bluuebunny/crossref_metadata_2025 huggingface dataset:
Mortality Rates After Posterior C1–2 Fusion for Displaced Type II Odontoid Fractures in Octogenarians
Authors: Clark Stephen , Nash Alysa , Shasti Mark , Brown Luke , Jauregui Julio J. , Mistretta Katherine , Koh Eugene , Banagan Kelley , Ludwig Steven , Gelb Daniel
Published: March 2018

Study Design.

Retrospective cohort study

Objective.

To assess 30-day and 1-year mortality rates as well as the most common complications associated with posterior C1–2 fusion in an octogenarian cohort.

Summary of Background Data.

Treatment of unstable type II odontoid fractures in elderly patients can present challenges. Recent evidence indicates in patients older than 80 years, posterior C1–2 fusion results in improved survival as compared to other modes of treatment.

Methods.

Retrospective analysis of 43 consecutive patients (25 female and 18 male; mean age 84.3 yr, range 80–89 yr; mean Charlson Comorbidity Index 1.4, (range 1–6); mean body mass index 24.8 ± 4.2 kg/m2, who underwent posterior C1-C2 fusion for management of unstable type II odontoid fracture by four fellowship trained spine surgeons at a single institution between January 2006 to June 2016.

Results.

Mean fracture displacement was 5.1 ± 3.6 mm and mean absolute value of angulation was 19.93° ± 12.93°. The most common complications were altered mental status (41.9%, n = 18), dysphagia (27.9%, n = 12) with 50% of those patients (6/12) requiring a feeding tube, and emergency reintubation (9.3%, n = 4). To the date of review completion, 25 of 43 patients expired (58.1%), median survival of 1.76 years from the date of surgery. Thirty-day and 1-year mortality rates were 2.3% and 18.6%, respectively. Patients who developed dysphagia were 14.5 times more likely to have expired at 1 year; dysphagia was also found to be significantly associated with degree of displacement. Fracture displacement was found to be associated with increased odds for 1-year mortality when accounting for age and requirement of a feeding tube.

Conclusion.

Posterior C1–2 fusion results in acceptably low mortality rates in octogenarians with unstable type II odontoid fractures when compared to nonoperative management mortality rates in current literature. Initial fracture displacement is associated with higher mortality rate in this patient population.

Level of Evidence: 4
Surgical Management of Geriatric Ankle Fractures
Authors: Schwartz Andrew M. , Kadakia Rishin J. , Bariteau Jason T.
Published: March 2018

There is a perpetual increase in the number of elderly people in the United States, both as a function of raw population size, and improvements in health care and its delivery. As such, it is our duty as foot and ankle surgeons to be participants in the improvement of geriatric health care. One area that has garnered burgeoning interest is geriatric ankle fractures. Typically managed nonoperatively, new evidence has supported surgical management of these fractures to spare morbidity and mortality. Classically, a lag screw and one-third tubular plate construct for the fibula and long lag screws in the medial malleolus was the mainstay of surgical treatment. This review paper looks at newer technologies and techniques, including fibular locking plates, fibular intramedullary nails, hindfoot fusion nails, and external fixation as important surgical techniques to hone in patients who often have diminished bone quality and wound-healing capabilities. Understanding these surgical modalities is a vital component in managing geriatric ankle fractures successfully.

Level of Evidence: Level IV. See Instructions for Authors for a complete description of levels of evidence.
Early Childhood Learning and the Pediatrician: A Qualitative Study Among Diverse, Low-Income Caregivers
Authors: Steinberg Jecca Rhea , Bruce Janine S. , Marin-Nevarez Paloma , Phan Kimmy , Merrell Sylvia Bereknyei , Chamberlain Lisa J.
Published: March 2018

Objective:

School readiness by kindergarten entry is associated with increased high school graduation, decreased juvenile arrest, and better long-term health. Inadequate early childhood learning (ECL) disproportionately affects low-income children. Pediatricians have near-universal access to children younger than 5 years but remain an underused ECL resource. This study examined caregivers' perceptions of ECL, the role of the pediatrician and pediatric office, and the use of community-based ECL resources among diverse, low-income caregivers whose children were not enrolled in preschool.

Methods:

Using community-engaged strategies, caregivers were recruited to participate in in-depth focus groups (FGs). Demographic and FG data were collected in English, Spanish, and Vietnamese. Qualitative data were analyzed with iterative transcript-based coding and theme analysis.

Results:

From June 2015 to August 2015, 69 low-income mothers (n = 46), fathers (n = 8), and grandparents (n = 15) from African-American (33%), Latino (32%), and Vietnamese (35%) communities participated in 12 FGs. Caregivers across groups wanted pediatricians to act as ECL experts and to provide ECL services. Caregivers valued ECL, especially when delivered by trusted sources. Utilization and perception of community ECL resources varied among groups. The greatest variation included different preferences for resource setting, accessibility, and acceptability, especially cultural acceptability. Each individual and groups' unique, and occasionally adverse, experiences and financial and logistical considerations informed ECL preferences.

