bluuebunny/crossref_metadata_2025 huggingface dataset:
An efficient transmission mode selection based on reinforcement learning for cooperative cognitive radio networks
Authors: Rahman Md. Arifur , Lee Young-Doo , Koo Insoo
Published: April 2016

Cooperative communication systems use cooperative relays for transmitting their data packets to the destination. Cooperative communication schemes having all relays participating in transmission may cause unnecessary wastes of most valuable spectrum resources. So it is mandatory to effectively select a transmission mode for cooperative cognitive radio networks (CCRNs). In this paper, an efficient transmission mode scheme based on Q-learning algorithm is proposed. State, action, and reward are defined to achieve a good performance on time delay and energy efficiency in data transmission as well as the interference to primary users during secondary users transmission. The proposed scheme selects an optimal action on the networks environment to maximize the total revenue of the multilateral metric. The simulation result shows that the proposed scheme can efficiently support the determination for the transmission mode and outperforms conventional schemes for a single metric in CCRNs.
Sensitivity of dendritic cells to NK-mediated lysis depends on the inflammatory environment and is modulated by CD54/CD226-driven interactions
Authors: Smith Laura E , Olszewski Marcin A , Georgoudaki Anna-Maria , Wagner Arnika K , Hägglöf Thomas , Karlsson Mikael C I , Dominguez-Villar Margarita , Garcia-Cozar Francisco , Mueller Steffan , Ravens Inga , Bernhardt Günter , Chambers Benedict J
Published: April 2016

Previous studies have suggested that NK cells may limit T cell responses by their ability to eradicate dendritic cells, as demonstrated by NK cell-mediated killing of dendritic cells generated from mouse bone marrow cells or human monocytes with GM-CSF. In the present study, we demonstrated that conventional dendritic cells, generated in vitro with Flt3 ligand or from spleens, were resistant to NK cell-mediated lysis. However, upon stimulation with GM-CSF, NK cells could mediate lysis of these dendritic cells. GM-CSF-stimulated Flt3 ligand dendritic cells or splenic dendritic cells increased surface expression of costimulatory molecules and known NK cell ligands. Likewise, NK cells could target dendritic cells in vivo, which could be inhibited, in part, by anti-GM-CSF antibodies. The blocking of CD54 or CD226 inhibited NK cell-mediated cytotoxicity of the GM-CSF-stimulated Flt3 ligand conventional dendritic cells. Furthermore, the CD226+NKG2A− subset of NK cells was selectively better at targeting GM-CSF-stimulated Flt3 ligand conventional dendritic cells. However, CD155, a known ligand for CD226, could also act as an inhibitor of NK cell-mediated lysis, as dendritic cells lacking CD155 were more sensitive to NK cell-mediated lysis than wild-type dendritic cells. We hypothesize that by only permitting a subset of NK cells to target activated dendritic cells during inflammation, this would allow the immune system to balance between dendritic cells able to drive adaptive immune responses and dendritic cells targeted for elimination by NK cells to hinder, e.g., spread of infection.
JAK/STAT regulation of Aspergillus fumigatus corneal infections and IL-6/23-stimulated neutrophil, IL-17, elastase, and MMP9 activity
Authors: Taylor Patricia R , Roy Sanhita , Meszaros Evan C , Sun Yan , Howell Scott J , Malemud Charles J , Pearlman Eric
Published: April 2016

IL-6 and IL-23 (IL-6/23) induce IL-17A (IL-17) production by a subpopulation of murine and human neutrophils, resulting in autocrine IL-17 activation, enhanced production of reactive oxygen species, and increased fungal killing. As IL-6 and IL-23 receptors trigger JAK1, −3/STAT3 and JAK2/STAT3 phosphorylation, respectively, we examined the role of this pathway in a murine model of fungal keratitis and also examined neutrophil elastase and gelatinase (matrix metalloproteinase 9) activity by IL-6/23-stimulated human neutrophils in vitro. We found that STAT3 phosphorylation of neutrophils in Aspergillus fumigatus-infected corne as was inhibited by the JAK/STAT inhibitor Ruxolitinib, resulting in impaired fungal killing and decreased matrix metalloproteinase 9 activity. In vitro, we showed that fungal killing by IL-6/23-stimulated human peripheral blood neutrophils was impaired by JAK/STAT inhibitors Ruxolitinib and Stattic, and by the retinoic acid receptor-related orphan receptor γt inhibitor SR1001. This was also associated with decreased reactive oxygen species, IL-17A production, and retinoic acid receptor-related orphan receptor γt translocation to the nucleus. We also demonstrate that IL-6/23-activated neutrophils exhibit increased elastase and gelatinase (matrix metalloproteinase 9) activity, which is inhibited by Ruxolitinib and Stattic but not by SR1001. Taken together, these observations indicate that the regulation of activity of IL-17-producing neutrophils by JAK/STAT inhibitors impairs reactive oxygen species production and fungal killing activity but also blocks elastase and gelatinase activity that can cause tissue damage.
Unexpected deaths of children and young people in the UK
Authors: Stallard Paul , Maguire Michelle , Daddow Justin , Shepperd Rosie , Foster Mike , Berry Jill
Published: April 2016

Aims and method

To review the deaths of children and young people who took their own life. We conducted a retrospective analysis of serious incident reports from a National Health Service trust and reviews by the child death overview panels of the local safeguarding children boards.

Results

We identified 23 deaths, with annual rates varying considerably between local authorities and over time. Over half of the children (n = 13, 56%) were not known to specialist child and adolescent mental health services, with 11 having no contact with any agency at the time of their death. Hanging was the most common method (n = 20, 87%) and of these, half (n =11, 55%) were low-level hangings.

