bluuebunny/crossref_metadata_2025 huggingface dataset:
Beta Cell Functional Adaptation and Dysfunction in Insulin Resistance and the Role of Chronic Kidney Disease
Authors: Stožer Andraž , Hojs Radovan , Dolenšek Jurij
Published: January 2019

Background: Beta cells are central in the pathophysiology of diabetes, since their functional adaptation maintains euglycemia in insulin-resistant individuals and beta cell dysfunction is required for the clinical picture of frank diabetes. The pathophysiological mechanisms driving compensation and decompensation are incompletely understood and little is known about the influence of chronic kidney disease (CKD) on beta cell function. Summary: In compensated insulin resistance, beta cells enhance their function at all stages in the stimulus-secretion coupling cascade, from the most proximal membrane depolarization to the intermediate increase in intracellular calcium concentration and the most distal granule fusion. Intercellular coupling is not disrupted at this early stage during disease progression. Later during progression, when hyperglycemia becomes more apparent owing to insufficient beta cell compensation, intracellular stimulus-secretion coupling becomes enhanced to an even larger degree, but intercellular coupling becomes disrupted, indicating that ineffective cell-to-cell signal transmission may be the earliest event in progression to frank diabetes. CKD can negatively affect beta cell function through increased levels of urea that reduce beta cell glucose utilization and impair insulin secretion, and possibly also through factors other than urea. It remains to be investigated whether urea and other factors of CKD can also affect intercellular coupling. Key messages: Beta cells enhance intracellular stimulus-secretion coupling in early insulin resistance. With worsening insulin resistance, intracellular coupling enhances even more, but intercellular coupling becomes disrupted. CKD negatively impacts beta cell function, but its influence on intercellular coupling awaits further studies.
DNA Methylation of the Leptin Gene Promoter is Altered by Chronic Alcohol Exposure in an Animal Model for Alcohol Dependence
Authors: Wieting Jelte , Rhein Mathias , Hillemacher Thomas , Lichtinghagen Ralf , Hoppe Viktoria , Müschen Lars , Glahn Alexander , Frieling Helge , Bleich Stefan , Muschler Marc
Published: January 2019

Appetite-regulating peptides, such as leptin, are linked to craving and have been in the focus of alcohol dependence research for years. The objective of our study was to investigate the dynamics of leptin gene promoter methylation during alcohol withdrawal and specific treatment in a rodent (rat) model for alcohol dependence. DNA methylation was measured using direct bisulfite sequencing at 0 h, 24 h, and 6 days of alcohol withdrawal as well as after treatment with alpha-melanocyte-stimulating hormone (alpha-MSH), Beta-Endorphin, or saline. We found significantly lower methylation levels in alcohol-consuming animals compared to alcohol-naïve animals. During 6 days of alcohol deprivation, this difference in methylation vanished. Leptin methylation of the alpha-MSH-treated group and 6 days alcohol-deprived animals was significantly higher than that in saline-treated animals, possibly indicating compensatory effects of the treatment. Our results further expand on previous findings from human studies that explain leptin’s role in bridging the gap between alcohol consumption and appetite regulation.
De que trata o texto? Leitores e críticos na pesquisa sobre literatura
Authors: Mata Anderson Da
Published: January 2019

A indagação que se faz neste artigo é sobre como o trabalho de formação na pesquisa em literatura pode impactar o processo de letramento de um jovem estudante na linguagem específica do campo. Cinco pesquisadores que participaram de um projeto de pesquisa sobre a crítica literária brasileira contemporânea publicada em periódicos foram entrevistados sobre o impacto da pesquisa nas suas formações como leitores. Essas entrevistas são entrecruzadas com os resultados da própria pesquisa, que auxiliam na compreensão desse processo de formação de leitores, uma vez que trata da crítica literária, que pode ser, ela própria uma forma de mediação de leituras.
Por um leitor com dúvidas – notas sobre arte e fascismo, de Anatol Rosenfeld
Authors: Ginzburg Jaime
Published: January 2019

O ensaio Arte e fascismo, de Anatol Rosenfeld, está diretamente ligado à Segunda Guerra Mundial e a seu impacto cultural. Esse ensaio apresenta dúvidas com relação ao valor estético atribuído a obras de arte criadas por pessoas que defenderam o fascismo. Os argumentos abrem espaço para antagonismos. Arte e fascismo é um texto no qual as dúvidas são muito importantes, para lidar com dificuldades éticas referentes a valores estéticos. Diante desses antagonismos, quando uma reflexão crítica não pode atingir nenhuma síntese, o leitor poderia perceber que é necessário enfatizar o quanto as dúvidas são importantes para pensar sobre desafios éticos e estéticos.
Quemando incienso en altares cercanos
Authors: Angeoletto Fabio , Richard Enrique , Duarte Taise Ernestina Prestes , Vacchiano Marcelo Caetano , Leandro Deleon da Silva , Essy Camila
Published: January 2019

El crecimiento masivo y global de las ciudades se ha convertido en uno de los más importantes retos  socioambientales del siglo XXI. Por lo tanto, es necesario un enfoque más proactivo en la búsqueda de alternativas para la conservación biológica. Este artículo analiza la importancia de los jardines domésticos urbanos como áreas estratégicas para la conservación biológica. Jardines domésticos urbanos (o quintais en portugués) se definen como espacios privados adyacentes a las viviendas, y que pueden contener, en grados variados, céspedes, polígonos con vegetación ornamental y alimentaria y fuentes de agua. É común que especies vegetales que han experimentado una disminución severa en sus hábitats silvestres, alcancen altas productividades o densidades en los jardines domésticos urbanos. Esos espacios tienen una enorme capacidad para el suporte de la biodiversidad aunque sea corriente en ellos un predominio de especies vegetales exóticas.
espaço dos pedestres
Authors: Zampieri Fábio Lúcio , Andrade Sheila Patrícia de , Dorneles Vanessa Goulart
Published: January 2019

