bluuebunny/crossref_metadata_2025 huggingface dataset:
Developing Immersive Simulations: The Potential of Theater in Teaching and Learning in Political Studies
Authors: Dacombe Rod , Morrow Elizabeth A.
Published: January 2017

Innovative teachers of political science have frequently moved beyond the confines of conventional teaching formats to better engage students with the demands of the discipline. In particular, the use of simulations has been proposed as an alternative to passive, lecture-based techniques, and a growing literature examines their value and efficacy. This article contributes to the literature by describing the development of a simulation that draws on the principles of immersive theater in an attempt to maximize participation while encouraging students to think critically about political concepts and ideas.
Teach a Student to Fish? International Relations Scholars in the Classroom
Authors: Rathbun Nina Srinivasan , Rathbun Brian C.
Published: January 2017

American higher-education institutions are under increasing pressure to prepare their students with practical skills for the workplace, and the social sciences—including political science—are not immune. Political figures have suggested—sometimes seconded by academics themselves—that research distracts academics from imparting practical skills to undergraduate students. Using a survey of international relations (IR) scholars, this article shows that this is not the case. Those who spend more time on research actually devote more time to policy-relevant research in their courses than more abstract and theoretical work, and they incorporate more contemporary issues. Research seems to encourage academics to teach their students to fish.
Forgotten but not gone: new developments in the understanding and treatment of tardive dyskinesia
Authors: Meyer Jonathan M.
Published: January 2017

The broad use of atypical antipsychotics was expected to dramatically reduce the prevalence and incidence of tardive dyskinesia (TD), but data show that TD remains an important challenge due the persistent nature of its symptoms and resistance to numerous treatment modalities, including antipsychotic discontinuation. Recent insights on genetic risk factors and new concepts surrounding pathophysiology have spurred interest in the possibility of targeted treatment for TD. As will be reviewed in this article, the number of evidence-based strategies for TD treatment is small: only clonazepam, amantadine, ginkgo biloba extract, and the vesicular monoamine transporter 2 (VMAT2) inhibitor tetrabenazine have compelling data. Using new insights into the metabolism of tetrabenazine and the properties of its active metabolites, 2 modifications of tetrabenazine have been synthesized to improve the kinetic profile, and are currently involved in double-blind placebo controlled studies aimed at U.S. Food and Drug Administration (FDA) regulatory approval. The possible availability of these new agents, deuterated tetrabenazine and valbenazine, significantly widens the range of treatment choices for patients with TD. For clinicians with patients at risk for TD due to dopamine antagonist exposure, experience has shown that the problem of TD will be an ongoing issue in modern psychiatry, and that an appreciation of new developments in the pathophysiology of, risk factors for, and treatment of TD is crucial to managing this condition.
A pragmatic approach to the diagnosis and treatment of mixed features in adults with mood disorders
Authors: McIntyre Roger S. , Lee Yena , Mansur Rodrigo B.
Published: January 2017

Mixed features specifier (MFS) is a new nosological entity defined and operationalized in the Diagnostic and Statistical Manual of Mental Disorders (DSM), 5th Edition. The impetus to introduce the MFS and supplant mixed states was protean, including the lack of ecological validity, high rates of misdiagnosis, and guideline discordant treatment for mixed states. Mixed features specifier identifies a phenotype in psychiatry with greater illness burden, as evidenced by earlier age at onset, higher episode frequency and chronicity, psychiatric and medical comorbidity, suicidality, and suboptimal response to conventional antidepressants. Mixed features in psychiatry have historical, conceptual, and nosological relevance; MFS according to DSM-5, is inherently neo-Kraepelinian insofar as individuals with either Major Depressive Disorder (MDD) or Bipolar Disorder (BD) may be affected by MFS. Clinicians are encouraged to screen all patients presenting with a major depressive episode (or hypomanic episode) for MFS. Although “overlapping symptoms” were excluded from the diagnostic criteria (eg, agitation, anxiety, irritability, insomnia), clinicians are encouraged to probe for these nonspecific symptoms as a possible proxy of co-existing MFS. In addition to conventional antidepressants, second generation antipsychotics and/or conventional mood stabilizers (eg, lithium) may be considered as first-line therapies for individuals with a depressive episode as part of MDD or BD with mixed features.
Recognizing and treating pseudobulbar affect
Authors: Sauvé William M.
Published: January 2017

Pseudobulbar affect, thought by many to be a relatively newly described condition, is in fact a very old one, described as early as the 19th century. It refers to those who experience inappropriate affect, disconnected from internal state, or mood, generally thought to be the result of an upper motor neuron injury or illness. One possible explanation for this condition’s relative obscurity is the dearth of treatment options; clinical medicine is not typically in the habit of identifying conditions that cannot be modified. Now, however, there is good evidence for the treatment of pseudobulbar affect, and even a therapy approved for use by the U.S. Food and Drug Administration (FDA). As a result, appropriate identification and subsequent management of pseudobulbar affect is more important than ever. This article purports to summarize the origins of pseudobulbar affect, most current hypotheses as to its physiopathology, clinical identification, and evidence for management.
Optimizing outcomes in ADHD treatment: from clinical targets to novel delivery systems
Authors: Mattingly Gregory W. , Anderson Richard H.
Published: January 2017

Our knowledge and understanding of the underlying neurobiology and symptomatic expression of ADHD has advanced dramatically over the past decade. Associated with these advances has been a similar explosion of new treatment options to individualize treatment for our patients.

This article will:

∙

review strategies to measure ADHD symptoms and functional difficulties while seeking to achieve full symptomatic remission throughout the day

∙

summarize recent findings regarding the management and prioritization of ADHD and comorbid conditions and

∙

discuss the various pharmacologic treatment options with a focus on recently developed molecules and novel delivery systems
Palliative care during the final week of life of older people in nursing homes: A register-based study
Authors: Smedbäck Jonas , Öhlén Joakim , Årestedt Kristofer , Alvariza Anette , Fürst Carl-Johan , Håkanson Cecilia
Published: January 2017

Objective:

Our aim was to explore the presence of symptoms, symptom relief, and other key aspects of palliative care during the final week of life among older people residing in nursing homes.