Clinical implications

Training is required to improve awareness, recognition and the assessment of children at risk of taking their own life. Specialist child mental health services should directly assess plans or attempts at hanging and offer advice about the seriousness of attempting this. National data (by age) on children and young people who take their own life should be routinely published to inform clinical and preventive services.
Workplace assessment in crisis? The way forward
Authors: O'Leary Denis , Al-Taiar Hasanan , Brown Nicholas , Bajorek Tomasz , Ghazirad Marjan , Shaddel Farshad
Published: April 2016

A recent Royal College of Physicians' study on assessment raises serious questions for workplace assessment. To address these, a system is recommended that bridges the gap from competence to performance and integrates supervised learning events (SLEs) that are formative in purpose with summative assessment of performance by entrustable professional activities (EPAs).
BASH: badmouthing, attitudes and stigmatisation in healthcare as experienced by medical students
Authors: Ajaz Ali , David Rhodri , Brown Damien , Smuk Melanie , Korszun Ania
Published: April 2016

Aims and method

We used an online questionnaire to investigate medical students' perceptions of the apparent hierarchy between specialties, whether they have witnessed disparaging comments (‘badmouthing’ or ‘bashing’) against other specialists and whether this has had an effect on their career choice.

Results

In total, 960 students from 13 medical schools completed the questionnaire; they ranked medical specialties according to the level of badmouthing and answered questions on their experience of specialty bashing. Psychiatry and general practice attracted the greatest number of negative comments, which were made by academic staff, doctors and students. Twenty-seven per cent of students had changed their career choice as a direct result of bashing and a further 25.5% stated they were more likely to change their specialty choice. Although 80.5% of students condemned badmouthing as unprofessional, 71.5% believed that it is a routine part of practising medicine.

Clinical implications

Bashing of psychiatry represents another form of stigmatisation that needs to be challenged in medical schools. It not only has an impact on recruitment into the specialty, but also has the wider effect of stigmatising people with mental health disorders.
Gestational Hypothyroidism Improves the Ability of the Female Offspring to Clear Streptococcus pneumoniae Infection and to Recover From Pneumococcal Pneumonia
Authors: Nieto Pamela A. , Peñaloza Hernán F. , Salazar-Echegarai Francisco J. , Castellanos Raquel M. , Opazo Maria Cecilia , Venegas Luis , Padilla Oslando , Kalergis Alexis M. , Riedel Claudia A. , Bueno Susan M.
Published: April 2016

Maternal thyroid hormones are essential for proper fetal development. A deficit of these hormones during gestation has enduring consequences in the central nervous system of the offspring, including detrimental learning and impaired memory. Few studies have shown that thyroid hormone deficiency has a transient effect in the number of T and B cells in the offspring gestated under hypothyroidism; however, there are no studies showing whether maternal hypothyroidism during gestation impacts the response of the offspring to infections. In this study, we have evaluated whether adult mice gestated in hypothyroid mothers have an altered response to pneumococcal pneumonia. We observed that female mice gestated in hypothyroidism have increased survival rate and less bacterial dissemination to blood and brain after an intranasal challenge with Streptococcus pneumoniae. Further, these mice had higher amounts of inflammatory cells in the lungs and reduced production of cytokines characteristic of sepsis in spleen, blood, and brain at 48 hours after infection. Interestingly, mice gestated in hypothyroid mothers had basally increased vascular permeability in the lungs. These observations suggest that gestational hypothyroidism alters the immune response and the physiology of lungs in the offspring, increasing the resistance to respiratory bacterial infections.
Long-Term Exposure of Pancreatic β-Cells to Palmitate Results in SREBP-1C-Dependent Decreases in GLP-1 Receptor Signaling via CREB and AKT and Insulin Secretory Response
Authors: Natalicchio Annalisa , Biondi Giuseppina , Marrano Nicola , Labarbuta Rossella , Tortosa Federica , Spagnuolo Rosaria , D'Oria Rossella , Carchia Emanuele , Leonardini Anna , Cignarelli Angelo , Perrini Sebastio , Laviola Luigi , Giorgino Francesco
Published: April 2016

The effects of prolonged exposure of pancreatic β-cells to high saturated fatty acids on glucagon-like peptide-1 (GLP-1) action were investigated. Murine islets, human pancreatic 1.1B4 cells, and rat INS-1E cells were exposed to palmitate for 24 hours. mRNA and protein expression/phosphorylation were measured by real-time RT-PCR and immunoblotting, respectively. Specific short interfering RNAs were used to knockdown expression of the GLP-1 receptor (Glp1r) and Srebf1. Insulin release was assessed with a specific ELISA. Exposure of murine islets, as well as of human and INS-1E β-cells, to palmitate reduced the ability of exendin-4 to augment insulin mRNA levels, protein content, and release. In addition, palmitate blocked exendin-4-stimulated cAMP-response element-binding protein and v-akt murine thymoma viral oncogene homolog phosphorylation, whereas phosphorylation of MAPK-ERK kinase-1/2 and ERK-1/2 was not altered. Similarly, RNA interference-mediated suppression of Glp1r expression prevented exendin-4-induced cAMP-response element-binding protein and v-akt murine thymoma viral oncogene homolog phosphorylation, but did not impair exendin-4 stimulation of MAPK-ERK kinase-1/2 and ERK-1/2. Both islets from mice fed a high fat diet and human and INS-1E β-cells exposed to palmitate showed reduced GLP-1 receptor and pancreatic duodenal homeobox-1 (PDX-1) and increased sterol regulatory element-binding protein (SREBP-1C) mRNA and protein levels. Furthermore, suppression of SREBP-1C protein expression prevented the reduction of PDX-1 and GLP-1 receptor levels and restored exendin-4 signaling and action. Finally, treatment of INS-1E cells with metformin for 24 h resulted in inhibition of SREBP-1C expression, increased PDX-1 and GLP-1 receptor levels, consequently, enhancement of exendin-4-induced insulin release. Palmitate impairs exendin-4 effects on β-cells by reducing PDX-1 and GLP-1 receptor expression and signaling in a SREBP-1C-dependent manner. Metformin counteracts the impairment of GLP-1 receptor signaling induced by palmitate.
Remembering the Slave Rebellion of Coro: Historical Memory and Politics in Venezuela
Authors: Ruette-Orihuela Krisna , Soriano Cristina
Published: April 2016

