bluuebunny/crossref_metadata_2025 huggingface dataset:
Lichtblick im angeschlagenen Kabinett
Authors: Murzin Gunter
Published: March 2016

Selten ist das Ansehen einer Bundesregierung in so kurzer Zeit nach einer erfolgreichen Wahl so tief gesunken wie das der schwarz-gel­ben Koalition. Entzaubert steht insbesondere der Überraschungssieger FDP da, der einen Politikwechsel versprach und nun entgeistert feststellen muss, dass Volkes Gunst schnell verloren gehen kann.
Marter ohne Ende
Authors: Ehrhardt Jana , Zehnder Adalbert
Published: March 2016

Der Berliner Politik fehlen seit Jahren Konzepte und Courage, um die Krankenhauslandschaft in der Hauptstadt entschlossen neu zu ordnen. Damit verbrennt sie Millionen. Für die beiden landeseigenen Krankenhauskonzerne, die Universitätsmedizin Charité und den Klinikverbund Vivantes, ist dies kaum noch auszuhalten.
Zwei unterschiedliche Kulturen?
Authors: Mostler Detlef
Published: March 2016

Verbandsnachrichten der ÖVKT - Österreichischer Verband der Krankenhaustechniker. Diese Seiten sind nur als PDF-Dokument verfügbar.
Nestlé entdeckt Stoffwechselkranke
Authors: Mau Jens
Published: March 2016

Der weltweit größte Nahrungsmittelkonzern Nestlé steigt in das Geschäft für klinische Nahrung für Stoffwechselkranke ein.
Bauen, finanzieren, betreiben
Authors: Zehnder Adalbert
Published: March 2016

Was muss man beachten, wenn man ein Krankenhaus „nachhaltig“ bauen will?
17,8 Millionen Klinikpatienten 2009
Authors: Mau Jens
Published: March 2016

Im Jahr 2009 wurden 17,8 Millionen Patienten stationär behandelt. Das hat das Statistische Bundesamt auf der Grundlage vorläufiger Ergebnisse der Krankenhausstatistik errechnet.
Pflege hat ihren Preis
Authors: Doelfs Guntram
Published: March 2016

Erst waren es die Ärzte, die Leiharbeit in der Klinik als profitables Geschäftsfeld für sich entdeckten. Nun steigen auch hoch qualifizierte Schwestern und Pfleger in das Geschäft ein.
Begehrte OP-Spezialisten
Authors: König Romy
Published: March 2016

Ein Beruf mit Zukunft ist es allemal: 82 Prozent der Krankenhäuser wollen künftig verstärkt Operationstechnische Assistenten (OTAs) einstellen, 56 Prozent sehen sogar einen explizit großen Bedarf an OTAs. Trotzdem gibt es mehr Bewerber als Ausbildungsplätze.
Hände weg vom Krankenhaus
Authors: Mühlnikel Ingrid
Published: March 2016

Gerade einmal drei (!) kommunale Aktiengesellschaften (AGs) gibt es im deutschen Krankenhaussektor (siehe Seite 15).
Hilfe für Kodier-Anfänger
Authors: Gaede Kirsten
Published: March 2016

Seit Kurzem gibt es in der Psychiatrie Operationen- und Prozedurenschlüssel. Ein Benchmarking des Instituts für Medizin Consulting soll den Kliniken die Einführung erleichtern.
Vom Einkaufszentrum lernen
Authors: Mau Jens
Published: March 2016

Ullrich Eidenmüller moderiert auf dem Hauptstadtkongress im Mai eine Podiumsdiskussion mit dem Titel „Gesundheitscenter schlägt Krankenhaus“. kma sprach mit ihm über Vernetzungsstrategien für Kliniken.
Deutlich unter dem Durchschnitt
Authors: Schmidt Hartmut
Published: March 2016

Meldungen über Klinik- und Pflegeheimaktien sind in den letzten Wochen Mangelware gewesen. Im Gegensatz zum Allgemeinmarkt hat sich dieser Sektor kaum bewegt.
Geldregen in der Wüste
Authors: Ehrhardt Jana
Published: March 2016

Alljährlich findet in Dubai Ende Januar die Arab Health statt. Auf der zweitgrößten Gesundheitsmesse der Welt warb in diesem Jahr der Gesundheitsminister Philipp Rösler für die deutsche Medizintechnik. Erfolgsaussichten: hervorragend.
Traut euch!
Authors: Gaede Kirsten
Published: March 2016

Viele Kliniken schrecken wegen rechtlicher Bedenken vor einer Neuver­teilung der Aufgaben zwischen Ärzten und Pflegekräften zurück. Doch die Vorsicht ist unbegründet: Es gibt sichere Lösungen, sagen Juristen und Fachgesellschaften.
Der beste Freund des Anästhesisten
Authors: König Romy
Published: March 2016

Im OP fehlen Fachkräfte. Die Anästhesietechnischen Assistenten könnten die Lücke füllen. Ähnlich wie die Operationstechnischen Assistenten bewähren sie sich nach einer grundständigen Ausbildung offenbar ebenso gut im OP wie Pflegekräfte.
So wirksam wie starker Kaffee
Authors: Thalmayr Maria
Published: March 2016

Verbandsnachrichten der FKT - Fachvereinigung Krankenhaustechnik (e. V.). Diese Seiten sind nur als PDF-Dokument verfügbar.
Immer noch ohne Führung
Authors: Mau Jens
Published: March 2016

Bei der Suche nach zwei Vorständen für die Uniklinik Freiburg hält Baden-Württembergs Wissenschaftsministerium die Fäden in der Hand – ohne Erfolg. Mitglieder des Aufsichtsrats kritisieren die Personalsuche als intransparent.
Mediclin kurz vor der Übernahme
Authors: Schmidt Hartmut
Published: March 2016

