bluuebunny/crossref_metadata_2025 huggingface dataset:
FEMOROACETABULAR IMPINGEMENT INSURANCE COVERAGE TRENDS IN RECENT YEARS: A COHORT BASED ANALYSIS
Authors: Nepple Jeffrey J. , Minaie Arya , Ross James , Bogunovic Ljiljana , Clohisy John
Published: March 2019

Background:

The diagnostic criteria for surgical indication of femoroacetabular impingement (FAI) remain controversial. With a growing body of literature investigating the quality of these criteria, little is known about the direction that these have had on changes of third-party policies. The purpose of this study was to measure how these changes in policy would affect the exclusion of a cohort of previously identified FAI patients who were treated operatively.

Methods:

Four insurance companies’ coverage policies with specific criteria for the surgical treatment of FAI were applied to this population at two time points, 2012 and 2018, to determine whether these third-party payer criteria for FAI surgery were met. The insurance criteria were assessed in a prospective multicenter cohort of 712 patients undergoing primary FAI surgery. The policies listed various combinations of age, symptom duration, positive impingement test, radiographic osteoarthritis, radiographic sign of CAM and/or pincer impingement, and physical exam findings.

Results:

The cohort of 712 hips included 324 men [45.5%] and 388 females [54.5] with a mean age of 28.7 years. Overall, insurance criteria were not met in: Insurance #1 old 30.1%, new 25.7%; Insurance #2 old and new 17.8%, Insurance #3 old 21.9%, new 21.1%; and Insurance #4 old 17.8%, new 14.9%-20.6%. In 2012, the average percent exclusion of the four companies was 21.9%, this number decreased slightly to 20.6% overall in 2018. The most likely reason to be excluded was found to be failure to meet imaging criteria. The second most likely failed characteristic was a negative impingement test (65 patients excluded). Several insurance companies continue to utilize Outerbridge criteria for cartilage lesions which cannot be assessed preoperatively.

Discussion and Conclusion:

The diagnosis of FAI and its surgical indications have no definitive set criteria. Our study shows that with a six-year span of growing literature and updated policies, nearly 1 in 5 patients deemed to need surgical intervention by experienced hip preservation surgeons would still be denied coverage. There is a need for continued improvement of consensus regarding the diagnosis of FAI and appropriate indications for surgical intervention based on the available literature.
RE-TEAR AND RE-OPERATION RATES FOR PEDIATRIC AND ADOLESCENT ANTERIOR CRUCIATE LIGAMENT RECONSTRUCTION
Authors: Pandya Nirav K.
Published: March 2019

BACKGROUND

Anterior cruciate ligament (ACL) injuries have become increasingly common in pediatric and adolescent patients over the last several decades, as this population has become more involved in athletic competition. ACL injuries in skeletally immature patients had historically been treated conservatively with bracing and activity modification; however, poor outcomes including extensive chondral and meniscal damage, increased recurrent instability, and increased sports drop out rates have been observed. Recognition of these poor outcomes has led to a shift towards early operative treatment, resulting in a significant rise in the number of pediatric ACL reconstructions being performed. Yet, a higher failure rate has been noted in this younger population within larger adult cohort studies. The purpose of this study was to evaluate the re-tear and re-operation rates in pediatric and adolescent ACL reconstruction.

METHODS

The was a retrospective review of pediatric and adolescent patients treated at a single tertiary children’s hospital for ACL reconstruction from 2011 to 2017 by the same pediatric orthopedic surgeon. Review of the electronic medical record was performed to obtain patient demographics, preoperative clinical and radiographic findings, operative notes, and postoperative outcomes. Re-tear and re-operation rates were calculated.

RESULTS

A total of 308 patients were identified during the study period of which sixty-six percent were female. The mean age of patients was 15.8 years with a mean follow-up of 1.8 +/- 0.8 years. Two-hundred fifty-three hamstring autografts (mean age 15.7+/- 4.1 years) and 55 bone tendon bone autograft (mean age 16.9 +/- 1.45 years) were performed. Two hundred forty-three patents had adult-style reconstructions performed, 40 had transphyseal reconstructions, 24 had partial transphyseal reconstruction, and 1 patient had an all-epiphyseal reconstruction. Average hamstring graft size was 8.3 mm +/- 0.5 mm and all BTB graft were 9 mm. The overall graft re-tear rate was 8.2%. The overall re-operation rate was 13.2% (17 revisions, 5 medial meniscus repairs, 3 I+D’s, 2 cyclops debridements, 1 removal of hardware, and 1 manipulation under anesthesia). The highest re-tear (12.5%) and re-operation (22.5%) rates were found in patients who underwent a transphyseal reconstruction. No growth disturbances which required surgical intervention were noted.