This article analyzes the construction and circulation of historical memories of the Coro slave rebellion in Venezuela between 1795 and 2014. We show how historical interpreters have inscribed divergent representations of this rebellion in documents, landscapes, historiographies, monuments, and music. In a political climate defined by ethnoracial and political tensions, colonial elites saw in the rebellion the republican ideology and racial violence of the Haitian Revolution. Fearing the persistence of social divisions and political resentment, nineteenth-century republican leaders all but effaced the rebellion from the nation’s historical memory. This episode was finally recovered by historians at the beginning of the twentieth century, and since the 1950s teachers, guerrilla members, and social activists have linked the rebellion to political discourses of ethnoracial struggle, cultural syncretism, bodily suffering, and social exclusion. Recently, communal organizations in the region have begun to connect it to contemporary anti-imperialist and socialist projects. We argue that historical memories have mobilized political identities at different times and imagined regional genealogies of struggle against imperialism and political oppression.
Women, Men, and the Legal Languages of Mining in the Colonial Andes
Authors: Bigelow Allison Margaret
Published: April 2016

Histories of colonial Latin American mining have cemented the image of a scientifically backward society whose pursuit of easy wealth sacrificed the lives of indigenous and African miners in places like Potosí. By examining a mid-seventeenth-century mine dispute between an Andean woman and a Spanish man, this article suggests how legal archives can reveal indigenous women’s contributions to the history of colonial silver. It also provides an appendix with one hundred cases of indigenous, creole, and Spanish women miners, refiners, and managers in Alto Perú, 1559–1801, suggesting how women of different socioeconomic and technical backgrounds participated in the silver industry.
Impaired mechanical response of an EDMD mutation leads to motility phenotypes that are repaired by loss of prenylation
Authors: Zuela Noam , Zwerger Monika , Levin Tal , Medalia Ohad , Gruenbaum Yosef
Published: April 2016

There are roughly 14 distinct heritable autosomal dominant diseases associated with mutations in lamins A/C, including Emery–Dreifuss muscular dystrophy (EDMD). The mechanical model proposes that the lamin mutations change the mechanical properties of muscle nuclei, leading to cell death and tissue deterioration. Here, we developed an experimental protocol that analyzes the effect of disease-linked lamin mutations on the response of nuclei to mechanical strain in living Caenorhabditis elegans. We found that the EDMD mutation L535P disrupts the nuclear mechanical response specifically in muscle nuclei. Inhibiting lamin prenylation rescued the mechanical response of the EDMD nuclei, reversed the muscle phenotypes and led to normal motility. The LINC complex and emerin were also required to regulate the mechanical response of C. elegans nuclei. This study provides evidence to support the mechanical model and offers a potential future therapeutic approach towards curing EDMD.
Bacterial meningitis: The importance of prevention
Authors: Watkins Jean
Published: April 2016

Bacterial meningitis/septicaemia is a serious infection with sometime fatal or life-changing consequences. Immediate recognition and treatment of the condition may improve the end result but the only preventative approach is vaccination, which is now available against certain types and strains of bacteria. This article focuses on immunisation. Previous articles in this series discussed causes of infection and symtoms, and management and complications.
School-based influenza immunisation programme pilot: Using an out-of-hours model
Authors: Gourlay Sandra , Stoddart Kathleen , Blackadder Ayleen , Hinton Shona , Penman Shona , Young Patricia , Osborne Michele , Robertson Shirley , Robertson Deborah , Robertson Calum
Published: April 2016

Influenza is a common and potentially serious viral infection. The Joint Committee of Vacination and Immunisation recommended that the seasonal influenza programme should be expanded in 2012 to include all children from the ages of 2–17 years in the UK. In NHS Forth Valley, the implementation of the influenza immunisation programme was presided over by multi-agency group including school nursing. School nurses provide a vital input to the immunisation of children and in response to the challenges presented by the introduction of the programme, the school nursing service implemented a weekend delivery model in pilot areas in NHS Forth Valley. The model is person-centred and geared towards the priorities of public health and protection. The model is also underpinned by minimising disruption to normal school nursing and education service workloads and to families. Strategies to support an accesible and family-friendly immunisation service have been identified and now need further translation into practice.
The vital school-local authority support link should not be broken
Authors: Feuchtwang Anna
Published: April 2016

With 7 000 children missing from education, the move to further weaken local authority-school links is dangerous, fears Anna Feuchtwang
Hot and cold: a comparison of modalities for non-invasive body contouring
Authors: Soos Emma , Clond Morgan
Published: April 2016

Non-surgical body contouring technologies have progressed rapidly following the introduction of Thermage in 2002. Since then, exciting developments in multiple modalities have followed, including radiofrequency, low-level laser therapy, cryolipolysis, and thermal and non-thermal ultrasound. Each of these treatment options are associated with distinct efficacy and side effect profiles. In this article, the authors provide a critical review of several body contouring technologies. Throughout the paper, the authors compare the mechanisms of action, efficacy and potential adverse effects of the five main modalities.
Male experiences of hair removal and loss: depilation practices and motivations
Authors: Williamson Heidi
Published: April 2016