Este artigo procura investigar as condições e problemáticas relacionadas aos passeios públicos a partir da percepção dos usuários. Para tanto, foi realizada uma pesquisa qualitativa baseada em entrevistas focalizadas com três diferentes grupos de pessoas – técnicos de urbanismo, pedestres adultos e pedestres idosos. A partir deste estudo pôde-se identificar diversas questões enfrentados pelos pedestres nas calçadas em Porto Alegre - RS, e também sistematizá-los em diferentes categorias, como: “acidentes”, “ambientais”, “conforto”, “manutenção”, “segurança pública”, entre outros. A pesquisa averiguou a falta de qualidade das calçadas brasileiras através do grande descontentamento dos grupos quanto as condições das calçadas, principalmente em relação à falta de manutenção e conforto, além da falta de atuação do poder público em prevenir estes problemas.
Invisibilidade social e produção do espaço subordinado em Belém (PA)
Authors: Cardoso Ana Claudia Duarte , Miranda Thales Barroso
Published: January 2019

As dificuldades históricas de aproximação entre a lógica ambiental e o planejamento urbano favoreceram práticas de exclusão socioambiental na expansão urbana de Belém, na medida em que novos arranjos espaciais e sociais ‘naturalizaram’ mudanças ambientais que afetam grupos sociais de menor renda oriundos da várzea (caboclos e ribeirinhos). A releitura da expansão de Belém revela uma progressiva desarticulação entre homem, modo de vida e base biofísica na produção da cidade; onde a supressão de vegetação, adensamento construtivo e localização dos rios contaminados com lançamentos de esgoto inviabilizaram práticas tradicionais e contribuíram para alterações no microclima urbano. Os dados empíricos indicam que na periferia metropolitana coexistem grupos sociais, desde os que dependem da natureza (agricultores e extrativistas urbanos) até típicos moradores da periferia da cidade capitalista, um ponto cego para as políticas urbanas que tendem a homogeneizar o espaço sem atenção ao potencial de soluções que a diversidade oferece aos desafios da exclusão social e do risco ambiental. Cartografias da ocorrência da água e vegetação, análises morfológicas e pesquisas de campo procuram revelar os potenciais positivos da resistência das velhas práticas para Belém e para a cidade brasileira em geral, mas principalmente para as cidades amazônicas, que ainda tomam a metrópole como referência de ‘civilização’.
Intraaortic Balloon Pump in Cardiogenic Shock Complicating Acute Myocardial Infarction
Authors: Thiele Holger , Zeymer Uwe , Thelemann Nathalie , Neumann Franz-Josef , Hausleiter Jörg , Abdel-Wahab Mohamed , Meyer-Saraei Roza , Fuernau Georg , Eitel Ingo , Hambrecht Rainer , Böhm Michael , Werdan Karl , Felix Stephan B. , Hennersdorf Marcus , Schneider Steffen , Ouarrak Taoufik , Desch Steffen , de Waha-Thiele Suzanne ,   On behalf of the IABP-SHOCK II Trial (Intraaortic Balloon Pump in Cardiogenic Shock II) Investigators, Alkisoglu Zehra , Follath Ferenc , Frey Sonja , Haerting Johannes , Huber Kurt , Maisch Bernhard , Messemer Beate , Ourrak Taoufik , Schuler Gerhard , Vonderschmitt Karin , Werdan Karl
Published: January 2019

Background:

The role of intraaortic balloon counterpulsation (IABP) in cardiogenic shock is still a subject of intense debate despite the neutral results of the IABP-SHOCK II trial (Intraaortic Balloon Pump in Cardiogenic Shock II) with subsequent downgrading in international guidelines. So far, randomized data on the impact of IABP on long-term clinical outcomes in patients with cardiogenic shock complicating acute myocardial infarction are lacking. Furthermore, only limited evidence is available on general long-term outcomes of patients with cardiogenic shock treated by contemporary practice.

Methods:

The IABP-SHOCK II trial is a multicenter, randomized, open-label trial. Between 2009 and 2012, 600 patients with cardiogenic shock complicating acute myocardial infarction undergoing early revascularization were randomized to IABP versus control.

Results:

Long-term follow-up was performed 6.2 years (interquartile range 5.6–6.7) after initial randomization. Follow-up was completed for 591 of 600 patients (98.5%). Mortality was not different between the IABP and the control group (66.3% versus 67.0%; relative risk, 0.99; 95% CI, 0.88–1.11;
P
=0.98). There were also no differences in recurrent myocardial infarction, stroke, repeat revascularization, or rehospitalization for cardiac reasons (all
P
>0.05). Survivors’ quality of life as assessed by the EuroQol 5D questionnaire and the New York Heart Association class did not differ between groups.

Conclusions:

IABP has no effect on all-cause mortality at 6-year long-term follow-up. Mortality is still very high, with two thirds of patients with cardiogenic shock dying despite contemporary treatment with revascularization therapy.