Method:

Our study employed data from the Swedish Palliative Care Register on all registered individuals aged 60 and older who had died in nursing homes during the years 2011 and 2012. Variables pertaining to monitoring and treatment of symptoms, end-of-life discussions, circumstances around the death, and the individual characteristics of deceased individuals were explored using descriptive statistics.

Results:

The most common underlying causes of death among the 49,172 deceased nursing home residents were circulatory diseases (42.2%) and dementia (22.7%). The most prevalent symptom was pain (58.7%), followed by rattles (42.4%), anxiety (33.0%), confusion (21.8%), shortness of breath (14.0%), and nausea (11.1%). Pain was the symptom with the highest degree of total relief (46.3%), whereas shortness of breath and confusion were totally relieved in 6.1 and 4.3% of all individuals, respectively. The use of valid instruments for symptom assessment was reported for pain in 12.3% and for other symptoms in 7.8% of subjects. The most prevalent individual prescriptions for injection PRN (pro re nata, according to circumstances) were for pain treatment (79.5%) and rattles (72.8%). End-of-life discussions were performed with 27.3% of all the deceased individuals and with 53.9% of their relatives. Of all individuals, 82.1% had someone present at death, and 15.8% died alone. Of all the nursing home resident deaths recorded, 45.3% died in their preferred place.

Significance of results:

There were large variations in degree of relief from different symptoms during the final week of life. Pain was the most prevalent symptom, and it was also the symptom with the highest proportion of total/partial relief. Other symptoms were less prevalent but also less well-relieved. Our results indicate a need for improvement of palliative care in nursing home settings, focusing on management of distressing symptoms and promotion of end-of-life discussions.
Assessment of genetic diversity of Mithun (Bos frontalis) population in Bhutan using microsatellite DNA markers
Authors: Tenzin Sangay , Dorji Jigme , Dorji Tashi , Kawamoto Yoshi
Published: January 2017

Genetic diversity of Mithun population in Bhutan was studied using 14 microsatellite markers. Two sets of two-step polymerase chain reactions were performed with multiplex and individual markers for genotyping 105 hair samples collected from Arong in Samdrupjongkhar (AS, 36) and Wangdigang in Zhemgang (WZ, 69). Fifty-three alleles were detected with average of 3.89 alleles and polymorphism information content of 0.44 ± 0.03 per locus. A low level of genetic variability within population was present with observed heterozygosity at 0.50 ± 0.06 and expected heterozygosity at 0.48 ± 0.06. Analysis of molecular variance attributed 58 percent of total variation to within the individuals. MeanFISandFITwere −0.056 and 0.005 respectively, indicated low level of population differentiation and limited out-breeding. The normal L-shaped distribution of allelic frequencies without any mode-shift revealed the absence of recent genetic bottleneck in Mithun populations. Therefore to manage inbreeding in the small Mithun population of Bhutan, periodic assessment of inbreeding levels and exchange of animals between farms is recommended to reduce frequency of introduction of animals from India.
Assessment of the genetic variability using pedigree analysis of the Sahiwal breed in Kenya
Authors: Mwangi S. , Muasya T.K. , Ilatsia E.D. , Kahi A.K.
Published: January 2017

Pedigree analysis using genealogical information of 18 315 animals born between 1949 and 2008 was done to quantify genetic variability of the Sahiwal population in Kenya. Generation intervals for sire pathways were longer than dam pathways and increased over year periods, from about 4–16 years. The later was due to use of old bulls for breeding in the last 2 year groups and cessation of progeny testing in the year 2000. Average inbreeding level in last year period studied was 1.2 percent. Genetic variability of the population as assessed based on gene origin statistics decreased over the years. The ratio of effective number of founders to founders of 0.06 showed unequal contribution of founders to the reference population. However, since the founding population, ancestors contributed equally as shown by the ratio of f
e/f
a of 0.94, which could also be due to lack of effective selection in this population. The ratio of f
g/f
a of 0.63 indicated genetic loss of genetic variability occurred through genetic drift in the Kenyan Sahiwal population. The small number of ancestors (16) that accounted for 50 percent of the total variation in the reference population suggested overuse of a small number of some animals as parents over generations. The smaller ratio of f
g/f
e compared with f
a/f
e also confirms loss of genetic variability in the population by genetic drift than bottlenecks. Therefore the breeding strategy for the Sahiwal population in Kenya should incorporate tools that balance rate of genetic gain and the future rate of inbreeding.
Reproductive parameters of some native bovine breeds: Sanmartinero and Casanareño
Authors: Moncaleano-Vega J. , Parra Molina R. , Peña Joya M.A. , Parra Arango J.L. , Góngora A.
Published: January 2017