Conclusion:

This exploratory study brings forth diverse caregivers' perspectives regarding the role of pediatricians in ECL and their desire for pediatricians to be an access point for high-quality, affordable ECL services. Caregivers' preferences regarding ECL programming may inform clinic-based pediatric ECL programming.
Heart-rate variability: a biomarker to study the influence of nutrition on physiological and psychological health?
Authors: Young Hayley A. , Benton David
Published: March 2018

As the influence of diet on health may take place over a period of decades, there is a need for biomarkers that help to identify those aspects of nutrition that have either a positive or a negative influence. The evidence is considered that heart-rate variability (HRV) (the time differences between one beat and the next) can be used to indicate the potential health benefits of food items. Reduced HRV is associated with the development of numerous conditions for example, diabetes, cardiovascular disease, inflammation, obesity and psychiatric disorders. Although more systematic research is required, various aspects of diet have been shown to benefit HRV acutely and in the longer term. Examples include a Mediterranean diet, omega-3 fatty acids, B-vitamins, probiotics, polyphenols and weight loss. Aspects of diet that are viewed as undesirable, for example high intakes of saturated or trans-fat and high glycaemic carbohydrates, have been found to reduce HRV. It is argued that the consistent relationship between HRV, health and morbidity supports the view that HRV has the potential to become a widely used biomarker when considering the influence of diet on mental and physical health.
Acute food deprivation separates motor-activating from anxiolytic effects of caffeine in a rat open field test model
Authors: Schulz Daniela
Published: March 2018

Similar doses of caffeine have been shown to produce either anxiolytic or anxiogenic effects in rats. The reasons for these conflicting results are not known. We hypothesized that food deprivation stress interacts with the stimulant effects of caffeine to increase anxiety-like behavior. We tested 32 female Sprague Dawley rats in a dim open field for 10 min. Half of the animals were food deprived for 24 h and injected (intraperitoneal) with caffeine (30 mg/kg; n=7) or deionized water (n=8) 20 min before the open field test. The other half was nondeprived and injected with caffeine (30 mg/kg; n=8) or deionized water (n=9). Results showed that nondeprived rats injected with caffeine moved longer distances and at a greater speed in the periphery and moved longer distances and spent more time in the center than rats treated with vehicle, indicative of motor-activating and/or anxiolytic effects of caffeine. Rats that were food deprived and injected with caffeine moved longer distances in the center and tended to spend more time there, indicative of anxiolysis. We conclude that caffeine had two effects on behavior, motor activation and a reduction of anxiety, and that food deprivation separated these effects.
Bioengineering Cardiac Tissue Constructs With Adult Rat Cardiomyocytes
Authors: Tao Ze-Wei , Mohamed Mohamed , Jacot Jeffrey G. , Birla Ravi K.
Published: March 2018

Bioengineering cardiac tissue constructs with adult cardiomyocytes may help treat adult heart defects and injury. In this study, we fabricated cardiac tissue constructs by seeding adult rat cardiomyocytes on a fibrin gel matrix and analyzed the electromechanical properties of the formed cardiac tissue constructs. Adult rat cardiomyocytes were isolated with a collagenase type II buffer using an optimized Langendorff perfusion system. Cardiac tissue constructs were fabricated using either indirect plating with cardiomyocytes that were cultured for 1 week and dedifferentiated or with freshly isolated cardiomyocytes. The current protocol generated (3.1 ± 0.5) × 106 (n = 5 hearts) fresh cardiomyocytes from a single heart. Tissue constructs obtained by both types of plating contracted up to 30 days, and electrogram (ECG) signals and contractile twitch forces were detected. The constructs bioengineered by indirect plating of dedifferentiated cardiomyocytes produced an ECG R wave amplitude of 15.1 ± 5.2 µV (n = 7 constructs), a twitch force of 70–110 µN, and a spontaneous contraction rate of about 390 bpm. The constructs bioengineered by direct plating of fresh cardiomyocytes generated an ECG R wave amplitude of 6.3 ± 2.5 µV (n = 8 constructs), a twitch force of 40–60 µN, and a spontaneous contraction rate of about 230 bpm. This study successfully bioengineered three-dimensional cardiac tissue constructs using primary adult cardiomyocytes.
Advantages of Integrating Pressure-Regulating Devices Into Mechanical Circulatory Support Pumps
Authors: Horvath David J. , Karimov Jamshid H. , Byram Nicole A. , Kuban Barry D. , Sunagawa Gengo , Moazami Nader , Fukamachi Kiyotaka
Published: March 2018

Control of mechanical circulatory support pump output typically requires that pressure-regulating functions be accomplished by active control of the speed or geometry of the device, with feedback from pressure or flow sensors. This article presents a different design approach, with a pressure-regulating device as the core design feature, allowing the essential control function of regulating pressure to be directly programmed into the hydromechanical design. We show the step-by-step transformation of a pressure-regulating device into a continuous-flow total artificial heart that passively balances left and right circulations without the need for pressure and flow sensors. In addition, we discuss a ventricular assist device that prevents backflow in the event of power interruption and also dynamically interacts with residual ventricle function to preserve pulsatility.
Opioid-Induced Hyperalgesia in the Nonsurgical Setting: A Systematic Review
Authors: Yang David Z. , Sin Billy , Beckhusen Joshua , Xia Dawei , Khaimova Rebecca , Iliev Ilia
Published: March 2018

Background:

Opioid-induced hyperalgesia (OIH) is a phenomenon that causes an increased pain sensitization and perception of pain to noxious stimuli secondary to opioid exposure. While this clinical effect has been described in the surgical setting, it is unclear if OIH occurs in the nonsurgical setting.

Study Question:

To review the available literature which evaluated OIH in nonsurgical settings.