Body hair has increasingly become a focus of male attention, with a growing number of men engaging in hair removal (depilation) and strategies to manage male pattern balding. Heidi Williamson explores the social and psychological drives that underpin practices around male body hair grooming, and outlines the psychosocial consequences of both depilation and androgenic alopecia
Mexican ‘surgeons’ are running the show—for better or for worse
Authors: Mendes Aysha
Published: April 2016

With both surgical and non-surgical cosmetic procedures on the rise worldwide, aesthetic nursing is becoming an increasingly popular profession. In this series, Aysha Mendes examines aesthetic nursing practices and cultural perceptions of beauty across the globe by focusing on a different country every month. This month's article looks at cultural influences of beauty and lack of regulation in Mexico
Overcoming stress in aesthetic nursing: a guide to avoiding burnout and fatigue
Authors: Waddill-Goad Suzanne
Published: April 2016

Several factors can cause nurses to experience heightened levels of stress, from issues related to staffing and schedules, to managing difficult colleagues and challenging patients. In a field that requires much patience and compassion, it can be difficult for nurses to manage stress levels effectively, argues Suzanne Waddill-Goad. In this article, she reflects on the impact of fatigue and burnout in the nursing profession
Harnessing the power of PR for business success in medical aesthetics
Authors: Kendrick Julia
Published: April 2016

With more aesthetic clinics arriving on the scene, standing out from the crowd and building a great reputation has never been more important. But is an inconsistent (or non-existent) PR strategy damaging your business? Can you navigate between PR and advertising to find the right way to engage with your customers? Julia Kendrick outlines how you can employ trusted techniques to achieve business success
The Broken BBC: From Public Service to Corporate Power
Authors: Lewis Gavin
Published: April 2016

In the face of austerity cuts to state infrastructure provision, the British Broadcasting Corporation has recently generated something of a moral panic about the future of public sector broadcasting—mobilizing both its own news channel and its friends in the corporate media around the issue. Yet in the midst of this ongoing existential crisis, few have asked: What is it we are being asked to defend?… As in car manufacturing, what is provided is a limitedly resourced primary product, altered for different consumption demands, by add-on and take-off parts.

Click here to purchase a PDF version of this article at the Monthly Review website.
Wie regenerativ ist die Energiewende tatsächlich? Das Energiekonzept der Bundesregierung zwischen Aufbruch und nicht regenerativen Mustern
Authors: Biesecker Adelheid , von Winterfeld Uta
Published: April 2016

Die Energiewende erfordert eine neue Energiekultur von Politik, Wissenschaft und Gesellschaft. Der Umstieg auf erneuerbare oder regenerative Energien folgt bislang aber vor allem technologischen und ökonomischen Prämissen. Aus nachhaltiger und vorsorgender Perspektive fehlt
die Sorge um und für die Regenerationsfähigkeit der Lebensgrundlagen ‐ auch für zukünftige Generationen. Aufgabe von Politik wäre es, Menschen zu einem regenerativen Umgang mit Energie zu befähigen.
A Performative Memoric Investigation of YoungGiftedandFat
Authors: Luckett Sharrell D. , Edwards Audrey , Stewart Megan J.
Published: April 2016

In 2013, Sharrell D. Luckett formed the Performance Studies & Arts Research Collective, which encourages members to explore their identities through the arts. Around this time, Audrey Edwards and Megan J. Stewart—both African American females and Collective members—became interested in autoethnography, and Luckett invited them to study closely with her. In this performative essay, Luckett, Edwards, and Stewart implicitly highlight various power negotiations enacted as professor/student, actress/stage manager, actress/assistant director, and mentor/mentee, while all working on their own autoethnographies, and while working collectively on Luckett's autoethnographic performance: YoungGiftedandFat.
Musical Representation and Vivaldi's Concerto Il Proteo, ò Il mondo al rovverscio, RV 544/572
Authors: Ossi Massimo
Published: April 2016

Vivaldi's concerto titles draw ambivalent reactions from historians, who see them as commercial hooks, rarely reflecting musical substance. But titles condition a work's reception, connecting it to a cultural context by which to steer a listener's reactions, both intellectual and affective. Eighteenth-century writers on aesthetics recognized the role of textual “ideas” in the reception of music. Vivaldi's Il Proteo, ò Il mondo al rovverscio is regarded as a “trick piece” in which the solo violin and cello parts are “reversed,” each being written in the other's clef. The concerto, however, invokes a deeper conception of the mundus inversus metaphor, in that it constitutes a remarkably sophisticated exploration of upside-down compositional practices. While the opening movement challenges notions of “correct” musical syntax, evoking the Carnival celebrations of the “world upside down,” the last presents a well-ordered example of Vivaldian ritornello form. Vivaldi included Il Proteo as the first concerto in a large group sold to Pietro Ottoboni in the mid-1720s, twelve of which bear titles. Some are as concrete as “The Four Seasons,” but others are more abstract, deriving from affective or intellectual subjects such as“Il riposo.” Il Proteo, in this context, seems especially sophisticated, cleverly satirizing some of the composer's own trademark compositional techniques. Its self-conscious treatment of style appears to address contemporary debates regarding music's ability to carry “meaning,” an ability that members of Ottoboni's Arcadian Academy seemed to deny but that others, such as the philosopher Antonio Conti, endorsed. Might Vivaldi have fueled these debates with a provocative set of concertos headed by Il Proteo?
Microscopía y Principales Características Morfológicas de Algunos Ectoparásitos de Interés Veterinario
Authors: Pulido-Villamarín Adriana del Pilar , Castañeda-Salazar Rubiela , Ibarra-Ávila Humberto , Gómez-Méndez Luis David , Barbosa-Buitrago Angélica María
Published: April 2016