En bovinos, la reducción de la eficiencia reproductiva de los sistemas de producción de carne y doble propósito se atribuye a factores nutricionales, sanitarios, climáticos y en última instancia a características genéticas de los animales. Sin embargo, en condiciones de trópico cálido húmedo, variaciones genéticas entre razas podrían reducir la edad al primer parto, el intervalo entre partos y aumentar la vida útil de las vacas. Las razas Sanmartinero y Casanareño podrían mejorar los sistemas de producción bovina debido al aporte de variantes genéticas que emergieron en el proceso de adaptación a las duras condiciones de la Orinoquía Colombiana. Actualmente, los genes con función biológica conocida se usan como marcadores moleculares para estimar parámetros de diversidad genética pecuaria facilitando la identificación y ubicación dentro del genoma de regiones que codifican o regulan la expresión de rasgos de interés económico. En ganado criollo colombiano Romosinuano se han identificado genes candidatos del eje Hormona de crecimiento/Factor de crecimiento similar a la insulina que se asocian positivamente con edad al primer parto, intervalo entre partos, longevidad y protección del embrión al estrés calórico. No obstante en las razas criollas Sanmartinero y Casanareño reconocidas empíricamente por estas características, no han sido sometidas a dichos análisis de genes candidatos que permitan promover un valor agregado a los animales. El objetivo de esta revisión es documentar algunos parámetros reproductivos y genéticos de las razas criollas Sanmartinero y Casanareño que soportan la necesidad de desarrollar estudios moleculares y justificar su uso en los sistemas de producción de carne y doble propósito de la Orinoquía colombiana.
Impacts of climate variability on livestock population dynamics and breed distribution patterns in selected districts of Western Amhara, Ethiopia
Authors: Alemayehu Kefyalew , Getu Addis
Published: January 2017

Climate change affects the livestock populations. As temperature increases, the rainfall distribution patterns shifts. These indirectly change the ecosystems like changes in crop yield, alter the distribution of animal diseases, geographically restriction of rare breed populations and increased competition for resources. Therefore, the objective of the study was to quantify impacts of climate variability on livestock population dynamics and breed distribution patterns. The study was conducted in Gondar Zuria, Farta and Bahir Dar Zuria districts. The sites were selected based on agro-ecology and livestock distribution potential. Data were collected through desk reviews of different documents and studies, focused group discussions, key informants interviews and different projection models. The results revealed that 70 percent of respondents believed that the trends of livestock breed distribution varied from year to year and from agro-ecology to agro-ecology. The number of cattle and equines are decreasing from year to year due to climate variability. Particularly, the crossbred cattle population decreased in 1998, 2002 and 2008 due to shortage of rainfall, increments of temperature and feed shortage. A correlation analysis was used to quantify impacts of temperature and rainfall on livestock population dynamics and breed distribution. The analyses revealed that sheep (r = −0.535, P < 0.05) and cattle (r = −0. 512, P < 0.05) were negatively affected by climate variability. Whereas goats were having positive relationship (r = 0.345, P < 0.001). As the average maximum temperature steadily increases, the population dynamics of ruminant livestock fluctuated after the year 1996. About 92.2, 78 and 83.3 percent respondents in Farta, Gondar Zuria and Bahir Dar Zuria districts, respectively, stated that there is a fluctuation in amount of rainfall distribution during the main rainy seasons. About 84.5 percent of respondent of the three districts also believed that climate change made variation in rainfall distribution. About 52 percent of the respondents also suggested that if livestock is to be protected from climate change and related effects, changing the farming system with appropriate breed is important and can be achieved with the zero-grazing system. The farmers also recommended with stocking climate change adaptive and productive breeds. In conclusion, climate variability affected livestock population dynamics and breed distribution pattern negatively.
Egg production and certain behavioural characteristics and mortality pattern of indigenous chicken of India
Authors: Kumar P.G. , Churchil R.R. , Jalaludeen A. , Narayanankutty K. , Peethambaran P.A. , Praveena P.E. , Chacko B. , Ajithbabu B.
Published: January 2017

A survey to document the behaviour characteristics and mortality pattern of indigenous chicken of Kerala and a field egg recording study to record egg production characteristics of these birds were conducted. Flight distance and height was 13.29 and 3.97 m, respectively. The territory radius of cocks was 121.15 m. The chick survivability at 4 weeks of age was 64.98 percent. The day-old and 8th week body weights were 28.83 and 347.24 g, respectively. The 20th and 40th week body weight of males were 1,428.42 and 1,936.67 g and that of females were 1,114.04 and 1,445.63 g, respectively. The mortality up to 72 weeks was 69.38 percent and major cause of mortality during chick, grower and layer stage were mongoose (44.63 percent), wolf (24.29 percent) and diseases (52.18 percent) respectively. The fertility was 71.22 percent and hatchability on total and fertile egg set were 62.26 and 87.42 percent, respectively. There were 2.13 clutches in a laying cycle with inter-clutch intervals of 1.11 days. The average clutch size and number of eggs per cycle were 7.27 and 14.32, respectively. The egg number up to 72 weeks on hen-day and hen-housed basis was 116.81 and 85.84, respectively and the eggs were laid in 7.7 cycles. The age at first egg and average age at sexual maturity were 155 and 199.26 days, respectively. The egg weight at 28, 40 and 72 weeks of age was 37.80, 40.74 and 43.31 g, respectively, and egg mass per bird was 4,659.04 g. The broodiness and incubation pause were 26.03 and 121.75 days, respectively.
Direkte orale Antikoagulantien
Authors: Merki Ramona , Schwarb Heike , Tsakiris Dimitrios A.
Published: January 2017

Zusammenfassung. Während der Behandlung mit direkten oralen Antikoagulantien (DOACs) sind meist keine Kontrollen der gerinnungshemmenden Wirkung oder der Medikamenten-Plasmaspiegel erforderlich. Bei Überdosierung, Medikamenteninteraktionen, Nieren- oder Leberinsuffizienz, sowie in vielen Notfallsituationen können solche Kontrollen erforderlich werden. Es sind Test-Kits zur Plasmaspiegel-Messung der meisten DOACs erhältlich. Stehen diese im Alltag nicht zur Verfügung, kann die Bestimmung der Faktor-Xa-Aktivität, der Thrombinzeit oder der aktivierten partiellen Thromboplastinzeit hilfreich sein. Der zeitliche Abstand der Blutentnahme zur Einnahme eines DOAC hat einen entscheidenden Einfluss auf die Resultate der Gerinnungstests.
Perioperatives Management der Antikoagulantien
Authors: Graf Lukas , Korte Wolfgang
Published: January 2017