Das laufende Übernahmeangebot von Asklepios an die Mediclin-Aktionäre war nur eine Frage der Zeit. Der Klinikkonzern aus dem Taunus begründet sein Angebot offiziell mit dem Ziel der strategischen Zusammenarbeit mit Mediclin. So will er den Wert beider Unternehmen steigern.
Kein Platz für Keime
Authors: Meixner Sarah
Published: March 2016

Hygienefreundliche Möbel- und Zimmerkonstruktionen minimieren die Besiedlungsflächen für Keime im Krankenhaus.
Angriff auf den GBA
Authors: Mühlnikel Ingrid
Published: March 2016

Politik und Industrie attackieren den Gemeinsamen Bundesausschuss. Sie fordern noch mehr Transparenz und setzen gerade an, das oberste Gremium im Gesundheitswesen zu entmachten. Profitieren würde die Industrie, sie könnte leichter Einfluss nehmen.
Der knallharte Samariter
Authors: Gaede Kirsten
Published: March 2016

Für manches kränkelnde kirchliche Haus ist Agaplesion die letzte Hoffnung. Der größte evangelische Krankenhausverbund ist ein Samariter – doch kein barmherziger: Kliniken, die ihm beitreten, müssen hart an sich arbeiten. Das sichert dem Konzern solide Gewinne und Investitionsmöglichkeiten.
Frisches Blut
Authors: Dirks Claudia
Published: March 2016

Er ist kein IT-Experte und trotzdem Chef eines IT-Verbandes. Der BVITG hat ihn vor Kurzem eingestellt, um Parteien zu einen, nach außen zu strahlen und sich von der Politik nicht die Butter vom Brot nehmen zu lassen.
Aktionäre belohnen Konjunkturresistenz
Authors: Schmidt Hartmut
Published: March 2016

Gute Nachrichten für Pflegeheim- und Klinikaktionäre: Ihre Wertpapiere haben sich in den vergangenen Wochen fast ausnahmslos besser als der Dax entwickelt. Nachdem sich ihre Wertpapiere lange nahe der Nulllinie bewegten, erleben sie nun ein regelrechtes Hoch: Curanum hat um 23 Prozent an Wert gewonnen, das Rhön-Klinikum um 15 Prozent und die Eifelhöhen-Klinik um 13 Prozent. Ebenfalls einen Gewinn – wenn auch einen weniger deutlichen - können die Aktionäre der Marseille-Kliniken (plus 4 Prozent) und Fresenius (plus 1) verbuchen.
Hebammen lohnen sich
Authors: Ehrhardt Jana
Published: March 2016

Jedes dritte Kind in Deutschland kommt per Kaiserschnitt zur Welt – viel zu viele, darin sind sich alle einig. Eine Stärkung der Rolle von Hebammen könnte Abhilfe schaffen, doch das Gegenteil ist der Fall. Dabei rechnen sich Hebammen auch für Kliniken.
Baupläne nach virtuellen Klinikabläufen
Authors: Dirks Claudia
Published: March 2016

In Riesa wird bis 2015 der Neubau eines Schwerpunkt-Krankenhauses entstehen. Und zwar ein Neubau, der aufgrund konkreter Simulationen optimierter Stationsabläufe und Transportwege geplant werden wird. Ein Novum im deutschen Gesundheitswesen.
Abschied ohne Schrecken
Authors: Gaede Kirsten
Published: March 2016

In diesen Tagen verlassen die letzten Zivildienstleistenden die Krankenhäuser. Die Kliniken bleiben relativ gelassen: Während die einen die Lücken mit Festangestellten kompensieren und ihre Prozesse straffen, setzen die anderen große Hoffnungen in den Bundesfreiwilligendienst.
Leichter gesagt als getan
Authors: Thalmayr Maria
Published: March 2016

Verbandsnachrichten der FKT - Fachvereinigung Krankenhaustechnik (e. V.). Diese Seiten sind nur als PDF-Dokument verfügbar.
UKE liebäugelt mit Lübeck
Authors: Dirks Claudia
Published: March 2016

Es gibt 17 interessante Vorschläge, das Universitätsklinikum Schleswig-Holstein (UKSH) zu retten. Dies hat das gerade abgeschlossene Markterkundungsverfahren ans Licht gebracht. Ob eine dieser Optionen verwirklicht wird, will das Kabinett nach der Sommerpause entscheiden.
Partikeltherapie auf der Kippe
Authors: Mau Jens
Published: March 2016

Die Partikeltherapie war als Durchbruch in der Krebsbehandlung geplant. Nun muss Siemens eingestehen, dass die Anlage in Gießen-Marburg nicht wirtschaftlich läuft. Sogar ein Komplettausstieg des Konzerns aus der Technologie ist möglich.
Zahlen ersetzen Ziele!?
Authors: Krammer Martin
Published: March 2016

Verbandsnachrichten der ÖVKT - Österreichischer Verband der Krankenhaustechniker. Diese Seiten sind nur als PDF-Dokument verfügbar.
Die dürftige Analysegrundlage der DGE
Authors: Gaede Kirsten
Published: March 2016

Klinikkost kann der Genesung schaden. Diese Meldung gelangte über die Deutsche Presseagentur (dpa) in nahezu alle Redaktionen der Republik.
Großes Interesse an Europa
Authors: Thalmayr Maria
Published: March 2016

Verbandsnachrichten der FKT - Fachvereinigung Krankenhaustechnik (e. V.). Diese Seiten sind nur als PDF-Dokument verfügbar.
Zuschüsse sollen Festbeträge ersetzen
Authors: Mau Jens
Published: March 2016

Fritz Beske plädiert dafür, dass Kompressionsstrümpfe, Bandagen und Einlagen über Zuschüsse und nicht mehr über einen Festbetrag finanziert werden. Anders seien die steigenden Kosten nicht mehr zu stemmen.
Schadstoffarme Zimmer für Allergiegeplagte
Authors: Zehnder Adalbert
Published: March 2016