Los ectoparásitos afectan de manera importante el estado sanitario de los animales debido a que sus efectos exfoliatrices, tóxicos y alérgicos causan un detrimento en su bienestar y, adicionalmente, pueden tener un efecto negativo en los índices de conversión alimenticia en animales de producción. Las ectoparasitosis pueden afectar animales de todas las especies y edades; sin embargo, los jóvenes son los más susceptibles. La importancia de un adecuado diagnóstico de estos problemas sanitarios está dada no solo por la incomodidad que generan en sus hospederos, sino por la posibilidad que tienen de transmitir otros agentes patógenos. El objetivo del presente trabajo fue presentar imágenes donde se describen algunas características morfológicas de determinados ectoparásitos de interés en Medicina Veterinaria, especialmente bajo las condiciones de Colombia.
Estandarización de una Técnica de PCR en Tiempo Real con Sondas TaqMan para la Detección de Leptospira spp Patógenas en Orina de Canes Domésticos
Authors: Sedano S. André , Pinto J. Chris E. , Siuce M. Juan , Calle E. Sonia
Published: April 2016

El presente estudio tuvo como objetivo estandarizar una técnica de PCR en tiempo real con sondas TaqMan para detectar la presencia de leptospiras patógenas en orina de perro infectada in vitro con cepas patrón de Leptospira sp. Las muestras fueron obtenidas de un perro clínicamente sano y negativo a la prueba de microaglutinación. Se utilizaron los cebadores Lepto R y Lepto F, específicos para Leptospira sp y una sonda TaqMan Lepto probe que amplifican e hibridan, respectivamente, una porción del gen rrs, capaces de diferenciar entre especies patógenas y no patógenas de Leptospira. Se estandarizó el protocolo de PCR en 35 ciclos, con un proceso de desnaturalización inicial a 95 °C por 5 min, seguida por una desnaturalización a 95 °C por 15 s y finalmente el alineamiento y extensión en un solo paso a 60 °C por 1 min. Los valores de ciclo umbral (Ct) determinados durante la estandarización de la PCR estuvieron en un rango de 12.53 a 18.21 para las 25 cepas patógenas de Leptospira sp, en tanto que las cepas saprófitas y otros bacterias no dieron productos específicos. El estándar fue detectado hasta una dilución de 102 con un Ct de 29.98 a una eficiencia de 1.13 y con un coeficiente de correlación (R2) de 0.993. Se detectó ADN en las muestras de orina infectada desde la dilución de 107 leptospiras/ml con un valor de Ct de 17.54 hasta una mínima dilución de 102 leptospiras/ml con un valor de Ct de 29.87.
Efecto de la Suplementación con una Mezcla Probiótica sobre el Comportamiento Productivo de Cuyes (Cavia porcellus) durante la Fase de Crecimiento y Acabado
Authors: Cano W. Javier , Carcelén C. Fernando , Ara G. Miguel , Quevedo G. Willian , Alvarado S. Arnaldo , Jiménez A. Ronald
Published: April 2016

Se evaluó el efecto de la adición de una mezcla probiótica en la dieta sobre la ganancia de peso, consumo de alimento y conversión alimenticia de cuyes en crecimiento y engorde. Se trabajó con 64 cuyes machos de un día de edad de una granja experimental en Huancayo, Perú. Los animales fueron distribuidos al azar en cuatro tratamientos consistentes en una dieta base de forraje (ryegrass-trébol rojo) suplementada con afrechillo de trigo, más 0, 100, 150 o 200 ml de una mezcla probiótica en suspensión de Lactobacillus-Bifidobacterium-Saccharomyces. La suspensión probiótica fue mezclada con 1 kg del suplemento y administrada por 10 semanas. Se observaron patrones significativos de respuesta lineal a los niveles del probiótico en ganancia de peso (y = 631.04571 + 0.60537x; r2=0.2971, p=0.029) y conversión alimenticia (y = 6.21121 - 0.0339x; r2=0.625, p=0.0003), sin que hubiera una respuesta significativa en consumo total de alimento. Se concluye que la mezcla probiótica tiene el potencial de incrementar la productividad y la eficiencia alimenticia en cuyes en crecimiento y acabado; sin embargo, mayores niveles del probiótico deberían ser explorados para obtener resultados biológicos y prácticos óptimos.
Trends in US Hospital Stays for Listeriosis in Infants
Authors: Veesenmeyer Angela F. , Edmonson M. Bruce
Published: April 2016

BACKGROUND AND OBJECTIVES:

Although listeriosis is rare in infants, it is common for young infants with suspected serious bacterial infection to be treated empirically with agents selected, in part, for their activity against Listeria monocytogenes. Our objectives were to describe the recent epidemiology of hospital discharges for listeriosis among infants in the United States and to precisely estimate the incidence of listeriosis according to infant age and meningitis status.

METHODS:

We generated national estimates for listeriosis discharges in each of the 6 years for which samples were available in the Kids’ Inpatient Database during the period 1997–2012. We used random-effects models to pool descriptive information and population rates across study years.

RESULTS:

The cumulative number of US hospital discharges for listeriosis in infants was 344 (95% confidence interval [CI]: 290–397) over the 6 study years. The pooled annual incidence rate in infants (per 100 000 births) was 1.41 (95% CI: 1.01–1.80) after accounting for marked fluctuation in annual rates (range: 0.66–1.86; I2 = 79.3%). Discharges for listeriosis without meningitis were particularly rare after the first week of life. Our models predicted only 2.7 (95% CI: 1.1–4.2) and 1.8 (95% CI: 0.0–3.6) such discharges per year in infants admitted at ages 7 to 28 days and 29 to 364 days, respectively.