Zusammenfassung. Auf Grund demographischer Faktoren und besserer Risikostratifizierung vergrössert sich die Gruppe der Patienten, welche oral antikoaguliert sind ständig. Naturgemäss sind somit auch mehr Patienten, die operiert werden müssen, antikoaguliert. Das periinterventionelle Vorgehen hängt einerseits vom eingesetzten Antikoagulans und andererseits vom individuellen Patientenrisiko ab. Im Vergleich zu den Vitamin K Antagonisten weisen die direkten oralen Antikoagulanzien (DOACs) eine deutlich kürzere Halbwertszeit auf. In ihrem pharmakokinetischen Verhalten sind sie mit subkutan applizierten niedermolekularen Heparinen vergleichbar. Deshalb kann in der periinterventionellen Situation bei den DOACs mit einer einfachen «stop and go» Strategie gearbeitet werden, während bei Vitamin K Antagonisten in ausgewählten Fällen (hohes Thromboembolie- oder Schlaganfallsrisiko) ein «Bridging» mit einer kürzer wirksamen Substanz (z. B. niedermolekulare Heparine) notwendig sein kann. Wie bei allen Antikoagulantien können bei DOACs in der periinterventionellen Situation Blutungen als unerwünschte Wirkung auftreten. Diese sind jedoch in aller Regel wegen der kurzen Halbwertszeit gut beherrschbar, zudem sind Antidots bereits (Dabigatran) respektive in absehbarer Zeit (Faktor Xa-Inhibitoren) verfügbar.
Thromboembolie und Antikoagulation bei Tumorpatienten
Authors: Grandoni Francesco , Kaiser Julie , Blum Sabine , Alberio Lorenzo
Published: January 2017

Zusammenfassung. Verschiedene epidemiologische Studien schätzen, dass zwischen 20 % und 30 % eines ersten thromboembolischen Ereignisses mit einer Krebserkrankung verbunden sind. Thromboembolische Ereignisse stellen eine klassische Komplikation von onkologischen Patienten dar. Diese Patienten haben nicht nur ein kürzeres Gesamtüberleben, sondern thrombotische Ereignisse sind auch die zweithäufigste Todesursache neben der malignen Erkrankung selbst. Zudem ist das Blutungsrisiko bei diesen Patienten erhöht. Dieser Artikel richtet sich an praktizierende ÄrztInnen, an AssistentInnen und an alle KollegInnen, die täglich Kontakt zu Krebspatienten haben. Der Artikel will einen einfachen, aber umfangsreichen Überblick über die praktischen Aspekte von thrombotischen Ereignissen vermitteln. Eine kurze pathophysiologische Einführung ist notwendig, um die klinischen und therapeutischen Konsequenzen zu besprechen. Dies ist umso wichtiger, weil die Krebserkrankung als eine heterogene Krankheit betrachtet werden muss. Klinische Aspekte sind ausführlicher berücksichtigt. Prävention und Behandlung thrombotischer Ereignisse sind ein Schwerpunkt des Artikels. Der Prävention solcher Ereignisse sollte mehr Achtung geschenkt werden, insbesondere direkt nachdem eine Krebsdiagnose gestellt wurde. Oft wird eine adäquate Prävention bei stationären Patienten durchgeführt, bei ambulanten Patienten ist es jedoch schwieriger, diejenigen mit einem erhöhten thrombotischen Risiko zu identifizieren und entsprechend primärprophylaktisch zu behandeln. Die Behandlung thrombotischer Ereignisse beruht vorwiegend auf niedermolekularen Heparinen. Auf Dauer, Alternativen und Risiken der Antikoagulation, sowie auf die Behandlung rezidivierender Ereignisse wird detailliert eingegangen. Die therapeutische Antikoagulation muss an den klinisch wechselnden, individuellen Zustand des Patienten anpasst werden. Dies trifft für den Krebspatienten besonders zu, weil Chemotherapie einen Einfluss auf das Gewicht, die Nierenfunktion und das Blutbild hat und auch selbst das Thromboserisiko beeinflusst. Die neuen, direkten oralen Antikoagulantien sind eine potentiell vielversprechende Option zur Behandlung thrombotischer Ereignisse. Die Indikation beim onkologischen Patienten ist jedoch aus mangelnden Daten zurzeit nicht anerkannt.
Thrombose in der Schwangerschaft
Authors: Brand Brigitte , Aegerter Christoph
Published: January 2017

Zusammenfassung. Die Schwangerschaft ist ein hyperkoagulabler Zustand, der durch zusätzliche Faktoren wie Alter, Art der Geburt, Co-Morbiditäten und Thrombophilie noch verstärkt werden kann. Die Inzidenz von venösen Thromboembolien (VTE) ist in der Schwangerschaft fünf-fach, im Wochenbett bis 60-fach erhöht [1 – 3]. Lungenembolien sind die häufigste direkte Todesursache [4] von Schwangeren in der westlichen Welt, in England wird eine Rate von 1.08/100’000 (95 % CI 0.71 – 1.59) Geburten und in den USA 11 % aller mütterliche Todesfälle angegeben [5, 6]. Eine korrekte Risikoeinschätzung und Wahl einer Prophylaxe sowie das Management bei VTE verdächtigen Symptomen sind deshalb sehr wichtig. Allerdings sind Schwangere typischerweise von den meisten randomisierten, kontrollierten Studien ausgeschlossen und die Empfehlungen leiten sich von Studien von Nicht-Schwangeren oder Beobachtungsstudien mit entsprechend niedriger Evidenz ab. Insbesondere Empfehlungen für das diagnostische Vorgehen bei Lungenembolie, optimale Dauer und Dosis der Antikoagulation bei VTE in der Schwangerschaft sowie Prophylaxe bei Risikopatientinnen sind nicht eindeutig etabliert und werden unterschiedlich gehandhabt. Das Vorgehen wird anhand von drei Fallbespielen dargestellt und mögliche Strategien im Kontext der verfügbaren Literatur diskutiert.
Praktische Tipps und Tricks zu den DOAC
Authors: Simeon Lucas , Wuillemin Walter A.
Published: January 2017