Data Sources:

A comprehensive literature search was performed using PubMed (January 1946–July 2017) using a variety of keywords for OIH. This review included randomized controlled trials with objectives to identify OIH in the nonsurgical setting. The clinical outcomes of interest were identification of OIH, adverse events, and impact of OIH on opioid consumption.

Results:

The search identified 8 studies that fulfilled the criteria. Six studies enrolled healthy male volunteers, 1 study used chronic low-back patients, and another used heroin-dependent treatment-seeking adults. Studies used various opioids and dosages, including remifentanil, alfentanil, fentanyl, morphine, methadone, and buprenorphine. Three primary experimental pain induction models were used to evaluate for OIH. Measured outcomes included hyperalgesia area, pain threshold, and pain tolerance. All 5 studies that used the electrical stimulation model identified OIH as a significant outcome. However, only 2 of 5 studies using the cold pressor model and 1 of 3 studies using the heat pressor model identified OIH. None of the trials explored clinical outcomes, such as effects on opioid consumption.

Conclusions:

Most included studies identified OIH as a significant outcome within the nonsurgical setting. However, due to conflicting conclusions and various limitations, the clinical impact of OIH could not be assessed. Clinicians should monitor for effects of OIH in the nonoperative setting because there is insufficient evidence from the available literature to conclude that OIH is consistently observed in this setting.
Nurses’ Caring Behaviors Toward Patients Undergoing Chemotherapy in Greece
Authors: Karlou Chyssoula , Papadopoulou Constantina , Papathanassoglou Elizabeth , Lemonidou Chryssoula , Vouzavali Fotini , Zafiropoulou-Koutroubas Anna , Katsaragakis Stelios , Patiraki Elisabeth
Published: March 2018

Background

Nurses’ caring behaviors are central in the quality of care of patients undergoing sophisticated chemotherapy protocols. However, there is a scarcity of research regarding these behaviors in non–Anglo-Saxon countries.

Objective

The aim of this study was to explore caring behaviors that nurses perceive as important in caring for patients in Greece receiving chemotherapy.

Methods

We used a mixed-methods design, including a survey in 7 oncology wards in 3 cancer hospitals in Attica, Greece, and a subsequent qualitative focus group investigation. Caring behaviors were explored through the Caring Behavior Inventory 24 and content analysis of 3 focus group interviews.

Results

A sample of 72 nurses (response rate, 68.5%) were surveyed, and 18 nurses participated in the focus groups. “Knowledge/skills” (5 [SD, 0.7]) was the most important caring behaviors. No significant associations with nurses’ characteristics were noted, except for higher scores in caring behaviors in participants who were married (P < .02). Six caring-related categories emerged from the qualitative analysis: “the concept of care,” “respect,” “nurse-patients’ connection,” “empathy,” “fear of cancer,” and “nurses’ professional role.” Moreover, they stressed barriers they faced in each category.

Conclusions

Integrated quantitative and qualitative data concur that operational tasks are central in Greek nurses’ caring behaviors. In addition, qualitative findings highlighted those skills equipping nurses to provide holistic individualized care in a hectic care environment.

Implications for Practice

Supporting nurses in attaining excellence in technical skills and in meaningfully engaging with patients receiving chemotherapy is essential in the realization of their caring role. These should be priorities for continuing education and practice improvement initiatives.
Relationships Between Smoking Status and Psychological Distress, Optimism, and Health Environment Perceptions at Time of Diagnosis of Actual or Suspected Lung Cancer
Authors: Choi Seung Hee , Chan Roxane R. , Lehto Rebecca H.
Published: March 2018

Background

While much research and practice resources have addressed smoking cessation among cancer patients, less emphasis has been placed on personal psychological and environment factors associated with smoking at the time of diagnosis.

Objective

The aim of this study was to examine differences in psychological distress, optimism, and perceptions of the health environment/illness experience based on smoking status in patients with current, former, and no smoking history with newly diagnosed suspected or actual lung cancer.

Methods

Data were derived from a descriptive study of 52 patients (34 men and 18 women aged 37-83 years) undergoing diagnostic evaluation for actual or suspected lung cancer. Descriptive statistics were used to characterize data. Analysis of variance, χ
2, and Spearman correlation tests were used to determine relationships among main study variables (smoking status, anxiety, worry, perceived cognitive functioning, optimistic outlook, health environment/illness experience perceptions).

Results

Current smoking status was associated with higher psychological distress (anxiety and worry) among patients facing a new suspected or actual cancer diagnosis.

Conclusions

The study was able to provide important information relative to smoking status and psychological distress at the time of diagnosis of suspected or actual lung cancer. Findings demonstrate needs for assessment and targeted interventions to reduce psychological distress and to promote long-term adaptation in patients smoking at time of diagnosis.

Implications for Practice

Nurses are positioned to provide support and resources for cancer patients. It is critical that smoking cessation interventions also address nicotine craving, emotion regulation, and adaptive coping skills.
Nursing Diagnoses, Interventions, and Activities as Described by a Nursing Minimum Data Set
Authors: Sanson Gianfranco , Alvaro Rosaria , Cocchieri Antonello , Vellone Ercole , Welton John , Maurici Massimo , Zega Maurizio , D’Agostino Fabio
Published: March 2018

Background

Oncological diseases affect the biopsychosocial aspects of a person’s health, resulting in the need for complex multidisciplinary care. The quality and outcomes of healthcare cannot be adequately assessed without considering the contribution of nursing care, whose essential elements such as the nursing diagnoses (NDs), nursing interventions (NIs), and nursing activities (NAs) can be recorded in the Nursing Minimum Data Set (NMDS). There has been little research using the NMDS in oncology setting.