Clinical Trial Registration:

URL:
https://www.clinicaltrials.gov/
. Unique identifier: NCT00491036.
Targeted Delivery of Sildenafil for Inhibiting Pulmonary Vascular Remodeling
Authors: Li Bingbing , He Wei , Ye Ling , Zhu Yuling , Tian Yali , Chen Lian , Yang Jun , Miao Mingxing , Shi Yejiao , Azevedo Helena S. , Ma Zhengliang , Hao Kun
Published: January 2019

Pulmonary arterial hypertension is a fatal lung disease caused by the progressive remodeling of small pulmonary arteries (PAs). Sildenafil can prevent the remodeling of PAs, but conventional sildenafil formulations have shown limited treatment efficacy for their poor accumulation in PAs. Here, glucuronic acid (GlcA)-modified liposomes (GlcA-Lips) were developed to improve the delivery of sildenafil to aberrant over-proliferative PA smooth muscle cells via targeting the GLUT-1 (glucose transport-1), and, therefore, inhibiting the remodeling of PAs in a monocrotaline-induced PA hypertension model. GlcA-Lips encapsulating sildenafil (GlcA-sildenafil-Lips) had a size of 90 nm and a pH-sensitive drug release pattern. Immunostaining assay indicated the overexpression of GLUT-1 in PA smooth muscle cells. Cellular uptake studies showed a 1-fold increase of GlcA-Lips uptake by PA smooth muscle cells and pharmacokinetics and biodistribution experiments indicated longer blood circulation time of GlcA-Lips and increased ability to target PAs by 1-fold after 8 hours administration. Two-week treatment indicated GlcA-sildenafil-Lips significantly inhibited the remodeling of PAs, with a 32% reduction in the PA pressure, a 41% decrease in the medial thickening, and a 44% reduction of the right ventricle cardiomyocyte hypertrophy, and improved survival rate. Immunohistochemical analysis showed enhanced expression of caspase-3, after administration of GlcA-sildenafil-Lips, and reduced expression of P-ERK1/2 (phosphorylated ERK1/2) and HK-2 (hexokinase-2), and increased level of eNOS (endothelial nitric oxide synthase) and cyclic GMP (cGMP). In conclusion, targeted delivery of sildenafil to PA smooth muscle cells with GlcA-Lips could effectively inhibit the remodeling of PAs in the monocrotaline-induced PA hypertension.
Increased Preeclampsia Risk and Reduced Aortic Compliance With In Vitro Fertilization Cycles in the Absence of a Corpus Luteum
Authors: von Versen-Höynck Frauke , Schaub Amelia M. , Chi Yueh-Yun , Chiu Kuei-Hsun , Liu Jing , Lingis Melissa , Stan Williams R. , Rhoton-Vlasak Alice , Nichols Wilmer W. , Fleischmann Raquel R. , Zhang Wendy , Winn Virginia D. , Segal Mark S. , Conrad Kirk P. , Baker Valerie L.
Published: January 2019

In vitro fertilization involving frozen embryo transfer and donor oocytes increases preeclampsia risk. These in vitro fertilization protocols typically yield pregnancies without a corpus luteum (CL), which secretes vasoactive hormones. We investigated whether in vitro fertilization pregnancies without a CL disrupt maternal circulatory adaptations and increase preeclampsia risk. Women with 0 (n=26), 1 (n=23), or >1 (n=22) CL were serially evaluated before, during, and after pregnancy. Because increasing arterial compliance is a major physiological adaptation in pregnancy, we assessed carotid-femoral pulse wave velocity and transit time. In a parallel prospective cohort study, obstetric outcomes for singleton livebirths achieved with autologous oocytes were compared between groups by CL number (n=683). The expected decline in carotid-femoral pulse wave velocity and rise in carotid-femoral transit time during the first trimester were attenuated in the 0-CL compared with combined single/multiple-CL cohorts, which were similar (group-time interaction:
P
=0.06 and 0.03, respectively). The blunted changes of carotid-femoral pulse wave velocity and carotid-femoral transit time from prepregnancy in the 0-CL cohort were most striking at 10 to 12 weeks of gestation (
P
=0.01 and 0.006, respectively, versus 1 and >1 CL). Zero CL was predictive of preeclampsia (adjusted odds ratio, 2.73; 95% CI, 1.14–6.49) and preeclampsia with severe features (6.45; 95% CI, 1.94–25.09) compared with 1 CL. Programmed frozen embryo transfer cycles (0 CL) were associated with higher rates of preeclampsia (12.8% versus 3.9%;
P
=0.02) and preeclampsia with severe features (9.6% versus 0.8%;
P
=0.002) compared with modified natural frozen embryo transfer cycles (1 CL). In common in vitro fertilization protocols, absence of the CL perturbed the maternal circulation in early pregnancy and increased the incidence of preeclampsia.
Four new species of Blacus Nees (Hymenoptera, Braconidae, Blacinae) from Mexico
Authors: SÁNCHEZ-GARCÍA JOSÉ ANTONIO , WHARTON ROBERT ALAN , ROMERO-NAPOLES JESÚS , FIGUEROA JOSÉ ISAAC , LÓPEZ-MARTÍNEZ VÍCTOR , MARTÍNEZ ANA MABEL , PÉREZ-PACHECO RAFAEL , PINEDA SAMUEL
Published: January 2019

Four new species of Blacus from Mexico are described and illustrated, B. basitarsis Sánchez et Wharton, sp. nov., B. huitepec Sánchez et Wharton, sp. nov., B. julianae Sánchez et Figueroa, sp. nov., and B. longipetiolatus Sánchez et Wharton, sp. nov.. Male genitalia are illustrated for comparison across all four species.
Division of the genus Nothopleurus Lacordaire, 1869 (Coleoptera: Cerambycidae: Prioninae)
Authors: SANTOS-SILVA ANTONIO , SWIFT IAN P. , NEARNS EUGENIO H.
Published: January 2019