CONCLUSIONS:

From the perspective of providing coverage against listeriosis, the routine practice of including ampicillin in the empirical treatment of febrile infants should be reevaluated for those older than 1 week without clinical evidence of meningitis.
Rates of ICU Transfers After a Scheduled Night-Shift Interprofessional Huddle
Authors: Newman Ross E. , Bingler Michael A. , Bauer Paul N. , Lee Brian R. , Mann Keith J.
Published: April 2016

OBJECTIVES:

To evaluate a scheduled interprofessional huddle among pediatric residents, nursing staff, and cardiologists on the number of high-risk transfers to the ICU.

METHODS:

A daily, night-shift huddle intervention was initiated between the in-house pediatric residents and nursing staff covering the cardiology ward patients with the at-home attending cardiologist. Retrospective cohort chart review identified high-risk transfers from the inpatient floor to the ICU over a 24-month period (eg, inotropic support, intubation, and/or respiratory support within 1 hour of ICU transfer). Satisfaction with the intervention and the impact of the intervention on team-based communication and resident education was collected using a retrospective pre-post survey.

RESULTS:

Ninety-three patients were identified as unscheduled transfers from the ward team to the ICU. Overall, 21 preintervention transfers were considered high risk, whereas only 8 patients were considered high risk after the intervention (P = .004). During the night shift, high risk transfers decreased from 8 of 17 (47%) to 3 of 21 patients (14%) (P = .03). Interprofessional communication improved with 12 of 14 nurses and 24 of 25 residents reporting effective communication after the intervention (P < .0001) compared with only 1 nurse and 15 residents reporting a positive experience before the intervention. Overall, all 3 provider groups stated an improved experience covering a high-risk cardiology patient population.

CONCLUSIONS:

Implementation of an interprofessional huddle may contribute to decreasing high-risk transfers to the ICU. Initiating a daily huddle was well received and allowed for open lines of communication across all provider groups.
National Survey on the Impact of Viral Testing for the ED and Inpatient Management of Febrile Young Infants
Authors: Burstein Brett , Dubrovsky Alexander Sasha , Greene Andrew Walsh , Quach Caroline
Published: April 2016

OBJECTIVE:

Well-appearing febrile infants with viral illnesses cannot be distinguished from those with occult life-threatening infections. Infants with respiratory viruses are less likely to have serious bacterial infections; however, current risk-stratification criteria predate widespread viral testing and there are limited data to safely inform physician management with this now common diagnostic tool. This study sought to explore the possible impact of respiratory virus testing on clinical decision-making for the management of febrile young infants <6 weeks old.

METHODS:

A scenario-based survey was sent to emergency department (ED) and inpatient physicians at all 16 Canadian tertiary pediatric centers. Participants were asked questions regarding management decisions with and without results of respiratory virus testing.

RESULTS:

Response rate was 78% (n = 330; 190 ED, 140 inpatient). Detection of a respiratory virus reduced admission rates among 3-week-old (83% vs 95%, P < .001) and 5-week-old infants (36% vs 52%, P < .001). Similarly, empirical antibiotic treatment was decreased by detection of a respiratory virus for 3-week-old (65% vs 92%, P < .001) and 5-week-old infants (25% vs 39%, P < .001). Management of 5-week-old infants differed between ED and inpatient physicians, both in the presence and absence of a respiratory virus. There was no consensus among inpatient physicians regarding admission duration for well infants with a detectable respiratory virus and otherwise negative workup.

CONCLUSIONS:

Respiratory virus testing appears to influence clinical decision-making for febrile infants <6 weeks, reducing both rates of admission and antimicrobial treatment. Important work is needed to better understand how to safely incorporate viral testing for the management of this vulnerable patient population.
Prebiotic activity of fructooligosaccharides produced by Bacillus subtilis natto CCT 7712
Authors: Silva P.B. , Garcia S. , Baldo C. , Celligoi M.A.P.C.
Published: April 2016

Bacillus subtilis natto is a potential source of fructooligosaccharides (FOS), which can be obtained by fermentation and may stimulate the growth of beneficial microorganisms in the colon representing a strategy to manipulate the intestinal microbiota acting as a prebiotic compound. The present study focuses on the ability of Lactobacillus ssp. strains to utilize FOS as a sole energy source. The results showed that FOS was equally good as glucose to provide energy source. The highest prebiotic activity score was obtained with Lactobacillus plantarum ATCC 14917 grown on FOS (0.526), followed by Lactobacillus casei (LC-1) (0.222). The lowest score was for Lactobacillus paracasei ATCC 27092 (−0.051). The results suggests that specific combinations of probiotic (L. plantarum ATCC 14917 and L. casei (LC-1)) and prebiotic (FOS) could be used as synbiotics in dairy and other foods.
Meio ambiente urbano e questão social: habitação popular em áreas de preservação ambiental
Authors: Gondim Linda Maria de Pontes
Published: April 2016

O artigo discute a relação entre cidade e meio ambiente como questão pública, face à multiplicação das ocupações de áreas de preservação ambiental por moradias de baixa renda. Embora o meio ambiente seja parte integrante, e não mero "cenário" da vida social, é recente o reconhecimento da dimensão ecológica da questão urbana. A discussão é feita à luz do caso de uma favela de Fortaleza, localizada em área de preservação permanente. Um projeto da Prefeitura para remover seus moradores para um conjunto nas proximidades atraiu novos ocupantes, cuja retirada imediata da área foi exigida pelo Ministério Público. Face à insuficiência de recursos para garantir habitação aos "invasores", sua remoção engendrou um dilema ético e social, contrapondo o direito à habitação ao direito ao meio ambiente saudável.
Membrane Localization of Human Equilibrative Nucleoside Transporter 1 in Tumor Cells May Predict Response to Adjuvant Gemcitabine in Resected Cholangiocarcinoma Patients
Authors: Brandi Giovanni , Deserti Marzia , Vasuri Francesco , Farioli Andrea , Degiovanni Alessio , Palloni Andrea , Frega Giorgio , Barbera Maria A. , Lorenzo Stefania , Garajova Ingrid , Di Marco Mariacristina , Pinna Antonio D. , Cescon Matteo , Cucchetti Alessandro , Ercolani Giorgio , D’Errico-Grigioni Antonietta , Pantaleo Maria A. , Biasco Guido , Tavolari Simona ,   on behalf of G.I.CO. (Gruppo Italiano Colangiocarcinoma)
Published: April 2016

Background.