CONCLUSIONS / SIGNIFICANCE

Pediatric and adolescent ACL reconstruction can be performed safely without a risk of growth disturbance. Patients had a high re-tear and re-operation rate; particularly in patients who underwent transphyseal reconstruction. Strategies must be developed to decrease the re-tear and re-operation rate in this population.
Quality Regulation? Access to High-Quality Specialists for Medicare Advantage Beneficiaries in California
Authors: Haeder Simon F.
Published: March 2019

Medicare Advantage enrollment has seen tremendous growth over the past decade. However, we know comparatively little about the experience of beneficiaries in the program. Our knowledge of Medicare Advantage provider networks is particularly limited. This article is one of the first major assessments of the issue. It seeks to answer 3 important questions. First, are Medicare Advantage plan networks made up of higher quality providers? Second, how significant are the network restrictions imposed by Medicare Advantage plans with regard to access to higher quality providers? And finally, how much provider choice are Medicare Advantage beneficiaries left with? To assess these questions, I utilize geospatial data and individual provider quality measures for cardiologists, endocrinologists, and obstetricians and gynecologists from California. I find that Medicare Advantage beneficiaries generally do well in large metropolitan areas compared to traditional Medicare. However, there are concerns for those in micropolitan and rural areas, and even those in standard metropolitan areas, at times. Crucially, the connection between provider quality and networks can only be fully understood when connected to assessments of provider access. These findings also raise questions about how we think about provider networks and the adequacy of current approaches to network regulation.
Advancing Public Health Education Through Place-Based Learning: “On the Road in the Deep South”
Authors: Fifolt Matthew , McCormick Lisa C.
Published: March 2019

Documented health disparities among racial and ethnic minorities exist in the United States, and health injustices frequently have deep historical ties, especially in the South. Therefore, it is critically important for students to understand root causes of both historical and contemporary public health issues and their effects on population health. In spring 2018, 15 undergraduate and graduate students from the University of Alabama at Birmingham participated in a six-credit-hour travel course by touring throughout the Deep South to learn more about the ways in which history and place interact with programs, policies, and practices to influence population health. Students saw firsthand how the social determinants of health frequently affected access to health care and discovered the value of a multidisciplinary approach to public health and health programs in addressing health equity. The purpose of this article is to describe student experiences with the travel course through an exploration of students’ reflective journal entries, blog posts, and student presentations. Additionally, the authors report results of a self-assessment designed to measure student interest and level of comfort in working with, or on behalf of, medically underserved populations. The article concludes with implications for public health and best practices for offering place-based courses across academic majors.
Escape the Traditional Classroom: Using Live-Action Games to Engage Students and Strengthen Concept Retention
Authors: Plump Carolyn M. , Meisel Steven I.
Published: March 2019

A constant challenge for faculty is to gain and to hold student interest so that substantive learning can occur. One way to achieve this is through the use of games. This article describes an escape room activity for the classroom that is modeled after commercial escape rooms. This fun, single-session team dynamics exercise can be used in an organizational behavior class or be easily adapted to other disciplines and courses. Research shows—and our survey results confirm—that games capture student attention, motivate them, and support learning when connected to specific outcomes. Furthermore, both the competitive element of the activity and the offer of a reward produced a stronger motivation for students to prepare for class and engage with the content. The additional preparation time required to create this novel activity will engage students, anchor class learning, and create readiness for understanding course concepts.
Racial disparities in access to HLA-matched unrelated donor transplants: a prospective 1312-patient analysis
Authors: Barker Juliet N. , Boughan Kirsten , Dahi Parastoo B. , Devlin Sean M. , Maloy Molly A. , Naputo Kristine , Mazis Christopher M. , Davis Eric , Nhaissi Melissa , Wells Deborah , Cooper Candice , Ponce Doris M. , Kernan Nancy , Scaradavou Andromachi , Giralt Sergio A. , Papadopoulos Esperanza B. , Politikos Ioannis
Published: March 2019

Availability of 8/8 HLA-allele matched unrelated donors (URDs) is a barrier for ethnic and racial minorities. We prospectively evaluated receipt of 8/8 HLA-allele matched URD or either 7/8 URD or cord blood (CB) transplants by patient ancestry from 2005 to 2017. Matched URDs were given priority if they were available. Of 1312 patients, 723 (55%) received 8/8 URD, 219 (17%) 7/8 URD, 319 (24%) CB, and 51 (4%) had no 7/8 or 8/8 URD or CB graft. Europeans were more likely to receive an 8/8 URD transplant than non-Europeans (67% vs 33%) and less likely to have no URD or CB graft (1% vs 9%). Southern Europeans received 8/8 URD transplants (41%) at rates similar to those of Asians (34%) and white Hispanics (35%); Africans were the least likely (18%) to undergo 8/8 URD transplantation. CB and 7/8 URDs extended transplant access to all groups. In 742 recent patients, marked racial disparity in 8/8 URD access between groups observed in earlier years persisted with only a modest increase in the percentage of 8/8 URD transplants. Of 78 recent African patients, 46% received a CB transplant and 14% had no 7/8 or 8/8 URD or CB graft. Increasing registry size has not resolved the racial disparity in URD access, which emphasizes the importance of alternative graft sources.
Receptor for advanced glycation end-products and environmental exposure related obstructive airways disease: a systematic review
Authors: Haider Syed H. , Oskuei Assad , Crowley George , Kwon Sophia , Lam Rachel , Riggs Jessica , Mikhail Mena , Talusan Angela , Veerappan Arul , Kim James S. , Caraher Erin J. , Nolan Anna
Published: March 2019

Background

Our group has identified the receptor for advanced glycation end-products (RAGE) as a predictor of World Trade Center particulate matter associated lung injury. The aim of this systematic review is to assess the relationship between RAGE and obstructive airways disease secondary to environmental exposure.