The genus Nothopleurus Lacordaire is reviewed and generic limits redefined. Two species are transferred from Nothopleurus to Olethrius Lacordaire and the following new combinations are proposed: Olethrius cariosicollis (Fairmaire), Olethrius macrothorax (Montrouzier). Nothopleurus arabicus (Buquet) is transferred from Nothopleurus and returned to its original genus as Mallodon arabicum. Mallodon castaneum (Casey) is revalidated in Nothopleurus. Hovorodon gen. nov. is proposed and Cerambyx maxillosus Drury is designated as the type species. Four species are transferred from Nothopleurus to the new genus: Nothopleurus bituberculatus (Palisot de Beauvois), Nothopleurus maxillosus (Drury), Nothopleurus santacruzensis Hovore & Santos-Silva, and Nothopleurus subcancellatus (Thomson). The species of Nothopleurus and of the new genus are redescribed and illustrated. A new country record is recorded for Nothopleurus subsulcatus (Dalman) (Bahamas) and new state records are recorded for N. lobigenis Bates (Mexico: Guerrero, Nayarit). Mallodon hornebecki Chevrolat is considered a valid described species and synonymous with Prionus bituberculatus (= Nothopleurus bituberculatus). In addition, keys are provided to the four species of Nothopleurus as well as the four species of Hovorodon gen. nov.
Systematics of Anopheles (Cellia) yaeyamaensis sp. n., alias species E of the An. minimus complex in southeastern Asia (Diptera: Culicidae)
Authors: SOMBOON PRADYA , RORY ANGELA , TSUDA YOSHIO , TAKAGI MASAHIRO , HARBACH RALPH E.
Published: January 2019

Species E of the Anopheles minimus sibling species complex is diagnosed and formally named An. yaeyamaensis Somboon & Harbach, sp. n. Information is provided on the morphology, genetics and bionomics of the species, which has a restricted distribution in the Yaeyama and Miyako Islands located at the southern end of the Ryukyu Archipelago of Japan.
Chitons (Mollusca, Polyplacophora) from the Maldive islands
Authors: DELL’ANGELO BRUNO , GORI SANDRO , BASCHIERI LEONARDO , BONFITTO ANTONIO
Published: January 2019

This paper is the first comprehensive and illustrated account of living Polyplacophora from the Maldive Islands. The only important previous contribution is that of E.A. Smith (1903), describing eight species. We determined 15 species sourced from 24 sampling sites, mainly at a depth of 20–40 meters, represented by 19 living specimens and 1112 valves. Only nine species (Parachiton hylkiae mauricejayi, Ischnochiton albinus, Ischnochiton sp., Rhyssoplax maldivensis, Tegulaplax hululensis, Lucilina sp., Acanthochitona penicillata, Craspedochiton cf. laqueatus, Cryptoplax burrowi) are represented by living specimens, the others by separate valves (Callochiton clausadeae, Lucilina perligera, L. carnosa, Acanthochitona sp., Craspedochiton sp., Cryptoplax sykesi), three of them (Lucilina perligera, Acanthochitona sp., Craspedochiton sp.) by only one or two valves. We did not find four of the species previously reported for the Maldives, i.e. Ischnochiton feliduensis, Callochiton platessa, Squamopleura miles and Schizochiton incisus. The specimen collected by J.S. Gardiner, and reported in Smith (1903) as Callochiton platessa Gould, has been studied, and it is not possible to attribute to any of the other Callochiton species from the Indian Ocean. It thus remains undetermined as Callochiton sp., and Callochiton platessa Gould must be deleted from the list of chiton species living in the Maldive Islands. The holotype of Ischnochiton feliduensis (the only specimen known) is illustrated to provide a complete and exhaustive survey of all the 19 chiton species now known from the Maldive Islands. Two species from other localities, Squamopleura miles and Schizochiton incisus, also are illustrated. The type material of Craspedochiton laqueatus and Cryptoplax burrowi has been examined. Eleven species are reported for the first time for the Maldives: Parachiton hylkiae mauricejayi, Ischnochiton albinus, Ischnochiton sp., Callochiton clausadeae, Lucilina perligera, L. carnosa, Lucilina sp., Acanthochitona penicillata, Acanthochitona sp., Craspedochiton sp. and Cryptoplax sykesi.
A Review of Chinese Raman Spectroscopy Research Over the Past Twenty Years
Authors: Wang Jie , Liu Kaiyuan , Jin Shangzhong , Jiang Li , Liang Pei
Published: January 2019

This paper introduces the major Chinese research groups in the fields of biomedicine, food safety, environmental testing, material research, archaeological and cultural relics, gem identification, forensic science, and other research areas of Raman spectroscopy and combined methods spanning the two decades from 1997 to 2017. Briefly summarized are the research directions and contents of the major Chinese Raman spectroscopy research groups, giving researchers engaged in Raman spectroscopy research a more comprehensive understanding of the state of Chinese Raman spectroscopy research and future development trends to further develop Raman spectroscopy and its applications.
Latent Structure of Early Adolescent Bullying Perpetration: A Taxometric Analysis of Raw and Ranked Scores
Authors: Walters Glenn D. , Espelage Dorothy L.
Published: January 2019

The purpose of this study was to investigate the latent structure type (categorical vs. dimensional) of bullying perpetration in a large sample of middle school students. A nine-item bullying scale was administered to 1,222 (625 boys, 597 girls) early adolescents enrolled in middle schools in a Midwestern state. Based on the results of a principal axis factoring analysis, the nine items were organized into four homogeneous scales. These scales were then used as indicators in a taxometric analysis of the bullying perpetration construct. According to the results of three nonredundant taxometric procedures (mean above minus below a cut, maximum covariance, and latent mode factor analysis), the total sample showed evidence of dimensional or continuous latent structure, but the male and female subsamples produced outcomes that were more ambiguous. Because the indicators were highly skewed and leptokurtic, raw scores were converted to rank normalized scores and the taxometric analyses recomputed. These recomputed analyses provided unequivocal support for dimensional latent structure in the total sample as well as in both subsamples. From these results, it was surmised that bullying perpetration is continuously organized and that rank normalized scores may improve the interpretability of taxometric findings derived from highly nonnormal indicators.
Border Practices at Beitbridge Border and Johannesburg Inner City: Implications for the SADC Regional Integration Project
Authors: Moyo Inocent , Nshimbi Christopher Changwe
Published: January 2019