Zusammenfassung. Aktuell sind in der Schweiz vier verschiedene Präparate der direkten oralen Antikoagulanzien (DOAC) verfügbar. Diese können in der Therapie venöser Thromboembolien, in der Schlaganfallsprophylaxe bei nicht valvulärem Vorhofflimmern und zwei Präparate in der Thromboembolieprophylaxe nach grossen orthopädischen Operationen der unteren Extremität eingesetzt werden. Die Einnahme erfolgt je nach Präparat und Indikation ein- oder zweimal pro Tag und kann mit Ausnahme von Rivaroxaban in therapeutischer Dosis unabhängig von der Nahrungsaufnahme erfolgen. Bei hohem Alter, niedrigem Körpergewicht und eingeschränkter Nierenfunktion kann eine Dosisanpassung notwendig sein. Vor der Verordnung soll in jedem Fall ein Interaktionscheck durchgeführt werden, da gewisse Medikamente die Wirkung der DOAC verlängern oder abschwächen können. In der Schwangerschaft und Stillzeit sind die DOAC kontraindiziert. Die Anwendung im gebärfähigen Alter muss in Kombination mit einer Antikonzeption erfolgen. Viele Gerinnungstests werden durch die DOAC beeinflusst – insbesondere auch der häufig verwendete Quick-Test. Durch Anwendung entsprechender diagnostischer und therapeutischer Algorithmen, können Blutungen in den allermeisten Fällen beherrscht werden. Mit Idarucizumab steht zudem ein Antidot für Dabigatran zur Verfügung. Für Andexanet, einem Antidot gegen Faktor-Xa-Hemmer, sind klinische Phase III-Studien am laufen und es darf mit einer baldigen Marktzulassung gerechnet werden.
Die Thrombose im Gepäck
Authors: Bonetti Nicole , Beer Jürg H.
Published: January 2017

Zusammenfassung. Das Reisen geht mit einer 3-fachen Erhöhung des Risikos für venöse Thromboembolien (VTE) einher. Angesichts der wachsenden Anzahl der Reisenden und derer Komorbiditäten und in Betracht der hohen Morbidität und Mortalität dieser Komplikation, sind präventive Massnahmen zusehends Angelegenheit der öffentlichen Gesundheit. Eine individualisierte Risikostratifizierung besonders unter Einbezug zusätzlicher Risikofaktoren für VTE ist zentral. Die Reisedauer ist ein wichtiger Reise-assoziierter Risikofaktor. Klare Richtlinien zur Prävention fehlen. Anhand einer Integration von persönlichen und Reise-assoziierten Faktoren können Risikogruppen definiert werden, wobei lediglich der Hochrisikogruppe prophylaktische Massnahmen zukommen sollten. Die am häufigsten empfohlene Strategie mit guter Evidenz ist das Tragen von Kompressionsstrümpfen. Als medikamentöse Prophylaxe sollten Antikoagulanzien gegenüber den Plättchenhemmern den Vorzug erhalten. Als Optionen sollten hierbei niedermolekulare Heparine oder auch DOAKs in der entsprechenden Dosierung gemäss Präferenzen von Arzt und Patient berücksichtigt werden.
Die gastrointestinale Blutung unter Antikoagulation, mit speziellem Fokus auf DOACs
Authors: Stricker Hans
Published: January 2017

Zusammenfassung. Die folgenschwersten Nebenwirkungen der Antikoagulantien sind die Blutungen. Im Vergleich zu den Vitamin K-Antagonisten führen alle direkten oralen Antikoagulantien (DOACs) zu weniger intrazerebralen Blutungen. Bei den gastrointestinalen Blutungen, die bezüglich Relevanz an zweiter Stelle stehen, gibt es aufgrund der randomisierten Studien, Registern, und Versicherungsdaten verschiedener Länder Hinweise auf mögliche Unterschiede zwischen den einzelnen neuen Substanzen. Zusammen mit den Risiko-Scores sollte es möglich sein, die Wahl des Antikoagulans für einen bestimmten Patienten individuell zu treffen. Das Management einer Blutung sollte multidisziplinär erfolgen.
Die klinische Bedeutung des TTR bei der oralen Antikoagulation in Studien und klinischem Alltag
Authors: Rickli Hans , Maeder Micha T.
Published: January 2017

Zusammenfassung. Die orale Antikoagulation (OAK) mit Vitamin-K-Antagonisten (VKA) ist eine wirksame Therapie mit einem schmalen therapeutischen Fenster ausgedrückt im therapeutischen INR (International Normalized Ratio)-Bereich. Gemäss bestehender Literatur beeinflusst die INR-Stabilität die Rate von thromboembolischen Ereignissen, Blutungen und Behandlungskosten. Eine TTR (Time in Therapeutic Range) von > 65 % ist definiert als stabile INR-Kontrolle. Im klinischen Alltag ist dies selten erreicht, was gleichbedeutend ist mit einem erhöhten Blutungs- bzw. Thromboembolierisiko. Verschiedene Faktoren wie jüngeres Alter, Malcompliance, verschiedene Polymorphismen wie CYP2C9 oder VKORC1 und Komorbidität sind assoziiert mit einer ungenügenden INR-Kontrolle. Klinische Tools zur Voraussage einer ungenügenden INR-Kontrolle können weniger als 10 % von deren Varianz erklären. Im klinischen Alltag ist bei Notwendigkeit einer OAK mit VKA Sorgfalt gefragt, und bei geeigneten Patienten ist die Option des Einsatzes von Direkten Oralen Antikoagulantien (DOAKs) in Betracht zu ziehen.
Hybrid haemodialysis vascular access salvage
Authors: Potisek Maja , Ključevšek Tomaž , Leskovar Boštjan
Published: January 2017

