dorsomedial hypothalamic nuclei, whereas its expression was independent of the presence of leptin in the SCN. These results suggest an indirect action of leptin on the SCN, possibly mediated by the medial hypothalamus. Taken together, these results highlight a central role of leptin in the relationship between metabolic disturbances and circadian disruptions.
Male Bovine GH Transgenic Mice Have Decreased Adiposity With an Adipose Depot-Specific Increase in Immune Cell Populations
Authors: Benencia Fabian , Harshman Stephanie , Duran-Ortiz Silvana , Lubbers Ellen R. , List Edward O. , Householder Lara , Al-Naeeli Mawadda , Liang Xiaoyu , Welch Lonnie , Kopchick John J. , Berryman Darlene E.
Published: December 2014

White adipose tissue (WAT) is composed of mature adipocytes and a stromal vascular fraction (SVF), which contains a variety of cells, including immune cells that vary among the different WAT depots. Growth hormone (GH) impacts immune function and adiposity in an adipose depot-specific manner. However, its effects on WAT immune cell populations remain unstudied. Bovine GH transgenic (bGH) mice are commonly used to study the in vivo effects of GH. These giant mice have an excess of GH action, impaired glucose metabolism, decreased adiposity, increased lean mass, and a shortened lifespan. Therefore, the purpose of this study was to characterize the WAT depot-specific differences in immune cell populations in the presence of excess GH in vivo. Three WAT depots were assessed: inguinal (sc), epididymal (EPI), and mesenteric (MES). Subcutaneous and MES bGH WAT depots showed a significantly higher number of total SVF cells, yet only MES bGH WAT had higher leukocyte counts compared with control samples. By means of flow cytometry analysis of the SVF, we detected greater macrophage and regulatory T-cell infiltration in sc and MES bGH WAT depots compared with controls. However, no differences were observed in the EPI WAT depot. RNA-sequencing confirmed significant alterations in pathways related to T-cell infiltration and activation in the sc depot with fewer significant changes in the EPI bGH WAT depot. These findings collectively point to a previously unrecognized role for GH in influencing the distribution of WAT immune cell populations in a depot-specific manner.
Comparative structural and functional analysis of the larval and adult dorsal vessel and its role in hemolymph circulation in the mosquito Anopheles gambiae
Authors: League Garrett P. , Onuh Ogechukwu C. , Hillyer Julián F.
Published: December 2014

Hemolymph circulation in insects is driven primarily by the contractile action of a dorsal vessel, which is divided into an abdominal heart and a thoracic aorta. As holometabolous insects, mosquitoes undergo striking morphological and physiological changes during metamorphosis. This study presents a comprehensive structural and functional analysis of the larval and adult dorsal vessel in the malaria mosquito Anopheles gambiae. Using intravital video imaging we show that, unlike the adult heart, the larval heart contracts exclusively in the anterograde direction and does not undergo heartbeat directional reversals. The larval heart contracts 30% slower than the adult heart, and hemolymph travels across the larval dorsal vessel at a velocity that is 215% slower than what is seen in adults. By fluorescently labeling muscle tissue we show that although the general structure of the heart and its ostia are similar across life stages, the heart-associated alary muscles are significantly less robust in larvae. Furthermore, unlike the adult ostia, which are the entry points for hemolymph into the heart, the larval ostia are almost entirely lacking in incurrent function. Instead, hemolymph enters the larval heart through incurrent openings located at the posterior terminus of the heart. These posterior openings are structurally similar across life stages, but in adults have an opposite, excurrent function. Finally, the larval aorta and heart differ significantly in the arrangement of their cardiomyocytes. In summary, this study provides an in-depth developmental comparison of the circulatory system of larval and adult mosquitoes.
Highly Efficient Thermally Activated Delayed Fluorescence Emitters with a Small Singlet–Triplet Energy Gap and Large Oscillator Strength
Authors: Sagara Yuta , Shizu Katsuyuki , Tanaka Hiroyuki , Miyazaki Hiroshi , Goushi Kenichi , Kaji Hironori , Adachi Chihaya
Published: December 2014

A strategy for designing highly efficient thermally activated delayed fluorescence (TADF) emitters was reported. TADF emitters with donor–acceptor–donor (D–A–D)-type structures showed highly efficient TADF because of their small singlet–triplet energy gap and large oscillator strength. An organic light-emitting diode containing a D–A–D-type TADF emitter, cis-BOX2, exhibited a high external electroluminescence quantum efficiency of 17.6%.
EFEITOS DO TABAGISMO NA FUNCIONALIDADE PULMONAR
Authors: Kock Kelser de Souza , Barros Hektor França
Published: December 2014

O tabagismo é um hábito frequente entre os brasileiros, causador de doenças que podem ser evitáveis, e um dos maiores causadores de morte por câncer de pulmão, doença coronariana, DPOC e AVC. O objetivo deste estudo foi avaliar a funcionalidade pulmonar, dispneia, índices socioeconômicos e perfil dos pacientes relacionado com o tabagismo, em pacientes que participam do programa de controle ao tabagismo do SUS em Tubarão – SC no ano de 2013. Foram avaliados 39 pacientes, sendo 76,9% mulheres, com idade média de 52 ± 10 anos e IMC médio de 28 ± 4 kg/m2. A carga tabágica foi de 44 anos-maço, com 41% dos indivíduos com dependência a nicotina grave, HAS e depressão como morbidades mais frequentes, escolaridade principalmente ensino fundamental incompleto (46,2%) e 51,2% com renda de até um salario mínimo. Foram demonstradas associações significativas entre tabagismo (anos-maço) e dependência à nicotina (r = 0,494; p = 0,001), dispneia (r = 0,424; p = 0,007) e variáveis espirométricas: VEF1 (r = -0,323; p = 0,045), VEF1/CVF (r = -0,391; p = 0,014) e FEF25-75 (r = -0,338; p = 0,035). A função pulmonar media dos pacientes foi considerada normal. Conclui-se que as variáveis relacionadas à obstrução pulmonar estão associadas à carga de tabagismo, destacando o papel da espirometria como ferramenta para a identificação dos tabagistas com probabilidade de desenvolver doença respiratória.