Regarded not only as a line that separates South Africa and Zimbabwe to underline the interiority and exteriority of the two countries, as well as to control and manage migration and immigration, Beitbridge border effectively plays out the immigration debates and dynamics at the heart of the nation-state of South Africa. Based on a qualitative study of how migrants from other African countries are treated at this border and in Johannesburg inner city, we suggest that the harassment suffered by the migrants at the hands of border officials, including immigration officials, the police and army, is indicative of a larger dynamic that exists in the centre, which is represented by Johannesburg inner city. Such bordering and rebordering practices at the border and at the centre reflect negatively on the spirit and letter of the Southern African Development Community (SADC) regional integration project.
The Intersection of Race, Gender, and Nationality in Sport: Media Representation of the Ogwumike Sisters
Authors: Zenquis Manuel R. , Mwaniki Munene F.
Published: January 2019

The diversity of Black America in general, and how it pertains to gender in particular, remains understudied in analyses of sports media. To get a better understanding of the Black female athlete in our society today, this project addresses the intersections of race, gender, and nationality/ethnicity in U.S. media. To do this, we use critical discourse analysis to examine the sports media representations of professional basketball players Nnemkadi and Chinenye Ogwumike. As relatively successful second-generation Black African female athletes, we find that the sisters represent a compelling site of analysis as a nexus of crisscrossing power relations. Our discussion focuses on the manipulations of foreign female Blackness to maintain White supremacy by media in the United States specifically, and the West more broadly.
The selective orexin-2 receptor antagonist seltorexant improves sleep: An exploratory double-blind, placebo controlled, crossover study in antidepressant-treated major depressive disorder patients with persistent insomnia
Authors: Brooks Sander , Jacobs Gabriël E , de Boer Peter , Kent Justine M , Van Nueten Luc , van Amerongen Guido , Zuiker Rob , Kezic Iva , Luthringer Remy , van der Ark Peter , van Gerven Joop MA , Drevets Wayne
Published: January 2019

Background:

Insomnia is common in patients with major depressive disorder. Although antidepressants improve mood, insomnia often persists as a result of physiological hyperarousal. The orexin-2 receptor is increasingly being recognized as a new target for the treatment of persistent insomnia in major depressive disorder .

Aim:

This exploratory study investigated the effects of seltorexant on objective sleep parameters and subjective depressive symptoms in antidepressant treated major depressive disorder patients with persistent insomnia.

Methods:

Twenty male and female patients received a single dose of 10, 20, 40 mg seltorexant and placebo with a washout period of seven days in a double-blind four-way crossover study. Effects on latency to persistent sleep, total sleep time and sleep efficiency were assessed with polysomnography. Subjective changes in mood were explored by the Quick Inventory of Depressive Symptomatology Self-Report. Safety was recorded and suicidal ideation and behavior were assessed with the Columbia Suicide Severity Rating Scale.

Results:

Latency to persistent sleep was significantly shorter for all doses of seltorexant compared to placebo. Placebo least square mean was 61.05 min with least square mean ratios treatment/placebo (80% confidence interval) of 0.32 (0.24–0.44), 0.15 (0.11–0.2) and 0.17 (0.12–0.23) 19.69, 9.2, 10.15 for 10, 20 and 40 mg seltorexant respectively, (all p<0.001). Total sleep time was significantly longer for all doses of seltorexant compared to placebo. Sleep efficiency was significantly improved. The Quick Inventory of Depressive Symptomatology Self-Report demonstrated a trend to mood-improvement for the 40 mg group.

Conclusions:

Seltorexant showed a statistically significant, dose-dependent decrease in latency to persistent sleep, and increase in total sleep time and sleep efficiency combined with a tendency toward subjectively improved mood.
Seeing power with a flashlight: DIY thermal sensing technology in the classroom
Authors: Kenny Catherine , Liboiron Max , Wylie Sara Ann
Published: January 2019

This paper contributes to the growing literature on ‘making and doing’ in Science and Technology Studies (STS) by describing and theorizing the teaching of making and doing. We describe a collaborative do-it-yourself (DIY) technology project taught simultaneously in Canada and the United States, in sociology and public health, to undergraduates with no prior electronics experience. Students built thermal flashlights – low cost digital tools for making thermal images – and employed them to research their surrounding environments. By making and using the thermal flashlights, learners investigated power in two senses: identifying social power relationships embedded within normally unquestioned infrastructures, and exploring these infrastructures’ connection to industrial forms of power, such as heat and electricity. Students and instructors came to understand how the control of power, light and temperature is vital to human-made infrastructure and environmental health threats that characterize the 21st century. Through this project, students went from being passive consumers of such power to become active investigators of their socio-technical systems by producing unique knowledge that enabled them to imagine how they might make and inhabit their environments differently. Breaking down the distinction between teaching and research, this article explores the promise of ‘making and doing’ in university courses to create new collaborative research platforms that could spread laterally and scale to transform social and technical infrastructures.
Effect of Timing of Ondansetron Administration on Incidence of Postoperative Vomiting in Paediatric Strabismus Surgery
Authors: Madan R. , Perumal T. , Subramaniam K. , Shende D. , Sadashivam S. , Garg S.
Published: January 2019