The use of gemcitabine as an adjuvant modality for cholangiocarcinoma (CC) is increasing, but limited data are available on predictive biomarkers of response. Human equilibrative nucleoside transporter 1 (hENT-1) is the major transporter involved in gemcitabine intracellular uptake. This study investigated the putative predictive role of hENT-1 localization in tumor cells of CC patients undergoing treatment with adjuvant gemcitabine.

Methods.

Seventy-one consecutive patients with resected CC receiving adjuvant gemcitabine at our center were retrospectively analyzed by immunohistochemistry for hENT-1 localization in tumor cells. The main outcome measure was disease-free survival (DFS). Hazard ratios (HRs) of relapse and associated 95% confidence intervals (CIs) were obtained from proportional hazards regression models stratified on quintiles of propensity score.

Results.

Twenty-three (32.4%) cases were negative for hENT-1, 22 (31.0%) were positive in the cytoplasm only, and 26 (36.6%) showed concomitant cytoplasm/membrane staining. Patients with membrane hENT-1 had a longer DFS (HR 0.49, 95% CI 0.24–0.99, p = .046) than those who were negative or positive only in the cytoplasm of tumor cells. Notably, the association between DFS and membrane hENT-1 was dependent on the number of gemcitabine cycles (one to two cycles: HR 0.96, 95% CI 0.34–2.68; three to four cycles: HR 0.99, 95% CI 0.34–2.90; five to six cycles: HR 0.27, 95% CI 0.10–0.77).

Conclusion.

hENT-1 localization on tumor cell membrane may predict response to adjuvant gemcitabine in CC patients receiving more than four cycles of chemotherapy. Further prospective randomized trials on larger populations are required to confirm these preliminary results, so that optimal gemcitabine-based chemotherapy may be tailored for CC patients in the adjuvant setting.
Vision for the Global Health and Cancer Section
Authors: Cazap Eduardo , Anderson Benjamin O.
Published: April 2016

The field of global oncology aims to develop strategies to diminish cancer incidence and improve curability and survival in a variety of ways. To aid this effort, the Global Health and Cancer section of The Oncologist publishes articles on the full spectrum of global cancer issues.
Role of Ragulator in the Regulation of Mechanistic Target of Rapamycin Signaling in Podocytes and Glomerular Function
Authors: Yao Yao , Wang Junying , Yoshida Sei , Nada Shigeyuki , Okada Masato , Inoki Ken
Published: April 2016

Aberrant activation of mechanistic target of rapamycin complex 1 (mTORC1) in glomerular podocytes leads to glomerular insufficiency and may contribute to the development of glomerular diseases, including diabetic nephropathy. Thus, an approach for preventing mTORC1 activation may allow circumvention of the onset and progression of mTORC1-dependent podocyte injury and glomerular diseases. mTORC1 activation requires inputs from both growth factors and nutrients that inactivate the tuberous sclerosis complex (TSC), a key suppressor of mTORC1, on the lysosome. Previous studies in mice revealed that the growth factor-phosphatidylinositol 3-kinase pathway and mTORC1 are essential for maintaining normal podocyte function, suggesting that direct inhibition of the phosphatidylinositol 3-kinase pathway or mTORC1 may not be an ideal approach to sustaining physiologic podocyte functions under certain disease conditions. Here, we report the role of the Ragulator complex, which recruits mTORC1 to lysosomes in response to nutrient availability in podocytes. Notably, podocytes lacking Ragulator maintain basal mTORC1 activity. Unlike podocyte-specific mTORC1-knockout mice, mice lacking functional Ragulator in podocytes did not show abnormalities in podocyte or glomerular function. However, aberrant mTORC1 activation induced by active Rheb in podocyte-specific TSC1-knockout (podo-TSC1 KO) mice did require Ragulator. Moreover, ablation of Ragulator in the podocytes of podo-TSC1 KO mice or streptozotocin-induced diabetic mice significantly blocked the development of pathologic renal phenotypes. These observations suggest that the blockade of mTORC1 recruitment to lysosomes may be a useful clinical approach to attenuate aberrant mTORC1 activation under certain disease conditions.
INFLUÊNCIA DA ATIVIDADE FÍSICA SOBRE CRITÉRIOS DIAGNÓSTICOS DA SÍNDROME METABÓLICA EM ESTUDANTES
Authors: Brito Lilian Messias Sampaio , Galvanin Carlos Eduardo , Do Amaral Daniel Claro , Kato Paulo Victor Kioshima , Cat Monica Nunes Lima , Boguszewski Margaret Cristina da Silva
Published: April 2016