Abstract. A well-functioning vascular access is essential for successful haemodialysis in patients with end-stage kidney failure. Sometimes, when we have exploited all conventional ways of vascular access salvage, we have to find a unique solution to preserve it.
Comparison of heat induced damage at the saphenofemoral junction after ablation with 1,470 nm laser or radiofrequency
Authors: Ozcinar Evren , Cakici Mehmet , Korun Oktay , Han Unsal , Kiziltepe Ugursay
Published: January 2017

Abstract. Background: The aim of this study was to evaluate the heat induced damage at the saphenofemoral junction level according to histopathological changes after radiofrequency or 1,470 nm radial tip laser ablation. Patients and methods: Varicose vein segments of 6–10 mm in diameter were exposed to radiofrequency (Closure Fast catheter, 7 cm heat segment, one cycle, 15 seconds, 10 Watt, 120 °C) or laser ablation (1,470 nm radial tip, continuous wave, vein diameter: 6 cm/8 cm/10 cm-power: 10 Watt-pullback speed: 2.2 mm/s, 1.7 mm/s, 1.3 mm/s-LEED: 45J/cm, 60J/cm, 75J/cm-EFE 25J/cm2, respectively). Approximate 2 cm segments of the vein were left untreated, then histopathological examinations of the untouched segments (5 slices: level 1 – furthest segment, level 2 – nearest segment) for heat induced damage were performed. A total damage scoring system was established, including the presence of endothelial swelling, intimal thickening, cellular vacuolisation in the muscle layer, oedema in the tunica media, and extent of necrosis. Results: At level 1, the furthest segment of the specimen, there was no significant difference between the laser and control group, while the total damage score of the radiofrequency group was significantly higher than the control group (p < 0.01). Radiofrequency group had higher total damage score compared to the laser group at level 1 (p < 0.01), 2 (p < 0.01), and 5 (p < 0.01); while no significant difference was observed at level 3 (p = 0.46) and 4 (p = 0.13). Conclusions: Significant heat induced damage may be seen even if the 2 cm segment of the vessel is left unablated. Radiofrequency ablation seems to cause more histological damage than laser ablation in this ex vivo study. Further in vivo studies are necessary, in order to validate these findings.
Acute hypersensitivity reaction to femoral drug-coated balloons
Authors: Lake Edward , Twigg Michael , Farquharson Finn
Published: January 2017

Abstract. We describe a case of an acute hypersensitivity reaction to a paclitaxel-coated balloon used in the peripheral arterial circulation. Clinicians using these products should be aware of this potential risk.
Diagnostik und Förderung bei Rechenschwäche
Authors: Fischer Ursula , Roesch Stephanie , Moeller Korbinian
Published: January 2017

Zusammenfassung. Die Literatur zur Rechenschwäche und Dyskalkulie wird zunehmend umfangreicher. So wurden bereits zahlreiche standardisierte Tests entwickelt und vielfältige Fördermanuale für Kinder mit Rechenschwäche publiziert. Dadurch verbessert sich zunehmend die Qualität von Diagnostik und Förderung. Es ist jedoch zu beobachten, dass die Entwicklung von Test- und Fördermaterial oft unabhängig voneinander geschieht: Während Fördermanuale meist aus dem tatsächlichen Förderbedarf sowie einem didaktischen Hintergrund erwachsen, werden standardisierte Tests oft aus einer theoretischen Perspektive hergeleitet und entwickelt. Somit stellt sich die interessante Frage, inwieweit die Diagnostik den tatsächlichen Förderbedarf abbildet und inwiefern den standardisierten Tests zur Rechenschwächediagnostik wertvolle Förderhinweise entnommen werden können. Zu diesem Zweck werden in diesem Übersichtsbeitrag die Inhalte mehrerer gängiger Tests und Fördermanuale gegenübergestellt. Somit soll sowohl Praktikern als auch Forschern die Gelegenheit gegeben werden, die potenziellen Überschneidungspunkte aber auch Gegensätze in den beiden Publikationssträngen zu vergleichen.
A Particular Kind of Wonder: The Experience of Magic past and Present
Authors: Lamont Peter
Published: January 2017

Wonder may be an important emotion, but the term wonder is remarkably ambiguous. For centuries, in psychological discourse, it has been defined as a variety of things. In an attempt to be more focused, and given the growing scientific interest in magic, this article describes a particular kind of wonder: the response to a magic trick. It first provides a historical perspective by considering continuity and change over time in this experience, and argues that, in certain respects, this particular kind of wonder has changed. It then describes in detail the experience of magic, considers the extent to which it might be considered acquired rather than innate, and how it relates to other emotions, such as surprise. In the process, it discusses the role of belief and offers some suggestions for future research. It concludes by noting the importance of context and meaning in shaping the nature of the experience, and argues for the value of both experimental and historical research in the attempt to understand such experiences.
Character Adaptation Systems Theory: A New Big Five for Personality and Psychotherapy
Authors: Henriques Gregg
Published: January 2017

Although personality theory and psychotherapy were originally closely linked, the past several decades have witnessed surprising gaps between these domains. This article seeks to close that gap via character adaptation systems theory (CAST), which is a formulation derived from Henriques's (2011) unified approach to psychology that links recent developments in personality theory with integrative visions of psychotherapy via the explication of 5 systems of character adaptation: (a) the habit system, (b) the experiential system, (c) the relationship system, (d) the defensive system, and (e) the justification system. This article delineates the nature of these systems of adaptation and how they connect to modern personality theory and the major systems of individual psychotherapy, as well as how they relate to important domains in human psychology and can be applied in the context of psychotherapy.
Arginine methylation of USP9X promotes its interaction with TDRD3 and its anti-apoptotic activities in breast cancer cells
Authors: Narayanan Nithya , Wang Zhihao , Li Ling , Yang Yanzhong
Published: January 2017