Brandverletzte, Krebspatienten oder entbindende Mütter brauchen speziell ausgestattete Krankenzimmer, klar.
Stammkunden satteln um
Authors: Stiller Eileen
Published: March 2016

Im Wachstumsmarkt Health-IT hat sich die Leitmesse Medica offenbar nicht stark genug positioniert, Stammkunden satteln auf andere Fachmessen um.
Krankenpflegehelfer zum Sondertarif
Authors: Hiltensperger Monika
Published: March 2016

Asklepios, Sana, Vivantes – immer mehr Klinikkonzerne und Krankenhäuser setzen Pflegeassistenten ein. Ihr Fazit: Die Assistenten können auf den meisten Stationen 20 Prozent der pflegerischen Tätigkeiten übernehmen und kosten sehr viel weniger als Krankenpflegehelfer. Allerdings müssen sie sorgfältig ausgebildet werden.
Der OP-Innovator
Authors: Dirks Claudia
Published: March 2016

Der geborene Leipziger ist Hals-Nasen-Ohren-Arzt in dritter Generation. Er baut Brücken von der Medizin zur computerassistierten Chirurgie, von dort zur Medizintechnik und von da direkt in die Entwicklungsabteilungen der Industrie.
Mit Spannung erwartet
Authors: Paulus Sebastian
Published: March 2016

Verbandsnachrichten der FKT - Fachvereinigung Krankenhaustechnik (e. V.). Diese Seiten sind nur als PDF-Dokument verfügbar.
Zwei Jahre länger Mehrleistungsabschlag
Authors: Mühlnikel Ingrid
Published: March 2016

Während sich die gesetzliche Krankenversicherung über sanierte Finanzen freuen darf, müssten die Krankenhäuser weiter bluten, kritisierte DKG-Präsident Rudolf Kösters auf dem 34. Deutschen Krankenhaustag. Der gesundheitspolitische Sprecher der CDU/CSU-Bundestagsfraktion Jens Spahn stellte eine Reduzierung der Sparauflagen für die Krankenhäuser in Aussicht – und formulierte Bedingungen.
Ist Contracting ein geeignetes Instrument?
Authors: Gullner Josef
Published: March 2016

Verbandsnachrichten der ÖVKT - Österreichischer Verband der Krankenhaustechniker. Diese Seiten sind nur als PDF-Dokument verfügbar.
Ausblick durch Rückblick
Authors: Murzin Gunter
Published: March 2016

Jahreswechsel bringt Muße. Milder als sonst blicke ich auf das Szenario.
Evaluation of Pericardial Fluid C-Type Natriuretic Peptide Levels in Patients Undergoing Coronary Bypass Surgery
Authors: Karahan Oguz , Karabacak Mustafa , Yuksel Volkan , Huseyin Serhat , Mavitas Binali , Guclu Orkut
Published: March 2016

Background Neurohumoral and hemodynamic mechanisms have an effect on cardiac activity. C-type natriuretic peptide (CNP) is accessible in the cardiovascular system. The aim of this study was to determine whether CNP concentrations in pericardial fluid and blood are related to cardiac dysfunction in patients undergoing coronary artery bypass graft surgery.

Materials and Methods In this study, 40 patients undergoing coronary artery bypass grafting were enrolled. The patients were separated into two groups according to left ventricular (LV) ejection fraction (EF): group 1 contained 28 patients with normal LV systolic function (LVEF ≥ 50%) and group 2 contained 12 patients with impaired LV systolic function (LVEF < 45%). Plasma and pericardial fluid samples were acquired during surgery to measure CNP levels.

Results In group 1, CNP levels were detected to be 0.46 ± 0.10 ng/mL in plasma and 0.66 ± 0.8 ng/mL in pericardial liquid. In group 2, these levels were 0.51 ± 0.09 and 0.79 ± 0.12 ng/mL, respectively. CNP levels were determined to be significantly higher in patients with low EF compared with those with normal EF in pericardial fluid concentrations (p = 0.013).

Conclusions CNP level in pericardial fluid is a more sensitive and proper marker of LV dysfunction than CNP levels in plasma. To the best of our knowledge, this study is the first to examine pericardial fluid CNP levels in patients undergoing coronary artery bypass surgery. It may have a valuable role in organizing cardiac remodeling and hypertrophy.
Numerical investigation of oscillatory thermocapillary flows under zero gravity in a circular liquid film with concave free surfaces
Authors: Yamamoto T. , Takagi Y. , Okano Y. , Dost S.
Published: March 2016

NASA astronaut Pettit has conducted thermocapillary flow experiments in water films suspended in a solid ring onboard the International Space Station (ISS) in 2003 and 2011. In one of these experiments, an oscillatory thermocapillary flow was observed. The developed flow broke its symmetry along the centerline of the film. To the best of our knowledge, there are no studies on such oscillatory thermocapillary flows in thin films, and the flow-mechanism giving rise to such oscillatory flows is also not well understood. In order to shed light on the subject, we have carried out a numerical simulation study. The simulation results have shown that the water film geometry (film surface shape; being concave) is an important parameter and give rise to three oscillatory flow structures in the film, namely, a hydrothermal wave developing near the heated section, a symmetric oscillatory flow due to temperature variations, and a symmetry breaking flow due to the hydrodynamic instability along the free boundary layer (mixing layer) and the development of the hydrothermal waves. Simulation results show that the symmetry-breaking phenomenon observed in the thin film experiment on the ISS can be explained by the hydrodynamic instability and the development of hydrothermal waves.
Coverage induced structural transformations of tetracene on Ag(110)
Authors: Takasugi Kazushiro , Yokoyama Takashi
Published: March 2016

Self-assembly of tetracene on an anisotropic surface of Ag(110) has been investigated using scanning tunneling microscopy and low-energy electron diffraction. We observe multistage structural transformations of the self-assembled tetracene on Ag(110) as a function of molecular coverages, which are accompanied by the changes in molecular orientations. They are analyzed by a balance between multiple molecule-molecule and anisotropic substrate-molecule interactions.
Casimir effect on graphene resonator
Authors: Inui Norio
Published: March 2016