Methods

A comprehensive search using PubMed and Embase was performed on January 5, 2018 utilising keywords focusing on environmental exposure, obstructive airways disease and RAGE and was registered with PROSPERO (CRD42018093834). We included original human research studies in English, focusing on pulmonary end-points associated with RAGE and environmental exposure.

Results

A total of 213 studies were identified by the initial search. After removing the duplicates and applying inclusion and exclusion criteria, we screened the titles and abstracts of 61 studies. Finally, 19 full-text articles were included. The exposures discussed in these articles include particulate matter (n=2) and cigarette smoke (n=17).

Conclusion

RAGE is a mediator of inflammation associated end-organ dysfunction such as obstructive airways disease. Soluble RAGE, a decoy receptor, may have a protective effect in some pulmonary processes. Overall, RAGE is biologically relevant in environmental exposure associated lung disease. Future investigations should focus on further understanding the role and therapeutic potential of RAGE in particulate matter exposure associated lung disease.
Cancer-associated thrombosis: the when, how and why
Authors: Fernandes Caio J. , Morinaga Luciana T. K. , Alves José L. , Castro Marcela A. , Calderaro Daniela , Jardim Carlos V. P. , Souza Rogerio
Published: March 2019

Cancer-associated thrombosis (CAT) is a condition in which relevance has been increasingly recognised both for physicians that deal with venous thromboembolism (VTE) and for oncologists. It is currently estimated that the annual incidence of VTE in patients with cancer is 0.5% compared to 0.1% in the general population. Active cancer accounts for 20% of the overall incidence of VTE. Of note, VTE is the second most prevalent cause of death in cancer, second only to the progression of the disease, and cancer is the most prevalent cause of deaths in VTE patients. Nevertheless, CAT presents several peculiarities that distinguish it from other VTE, both in pathophysiology mechanisms, risk factors and especially in treatment, which need to be considered. CAT data will be reviewed in this review.
Time to epinephrine treatment is associated with the risk of mortality in children who achieve sustained ROSC after traumatic out-of-hospital cardiac arrest
Authors: Lin Yan-Ren , Wu Meng-Huan , Chen Tren-Yi , Syue Yuan-Jhen , Yang Mei-Chueh , Lee Tsung-Han , Lin Chih-Ming , Chou Chu-Chung , Chang Chin-Fu , Li Chao-Jui
Published: March 2019

Background

The benefits of early epinephrine administration in pediatric with nontraumatic out-of-hospital cardiac arrest (OHCA) have been reported; however, the effects in pediatric cases of traumatic OHCA are unclear. Since the volume-related pharmacokinetics of early epinephrine may differ obviously with and without hemorrhagic shock (HS), beneficial or harmful effects of nonselective epinephrine stimulation (alpha and beta agonists) may also be enhanced with early administration. In this study, we aimed to analyze the therapeutic effect of early epinephrine administration in pediatric cases of HS and non-HS traumatic OHCA.

Methods

This was a multicenter retrospective study (2003–2014). Children (aged ≤ 19 years) who experienced traumatic OHCA and were administered epinephrine for resuscitation were included. Children were classified into the HS (blood loss > 30% of total body fluid) and non-HS groups. The demographics, outcomes, postresuscitation hemodynamics (the first hour) after the sustained return of spontaneous circulation (ROSC), and survival durations were analyzed and correlated with the time to epinephrine administration (early < 15, middle 15–30, late > 30 min) in the HS and non-HS groups. Cox regression analysis was used to adjust for risk factors of mortality.

Results

A total of 509 children were included. Most of them (n = 348, 68.4%) had HS OHCA. Early epinephrine administration was implemented in 131 (25.7%) children. In both the HS and non-HS groups, early epinephrine administration was associated with achieving sustained ROSC (both p < 0.05) but was not related to survival or good neurological outcomes (without adjusting for confounding factors). However, early epinephrine administration in the HS group increased cardiac output but induced metabolic acidosis and decreased urine output during the initial postresuscitation period (all p < 0.05). After adjusting for confounding factors, early epinephrine administration was a risk factor of mortality in the HS group (HR 4.52, 95% CI 2.73–15.91).

Conclusion

Early epinephrine was significantly associated with achieving sustained ROSC in pediatric cases of HS and non-HS traumatic OHCA. For children with HS, early epinephrine administration was associated with both beneficial (increased cardiac output) and harmful effects (decreased urine output and metabolic acidosis) during the postresuscitation period. More importantly, early epinephrine was a risk factor associated with mortality in the HS group.
Bridging Indigenous and science-based knowledge in coastal-marine research, monitoring, and management in Canada: a systematic map protocol
Authors: Alexander Steven M. , Provencher Jennifer F. , Henri Dominique A. , Taylor Jessica J. , Cooke Steven J.
Published: March 2019

Background

The incorporation of multiple types of knowledge (e.g., science, Indigenous knowledge, traditional ecological knowledge) is an important undertaking, which can strengthen the evidence-base for policy advice, decision making, and environmental management. While the benefits of incorporating multiple types of knowledge in environmental research and management are many, successfully doing so has remained a challenge. In response there has been a number of recent reviews that have sought to better understand the what and how, when it comes to bridging Indigenous and science-based knowledge. Yet there continues to be a need for methods, models, and approaches for integrative work. This systematic map seeks to examine the extent, range, and nature of the published literature (i.e., peer-reviewed and grey) that integrates and/or includes Indigenous and science-based knowledge in coastal-marine research, monitoring, or management in Canada. Results from this study can be used to inform new and ongoing research and monitoring efforts and highlight evidence gaps.