This prospective, randomized, double-blinded study evaluated the effect of the timing of ondansetron administration on its antiemetic efficacy in children undergoing elective strabismus surgery. One hundred and twenty children aged one to 15 years, ASA physical status 1 or 2, were randomly allocated to receive intravenous ondansetron 100 μg/kg either at induction (Group 1) or at the end of the surgery (Group 2). All patients had general anaesthesia induced and maintained with nitrous oxide and halothane, muscle relaxation with vecuronium, endotracheal intubation, reversal with neostigmine and glycopyrrolate, and pethidine 0.5 mg/kg analgesia. Episodes of nausea and vomiting were evaluated at 0 to 2, 2 to 6 and 6 to 24 hour intervals by a blinded observer. Demographic data, duration of anaesthesia, type of surgery, incidence of previous postoperative nausea or vomiting and motion sickness and number of patients who developed oculocardiac reflex requiring atropine treatment were similar in both groups. The incidence of emesis in the first 24 hours following surgery was similar in both groups (35% Group 1, 33.3% Group 2, P=1.00). Severity of emesis (median number of emetic episodes, rescue antiemetic requirement and mean time to the onset of first episode of emesis) and mean time to discharge from the post anaesthesia care unit were also similar in the two groups. We conclude that the timing of ondansetron administration either before or after the surgical manipulation of extraocular muscles had similar antiemetic efficacy following strabismus surgery in children.
Retroperitoneoscopic Excision of Phaeochromocytoma—Haemodynamic Events, Complications and Outcome
Authors: Subramaniam R. , Pandit B. , Sadhasivam S. , Sridevi K. B. , Kaul H. L.
Published: January 2019

Over a period of 15 months, 11 patients with phaeochromocytoma underwent retroperitoneoscopic excision of their tumours. Five patients had bilateral tumours. All patients underwent thorough preoperative evaluation and preparation with α- and β-blockade. In the majority of the patients a hypertensive response was seen during generation of pneumoretroperitoneum. However, the period of tumour dissection and excision was devoid of large haemodynamic fluctuations. The average time taken was 3.5 to 4 hours per gland. Blood loss in successful laparoscopic excision averaged 240 ml (range 120 to 700 ml). In these patients satisfactory postoperative analgesia could be provided with intramuscular pethidine or intramuscular diclofenac sodium. In three patients the procedure had to be converted to open laparotomy due to haemorrhage. All three patients had preoperative radiological evidence of inferior vena cava and aortic involvement. Patient selection plays an important role in a successful outcome.
The Dose-Effect Relationship for Morphine and Vomiting after Day-Stay Tonsillectomy in Children
Authors: Anderson B. J. , Ralph C. J. , Stewart A. W. , Barber C. , Holford N. H. G.
Published: January 2019

A dose-response curve for intravenous morphine and vomiting was investigated in children having day-stay tonsillectomy. A retrospective chart review was performed for the 164 children fulfilling the inclusion criteria. Morphine (mean 0.09 mg/kg SD 0.05) was used in 108 children in the perioperative period and a further 56 children were given no opioid. Fifty-five of these 164 children vomited and 20 children required an overnight stay in hospital because of vomiting. The probability of vomiting or overnight stay in hospital was related to morphine dose (by logistic regression). The overall probability of vomiting after morphine 0.1 mg/kg was 50% and the probability of admission for vomiting with this dose was 10%. Pharmacodynamic parameter estimates for postoperative vomiting were P0 (the baseline probability of vomiting, with no opioid) 0.115, Pmax (the maximal probability of vomiting due to morphine) 0.997, ED50 (morphine dose that induces an effect equivalent to 50% of the logit Pmax) 0.18 mg/kg. Parameter estimates for overnight stay because of vomiting after morphine administration were P0 0.038, Pmax 0.999, ED50 0.369 mg/kg. Satisfactory postoperative analgesia in children has been reported with morphine 0.05 to 0.15 mg/kg. Doses above 0.1 mg/kg are associated with a greater than 50% incidence of vomiting. Our data suggests that lower doses of morphine are associated with a decreased incidence of emesis after tonsillectomy in children.
Co-Administration of Drugs and Blood Products
Authors: Birch C. , Hogan C. , Mahoney G.
Published: January 2019

The addition of a drug to a blood product intravenous line raises the question of physical and chemical compatibility of the drug with the blood and any preservatives or additives in the blood product.

This clinical scenario is encountered frequently, however the practice has not been well studied. Protocols at most institutions prohibit the addition of drugs to blood products. We investigated the addition of analgesic drugs used for patient-controlled analgesia (morphine 1 mg/ml, pethidine 10 mg/ml and ketamine 1 mg/ml) to a standard red cell concentrate, resuspended red blood cells.

The red cells were analysed by a Blood Transfusion Service Haematologist and subjected to standard quality control tests. The morphology of the red cells in resuspended red blood cell preparations was unchanged by the addition of these drugs at any stage during storage. The drug concentration in the resuspended red blood cell serum was measured at 0 and at 20 minutes and there was no decrease in concentration which showed that there was no loss of free drug in the resuspended red blood cell serum.