We theoretically investigated the influence of the Casimir effect on mechanical properties of a graphene resonator, where a graphene sheet is located in parallel with a perfectly conducting plate. The Casimir force arising from this effect strongly attracts a graphene sheet to a perfectly conducting plate and increases the tension of a graphene sheet as the separation distance between them decreases. The maximum vertical displacement of a graphene sheet to the substrate increases obeying a power law of a separation distance with an exponent of 4/3 as the separation distance decreases. For small separation distances, the Casimir force is excessively strong for the graphene sheet to maintain a free-standing shape, consequently resulting in the adhesion of the sheet to the substrate below a critical separation distance. The resonant frequency increases over a wide range as the separation distance decreases for large separation distances. However, it then rapidly decreases for small separations and converges to zero at a critical separation. These various behaviors enable the control of a graphene resonator.
Heat-assisted magnetic recording of bit-patterned media beyond 10 Tb/in2
Authors: Vogler Christoph , Abert Claas , Bruckner Florian , Suess Dieter , Praetorius Dirk
Published: March 2016

The limits of areal storage density that is achievable with heat-assisted magnetic recording are unknown. We addressed this central question and investigated the areal density of bit-patterned media. We analyzed the detailed switching behavior of a recording bit under various external conditions, allowing us to compute the bit error rate of a write process (shingled and conventional) for various grain spacings, write head positions, and write temperatures. Hence, we were able to optimize the areal density yielding values beyond 10 Tb/in2. Our model is based on the Landau-Lifshitz-Bloch equation and uses hard magnetic recording grains with a 5-nm diameter and 10-nm height. It assumes a realistic distribution of the Curie temperature of the underlying material, grain size, as well as grain and head position.
Design of a mobile thermal battery and analysis of thermal characteristics
Authors: Yilbas B. S. , Khalil Anwar M.
Published: March 2016

Thermal characteristics of a mobile thermal battery, consisting of a steel tube, metallic meshes, and the phase change material, are investigated. Concentrated solar heating of the steel tube is considered and the governing equations of heat transfer and the flow field, due to the natural convection, are solved numerically. Lithium nitrate is used as a phase change material due to its high latent heat of melting and aluminum is used as the metallic mesh material. The maximum and minimum temperature difference in the tube is predicted and the temperature parameter is introduced to assess the thermal storage performance of the mobile thermal battery. The numerical code is validated with the data reported in the early study and findings revealed that both results are in good agreement. It is found that temperature predictions agree well with the previous data. The use of metallic meshes inside the steel tube significantly improves the heat conduction in the phase change material. In this case, almost uniform temperature distribution is achieved inside the tube during the cycle of thermal energy storage. Sensible heating in the liquid phase of the phase change material results in the increase in the localized excessive temperature, which has an adverse effect on achieving a uniform temperature distribution inside the thermal battery.
Evolution of spin phonon coupling by substituting Cd for Zn in the frustrated spinel ZnCr2Se4
Authors: Chen Xuliang , Yang Zhaorong
Published: March 2016

Frustration makes a tremendous amount of degenerate ground states which provides no energy scale of its own. Any perturbation has to be considered strong and fascinating phenomena may be emergent upon relieving of frustration. Here, we report the evolution of spin phonon coupling in the frustrated spinel system Zn1−xCdxCr2Se4 (0 ≤ x ≤ 1) from magnetization, specific heat and thermal conductivity. Our results give clear evidences that the spin-orientated structural transitions decay rapidly as x going from 0 to 0.4 while the correlations between spin and lattice degrees of freedom for 0.6 ≤ x ≤ 1 become weak and can be explained in terms of the traditional magnetostriction effect. In addition, for 0 ≤ x ≤ 0.4 thermal carriers reveal strong scattering from spin fluctuations in the vicinity of TN owing to strong frustration, in stark contrast with those for 0.6 ≤ x ≤ 1 where traditional phonon-like heat conduction behaviors are observed. Moreover, it is shown that a moderate applied magnetic field can drive readily the fluctuations-scattered thermal conductivity toward traditional phonon-like one as observed in CdCr2Se4, reaching about 30% for x = 0.4 at 25 K in 1 T. Such strong field-sensitive effects may introduce new promising functionalities for potential applications.
Low-cost Ce1-xSmx(Fe, Co, Ti)12 alloys for permanent magnets
Authors: Gabay A. M. , Martín-Cid A. , Barandiaran J. M. , Salazar D. , Hadjipanayis G. C.
Published: March 2016

Ce1-xSmxFe9Co2Ti alloys based on the ThMn12-type crystal structure have been synthesized via melt-spinning of prefabricated alloys and via mechanochemical processing of CeO2- Sm2O3- Fe2O3-TiO2- Co - Ca - CaO powder mixtures. Coercive fields up to 0.8 kOe and 2.1 kOe were obtained in annealed melt-spun alloys with x = 0 and x = 0.5, respectively. Submicron, partially anisotropic particles collected after the mechanochemical synthesis for x = 0.5 and x = 1 exhibited coercivity (energy product) of 1.8 kOe (5.4 MGOe) and 5.8 kOe (9.9 MGOe), respectively. The low magnetic anisotropy field of CeFe9Co2Ti alloy requires at least a partial Sm-substitution for Ce in order to develop a reasonably high coercivity.
Does the grey nurse shark (Carcharias taurus) exhibit agonistic pectoral fin depression? A stereo-video photogrammetric assessment off eastern Australia
Authors: Smith Kirby R. , Scarpaci Carol , Louden Brett M. , Otway Nicholas M.
Published: March 2016