Methods

The systematic map will aim to capture all available studies relevant to the question found in the peer-reviewed and grey literature. Accordingly, the search will leverage four databases focused on peer reviewed publications, carefully selected specialist websites, and two web-based search engines. Reference sections of relevant review articles will also be cross-checked to identify articles that were not found using the search strategy. All searches will be conducted in English. Search results will be reviewed in two stages: (1) title and abstract; and (2) full text. All screening decisions will be included in the database. The systematic map will employ a narrative synthesis approach that will include the use of descriptive statistics, tables (including SM database), and figures (including map with the studies geospatially referenced). In addition, an online version of the map and queryable database will be developed similar to other knowledge mobilization tools.
Recovering the microseismic response from a geomechanical simulation
Authors: Sherman Christopher S. , Morris Joseph P. , Fu Pengcheng , Settgast Randolph R.
Published: March 2019

The analysis of microseismic events is one of a few tools available for characterizing processes that occur within the subsurface. We have developed a method for modeling microseismic activity in the subsurface that allows us to model microseismic events at the reservoir scale. By embedding this method in a fully coupled hydromechanical numerical code, we simulate the development of hydraulic fractures in an unconventional reservoir with an explicitly represented discrete fracture network for a relatively simple synthetic model and a more complicated model based upon field observations. The results demonstrate that the model can be effectively calibrated against measured microseismic activity, and it can be used to make predictions regarding the timing, location, and amplitude of events in the subsurface.
Workflows for near-field exploration
Authors: Hulsey Josiah , Bernaez Alberto , Strickland Beth , Cook Andrew
Published: March 2019

In 2018, a near-field exploration (NFE) prospect was drilled as part of a six-well infill campaign in the Deepwater Gulf of Mexico Auger field. With its inclusion in the middle of an active infill drilling campaign, this well differed in scope from a typical NFE well. A limited time frame existed to appraise the results and form a completion strategy. The subsurface team developed three workflows that allowed for the rapid appraisal of predrill and postdrill volumetrics in conjunction with a flexible well design that led to the successful drilling of this prospect. The first workflow consisted of two steps. We first calculated in-place volumetrics by transposing multiple analog stratigraphies and properties into the prospect area. We then created a fine-scale 3D reservoir model to be used for estimated ultimate recovery. We built this model to be flexible enough to take in the real-time well results without necessitating a complete model rebuild and also used it in the third workflow. We then established the minimum amount of net sand needed to merit a completion in the second workflow through a scenario testing process that enabled efficient decision-making during drilling operations. In the final workflow, we integrated the real-time results with the initial reservoir model to test different completion scenarios. These three workflows and strategies are not unique to the Auger field, and they can easily be implemented or adapted to NFE prospects in other mature fields.
Genomic Profiling Identifies Outcome-Relevant Mechanisms of Innate and Acquired Resistance to Third-Generation Epidermal Growth Factor Receptor Tyrosine Kinase Inhibitor Therapy in Lung Cancer
Authors: Michels Sebastian , Heydt Carina , van Veggel Bianca , Deschler-Baier Barbara , Pardo Nuria , Monkhorst Kim , Rüsseler Vanessa , Stratmann Jan , Griesinger Frank , Steinhauser Susanne , Kostenko Anna , Diebold Joachim , Fassunke Jana , Fischer Rieke , Engel-Riedel Walburga , Gautschi Oliver , Geissinger Eva , Haneder Stefan , Ihle Michaela A. , Kopp Hans-Georg , de Langen Adrianus J. , Martinez-Marti Alex , Nogova Lucia , Persigehl Thorsten , Plenker Dennis , Puesken Michael , Rodermann Ernst , Rosenwald Andreas , Scheel Andreas H. , Scheffler Matthias , Spengler Werner , Seggewiss-Bernhardt Ruth , Brägelmann Johannes , Sebastian Martin , Vrugt Bart , Hellmich Martin , Sos Martin L. , Heukamp Lukas C. , Felip Enriqueta , Merkelbach-Bruse Sabine , Smit Egbert F. , Büttner Reinhard , Wolf Jürgen
Published: March 2019

PURPOSE

Third-generation epidermal growth factor receptor ( EGFR) tyrosine kinase inhibitors (TKIs) are effective in acquired resistance (AR) to early-generation EGFR TKIs in EGFR-mutant lung cancer. However, efficacy is marked by interindividual heterogeneity. We present the molecular profiles of pretreatment and post-treatment samples from patients treated with third-generation EGFR TKIs and their impact on treatment outcomes.

METHODS

Using the databases of two lung cancer networks and two lung cancer centers, we molecularly characterized 124 patients with EGFR p.T790M-positive AR to early-generation EGFR TKIs. In 56 patients, correlative analyses of third-generation EGFR TKI treatment outcomes and molecular characteristics were feasible. In addition, matched post-treatment biopsy samples were collected for 29 patients with progression to third-generation EGFR TKIs.