Objective

The aim of this study was to describe the prevalence and distribution of NDs, NIs, and NAs and their relationship across patient age and medical diagnoses.

Methods

This was a prospective observational study. Data were collected between July and December 2014 through an NMDS and the hospital discharge register in an Italian hospital oncology unit.

Results

On average, for each of 435 enrolled patients, 5.7 NDs were identified on admission; the most frequent ND was risk for infection. During the hospital stay, 16.2 NIs per patient were planned, from which 25.2 NAs per day per patient were delivered. Only a third of NAs were based on a medical order, being the highest percentage delivered on nursing prescriptions. The number of NDs, NIs, and NAs was not related to patient age, but differed significantly among medical diagnoses.

Conclusions

An NMDS can depict patient needs and nursing care delivered in oncology patients. Such data can effectively describe nursing contribution to patient care.

Implications for Practice

The use of an NMDS raises the visibility of nursing care in the clinical records. Such data enable comparison and benchmarking with other healthcare professions and international data.
Debriefing Interprofessionally
Authors: Poore Julie A. , Dawson Justine C. , Dunbar Dawne-Marie , Parrish Kathryn
Published: March 2018

As the health care environment increases in complexity and patient acuity rises, health profession graduates need to be prepared to work collaboratively to improve patient outcomes. The interprofessional debriefing tool (Debriefing Interprofessionally: Recognition & Reflection) presented in this article allows any simulation to be transformed into an interprofessional learning opportunity. The debriefing tool frames questions for both uniprofessional and multiprofessional simulation and is aligned with the Core Competencies for Interprofessional Collaborative Practice and with Quality and Safety Education for Nurses.
Going Off Grid: Modeling an Automated Record Search to Process Electronically Reported Reactive Nontreponemal Syphilis Tests
Authors: Matthias James , Keller Gayle , Cha Susan , Wilson Craig , Peterman Thomas A.
Published: March 2018

Background

Before searching prior records, sexually transmitted disease programs use syphilis reactor grids to exclude some reactive nontreponemal test results (RNTs) based on patient age, gender, and test titer. We propose a new algorithm that starts with comparing RNTs to previous syphilis nontreponemal tests and current treponemal test results.

Methods

Deduplicated RNTs from Florida's surveillance system (2006–2015) were extracted and stratified on morbidity. An algorithm was developed to triage RNTs. Sensitivity and specificity of the algorithm and the current reactor grid were estimated using reported syphilis cases. A random sample of cases missed by the proposed algorithm, stratified by stage of disease, was reviewed to verify case classification.

Results

Reported RNTs increased 58% from 2006 (n = 34,808) to 2015 (n = 55,001) (total = 372,902). The current reactor grid removed 91,518 (24.5%) RNTs and missed 1149 potential cases. Strictly following the reactor grid would result in a sensitivity of 97.4% and a specificity of 27.5%. The proposed algorithm would remove 242,078 (64.9%) RNTs and miss 2768 potential cases. This results in a slightly lower sensitivity of 93.8%, but nearly triples the specificity, 72.9%. A review of a random sample of the 2768 cases estimated that 72.7% would not have met the syphilis surveillance case definition, resulting in an adjusted sensitivity of 98.4%.

Conclusions

In Florida, an algorithm that starts by searching previous syphilis test results vastly improved specificity and slightly improved sensitivity compared with the current reactor grid. Implementing an automated algorithm could increase case ascertainment efficiency and further prioritize likely cases for investigation.
Renal Histopathologic Findings Associated With Severity of Clinical Acute Kidney Injury
Authors: Kudose Satoru , Hoshi Masato , Jain Sanjay , Gaut Joseph P.
Published: March 2018

Acute kidney injury (AKI) is a significant cause of morbidity and mortality. Acute tubular injury is considered to be the early pathologic manifestation of AKI, however, the underlying pathology is complex, lacks standards for interpretation, and its relationship with AKI often is unclear or inconsistent. To clarify clinicopathologic correlations in AKI, we evaluated 32 histologic findings in 100 kidney biopsies from patients with AKI as a training set to correlate pathologic findings with clinical AKI grades. Kidney Injury Molecule-1 quantitative immunohistochemistry was performed to confirm tubular injury. A separate cohort of 50 biopsies were evaluated blinded to clinical information to validate the findings. Pathologic tubular injury correlated best with Kidney Disease Improving Global Outcomes criteria. Tubular epithelial simplification, tubular epithelial mitosis, and cell sloughing correlated well with clinically severe AKI and were used to construct a tubular injury classification scheme with sensitivity of 0.93 (0.85, 1), specificity of 0.95 (0.83, 1), and area under the receiver-operating characteristic curve of 0.98 (0.98, 1) for grades 2 to 3 AKI. Predictive ability of the model did not improve when Kidney Injury Molecule-1 immunostaining results were added. The results show a strong correlation between pathologic tubular injury and modern clinical definitions of AKI. The proposed classification scheme may aid in development of more precise and clinically meaningful interpretations of pathologic tubular injury in native kidney biopsies and provides simple pathologic criteria without special studies that can easily be adopted globally.
Acral Spitz Nevi
Authors: Wiedemeyer Katharina , Guadagno Antonio , Davey Jonathan , Brenn Thomas
Published: March 2018