Underwater stereo-video photogrammetry was used to document the pectoral fin positions of various life-history stages of the critically endangered east Australian population of the grey nurse shark (Carcharias taurus) during normal swimming behaviour at multiple aggregation sites. A wide range in pectoral fin positions was recorded with dihedral pectoral fin angles ranging from –25 to 88°. Pectoral fin angles varied significantly among sites and this was attributed to the differing navigational and energetic requirements of the sharks. There was no significant relationship between pectoral fin angles and distances separating the shark and scuba diver. The wide range in pectoral fin angles, interactive use of the fins during swimming, low-energy behaviours of the sharks at aggregation sites and absence of ‘fight’ response agonistic behaviour indicated that the species does not exhibit agonistic pectoral fin depression. Reports of agonistic pectoral fin depression in the grey nurse shark obtained with visual estimates should be treated as preliminary observations requiring further testing using accurate sampling methods such as stereo photogrammetry. It is important that diver compliance with existing management guidelines that prohibit divers from chasing or harassing grey nurse sharks and blocking cave and gutter entrances is maintained.
A sound family for a healthy nation: Motherhood in Tajik national politics and society
Authors: Roche Sophie
Published: March 2016

Since independence in 1991, Central Asian countries have put great effort into creating their respective national narratives, which are often based on an ethnic imagination. In Tajikistan this included the idea of shaping society via the family unit. Increasingly, motherhood became the focus of attention, which was made possible by merging two concepts. On the one hand, women are considered as “cultured” and educated people who the Soviet Union freed from “backward” traditions. On the other hand, traditions were reinvented such that the woman is considered the ultimate mother of the nation and the backbone of tradition. This article examines the changing status of motherhood in society and politics through efforts to create a sound family and a healthy nation.
SNX9 promotes metastasis by enhancing cancer cell invasion via differential regulation of RhoGTPases
Authors: Bendris Nawal , Williams Karla C. , Reis Carlos R. , Welf Erik S. , Chen Ping-Hung , Lemmers Bénédicte , Hahne Michael , Leong Hon Sing , Schmid Sandra L.
Published: March 2016

Despite current advances in cancer research, metastasis remains the leading factor in cancer-related deaths. Here we identify sorting nexin 9 (SNX9) as a new regulator of breast cancer metastasis. We detect an increase in SNX9 expression in human breast cancer metastases compared with primary tumors and demonstrate that SNX9 expression in MDA-MB-231 breast cancer cells is necessary to maintain their ability to metastasize in a chick embryo model. Conversely, SNX9 knockdown impairs this process. In vitro studies using several cancer cell lines derived from a variety of human tumors reveal a role for SNX9 in cell invasion and identify mechanisms responsible for this novel function. We show that SNX9 controls the activation of RhoA and Cdc42 GTPases and also regulates cell motility via the modulation of well-known molecules involved in metastasis, namely RhoA-ROCK and N-WASP. In addition, we find that SNX9 is required for RhoGTPase-dependent, clathrin-independent endocytosis, and in this capacity can functionally substitute to the bona fide Rho GAP, GTPase regulator associated with focal adhesion kinase (GRAF1). Taken together, our data establish novel roles for SNX9 as a multifunctional protein scaffold that regulates, and potentially coordinates, several cellular processes that together can enhance cancer cell metastasis.
Sirtuin 1 Stimulation Attenuates Ischemic Liver Injury and Enhances Mitochondrial Recovery and Autophagy
Authors: Khader Adam , Yang Weng-Lang , Godwin Andrew , Prince Jose M. , Nicastro Jeffrey M. , Coppa Gene F. , Wang Ping
Published: March 2016

Objectives:

Hepatic ischemia-reperfusion is a major clinical problem with limited treatment options. The pathophysiology of hepatic ischemia-reperfusion is characterized by mitochondrial dysfunction and cellular energy deficits. Sirtuin 1 is an energy-sensing enzyme known to modulate mitochondrial biogenesis. We hypothesized that pharmacologic activation of sirtuin 1 is protective after hepatic ischemia-reperfusion injury.

Design:

Animal study.

Setting:

University-based experimental laboratory.

Subjects:

Wild-type C57BL/6 mice.

Interventions:

C57BL/6 mice were subjected to 60-minute partial hepatic ischemia-reperfusion and posttreated with sirtuin 1 activator, SRT1720 (20 mg/kg), or vehicle. Blood and liver were collected at 24 hours after ischemia-reperfusion for analyses of hepatic injury, adenosine triphosphate levels, mitochondrial mass, autophagy, inflammation, and oxidative stress. H4IIE hepatoma cells and rat primary hepatocytes were incubated with oxyrase to induce hypoxia followed by reoxygenation in the presence or absence of SRT1720 for assessment of mitochondrial mass, mitochondrial membrane potential, and autophagy.

Measurements and Main Results:

SRT1720 restored the reduction in mitochondrial mass, enhanced autophagy, and preserved adenosine triphosphate levels in the liver after ischemia-reperfusion, which was associated with a decrease in ischemia-reperfusion–induced hepatic injury, apoptosis, and necrosis. Ischemia-reperfusion–induced inflammation was also significantly reduced by SRT1720 as measured by systemic and hepatic cytokine and chemokine levels, as well as a decrease in neutrophil infiltration to the liver. Furthermore, oxidative stress was markedly attenuated in the SRT1720-treated mice compared with the vehicle. SRT1720 treatment increased adenosine triphosphate levels and survival of cultured hepatocytes after hypoxia-reoxygenation. SRT1720 not only increased the mitochondrial mass but also increased mitochondrial membrane potential per cell in cultured hepatocytes after hypoxia-reoxygenation. Moreover, SRT1720 prevented the hypoxia-reoxygenation–induced mitochondrial depolarization and resulted in an enhancement of autophagy in cultured hepatocytes after hypoxia-reoxygenation.