RESULTS

Co-occurring genetic aberrations were found in 74.4% of EGFR p.T790-positive samples (n = 124). Mutations in TP53 were the most frequent aberrations detected (44.5%; n = 53) and had no significant impact on third-generation EGFR TKI treatment. Mesenchymal-epithelial transition factor ( MET) amplifications were found in 5% of samples (n = 6) and reduced efficacy of third-generation EGFR TKIs significantly (eg, median progression-free survival, 1.0 months; 95% CI, 0.37 to 1.72 v 8.2 months; 95% CI, 1.69 to 14.77 months; P ≤ .001). Genetic changes in the 29 samples with AR to third-generation EGFR TKIs were found in EGFR (eg, p.T790M loss, acquisition of p.C797S or p.G724S) or in other genes (eg, MET amplification, KRAS mutations).

CONCLUSION

Additional genetic aberrations are frequent in EGFR-mutant lung cancer and may mediate innate and AR to third-generation EGFR TKIs. MET amplification was strongly associated with primary treatment failure and was a common mechanism of AR to third-generation EGFR TKIs. Thus, combining EGFR inhibitors with TKIs targeting common mechanisms of resistance may delay AR.
Escape From Oblivion: Neural Mechanisms of Emergence From General Anesthesia
Authors: Kelz Max B. , García Paul S. , Mashour George A. , Solt Ken
Published: March 2019

The question of how general anesthetics suppress consciousness has persisted since the mid-19th century, but it is only relatively recently that the field has turned its focus to a systematic understanding of emergence. Once assumed to be a purely passive process, spontaneously occurring as residual levels of anesthetics dwindle below a critical value, emergence from general anesthesia has been reconsidered as an active and controllable process. Emergence is driven by mechanisms that can be distinct from entry to the anesthetized state. In this narrative review, we focus on the burgeoning scientific understanding of anesthetic emergence, summarizing current knowledge of the neurotransmitter, neuromodulators, and neuronal groups that prime the brain as it prepares for its journey back from oblivion. We also review evidence for possible strategies that may actively bias the brain back toward the wakeful state.
Neuroinflammation in the Developing Brain: Risk Factors, Involvement of Microglial Cells, and Implication for Early Anesthesia
Authors: Baud Olivier , Saint-Faust Marie
Published: March 2019

Microglia cells, the resident macrophages of the central nervous system, are key actors for specific brain functions that are critical for development and health. Microglial reactivity and functions, even when immature, play a major role if the developing brain is subjected to abnormal perinatal events. Brain exposure to general anesthesia, surgery, or analgesic drugs during early infancy may adversely affect its maturation and plasticity after injury. A better understanding of the regulation of microglial activation in the developing brain and interactions with specific anesthetic drugs is expected to give novel insights into the mechanisms underlying their potential adverse effects. This review recapitulates the most frequent perinatal circumstances associated with exacerbated systemic inflammation and neuroinflammation together with the double-edged role of microglia associated with subsequent brain damage. A role for microglial reactivity in both potential anesthetic toxicity and neuroprotection is emerging. However, further preclinical experiments are needed to better understand regulatory mechanisms of the developing microglia, and interaction between anesthesia and neuroinflammation in the developing brain.
Anesthetic Management of Emergency Endovascular Thrombectomy for Acute Ischemic Stroke, Part 2: Integrating and Applying Observational Reports and Randomized Clinical Trials
Authors: Hindman Bradley J. , Dexter Franklin
Published: March 2019

The 2018 American Heart Association stroke care guidelines consider endovascular thrombectomy to be the standard of care for patients who have acute ischemic stroke in the anterior circulation when arterial puncture can be made: (1) within 6 h of symptom onset; or (2) within 6–24 h of symptom onset when specific eligibility criteria are satisfied. The aim of this 2-part review is to provide practical perspective on the clinical literature regarding anesthesia care of endovascular thrombectomy patients. In the preceding companion article (part 1), the rationale for rapid workflow and maintenance of blood pressure before reperfusion were reviewed. Also in part 1, the key patient and procedural factors determining endovascular thrombectomy effectiveness were identified. In this article (part 2), the observational literature regarding anesthesia for endovascular thrombectomy is summarized briefly, largely to identify its numerous biases, but also to develop hypotheses regarding sedation versus general anesthesia pertaining to workflow, hemodynamic management, and intra– and post–endovascular thrombectomy adverse events. These hypotheses underlie the conduct and outcome measures of 3 recent randomized clinical trials of sedation versus general anesthesia for endovascular thrombectomy. A meta-analysis of functional outcomes from these 3 trials show, when managed according to trial protocols, sedation and general anesthesia result in outcomes that are not significantly different. Details regarding anesthesia and hemodynamic management from these 3 trials are provided. This article concludes with a pragmatic approach to real-time anesthesia decision-making (sedation versus general anesthesia) and the goals and methods of acute phase anesthesia management of endovascular thrombectomy patients.
Transcriptomic analysis of Spodoptera frugiperda Sf9 cells resistant to Bacillus thuringiensis Cry1Ca toxin, reveals that extracellular Ca2+, Mg2+ and production of cAMP are involved in toxicity
Authors: Castella Claude , Pauron David , Hilliou Frédérique , Trang Van Tran , Zucchini-Pascal Nathalie , Gallet Armel , Barbero Pierre
Published: March 2019