This study demonstrates that the concern regarding injury to red cells in standard red cell concentrates by addition of these drugs is unjustified.
Excision of a Giant Hydatid Cyst of the Lung under Thoracic Epidural Anaesthesia
Authors: Dyer R. A. , Gordon P. C. , De Groot K. M. , Walther G. , James M. F. M.
Published: January 2019

We present a patient with a large pulmonary hydatid cyst compressing underlying lung, with previous pulmonary tuberculosis, who presented in respiratory failure. After institution of thoracic epidural anaesthesia employing 0.25% bupivacaine, 1% lignocaine and fentanyl, the patient was placed in the sitting position and the hydatid cyst excised and drained after a limited rib resection. An air leak persisted until the 16th postoperative day. A marked improvement in symptoms as well as in spirometry and arterial blood gases occurred, and the patient was discharged on the 20th day. Thoracic epidural anaesthesia may be a safer method than general anaesthesia for removal of a hydatid cyst in a patient with severe respiratory compromise.
Cricoid Pressure: Beware the Patient with a Goitre
Authors: Fairweather N. L.
Published: January 2019

A case of acute thyroid swelling is reported following intubation of a young woman with a pre-existing small goitre.

The thyroid enlargement then distorted the airway, necessitating an emergency thyroidectomy.

The application of cricoid pressure was believed to have caused the intrathyroidal bleeding and the complications of cricoid pressure are reviewed.
Epidural Anaesthesia for Endovascular Stent Graft Repair of a Ruptured Thoracic Aneurysm
Authors: Leykin Y. , Rubulotta F. M. , Mancinelli P. , Tosolini G. , Gullo A.
Published: January 2019

We present a case report of the anaesthetic management of a 77-year-old man requiring endovascular thoracic stent graft repair The patient had a history of poorly controlled type II diabetes mellitus and chronic renal failure. Chest X-ray and CT scan shoowed a right pleural effusion, generalized emphysema and an enlarged thyroid extending into the upper mediastinum, compromising the tracheal lumen. Endovascular stent grat repair was successfully performed under epidural anaesthesia and intravenous sedation.
Messenger RNA Expression of Multiple Immune Mediators in Leukocytes from Elective Orthopaedic Surgical Patients
Authors: Ireland N. , Kalkoff M. , Cursons R. T. , Sleigh J. W.
Published: January 2019

The aim of this longitudinal observational study was to investigate and describe the spectrum of messenger ribonucleic acid (mRNA) expression of multiple inflammatory markers in circulating leukocytes after major orthopaedic surgery. We studied ten elective arthroplasty patients perioperatively on the orthopaedic ward, and eight healthy volunteers for a comparison group. Venous blood specimens were collected preoperatively, and 6, and 24 hours postoperatively, together with 6- and 24-hour postoperative wound drain specimens. The mRNA of 21 different inflammatory mediators was measured by real-time reverse transcriptase Polymerase Chain Reaction. Comparisons were made with the venous blood of eight healthy comparison subjects. There were significant differences (P<0.01) between preoperative specimens and normal comparisons (i.e. higher MPO, PDGF, TREM and IRAKM; lower mtHSP) reflecting the effects of chronic inflammation associated with osteoarthritis. There were significant increases (P<0.01) in expression of IL-8, MPO, IL-1β, TREM, MMP9, and C5aR in circulating blood at 24 hours postoperatively, but not at six hours. There was no significant decrease in expression of any inflammatory mediator. There was no statistical difference in inflammatory mediator expression between drain specimens and venous specimens taken at the same time. We conclude that, in uncomplicated orthopaedic surgical patients, there was up-regulation of some cytokine mRNAs at both the local and systemic levels during the first day after surgery. We observed no evidence of immune compartmentalization, and found no evidence for innate immune paresis within the first day after surgery.
Phrenic Nerve Palsy in Severe Tetanus
Authors: Panda N. B. , Yaddanapudi S. , Bharadwaj N. , Das C. , Chari P.
Published: January 2019

Unilateral or bilateral raised hemidiaphragms were observed on chest X-ray in three patients with severe tetanus. Diaphragmatic movement was absent on ultrasonography and fluoroscopy. Nerve conduction study confirmed phrenic nerve palsy. Bilateral involvement caused delayed weaning from the ventilator, whereas unilateral involvement was asymptomatic. There was complete recovery from phrenic nerve palsy in all patients.
Efficacy of Low-dose Dexamethasone for Preventing Postoperative Nausea and Vomiting following Strabismus Repair in Children
Authors: Mathew P. J. , Madan R. , Subramaniam R. , Bhatia A. , Mala C. G. , Soodan A. , Kaul H. L.
Published: January 2019

We studied the efficacy of a range of doses of dexamethasone for prevention of postoperative nausea and vomiting following strabismus repair in children in a hospital-based, prospective, double-blinded, randomized, placebo-controlled trial.

Two hundred and ten children were randomized to receive either dexamethasone in one of four dosages: 50 μg/kg (Group 1), 100 μg/kg (Group 2), 200 μg/kg (Group 3) and 250 μg/kg (Group 4) or normal saline (Group 5) prior to corrective surgery for strabismus. Anaesthesia was standardized and included nitrous oxide, pethidine, intubation and the use of muscle relaxant and reversal with neostigmine. Postoperative nausea and vomiting were evaluated in epochs of 0-2 hours, 2-6 hours and 6-24 hours after surgery. Parent satisfaction was assessed 24 hours after surgery and the operated eye was examined for wound infection and delayed healing one week later.

Dexamethasone was effective in preventing nausea and vomiting after strabismus repair: 57.1% children in Group 1, 42.9% in Group 2, 52.4% in Group 3, and 59.5% in Group 4 were free from postoperative nausea and vomiting compared with 7.1% in placebo group. The lowest dose of 50 μg/kg was as efficacious as the higher dosages of dexamethasone during the 24 hours studied. Of the children who developed postoperative nausea and vomiting, those who received dexamethasone had significantly fewer episodes than those in the placebo group.