The Tudor domain-containing proteins are characterized by their specific interactions with methylated protein motifs, including methyl-arginines and methyl-lysines. The Tudor domain-containing protein 3 (TDRD3) is one of the major methyl-arginine effector molecules that recognizes methylated arginine residues on histones and the C-terminal domain of RNA polymerase II, and activates transcription. However, majority of the cellular TDRD3 localizes to the cytoplasm and its functions there are still elusive. Here, we have identified ubiquitin-specific protease 9 X-linked (USP9X) as a TDRD3-interacting protein by GST (glutathione S-transferase) pull-down and co-immunoprecipitation. Detailed characterization suggests that the interaction between TDRD3 and USP9X is mediated through the Tudor domain of TDRD3 and the arginine methylation of USP9X. This interaction plays a critical role in TDRD3 protein stability, as knockdown of USP9X expression leads to increased TDRD3 ubiquitination. We also found that USP9X co-localizes with TDRD3 in cytoplasmic stress granules and this localization is diminished in Tdrd3-null mouse embryonic fibroblast cells, suggesting that TDRD3 is essential for USP9X stress granule localization. Furthermore, we found that one of the USP9X de-ubiquitination targets, myeloid cell leukemia protein 1, is regulated by TDRD3, indicating that TDRD3 potentially regulates USP9X de-ubiquitinase activity. Finally, we show that knockdown of TDRD3 expression sensitizes breast cancer cells to chemotherapeutic drug-induced apoptosis, likely due to its regulation of USP9X. This study provides a novel candidate strategy for targeting apoptosis pathways in cancer therapy.
Interferon epsilon promotes HIV restriction at multiple steps of viral replication
Authors: Garcia‐Minambres Albert , Eid Sahar G , Mangan Niamh E , Pade Corinna , Lim San S , Matthews Antony Y , de Weerd Nicole A , Hertzog Paul J , Mak Johnson
Published: January 2017

Interferon epsilon (IFNɛ) is a type I IFN that is expressed constitutively in the female reproductive tract (FRT), and contributes to protection in models of sexually transmitted infections. Using multiple cell systems, including reporter cell lines and activated peripheral blood lymphocytes (PBLs), we show that recombinant IFNɛ impairs HIV infection at stage(s) post HIV entry and up to the translation of viral proteins. Consistent with this, IFNɛ upregulated a number of host cell restriction factors that block HIV at these stages of the replication cycle. The potency of IFNɛ induction of these HIV restriction factors was comparable to conventional type I IFNs, namely IFNα and IFNβ. IFNɛ also significantly reduced the infectivity of progeny virion particles likely by inducing expression of HIV restriction factors, such as IFITM3, which act at that stage of infection. Thus, our data demonstrate that human IFNɛ suppresses HIV replication at multiple stages of infection.
The Pseudomonas putida T6SS is a plant warden against phytopathogens
Authors: Bernal Patricia , Allsopp Luke P , Filloux Alain , Llamas María A
Published: January 2017

Bacterial type VI secretion systems (T6SSs) are molecular weapons designed to deliver toxic effectors into prey cells. These nanomachines have an important role in inter-bacterial competition and provide advantages to T6SS active strains in polymicrobial environments. Here we analyze the genome of the biocontrol agent Pseudomonas putida KT2440 and identify three T6SS gene clusters (K1-, K2- and K3-T6SS). Besides, 10 T6SS effector–immunity pairs were found, including putative nucleases and pore-forming colicins. We show that the K1-T6SS is a potent antibacterial device, which secretes a toxic Rhs-type effector Tke2. Remarkably, P. putida eradicates a broad range of bacteria in a K1-T6SS-dependent manner, including resilient phytopathogens, which demonstrates that the T6SS is instrumental to empower P. putida to fight against competitors. Furthermore, we observed a drastically reduced necrosis on the leaves of Nicotiana benthamiana during co-infection with P. putida and Xanthomonas campestris. Such protection is dependent on the activity of the P. putida T6SS. Many routes have been explored to develop biocontrol agents capable of manipulating the microbial composition of the rhizosphere and phyllosphere. Here we unveil a novel mechanism for plant biocontrol, which needs to be considered for the selection of plant wardens whose mission is to prevent phytopathogen infections.
Faecalibacterium prausnitzii: from microbiology to diagnostics and prognostics
Authors: Lopez-Siles Mireia , Duncan Sylvia H , Garcia-Gil L Jesús , Martinez-Medina Margarita
Published: January 2017

There is an increasing interest in Faecalibacterium prausnitzii, one of the most abundant bacterial species found in the gut, given its potentially important role in promoting gut health. Although some studies have phenotypically characterized strains of this species, it remains a challenge to determine which factors have a key role in maintaining the abundance of this bacterium in the gut. Besides, phylogenetic analysis has shown that at least two different F. prausnitzii phylogroups can be found within this species and their distribution is different between healthy subjects and patients with gut disorders. It also remains unknown whether or not there are other phylogroups within this species, and also if other Faecalibacterium species exist. Finally, many studies have shown that F. prausnitzii abundance is reduced in different intestinal disorders. It has been proposed that F. prausnitzii monitoring may therefore serve as biomarker to assist in gut diseases diagnostics. In this mini-review, we aim to serve as an overview of F. prausnitzii phylogeny, ecophysiology and diversity. In addition, strategies to modulate the abundance of F. prausnitzii in the gut as well as its application as a biomarker for diagnostics and prognostics of gut diseases are discussed. This species may be a useful potential biomarker to assist in ulcerative colitis and Crohn’s disease discrimination.
Endemicity of the cosmopolitan mesophilic chemolithoautotroph Sulfurimonas at deep-sea hydrothermal vents
Authors: Mino Sayaka , Nakagawa Satoshi , Makita Hiroko , Toki Tomohiro , Miyazaki Junichi , Sievert Stefan M , Polz Martin F , Inagaki Fumio , Godfroy Anne , Kato Shingo , Watanabe Hiromi , Nunoura Takuro , Nakamura Koichi , Imachi Hiroyuki , Watsuji Tomo-o , Kojima Shigeaki , Takai Ken , Sawabe Tomoo
Published: January 2017