Bacillus thuringiensis (Bt) produces pore forming toxins that have been used for pest control in agriculture for many years. However, their molecular and cellular mode of action is still unclear. While a first model, referred to as the pore forming model, is the most widely accepted scenario, a second model proposed that toxins could trigger an Mg2+- dependent intracellular signalling pathway leading to cell death. Although Cry1Ca has been shown to form ionic pores in the plasma membrane leading to cell swelling and death, we investigated the existence of other cellular or molecular events involved in Cry1Ca toxicity. The Sf9 insect cell line, derived from Spodoptera frugiperda, is highly and specifically sensitive to Cry1Ca. Through a selection program we developed various levels of laboratory-evolved Cry1Ca resistant Sf9 cell lines. Using a specific S. frugiperda microarray we performed a comparative transcriptomic analysis between sensitive and resistant cells and revealed genes differentially expressed in resistant cells and related to cation-dependent signalling pathways. Ion chelators protected sensitive cells from Cry1Ca toxicity suggesting the necessity of both Ca2+ and/or Mg2+ for toxin action. Selected cells were highly resistant to Cry1Ca while toxin binding onto their plasma membrane was not affected. This suggested a resistance mechanism different from the classical “loss of toxin binding”. We observed a correlation between Cry1Ca cytotoxicity and the increase of intracellular cAMP levels. Indeed, Sf9 sensitive cells produced high levels of cAMP upon toxin stimulation, while Sf9 resistant cells were unable to increase their intracellular cAMP. Together, these results provide new information about the mechanism of Cry1Ca toxicity and clues to potential resistance factors yet to discover.
An exercise-induced improvement in isolated skeletal muscle contractility does not affect the performance-enhancing benefit of 70 µmol l−1 caffeine treatment
Authors: Tallis Jason , Higgins Matthew F. , Cox Val M. , Duncan Michael J. , James Rob S.
Published: March 2019

This study aimed to examine the effects of exercise-induced increases in skeletal muscle contractile performance on isolated skeletal muscle caffeine sensitivity in mice. CD1 mice (n=28; 30 weeks old) either served as controls or underwent 8 weeks of voluntary wheel running. Following the treatment intervention, whole soleus (SOL) or a section of the costal diaphragm (DIA) was isolated from each mouse and tested to determine the effect of 70 µmol l−1 caffeine on work loop power output. Although caffeine elicited a significant increase in power of both the SOL and the DIA relative to levels in a non-caffeine-treated control, the effect was not different between the experimental groups, despite the muscles of the trained group producing significantly greater muscle power. There was no significant relationship between training volume or baseline work loop power and the caffeine response. These results indicate that an exercise-induced increase in muscle performance did not influence the performance-enhancing effects of caffeine.
Weighing the evidence for using vascular conductance, not resistance, in comparative cardiovascular physiology
Authors: Joyce William , White Daniel W. , Raven Peter B. , Wang Tobias
Published: March 2019

Vascular resistance and conductance are reciprocal indices of vascular tone that are often assumed to be interchangeable. However, in most animals in vivo, blood flow (i.e. cardiac output) typically varies much more than arterial blood pressure. When blood flow changes at a constant pressure, the relationship between conductance and blood flow is linear, whereas the relationship between resistance and blood flow is non-linear. Thus, for a given change in blood flow, the change in resistance depends on the starting point, whereas the attendant change in conductance is proportional to the change in blood flow regardless of the starting conditions. By comparing the effects of physical activity at different temperatures or between species – concepts at the heart of comparative cardiovascular physiology – we demonstrate that the difference between choosing resistance or conductance can be marked. We also explain here how the ratio of conductance in the pulmonary and systemic circulations provides a more intuitive description of cardiac shunt patterns in the reptilian cardiovascular system than the more commonly used ratio of resistance. Finally, we posit that, although the decision to use conductance or resistance should be made on a case-by-case basis, in most circumstances, conductance is a more faithful portrayal of cardiovascular regulation in vertebrates.
EEG correlation at a distance: A re-analysis of two studies using a machine learning approach
Authors: Bilucaglia Marco , Pederzoli Luciano , Giroldini William , Prati Elena , Tressoldi Patrizio
Published: March 2019

Background: In this paper, data from two studies relative to the relationship between the electroencephalogram (EEG) activities of two isolated and physically separated subjects were re-analyzed using machine-learning algorithms.

The first dataset comprises the data of 25 pairs of participants where one member of each pair was stimulated with a visual and an auditory 500 Hz signals of 1 second duration.

The second dataset consisted of the data of 20 pairs of participants where one member of each pair received visual and auditory stimulation lasting 1 second duration with on-off modulation at 10, 12, and 14 Hz.

Methods and Results: Applying a ‘linear discriminant classifier’ to the first dataset, it was possible to correctly classify 50.74% of the EEG activity of non-stimulated participants, correlated to the remote sensorial stimulation of the distant partner.

In the second dataset, the percentage of correctly classified EEG activity in the non-stimulated partners was 51.17%, 50.45% and 51.91%, respectively, for the 10, 12, and 14 Hz stimulations, with respect the condition of no stimulation in the distant partner.