Spitz nevi on acral sites are rare and poorly documented. The combination of Spitzoid cytomorphology and atypical architectural features of the junctional component may lead to an erroneous diagnosis of melanoma. To study the clinicopthologic and immunohistochemical features, 50 Spitz nevi localized on the distal extremities were retrieved from departmental files. Clinical data and follow-up were obtained and the histologic features were analyzed. P16 and P21 immunohistochemical staining of the dermal component was compared with that of 10 acral lentiginous melanomas and 10 acral nevi. Acral Spitz nevi affected young adults (median: 24.5 y; range: 4 to 61 y) with a female predominence and a predilection for the feet. They were pigmented measuring 1 to 15 mm (median: 4 mm). Follow-up, available for 45 patients (median: 48 mo; range: 4 to 228 mo), revealed no local recurrence, metastasis or mortality. Histologically, acral Spitz nevi were composed of large epithelioid and/or spindled melanocytes. They were well circumscribed with occasional asymmetry. The junctional component was broad with a lentiginous and nested growth and shoulder formation. Marked pagetoid spread and transepidermal elimination of junctional nests were common features. Focal active regression of the dermal component was frequently noted but there was no nuclear pleomorphism or dermal mitotic activity. Acral Spitz nevi were characterized by strong and diffuse P16 and P21 expression, which differs from acral nevi and acral lentiginous melanoma. Acral Spitz nevi are a distinctive subgroup of Spitz nevi with benign behavior. Awareness of the subtle histologic differentiating features and the distinctive P16/P21 expression pattern allows separation from melanoma.
18F-FDG PET/CT for Monitoring Response of Merkel Cell Carcinoma to the Novel Programmed Cell Death Ligand 1 Inhibitor Avelumab
Authors: Eshghi Naghmehossadat , Lundeen Tamara F. , MacKinnon Lea , Avery Ryan , Kuo Phillip H.
Published: March 2018

An 85-year-old man with stage IIIA Merkel cell carcinoma of the left arm was initially treated with local excision and axillary node dissection followed by radiation therapy. Eight months after surgery, whole-body FDG PET/CT demonstrated intensely hypermetabolic hepatic metastases and abdominal lymphadenopathy. Given his age and comorbidities, he was considered a poor candidate for chemotherapy, and therefore the novel programmed cell death ligand 1 inhibitor avelumab was initiated. FDG PET/CT after 4 cycles showed complete resolution of hepatic and nodal metastases. Whole-body FDG PET/CT can be used for monitoring response of multisystem metastases from Merkel cell carcinoma to active immunotherapy.
Excess sodium is deleterious on endothelial and glycocalyx barrier function: A microfluidic study
Authors: Martin Jonathan V. , Liberati David M. , Diebel Lawrence N.
Published: March 2018

BACKGROUND

Hypernatremia is a common problem affecting critically ill patients, whether due to underlying pathology or the subsequent result of hypertonic fluid resuscitation. Numerous studies have been published, suggesting that hypernatremia may adversely affect the vascular endothelial glycocalyx. Our study aimed to evaluate if high sodium concentration would impair the endothelial and glycocalyx barrier function and if stress conditions that simulate the shock microenvironment would exacerbate any observed adverse effects of hypernatremia.

METHODS

Human umbilical vein endothelial cells (HUVEC) were cultured in microfluidic channels subjected to flow conditions overnight to stimulate glycocalyx growth. Cells were then subjected to sodium (Na+) concentrations of either 150 mEq/L or 160 mEq/L, with Hepes solution applied to media to maintain physiologic pH. Subsets of HUVEC were also exposed to hypoxia/reoxygenation and epinephrine (HR + Epi) to simulate shock insult, then followed by Na+ treatment. Perfusate was then collected 60 minutes and 120 minutes following treatments. Relevant biomarkers were then evaluated and HUVEC underwent fluorescent staining followed by microscopy.

RESULTS

Glycocalyx degradation as indexed by hyaluronic acid and syndecan-1 was elevated in all subgroups, particularly those subjected to HR + Epi with Na+ 160 mEq/L. Thickness of the glycocalyx as evaluated by fluorescent microscopy was reduced to half of baseline with Na+ 160 mEq/L and to one third of baseline with additional insult of HR + Epi. Endothelial activation/injury as indexed by soluble thrombomodulin was elevated in all subgroups. A profibrinolytic coagulopathy phenotype was demonstrated in all subgroups with increased tissue plasminogen activator levels and decreased plasminogen activator inhibitor-1 levels.

CONCLUSION

Our data suggest that hypernatremia results in degradation of the endothelial glycocalyx with further exacerbation by shock conditions. A clinical study using clinical measurements of the endothelial glycocalyx in critically ill or injured patients with acquired hypernatremia would be warranted.
Intravenous administration of synthetic platelets (SynthoPlate) in a mouse liver injury model of uncontrolled hemorrhage improves hemostasis
Authors: Dyer Mitchell R. , Hickman DaShawn , Luc Norman , Haldeman Shannon , Loughran Patricia , Pawlowski Christa , Sen Gupta Anirban , Neal Matthew D.
Published: March 2018

BACKGROUND

Clinical resuscitative treatment of traumatic hemorrhage involves transfusion of RBC, platelets and plasma in controlled ratios. However, use of such blood components, especially platelets, present many challenges including availability, portability, contamination risks, and short shelf-life, which limit the use of platelet transfusions outside of large trauma centers such as remote civilian hospitals and austere prehospital settings. This has prompted significant research in platelet substitutes that may resolve the above issues while providing platelet-mimetic hemostatic action. In this framework, we have developed a synthetic platelet surrogate, SynthoPlate, by integrative decoration of platelet function mimetic peptides on a biocompatible lipid nanovesicle platform. We have previously demonstrated hemostatic capability of SynthoPlate in correcting tail-bleeding time in thrombocytopenic mice. Building on this, we hypothesized that SynthoPlate transfusion would decrease bleeding in a murine model of acute hemorrhagic shock.