Conclusions:

Pharmacologic stimulation of sirtuin 1 attenuates liver injury after hepatic ischemia-reperfusion by restoring mitochondrial mass and membrane potential, which is associated with the enhancement of autophagy.
Impact of a Sequential Intervention on Albumin Utilization in Critical Care*
Authors: Lyu Peter F. , Hockenberry Jason M. , Gaydos Laura M. , Howard David H. , Buchman Timothy G. , Murphy David J.
Published: March 2016

Objectives:

Literature generally finds no advantages in mortality risk for albumin over cheaper alternatives in many settings. Few studies have combined financial and nonfinancial strategies to reduce albumin overuse. We evaluated the effect of a sequential multifaceted intervention on decreasing albumin use in ICU and explore the effects of different strategies.

Design:

Prospective prepost cohort study.

Setting:

Eight ICUs at two hospitals in an academic healthcare system.

Patients:

Adult patients admitted to study ICUs from September 2011 to August 2014 (n = 22,004).

Interventions:

Over 2 years, providers in study ICUs participated in an intervention to reduce albumin use involving monthly feedback and explicit financial incentives in the first year and internal guidelines and order process changes in the second year.

Measurements and Main Results:

Outcomes measured were albumin orders per ICU admission, direct albumin costs, and mortality. Mean (sd) utilization decreased 37% from 2.7 orders (6.8) per admission during the baseline to 1.7 orders (4.6) during the intervention (p < 0.001). Regression analysis revealed that the intervention was independently associated with 0.9 fewer orders per admission, a 42% relative decrease. This adjusted effect consisted of an 18% reduction in the probability of using any albumin (p < 0.001) and a 29% reduction in the number of orders per admission among patients receiving any (p < 0.001). Secondary analysis revealed that probability reductions were concurrent with internal guidelines and order process modification while reductions in quantity occurred largely during the financial incentives and feedback period. Estimated cost savings totaled $2.5M during the 2-year intervention. There was no significant difference in ICU or hospital mortality between baseline and intervention.

Conclusions:

A sequential intervention achieved significant reductions in ICU albumin use and cost savings without changes in patient outcomes, supporting the combination of financial and nonfinancial strategies to align providers with evidence-based practices.
Effects of Tocilizumab on Experimental Severe Acute Pancreatitis and Associated Acute Lung Injury
Authors: Chen Ke-Ling , Lv Zhao-Ying , Yang Hong-Wei , Liu Yong , Long Fei-Wu , Zhou Bin , Sun Xiao-Feng , Peng Zhi-Hai , Zhou Zong-Guang , Li Yuan
Published: March 2016

Objective:

To examine the therapeutic effects of tocilizumab, an antibody against interleukin-6 receptor, on experimental severe acute pancreatitis and associated acute lung injury. The optimal dose of tocilizumab and the activation of interleukin-6 inflammatory signaling were also investigated.

Design:

Randomized experiment.

Setting:

Research laboratory at a university hospital.

Subject:

Experimental severe acute pancreatitis in rats.

Interventions:

Severe acute pancreatitis was induced by retrograde injection of sodium taurocholate (50 mg/kg) into the biliopancreatic duct. In dose-study, rats were administered with different doses of tocilizumab (1, 2, 4, 8, and 16 mg/kg) through the tail vein after severe acute pancreatitis induction. In safety-study, rats without severe acute pancreatitis induction were treated with high doses of tocilizumab (8, 16, 32, and 64 mg/kg). Serum and tissue samples of rats in time-study were collected for biomolecular and histologic evaluations at different time points (2, 6, 12, 18, and 24 hr).

Measurements and Main Results:

1) Under the administration of tocilizumab, histopathological scores of pancreas and lung were decreased, and severity parameters related to severe acute pancreatitis and associated lung injury, including serum amylase, C-reactive protein, lung surfactant protein level, and myeloperoxidase activity, were all significant alleviated in rat models. 2) Dose-study demonstrated that 2 mg/kg tocilizumab was the optimal treatment dose. 3) Basing on multi-organ pathologic evaluation, physiological and biochemical data, no adverse effect and toxicity of tocilizumab were observed in safety-study. 4) Pancreatic nuclear factor-κB and signal transducer and activator of transcription 3 were deactivated, and the serum chemokine (C-X-C motif) ligand 1 was down-regulated after tocilizumab administration.

Conclusions:

Our study demonstrated tocilizumab, as a marketed drug commonly used for immune-mediated diseases, was safe and effective for the treatment of experimental severe acute pancreatitis and associated acute lung injury. Our findings provide experimental evidences for potential clinical application of tocilizumab in severe acute pancreatitis and associated complications.
Melioidosis Causing Critical Illness: A Review of 24 Years of Experience From the Royal Darwin Hospital ICU*
Authors: Stephens Dianne P. , Thomas Jane H. , Ward Linda M. , Currie Bart J.
Published: March 2016

Objectives:

Melioidosis is increasing in incidence with newly recognized foci of melioidosis in the Americas, Africa, and elsewhere. This review describes the demographics, management, and outcomes of a large cohort of critically ill patients with melioidosis.

Design:

Data were extracted from two prospective databases—the Menzies School of Health Research Melioidosis Database (1989–2013) and the Royal Darwin Hospital ICU Melioidosis Database (2001–2013).

Setting and Patients:

The Royal Darwin Hospital ICU is the only ICU in the tropical Top End of Northern Territory of Australia, an endemic area for melioidosis. The study included all patients with melioidosis admitted to Royal Darwin Hospital ICU from 1989 to 2013.

Measurements and Main Results:

From 1989 to 2013, 207 patients with melioidosis required admission to ICU. Mortality reduced from 92% (1989–1997) to 26% (1998–2013) (p < 0.001). The reduced mortality coincided with the introduction of an intensivist-led service, meropenem, and adjuvant granulocyte colony–stimulating factor for confirmed melioidosis sepsis in 1998. Pneumonia was the presenting illness in 155 of 207 (75%). ICU melioidosis patients (2001–2013) had an Acute Physiology and Chronic Health Evaluation II score of 23, median length of stay in the ICU of 7 days, and median ventilation hours of 130 and one third required renal replacement therapy.