Conclusions: The analysis of EEG activity using machine-learning algorithms has produced advances in the study of the connection between the EEG activities of the stimulated partner and the isolated distant partner, opening new insight into the possibility to devise practical application for non-conventional “mental telecommunications” between physically and sensorially separated participants.
Burden of drug-resistant pulmonary tuberculosis in Pakistani children: A cross-sectional study
Authors: Laghari Ghulam Shabbir , Hussain Zahid , Khemani Lavina , Hussain Syed Zohaib Maroof , Yaqoob Uzair
Published: March 2019

Introduction: The incidence of drug-resistant tuberculosis (TB) is rapidly increasing worldwide. Children in high TB burden countries are rapidly being reported to be affected by multidrug-resistant TB (resistant to isoniazid and rifampicin). The aim of this study is to evaluate the pattern of drug sensitivity among children suffering with TB.

Methods: Known cases of pulmonary TB, with sputum smear positive even after two months of compliance to 1st line anti-tuberculous therapy were included after gaining informed consent. Specimens used for drug sensitivity analysis were either sputum or bronchoalveolar lavage. Patient age, gender, history of TB contact, and duration of treatment were also recorded. Data was entered and analyzed using SPSS v.22.

Results: There were 32 male (64%) and 18 female (36%) children in the study. Their mean age was 12.84 ± 2.54 years. History of household TB contact was positive in 29 (58%) children. Among 1st line anti-tuberculous therapy, ethambutol and streptomycin were most sensitive (n=44; 88%). Rifampin was least sensitive (n=17; 34%). There were 32 (64%) children with multidrug-resistant tuberculosis (MDR-TB). A positive history of household TB contact (either resistant or non-resistant) was seen to have a statistically significant impact on incidence of MDR-TB (p value=0.03)

Conclusion: Pediatric drug-resistant TB is a rising concern. Awareness programs on national and international levels are needed to educate the general population regarding the importance of preventing TB household contact, especially amongst children.
Frequency of Ethical Issues on a Hospitalist Teaching Service at an Urban, Tertiary Care Center
Authors: McCarthy Matthew W , de Asua Diego Real , Gabbay Ezra , Christos Paul J , Fins Joseph J
Published: March 2019

Little is known about the daily ethical conflicts encountered by hospitalists that do not prompt a formal clinical ethics consultation. We describe the frequencies of ethical issues identified during daily rounds on hospitalist teaching services at a metropolitan, tertiary‐care, teaching hospital. Data were collected from September 2017 through May 2018 by two attending hospitalists from the ethics committee who were embedded on rounds. A total of 270 patients were evaluated and 113 ethical issues were identified in 77 of those patients. These issues most frequently involved discussions about goals of care, treatment refusals, decision‐making capacity, discharge planning, cardiopulmonary resuscitation status, and pain management. Only five formal consults were brought to the Hospital Ethics Committee for these 270 patients. Our data are the first prospective description of ethical issues arising on academic hospitalist teaching services and are an important step in the development of a targeted ethics curriculum for hospitalists.
RELIME: CONSTRUCCIÓN, DESARROLLO Y CONSOLIDACIÓN. ¿A DÓNDE NOS DIRIGIMOS?
Authors: Cantoral Uriza Ricardo , Reyes-Gasperini Daniela , Ríos Jarquín Diana Wendolyne , Castro-Pérez Benito
Published: March 2019

Desde su fundación, la Revista Latinoamericana de Investigación en Matemática Educativa (Relime) ha sido parte de un amplio proyecto disciplinar cuyas medidas de acción han sido lideradas por grupos activos de miembros de una comunidad de referencia: la Matemática Educativa en Latinoamérica. La revista surge con un objetivo dual; el de promover y fomentar la escritura de artículos de investigación de alta calidad en la región, así como favorecer el proceso de profesionalización de la disciplina en beneficio de los sistemas educativos de América Latina (Farfán, 1997). Este objetivo, si bien aún no alcanzado plenamente, ha sido un factor de desarrollo en la región y en el orbe.
Observatorio de Derecho Internacional: Actividad Internacional 2017
Authors: Varios autores .
Published: March 2019

.
Preliminares
Authors: ACDI ACDI
Published: March 2019

.
Editorial
Authors: Abello-Galvis Ricardo
Published: March 2019

.
Sharing Guilt: How Better Access to Information May Backfire
Authors: Inderst Roman , Khalmetski Kiryl , Ockenfels Axel
Published: March 2019

We study strategic communication between a customer and an advisor who is privately informed about the most suitable choice for the customer but whose preferences are misaligned with the customer’s preferences. The advisor sends a message to the customer who, in turn, can secure herself from bad advice by acquiring costly information on her own. In our experiments, we find that making the customer’s information acquisition less costly leads to less prosocial behavior of the advisor. This can be explained by a model of shared guilt, which predicts a shift in causal attribution of guilt from the advisor to the customer if the latter could have avoided her ex post disappointment. We conclude that providing better access to information through, for example, consumer protection regulation or digital information aggregation and dissemination, may have unintended negative consequences on peoples’ willingness to take responsibility for each other.

Data files and the online appendices are available at https://doi.org/10.1287/mnsc.2018.3101 .