METHODS

A validated model of uncontrolled intraperitoneal hemorrhage, via liver laceration was used to induce hemorrhagic shock in mice. SynthoPlate, control (unmodified) particles, and normal saline were administered as pretreatment and recue infusions to mice undergoing liver laceration and evaluated for hemostatic benefit by determining differences in blood loss and monitoring real-time hemodynamic data.

RESULTS

Pretreatment SynthoPlate transfusion resulted in significant reduction of blood loss following hemorrhage, compared with control particles or normal saline treatment (0.86 ± 0.16 g control particles [CP] vs. 0.84 ± 0.13 g normal saline [NS] vs. 0.68 ± 0.09 g SynthoPlate, p < 0.005). SynthoPlate transfused mice demonstrated improved hemodynamics taking significantly longer to develop post-injury hypotension (168.3 ± 106.6 seconds CP vs. 137 ± 58 seconds NS vs. 546.7 ± 329.8 seconds SynthoPlate, p < 0.05). SynthoPlate infusion following liver laceration, that is, rescue transfusion, also resulted in a significant decrease in blood loss (0.89 ± 0.17 g CP vs. 0.92 ± 0.19 g NS vs. 0.69 ± 0.18 g SynthoPlate, p < 0.05).

CONCLUSION

Transfusion of SynthoPlate particles reduces blood loss in a murine model of liver injury, and SynthoPlates may represent a viable transfusion product for the mitigation of blood loss in acute, severe hemorrhagic shock.
Investigation on preferably oriented abnormal growth of CdSe nanorods along (0002) plane synthesized by henna leaf extract-mediated green synthesis
Authors: Iyyappa Rajan P. , Judith Vijaya J. , Jesudoss S. K. , Kaviyarasu K. , Lee Seung-Cheol , John Kennedy L. , Jothiramalingam R. , Al-Lohedan Hamad A. , Mahamad Abdullah M.
Published: March 2018

The theme of this work is to highlight the significance of green plant extracts in the synthesis of nanostructures. In asserting this statement, herein, we report our obtained results on the synthesis of hexagonal CdSe nanorods preferably oriented along (0002) plane through henna leaf extract-mediated reaction along with a discussion about the structural, morphological and optical properties of the synthesized nanorods. The possible mechanism for the synthesis of CdSe nanorods was explored. The formation of nanorods along (0002) plane was confirmed by the relatively high intensity of the (0002) peak in X-ray diffraction pattern. To account for the experimentally realistic condition, we have calculated the surface energies of hexagonal CdSe surface slabs along the low indexed (0002),

(
10

1
¯

0
)

and

(
11

2
¯

0
)

plane surfaces using density functional theory approach and the calculated surface energy value for (0002) surface is 802.7 mJ m
−2
, which is higher than

(
11

2
¯

0
)

and

(
10

1
¯

0
)

surfaces. On realizing the calculated surface energies of these slabs, we determined that the combination of

(
11

2
¯

0
)

and

(
10

1
¯

0
)

planes with lower surface energies will lead to the formation of CdSe nanorods growth along (0002) orientation. Finally, we argue that the design of new greener route for the synthesis of novel functional nanomaterials is highly desired.
Water-mediated green synthesis of PbS quantum dot and its glutathione and biotin conjugates for non-invasive live cell imaging
Authors: Vijaya Bharathi M. , Maiti Santanu , Sarkar Bidisha , Ghosh Kaustab , Paira Priyankar
Published: March 2018

This study addresses the cellular uptake of nanomaterials in the field of bio-applications. In the present study, we have synthesized water-soluble lead sulfide quantum dot (PbS QD) with glutathione and 3-MPA (mercaptopropionic acid) as the stabilizing ligand using a green approach. 3-MPA-capped QDs were further modified with streptavidin and then bound to biotin because of its high conjugation efficiency. Labelling and bio-imaging of cells with these bio-conjugated QDs were evaluated. The bright red fluorescence from these types of QDs in HeLa cells makes these materials suitable for deep tissue imaging.
Unexpected solvent effects on the UV/Vis absorption spectra of
o
-cresol in toluene and benzene: in contrast with non-aromatic solvents
Authors: Zheng Dong , Yuan Xiang-Ai , Ma Haibo , Li Xiaoxiong , Wang Xizhang , Liu Ziteng , Ma Jing
Published: March 2018