Conclusions:

The mortality for critically ill patients with melioidosis in the Top End of the Northern Territory of Australia has substantially reduced over the past 24 years. The reduction in mortality coincided with the introduction of an intensivist-led model of care, the empiric use of meropenem, and adjunctive treatment with granulocyte colony–stimulating factor in 1998.
The Fragility Index in Multicenter Randomized Controlled Critical Care Trials*
Authors: Ridgeon Elliott E. , Young Paul J. , Bellomo Rinaldo , Mucchetti Marta , Lembo Rosalba , Landoni Giovanni
Published: March 2016

Objectives:

Recent literature has drawn attention to the potential inadequacy of frequentist analysis and threshold p values as tools for reporting outcomes in clinical trials. The fragility index, which is a measure of how many events the statistical significance of a result depends on, has been suggested as a means to aid the interpretation of trial results. This study aimed to calculate the fragility index of clinical trials in critical care medicine reporting a statistically significant effect on mortality (increasing or decreasing mortality).

Data Sources:

Literature search (PubMed/MEDLINE) to identify all multicenter randomized controlled trials in critical care medicine.

Study Selection:

We identified 862 trials; of which 56 fulfilled eligibility criteria and were included in our analysis.

Data Extraction:

Calculation of fragility index for trials reporting a statistically significant effect on mortality, and analysis of the relationship between trial characteristics and fragility index.

Data Synthesis:

The median fragility index was 2 (interquartile range, 1–3.5), and greater than 40% of trials had a fragility index of less than or equal to 1. 12.5% of trials reported loss to follow-up greater than their fragility index. Trial sample size was positively correlated, and reported p value was negatively correlated, with fragility index.

Conclusions:

In critical care trials reporting statistically significant effects on mortality, the findings often depend on a small number of events. Critical care clinicians should be wary of basing decisions on trials with a low fragility index. We advocate the reporting of fragility index for future trials in critical care to aid interpretation and decision making by clinicians.
Brief time-based activity pacing instruction as a singular behavioral intervention was not effective in participants with symptomatic osteoarthritis
Authors: Murphy Susan L. , Kratz Anna L. , Kidwell Kelley , Lyden Angela K. , Geisser Michael E. , Williams David A.
Published: March 2016

Osteoarthritis (OA) of the lower extremities is a prevalent cause of disability in which symptoms interfere with mobility and activity participation. Behavioral self-management for OA symptomatology is commonly recommended; but these interventions are underutilized, unstandardized in application, and at times, unavailable in the context of clinical care. For people with chronic pain, rehabilitation professionals may select to apply activity pacing instruction as one behavioral strategy to manage symptoms. Activity pacing is widely used in combination with other pharmacological and behavioral interventions but has not been studied as a singular behavioral intervention for people with OA. The purpose of this study was to evaluate the effectiveness of an occupational therapist-delivered, time-based activity pacing program for treatment of pain, fatigue, and physical function in people with symptomatic knee or hip OA. A 3-arm randomized controlled trial was conducted in which 193 people were randomized into tailored activity pacing, general activity pacing, or usual care arms. Assessments were done at 10 weeks and 6 months after baseline. Using linear mixed models, Western Ontario and McMaster Universities Osteoarthritis Index pain scores changed over time, decreasing the most in the general and usual care groups; only the usual care group had decreased pain over 6 months. The tailored and general activity pacing groups reported higher frequency of pacing behaviors than the usual care group at 10 weeks, but pacing was not sustained at 6 months. This trial does not support the use of time-based pacing as a singular behavioral strategy for people with knee or hip OA.
Free Amino Acids in Human Milk and Associations With Maternal Anthropometry and Infant Growth
Authors: Larnkjær Anni , Bruun Signe , Pedersen Dorthe , Zachariassen Gitte , Barkholt Vibeke , Agostoni Carlo , M⊘lgaard Christian , Husby Steffen , Michaelsen Kim F.
Published: March 2016

Objectives:

Free glutamic acid has an appetite‐regulating effect and studies with infant formula have suggested that free amino acids (FAA), especially glutamic acid, can downregulate intake. The content of glutamic acid and glutamine is high in breast milk but varies considerably between mothers. The aim was to investigate whether maternal anthropometry was associated with the content of the FAA glutamic acid or glutamine in breast milk and whether there was a negative association between these FAA and current size or early infant growth in fully breastfed infants.

Methods:

From a subgroup of 78 mothers, of which 50 were fully breast feeding, from the Odense Child Cohort breast milk samples were collected 4 months after birth and analyzed for FAA. Information regarding breastfeeding status and infant weight and length was also recorded.

Results:

There was a large variation in the concentration of the FAAs between mothers. Glutamic acid was positively correlated with mother's prepregnancy weight and height (P ⩽ 0.028), but not body mass index. There was no negative correlation between the 2 FAA and infant weight or body mass index. Infant length at 4 months was, however, positively associated with glutamine, (P = 0.013) but the correlation was attenuated when controlling for birth length (P = 0.089).