We conclude that dexamethasone 50 μg/kg is effective for the prevention of postoperative nausea and vomiting following strabismus repair in children.
Antibiotic Resistance in the Intensive Care Unit: A Primer in Bacteriology
Authors: Iredell J. , Lipman J.
Published: January 2019

The clinical use of potent, well-tolerated, broad-spectrum antibiotics has been paralleled by the development of resistance in bacteria, and the prevalence of highly resistant bacteria in some intensive care units is despairingly commonplace. The intensive care community faces the realistic prospect of untreatable nosocomial infections and should be searching for new approaches to diagnose and manage resistant bacteria. In this review, we discuss some of the relevant underlying biology, with a particular focus on genetic transfer vehicles and the relationship of selection pressure to their movements. It is an attempt to demystify the relevant language and concepts for the anaesthetist and intensivist, to explain some of the reasons for the emergence of resistance in bacteria, and to provide a contextual basis for discussion of management approaches such as selective decontamination and antibiotic cycling.
Brugada Syndrome following Tricyclic Antidepressant Overdose
Authors: Bigwood B. , Galler D. , Amir N. , Smith W.
Published: January 2019

The Brugada syndrome, a pro-arrhythmogenic repolarization abnormality, is becoming increasingly recognised as a cause of collapse and sudden cardiac death3. We report a case of a 48-year-old man with a tricyclic overdose and a delayed presentation of the Brugada pattern in the ICU. This case raises the need for clinicians to be aware of the Brugada pattern and those patients potentially at risk.
Provision for Major Obstetric Haemorrhage: An Australian and New Zealand Survey and Review
Authors: Fowler S. J.
Published: January 2019

Obstetric haemorrhage is a leading cause of maternal death and the most common contributor to serious obstetric morbidity. Maternal mortality audit data suggest that appropriate preparation and good emergency management leads to improved outcome. The aim of this study was to assess facilities relevant to major obstetric haemorrhage management in all units in Australia and New Zealand that offer operative obstetric services. The questionnaire was divided into ten sections: demographics, facilities, staffing, policies and guidelines, drugs, procedures, equipment, point of care testing, availability of O negative blood and free comments. Responses were received from 240 (76.4%) of the 314 hospitals surveyed (187 public and 53 private). One hundred and nine units (45%) had fewer than 500 deliveries per year. Distances to referral facilities were frequently very large. Of the 90 hospitals (38.1%) without an onsite blood bank, 12 did not have a supply of blood for emergencies. Half of all units (n=121) had on-site intensive care or high dependency facilities and 72.9% (n=175) had an on-site cardiac arrest team. Only 58.8% of units (n=141) had a written haemorrhage protocol. Findings are presented in the context of other literature, including evidence-based guidelines. Haemorrhage responds well to appropriate treatment, although careful preparation and anticipation of problems is required. In our region geographical factors and different systems of healthcare complicate provision of obstetric services. Where facilities are limited, women should be offered antenatal transfer to a larger centre.
Performance of Three Systems for Warming Intravenous Fluids at Different Flow Rates
Authors: Satoh J. , Yamakage M. , Wasaki S. I. , Namiki A.
Published: January 2019

This study compared the intravenous fluid warming capabilities of three systems at different flow rates. The devices studied were a water-bath warmer, a dry-heat plate warmer, and an intravenous fluid tube warmer. Ambient temperature was controlled at 22° to 24°C. Normal saline (0.9% NaCl) at either room temperature (21° to 23°C) or at ice-cold temperature (3° to 5°C) was administered through each device at a range of flow rates (2 to 100 ml/min). To mimic clinical conditions, the temperature of the fluid was measured with thermocouples at the end of a one metre tube connected to the outflow of the warmer for the first two devices and at the end of the 1.2m warming tubing for the intravenous fluid tube warmer. The temperature of fluid delivered by the water bath warmer increased as the flow rate was increased up to 15 to 20 ml/min but decreased with greater flow rates. The temperature of the fluid delivered by the dry-heat plate warmer significantly increased as the flow rate was increased within the range tested (due to decreased cooling after leaving the device at higher flow rates). The temperature of fluid delivered by the intravenous fluid tube warmer did not depend on the flow rate up to 20 ml/min but significantly and fluid temperature-dependently decreased at higher flow rates (>30 ml/min). Under the conditions of our testing, the dry heat plate warmer delivered the highest temperature fluid at high flow rates.
Effect of Tramadol on Bispectral Index during Intravenous Anaesthesia with Propofol and Remifentanil
Authors: Fodale V. , Tescione M. , Roscitano C. , Pino G. , Amato A. , Santamaria L. B.
Published: January 2019

The aim of this study was to investigate the effects of tramadol on the Bispectral Index (BIS) during total intravenous propofol-remifentanil anaesthesia. Forty-four adult ASA Physical status I-II patients, scheduled for elective general surgical procedures were included in a prospective observational randomized study. Doses for anaesthetics and opioids were adjusted to keep the BIS value at 50±5. After 20 minutes of stable anaesthesia, the subjects were randomly allocated to receive intravenous saline (control group) or tramadol 1.5 mg/kg (tramadol group). BIS values, mean arterial pressure, and heart rate were recorded every five minutes for 20 minutes. Mean BIS values after tramadol administration were not significantly different from those following saline, throughout the observation period (P>0.05). There were no patients in whom BIS values were more than 60 or who presented explicit recall of events under anaesthesia. There were no significant changes in mean arterial pressure, SpO2, or heart rate (P>0.05). The results indicate that the administration of tramadol during stable total intravenous anaesthesia with propofol-remifentanil does not affect BIS values. The clinical relevance is that tramadol can be safely administered pre- and intraoperatively as pre-emptive or preventive analgesia without modification of the depth of anaesthesia.