Cresol is a prototype molecule in understanding intermolecular interactions in material and biological systems, because it offers different binding sites with various solvents and protonation states under different pH values. It is found that the UV/Vis absorption spectra of
o
-cresol in aromatic solvents (benzene, toluene) are characterized by a sharp peak, unlike the broad double-peaks in 11 non-aromatic solvents. Both molecular dynamics simulations and electronic structure calculations revealed the formation of intermolecular π-complexation between
o
-cresol and aromatic solvents. The thermal movements of solvent and solute molecules render the conformations of
o
-cresol changing between
trans
and
cis
isomers. The π-interaction makes the
cis
configuration a dominant isomer, hence leading to the single keen-edged UV/Vis absorption peak at approximately 283 nm. The free conformation changes between
trans
and
cis
in aqueous solution rationalize the broader absorption peaks in the range of 260–280 nm. The pH dependence of the UV/Vis absorption spectra in aqueous solutions is also rationalized by different protonation states of
o
-cresol. The explicit solvent model with long-ranged interactions is vital to describe the effects of π-complexation and electrostatic interaction on the UV/Vis absorption spectra of
o
-cresol in toluene and alkaline aqueous (pH > 10.3) solutions, respectively.
Palaeoecological inferences for the fossil Australian snakesYurlunggurandWonambi(Serpentes, Madtsoiidae)
Authors: Palci Alessandro , Hutchinson Mark N. , Caldwell Michael W. , Scanlon John D. , Lee Michael S. Y.
Published: March 2018

Madtsoiids are among the most basal snakes, with a fossil record dating back to the Upper Cretaceous (Cenomanian). Most representatives went extinct by the end of the Eocene, but some survived in Australia until the Late Cenozoic.YurlunggurandWonambiare two of these late forms, and also the best-known madtsoiids to date. A better understanding of the anatomy and palaeoecology of these taxa may shed light on the evolution and extinction of this poorly known group of snakes and on early snake evolution in general. A digital endocast of the inner ear ofYurlunggurwas compared to those of 81 species of snakes and lizards with known ecological preferences using three-dimensional geometric morphometrics. The inner ear ofYurlunggurmost closely resembles both that of certain semiaquatic snakes and that of some semifossorial snakes. Other cranial and postcranial features of this snake support the semifossorial interpretation. While the digital endocast of the inner ear ofWonambiis too incomplete to be included in a geometric morphometrics study, its preserved morphology is very different from that ofYurlunggurand suggests a more generalist ecology. Osteology, palaeoclimatic data and the palaeobiogeographic distribution of these two snakes are all consistent with these inferred ecological differences.
Nanostructured mesoporous silica: influence of the preparation conditions on the physical-surface properties for efficient organic dye uptake
Authors: Morsi Rania E. , Mohamed Rasha S.
Published: March 2018

A series of ordered mesoporous silica such as MCM-41, SBA-3 and SBA-15, in addition to silica micro- (SM) and nano- (SN) mesoporous particles, were prepared. The preparation conditions were found to greatly influence the physical-surface properties including morphological structure, porosity, particle size, aggregate average size, surface area, pore size, pore volume and zeta potential of the prepared silica, while the chemical structure, predicted from FT-IR spectra, and the diffraction patterns, predicted from wide-angle X-ray diffraction spectra, were identical. Surface areas of approximately 1500, 1027, 600, 552 and 317 m2 g−1, pore volumes of 0.93, 0.56, 0.82, 0.72 and 0.5 cm3 g−1, radii of 2.48, 2.2, 5.66, 6.6 and 8.98 nm, average aggregate sizes of 56, 65.4, 220.9, 73, 61.1 and 261 nm and zeta potential values of −32.8, −46.1, −26.3, −31.4 and −25.9 mV were obtained for MCM-41, SBA-3, SBA-15, SN and SM, respectively. Methylene blue dye uptake capacity of the prepared silica types was investigated using the batch technique and, in addition, the most effective material was further studied by the column flow system. The kinetics and isotherms of the uptake process were studied. The morphological structure, surface area, pore radius and zeta potential values were the most correlated factors.
Synthesis of a single-crystal Fe
2
O
3
nanowire array based on stress-induced atomic diffusion used for solar water splitting
Authors: Xie Yiyuan , Ju Yang , Toku Yuhki , Morita Yasuyuki
Published: March 2018

In this study, we successfully fabricated a single-crystal Fe
2
O
3
nanowire array based on stress-induced atomic diffusion and used this array as the photoelectrode for solar water splitting. With the surface polishing treatment on the sample surface, the density of the Fe
2
O
3
nanowire array reached up to 28.75 wire µm
−2
when heated for 90 min at 600°C. The photocurrent density of the optimized sample was 0.9 mA cm
−2
at 1.23 V versus a reversible hydrogen electrode in a three-electrode system under AM 1.5 G illumination. The incident photon-to-electron conversion efficiency was 6.8% at 400 nm.
Developmental plasticity of the stress response in female but not in male guppies
Authors: Chouinard-Thuly L. , Reddon A. R. , Leris I. , Earley R. L. , Reader S. M.
Published: March 2018

To survive, animals must respond appropriately to stress. Stress responses are costly, so early-life experiences with potential stressors could adaptively tailor adult stress responses to local conditions. However, how multiple stressors influence the development of the stress response remains unclear, as is the role of sex. Trinidadian guppies (Poecilia reticulata) are small fish with extensive life-history differences between the sexes and population variation in predation pressure and social density. We investigated how sex and early-life experience influence hormonal stress responses by manipulating conspecific density and perceived predation risk during development. In adults, we sampled cortisol twice to measure initial release and change over time in response to a recurring stressor. The sexes differed considerably in their physiological stress response. Males released more cortisol for their body mass than females and did not reduce cortisol release over time. By contrast, all females, except those reared at high density together with predation cues, reduced cortisol release over time. Cortisol responses of males were thus less dynamic in response to current circumstances and early-life experiences than females, consistent with life-history differences between the sexes. Our study underscores the importance of early-life experiences, interacting ecological factors and sex differences in the organization of the stress response.
Genome-wide analyses of the bHLH superfamily in crustaceans: reappraisal of higher-order groupings and evidence for lineage-specific duplications
Authors: Chang Wai Hoong , Lai Alvina G.
Published: March 2018