Conclusions:

The hypothesis that a high content of glutamic acid and glutamine in breast milk could downregulate milk intake to a degree affecting early growth could not be confirmed. Maternal factors associated with the level of these FAA in milk and the potential effect on the infant should be investigated further.
A fast and accurate method for detection of IBD shared haplotypes in genome-wide SNP data
Authors: Bjelland Douglas W. , Lingala Uday , Patel Piyush S. , Jones Matt , Keller Matthew C.
Published: March 2016

Identical by descent (IBD) segments are used to understand a number of fundamental issues in genetics. IBD segments are typically detected using long stretches of identical alleles between haplotypes in whole-genome SNP data. Phase or SNP call errors in genomic data can degrade accuracy of IBD detection and lead to false positive calls, false negative calls, and under‐ or overextension of true IBD segments. Furthermore, the number of comparisons increases quadratically with sample size, requiring high computational efficiency. We developed a new IBD segment detection program, FISHR (FindIBDSharedHaplotypesRapidly), in an attempt to accurately detect IBD segments and to better estimate their endpoints using an algorithm that is fast enough to be deployed on the very large whole-genome SNP datasets. We compared the performance of FISHR to three leading IBD segment detection programs: GERMLINE, refinedIBD, and HaploScore. Using simulated and real genomic sequence data, we show that FISHR is slightly more accurate than all programs at detecting long (>3 cM) IBD segments but slightly less accurate than refinedIBD at detecting short (~1 cM) IBD segments. Moreover, FISHR outperforms all programs in determining the true endpoints of IBD segments, which is important for several reasons. FISHR takes two to four times longer than GERMLINE to run, whereas both GERMLINE and FISHR were orders of magnitude faster than refinedIBD and HaploScore. Overall, FISHR provides accurate IBD detection in unrelated individuals and is computationally efficient enough to be utilized on large SNP datasets > 20,000 individuals.
Active Microrheology of Intestinal Mucus in the Larval Zebrafish
Authors: Taormina Michael J. , Parthasarathy Raghuveer
Published: March 2016

Mucus is a complex biological fluid that plays a variety of functional roles in many physiological systems. Intestinal mucus in particular serves as a physical barrier to pathogens, a medium for the diffusion of nutrients and metabolites, and an environmental home for colonizing microbes. Its rheological properties have therefore been the subject of many investigations, thus far limited, however, toin vitrostudies due to the difficulty of measurement in the natural context of the gut. This limitation especially hinders our understanding of how the gut microbiota interact with the intestinal environment, since examination of this calls not only for in vivo measurement techniques, but for techniques that can be applied to model organisms in which the microbial state of the gut can be controlled. We address this challenge by developing a method that combines magnetic microrheology, light sheet fluorescence microscopy, and microgavage of particles, applying this to the larval zebrafish, a model vertebrate. We present measurements of the viscosity of mucus within the intestinal bulb of both germ-free (devoid of intestinal microbes) and conventionally reared larval zebrafish. At the length scale probed (≈ 10μm), we find that mucus behaves as a Newtonian fluid, with no discernable elastic component. Surprisingly, despite known differences in the the number of secretory cells in germ-free zebrafish and their conventional counterparts, the fluid viscosity for these two groups was very similar. Our measurements provide the firstin vivomeasurements of intestinal mucus rheology at micron length scales in living animals, quantifying of an important biomaterial environment and highlighting the utility of active magnetic microrheology for biophysical studies.
Molecular genetic contributions to social deprivation and household income in UK Biobank (n = 112,151)
Authors: Hill W David , Hagenaars Saskia P , Marioni Riccardo E , Harris Sarah E , Liewald David CM , Davies Gail ,   International Consortium for Blood Pressure, McIntosh Andrew M , Gale Catharine R , Deary Ian J
Published: March 2016

Individuals with lower socio-economic status (SES) are at increased risk of physical and mental illnesses and tend to die at an earlier age [1-3]. Explanations for the association between SES and health typically focus on factors that are environmental in origin [4]. However, common single nucleotide polymorphisms (SNPs) have been found collectively to explain around 18% (SE = 5%) of the phenotypic variance of an area-based social deprivation measure of SES [5]. Molecular genetic studies have also shown that physical and psychiatric diseases are at least partly heritable [6]. It is possible, therefore, that phenotypic associations between SES and health arise partly due to a shared genetic etiology. We conducted a genome-wide association study (GWAS) on social deprivation and on household income using the 112,151 participants of UK Biobank. We find that common SNPs explain 21% (SE = 0.5%) of the variation in social deprivation and 11% (SE = 0.7%) in household income. Two independent SNPs attained genome-wide significance for household income, rs187848990 on chromosome 2, and rs8100891 on chromosome 19. Genes in the regions of these SNPs have been associated with intellectual disabilities, schizophrenia, and synaptic plasticity. Extensive genetic correlations were found between both measures of socioeconomic status and illnesses, anthropometric variables, psychiatric disorders, and cognitive ability. These findings show that some SNPs associated with SES are involved in the brain and central nervous system. The genetic associations with SES are probably mediated via other partly-heritable variables, including cognitive ability, education, personality, and health.
Novel Genetic Risk factors for Asthma in African American Children: Precision Medicine and The SAGE II Study
Authors: White MJ , Risse-Adams O , Goddard P , Contreras MG , Adams J , Hu D , Eng C , Oh SS , Davis A , Meade K , Brigino-Buenaventura E , Lenoir MA , Bibbins-Domingo K , Pino-Yanes M , Burchard E
Published: March 2016

Background

Asthma, an inflammatory disorder of the airways, is the most common chronic disease of children worldwide. There are significant racial/ethnic disparities in asthma prevalence, morbidity and mortality among U.S. children. This trend is mirrored in obesity, which may share genetic and environmental risk factors with asthma. The majority of asthma biomedical research has been performed in populations of European decent.

Objective

We sought to identify genetic risk factors for asthma in African American children. We also assessed the generalizability of genetic variants associated with asthma in European and Asian populations to African American children.

Methods

Our study population consisted of 1227 (812 asthma cases, 415 controls) African American children with genome-wide single nucleotide polymorphism (SNP) data. Logistic regression was used to identify associations between SNP genotype and asthma status.

Results

We identified a novel variant in thePTCHD3gene that is significantly associated with asthma (rs660498, p = 2.2 x10−7) independent of obesity status. Approximately 5% of previously reported asthma genetic associations identified in European populations replicated in African Americans.

Conclusions

Our identification of novel variants associated with asthma in African American children, coupled with our inability to replicate the majority of findings reported in European Americans, underscores the necessity for including diverse populations in biomedical studies of asthma.