Introdução: A Síndrome Metabólica está associada a um conjunto de fatores de risco que aumentam as chances de um indivíduo desenvolver doenças cardiovasculares e diabetes tipo 2. A incidência destas doenças vem aumentando em crianças e adolescentes. O tratamento se baseia principalmente em mudanças no estilo de vida, por meio de dieta saudável e prática de atividade física. Objetivo: Determinar a influência da atividade física sobre alguns dos critérios diagnósticos para Sindrome Metabolica. Casuística e Métodos: Foram avaliados 294 adolescentes de 12 a 16 anos matriculados em Escolas Públicas em Tempo Integral. O questionário The Three Day Physical Activity Recall foi utilizado para categorizar os adolescentes quanto à intensidade de atividade física. Dois grupos foram identificados: grupo I, com atividade física moderada à vigorosa inferior a 300 minutos/semana; grupo II, com atividade física moderada à vigorosa igual ou superior a 300 minutos/semana. Foram avaliados a estatura, peso e circunferência abdominal e aferida a pressão sanguínea. O Índice de Massa Corporal foi calculado e transformado em z-score. A análise dos dados foi realizada com o programa estatístico. Resultados: Dos 294 adolescentes, 125 (59%) foram classificados no grupo I. Neste grupo, 24 (12,8%) apresentavam medidas elevadas de circunferência abdominal e 27 (14,9%) níveis elevados de pressão arterial. Dos 87 (41%) classificados no grupo II, 14 (15,7%) apresentavam medidas elevadas de circunferência abdominal e 11 (12,8%) níveis elevados de pressão arterial. Em relação ao Indice de Massa Corporal, 38 indivíduos no grupo I (20,5%) e 20 grupo II (23,5%), apresentavam sobrepeso ou obesidade. Conclusão: Mais de 20% dos indivíduos em ambos os grupos apresentarem Indice de massa corporal elevado. Não observamos relação do nível de atividade física com a frequência de obesidade abdominal e com os níveis pressóricos.
ACOMPANHAMENTO FARMACOTERAPÊUTICO EM IDOSOS
Authors: Maschio de Lima Tiago Aparecido , Fazan Eduardo Roberto , Pereira Luis Lenin Vicente , De Godoy Moacir Fernandes
Published: April 2016

Introdução: O acompanhamento farmacoterapêutico é um instrumento da Atenção Farmacêutica, no qual o farmacêutico se responsabiliza pelas necessidades do paciente relacionadas à farmacoterapia mediante a detecção, a prevenção e a resolução de problemas relacionados aos medicamentos. Objetivo: Realizar acompanhamento farmacoterapêutico em pacientes idosos atendidos em uma farmácia popular. Casuística e Métodos: Estudo descritivo exploratório com abordagem quantitativa por meio de entrevista baseada na metodologia Dáder. Foram coletados dados demográficos, sociais, econômicos, clínicos e farmacológicos usando um questionário com questões abertas e fechadas para investigar problemas relacionados aos medicamentos. Resultados: Participaram do estudo 10 idosos. A média de idade foi 73,7±4,67 e 60% eram mulheres. No total foram prescritos 45 medicamentos, mediana 4, mínimo 3 e máximo 7. As classes terapêuticas mais prescritas foram anti-hipertensivos (31,11%), antilipêmicos (15,56%), antiúlceras (15,56%), hipoglicemiantes (15,55%) e antiplaquetários (8,89%). Foram identificados 20 problemas relacionados aos medicamentos em uso, dentre eles, os referentes à efetividade 25%, à segurança 40% e à adesão 35%. Cinco tipos de interações medicamentosas potenciais foram detectadas. O desconforto estomacal foi a reação adversa relatada por 80% dos idosos. A avaliação da adesão demonstrou que 70% dos idosos não aderem ao tratamento medicamentoso. Conclusão: Observa-se a ocorrência de problemas relacionados aos medicamentos em idosos, reforçando a importância do acompanhamento farmacoterapêutico para melhorar a farmacoterapia, preservar a segurança do paciente, e garantir o uso racional de medicamentos.
SOBREPESO E OBESIDADE EM JOVENS ESCOLARES
Authors: Malinski Maurício Pedroso , Voser Rogério Da Cunha
Published: April 2016

Introdução: A obesidade é classificada como um transtorno de saúde frequente e complexo, provocado por um desequilíbrio entre a ingestão de calorias e o dispêndio de energia. É considerada uma preocupação crescente no âmbito da saúde pública e vem sendo discutida pelas maiores entidades de saúde do mundo. Objetivo: Conhecer o perfil de sobrepeso e obesidade em escolares do município de Porto Alegre, Rio Grande do Sul. Material e Métodos: A amostra foi constituída de 427 alunos (217 do sexo masculino e 210 do sexo feminino), na faixa etária entre cinco e 19 anos, de uma escola da rede de ensino privada e duas da rede de ensino pública. Foram coletados massa corporal em quilos e estatura em metros, ambas as aferições utilizando balança Filizola®. Foi realizado cálculo de Índice de Massa Corporal, por meio dos programas Calculador de Índice de Massa Corporal e Diagnóstico Nutricional Versão 6.1©, que utiliza as tabelas da Organização Mundial da Saúde para diagnóstico nutricional. Para a análise estatística foi realizado Teste Exato de Fisher para todas as variáveis. Resultados: Classificaram-se com sobrepeso 96 indivíduos (22,5%), 64 sujeitos com obesidade (15%) e com obesidade grave 27 indivíduos (6,3%), totalizando 187 pessoas (43,8%) da amostra com sobrepeso. Na comparação entre os sexos houve diferenças significantes. O perfil de obesidade e sobrepeso foi semelhante, tanto na maioria das faixas etárias quanto nas escolas das redes pública e privada. Conclusão: Há uma alta taxa de indivíduos com excesso de peso entre os avaliados. Este é um aspecto importante para um delineamento de intervenções por parte dos profissionais de saúde para diminuir essas taxas e consequentemente melhorar a qualidade de vida dos indivíduos envolvidos.