The basic helix-loop-helix (bHLH) proteins represent a key group of transcription factors implicated in numerous eukaryotic developmental and signal transduction processes. Characterization of bHLHs from model species such as humans, fruit flies, nematodes and plants have yielded important information on their functions and evolutionary origin. However, relatively little is known about bHLHs in non-model organisms despite the availability of a vast number of high-throughput sequencing datasets, enabling previously intractable genome-wide and cross-species analyses to be now performed. We extensively searched for bHLHs in 126 crustacean species represented across major Crustacea taxa and identified 3777 putative bHLH orthologues. We have also included seven whole-genome datasets representative of major arthropod lineages to obtain a more accurate prediction of the full bHLH gene complement. With focus on important food crop species from Decapoda, we further defined higher-order groupings and have successfully recapitulated previous observations in other animals. Importantly, we also observed evidence for lineage-specific bHLH expansions in two basal crustaceans (branchiopod and copepod), suggesting a mode of evolution through gene duplication as an adaptation to changing environments. In-depth analysis on bHLH-PAS members confirms the phenomenon coined as ‘modular evolution’ (independently evolved domains) typically seen in multidomain proteins. With the amphipod
Parhyale hawaiensis
as the exception, our analyses have focused on crustacean transcriptome datasets. Hence, there is a clear requirement for future analyses on whole-genome sequences to overcome potential limitations associated with transcriptome mining. Nonetheless, the present work will serve as a key resource for future mechanistic and biochemical studies on bHLHs in economically important crustacean food crop species.
Heel impact forces during barefoot versus minimally shod walking among Tarahumara subsistence farmers and urban Americans
Authors: Wallace Ian J. , Koch Elizabeth , Holowka Nicholas B. , Lieberman Daniel E.
Published: March 2018

Despite substantial recent interest in walking barefoot and in minimal footwear, little is known about potential differences in walking biomechanics when unshod versus minimally shod. To test the hypothesis that heel impact forces are similar during barefoot and minimally shod walking, we analysed ground reaction forces recorded in both conditions with a pedography platform among indigenous subsistence farmers, the Tarahumara of Mexico, who habitually wear minimal sandals, as well as among urban Americans wearing commercially available minimal sandals. Among both the Tarahumara (
n 
= 35) and Americans (
n 
= 30), impact peaks generated in sandals had significantly (
p 
< 0.05) higher force magnitudes, slower loading rates and larger vertical impulses than during barefoot walking. These kinetic differences were partly due to individuals' significantly greater effective mass when walking in sandals. Our results indicate that, in general, people tread more lightly when walking barefoot than in minimal footwear. Further research is needed to test if the variations in impact peaks generated by walking barefoot or in minimal shoes have consequences for musculoskeletal health.
Continuum modelling of segregating tridisperse granular chute flow
Authors: Deng Zhekai , Umbanhowar Paul B. , Ottino Julio M. , Lueptow Richard M.
Published: March 2018

Segregation and mixing of size multidisperse granular materials remain challenging problems in many industrial applications. In this paper, we apply a continuum-based model that captures the effects of segregation, diffusion and advection for size tridisperse granular flow in quasi-two-dimensional chute flow. The model uses the kinematics of the flow and other physical parameters such as the diffusion coefficient and the percolation length scale, quantities that can be determined directly from experiment, simulation or theory and that are not arbitrarily adjustable. The predictions from the model are consistent with experimentally validated discrete element method (DEM) simulations over a wide range of flow conditions and particle sizes. The degree of segregation depends on the Péclet number,
Pe
, defined as the ratio of the segregation rate to the diffusion rate, the relative segregation strength
κ

ij

between particle species
i
and
j
, and a characteristic length
L
, which is determined by the strength of segregation between smallest and largest particles. A parametric study of particle size,
κ

ij

,
Pe
and
L
demonstrates how particle segregation patterns depend on the interplay of advection, segregation and diffusion. Finally, the segregation pattern is also affected by the velocity profile and the degree of basal slip at the chute surface. The model is applicable to different flow geometries, and should be easily adapted to segregation driven by other particle properties such as density and shape.
Resilience of riverbed vegetation to uprooting by flow
Authors: Perona P. , Crouzy B.
Published: March 2018

Riverine ecosystem biodiversity is largely maintained by ecogeomorphic processes including vegetation renewal via uprooting and recovery times to flow disturbances. Plant roots thus heavily contribute to engineering resilience to perturbation of such ecosystems. We show that vegetation uprooting by flow occurs as a fatigue-like mechanism, which statistically requires a given exposure time to imposed riverbed flow erosion rates before the plant collapses. We formulate a physically based stochastic model for the actual plant rooting depth and the time-to-uprooting, which allows us to define plant resilience to uprooting for generic time-dependent flow erosion dynamics. This theory shows that plant resilience to uprooting depends on the time-to-uprooting and that root mechanical anchoring acts as a process memory stored within the plant–soil system. The model is validated against measured data of time-to-uprooting ofAvena sativaseedlings with various root lengths under different flow conditions. This allows for assessing the natural variance of the uprooting-by-flow process and to compute the prediction entropy, which quantifies the relative importance of the deterministic and the random components affecting the process.