Rich animal and microbial communities have been found at deep-sea hydrothermal vents. Although the biogeography of vent macrofauna is well understood, the corresponding knowledge about vent microbial biogeography is lacking. Here, we apply the multilocus sequence analysis (MLSA) to assess the genetic variation of 109 Sulfurimonas strains with ⩾98% 16S rRNA gene sequence similarity, which were isolated from four different geographical regions (Okinawa Trough (OT), Mariana Volcanic Arc and Trough (MVAT), Central Indian Ridge (CIR) and Mid-Atlantic Ridge (MAR)). Sequence typing based on 11 protein-coding genes revealed high genetic variation, including some allele types that are widespread within regions, resulting in 102 nucleotide sequence types (STs). This genetic variation was predominantly due to mutation rather than recombination. Phylogenetic analysis of the 11 concatenated genes showed a clear geographical isolation corresponding to the hydrothermal regions they originated from, suggesting limited dispersal. Genetic differentiation among Sulfurimonas populations was primarily influenced by geographical distance rather than gas composition of vent fluid or habitat, although in situ environmental conditions of each microhabitat could not be examined. Nevertheless, Sulfurimonas may possess a higher dispersal capability compared with deep-sea hydrothermal vent thermophiles. This is the first report on MLSA of deep-sea hydrothermal vent Epsilonproteobacteria, which is indicative of allopatric speciation.
In vivo single-molecule imaging of syntaxin1A reveals polyphosphoinositide- and activity-dependent trapping in presynaptic nanoclusters
Authors: Bademosi Adekunle T. , Lauwers Elsa , Padmanabhan Pranesh , Odierna Lorenzo , Chai Ye Jin , Papadopulos Andreas , Goodhill Geoffrey J. , Verstreken Patrik , van Swinderen Bruno , Meunier Frédéric A.
Published: January 2017

Syntaxin1A is organized in nanoclusters that are critical for the docking and priming of secretory vesicles from neurosecretory cells. Whether and how these nanoclusters are affected by neurotransmitter release in nerve terminals from a living organism is unknown. Here we imaged photoconvertible syntaxin1A-mEos2 in the motor nerve terminal ofDrosophilalarvae by single-particle tracking photoactivation localization microscopy. Opto- and thermo-genetic neuronal stimulation increased syntaxin1A-mEos2 mobility, and reduced the size and molecular density of nanoclusters, suggesting an activity-dependent release of syntaxin1A from the confinement of nanoclusters. Syntaxin1A mobility was increased by mutating its polyphosphoinositide-binding site or preventing SNARE complex assembly via co-expression of tetanus toxin light chain. In contrast, syntaxin1A mobility was reduced by preventing SNARE complex disassembly. Our data demonstrate that polyphosphoinositide favours syntaxin1A trapping, and show that SNARE complex disassembly leads to syntaxin1A dissociation from nanoclusters. Lateral diffusion and trapping of syntaxin1A in nanoclusters therefore dynamically regulate neurotransmitter release.
JAK/STAT controls organ size and fate specification by regulating morphogen production and signalling
Authors: Recasens-Alvarez Carles , Ferreira Ana , Milán Marco
Published: January 2017

A stable pool of morphogen-producing cells is critical for the development of any organ or tissue. Here we present evidence that JAK/STAT signalling in the Drosophila wing promotes the cycling and survival of Hedgehog-producing cells, thereby allowing the stable localization of the nearby BMP/Dpp-organizing centre in the developing wing appendage. We identify the inhibitor of apoptosis dIAP1 and Cyclin A as two critical genes regulated by JAK/STAT and contributing to the growth of the Hedgehog-expressing cell population. We also unravel an early role of JAK/STAT in guaranteeing Wingless-mediated appendage specification, and a later one in restricting the Dpp-organizing activity to the appendage itself. These results unveil a fundamental role of the conserved JAK/STAT pathway in limb specification and growth by regulating morphogen production and signalling, and a function of pro-survival cues and mitogenic signals in the regulation of the pool of morphogen-producing cells in a developing organ.
An allosteric conduit facilitates dynamic multisite substrate recognition by the SCFCdc4 ubiquitin ligase
Authors: Csizmok Veronika , Orlicky Stephen , Cheng Jing , Song Jianhui , Bah Alaji , Delgoshaie Neda , Lin Hong , Mittag Tanja , Sicheri Frank , Chan Hue Sun , Tyers Mike , Forman-Kay Julie D.
Published: January 2017

The ubiquitin ligase SCFCdc4 mediates phosphorylation-dependent elimination of numerous substrates by binding one or more Cdc4 phosphodegrons (CPDs). Methyl-based NMR analysis of the Cdc4 WD40 domain demonstrates that Cyclin E, Sic1 and Ash1 degrons have variable effects on the primary Cdc4WD40 binding pocket. Unexpectedly, a Sic1-derived multi-CPD substrate (pSic1) perturbs methyls around a previously documented allosteric binding site for the chemical inhibitor SCF-I2. NMR cross-saturation experiments confirm direct contact between pSic1 and the allosteric pocket. Phosphopeptide affinity measurements reveal negative allosteric communication between the primary CPD and allosteric pockets. Mathematical modelling indicates that the allosteric pocket may enhance ultrasensitivity by tethering pSic1 to Cdc4. These results suggest negative allosteric interaction between two distinct binding pockets on the Cdc4WD40 domain may facilitate dynamic exchange of multiple CPD sites to confer ultrasensitive dependence on substrate phosphorylation.