This paper was accepted by Uri Gneezy, behavioral economics.
In space
Authors: O'Connor Anne , Dickinson Kath
Published: March 2019

Proprioception – our sense of our body in relation to the world – how it develops and what happens when problems arise. By Anne O'Connor and Dr Kath Dickinson
We belong
Authors: Rawstrone Annette
Published: March 2019

How research among parents in East London led to a new way of providing SEND services. By Annette Rawstrone
Good looking
Authors: Goddard Charlotte
Published: March 2019

How should practitioners best be observing children, assessing progress and letting this knowledge inform their planning, asks Charlotte Goddard
Rho-kinase and PKCα Inhibition Induces Primary Cilia Elongation and Alters the Behavior of Undifferentiated and Differentiated Temperature-sensitive Mouse Cochlear Cells
Authors: Kakiuchi Akito , Kohno Takayuki , Kakuki Takuya , Kaneko Yakuto , Konno Takumi , Hosaka Yukino , Hata Tomohiro , Kikuchi Shin , Ninomiya Takafumi , Himi Tetsuo , Takano Kenichi , Kojima Takashi
Published: March 2019

Primary cilia, regulated via distinct signal transduction pathways, play crucial roles in various cellular behaviors. However, the full regulatory mechanism involved in primary cilia development during cellular differentiation is not fully understood, particularly for the sensory hair cells of the mammalian cochlea. In this study, we investigated the effects of the Rho-kinase inhibitor Y27632 and PKCα inhibitor GF109203X on primary cilia-related cell behavior in undifferentiated and differentiated temperature-sensitive mouse cochlear precursor hair cells (the conditionally immortalized US/VOT-E36 cell line). Our results indicate that treatment with Y27632 or GF109203X induced primary cilia elongation and tubulin acetylation in both differentiated and undifferentiated cells. Concomitant with cilia elongation, Y27632 treatment also increased Hook2 and cyclinD1 expression, while only Hook2 expression was increased after treatment with GF109203X. In the undifferentiated cells, we observed an increase in the number of S and G2/M stage cells and a decrease of G1 cells after treatment with Y27632, while the opposite was observed after treatment with GF109203X. Finally, while both treatments decreased oxidative stress, only treatment with Y27632, not GF109203X, induced cell cycle-dependent cell proliferation and cell migration.
Antibacterial and Antioxidant activities of Indonesian ginger (jahe emprit) essential oil extracted by hydrodistillation
Authors: Azizah Nurul , Filaila Euis , Salahuddin Salahuddin , Agustian Egi , Sulaswatty Anny , Artanti Nina
Published: March 2019

The rhizome of ginger is commonly used as a spice, food, beverage as well as medicine. Plant essential oils including from ginger have been widely used for food preservation, pharmaceutical and alternative medicines.  Currently there are growing interest of consumer for natural sources such as essential oils for natural antibacterial and antioxidant.  Jahe emprit (Zingiber officinale var. Amarum) is one of Indonesian ginger variety used to obtain ginger essential oil. The objective of current study was to investigate the effect of solvent to feed (SF) ratio in hydrodistillation process on yield, chemicals content, antibacterial and antioxidant activities of ginger essential oils from jahe emprit.  SF ratio used in this study is 0.7: 1, 1.7: 1, 2.7: 1.  Chemicals content was conducted using GCMS analysis.  Antibacterial assay was conducted using disc diffusion method against Escherichia coli and Staphylococcus aureus.  Antioxidant assay was conducted using DPPH free radical scavenging assay.  The results show that the highest essential oil yield was obtained from SF ratio 1.7:1 which gave yield of 3.7%.  GCMS analysis shows that camphene was always the major compound present in those 3 SF ratio, although the amount present was differed.  Besides, 4 other major compounds present were varied.  Antibacterial assay using 1% concentration showed ginger oil obtained from SF 0.7:1 and 2.7:1 have the same activities for S. aureus, whereas SF ratio 1.7:1 has the lowest activities.  However for E. coli, all SF ratio gave same results.  For antioxidant activities at 1000 ppm concentration, the highest activity was obtained from SF ratio 2.7:1
Microwave Assisted Synthesis of 1,5-Benzothiazepines Using Greener Reaction Medium
Authors: Kotalwar Sanjay S. , Kale Amol D. , Kohire Ram B. , Jagrut Vasant B.
Published: March 2019

An efficient and eco-friendly synthesis of 1,5-benzothiazepines has been developed by the reaction of various 2-propen-1-ones with 2-aminothiophenol using microwave irradiation in greener reaction medium, glycerol. The clean reaction conditions, shorter reaction time, high yields and non-toxic, biodegradable reaction medium manufactured from renewable sources are unique features of this method.
CONCEPTUAL MODEL OF SOCIAL MECHANISM OF PROVISION OF SOCIAL SECURITY IN THE SPHERE OF INTERETHNIC AND INTERCONFESSION RELATIONS
Authors: Maximova Svetlana G. , Surtaeva Olga V. , Noyanzina Oksana E. , Omelchenko Daria A.
Published: March 2019

An article presents the analysis of methodological approaches to the construction of a model of social mechanism of provision of social security in the sphere of interethnic and interconfession relations in conditions of the migration processes transformation. A general focus lays on the analysis of social mechanism of provision of social security in the context of social risks in the sphere of interethnic and interconfession relations; it includes three level of analysis: micro level (institutional), meso level (social-group) and micro level (individual). The given conceptual model has a number of important methodological and methodical functions, helps to make the understanding of the process of provision of social security in the sphere of interethnic and interconfession relations more holistic; makes interregional and international correlations in the study of interethnic and interconfession relations in conditions of the migration processes transformation more system and operationalized.