bluuebunny/crossref_metadata_2025 huggingface dataset:
Density of the burrowing scorpion Urodacus armatus (Scorpiones; Scorpionidae) in relation to vegetation types: implications for population decline following agricultural clearing
Authors: T. Smith G.
Published: May 2016

The density of the burrowing scorpion Urodacus armatus in relation to vegetation type was assessed by counting the number of burrows, both the annual cohort of dispersing second instar and all older scorpions. The counts were made in 18 two metre wide transects across a 730 ha portion of Durokoppin Nature Reserve in the central wheatbelt of Western Australia. Densities were highest in woodlands (593/ha to 1950/ha), whereas in shrub and mallee associations densities were considerable lower (47/ha to 382/ha). Productivity, as measured by the ratio of second to older instar scorpions, ranged from 0.42 in low, open heath to 2.68 in Wandoo/Salmon Gum Eucalyptus capillosa/E. salmonophloia woodland. However, the correlation between productivity and the density of older scorpions in the vegetation associations was not significant. Total population in the study area was 254 954, of which 165 934 were second instar scorpions. Biomass estimates for second instar and older scorpions were 12 kg and 156 kg respectively. Observations throughout the wheatbelt indicated that the relationship between density and vegetation was comparable to that found in the study area. Using the data on the areas of the vegetation associations in the Avon Botanical District, before and after agricultural clearing (Beard and Sprenger 1984), and the densities in the present study, the abundance and biomass, pre- and post-clearing were calculated. The standing population (excluding the annual cohort) would have been of the order of 1.2 billion, with an annual influx of 2.6 billion. The biomasses would have been 690 tonnes and 210 tonnes respectively. Clearing reduced the area of habitat by 86% and the standing population by 92% and in woodland by 97%. The implications of these results for other species are discussed.
Systematic affinities of island and mainland populations of the Dunnart Sminthopsis griseoventer in Western Australia: data from allozymes and mitochondrial DNA
Authors: Labrinidis A. , J. B. Cooper S. , Adams M. , Baczocha N.
Published: May 2016

The systematic affinities of Boullanger Island and Western Australian mainland populations of the Grey-bellied Dunnart Sminthopsis griseoventer were investigated using allozyme electrophoresis and phylogenetic analysis of a 404 bp region of the mitochondrial DNA (mtDNA) control region. Forty-six allozyme loci were screened for variation and found to be monomorphic in S. griseoventer from both Boullanger Island and one mainland population. Low levels of variation were also detected in the control region sequence, with just one haplotype observed among eight island individuals and three haplotypes among 10 mainland individuals, each differing at between two and four nucleotide sites (0.5?1.0% divergence). Phylogenetic analyses using maximum parsimony of control region sequence from mainland and island taxa, and four species of the "murina complex", S. aitkeni, S. murina, S. gilberti and S. dolichura, indicated that the island and mainland taxa formed a monophyletic group to the exclusion of the other "murina complex" species, but were paraphyletic at the level of the individual haplotypes. These results are consistent with the hypothesis that mainland and island populations of S. griseoventer comprise a single species, and suggest that there has been no long-term barrier to gene flow between these populations. Analyses of molecular variation provided evidence the island population represents a separate management unit for conservation, but are insufficient to determine whether there has been inbreeding or a recent bottleneck in the island population.
Comment on the efficacy of Queensland nature conservation legislation in relation to Acrodipsas illidgei (Waterhouse and Lyell) (Lepidoptera: Lycaenidae: Theclinae)
Authors: P. Beale J.
Published: May 2016

This discussion paper highlights shortcomings of the conservation regulations with respect to Illidge's Ant-blue Acrodipsas iIIidgei (Waterhouse and Lyell). The legislation has many deficiencies which are not fully realized until they have been experienced first hand. A. illidgei provides a case study of an unforeseen practical effect of Queensland conservation legislation, namely the actual hindering of conservation through the regulations controlling scientific activities and amateur collecting and study. The permit regulations appear virtually impossible to enforce and probably have no significant effect on collecting activity. Moreover, the legislation discourages the study and monitoring of listed species. A number of suggested measures to improve the efficacy of conservation legislation are indicated.
Granite Outcrops Symposium
Authors: Cox Brad
Published: May 2016

Western Australia is a flat landscape. Granite outcrops are one of the few features that rise above the terrain. This makes them unique landmarks for people, and islands for plants and animals. They are highly significant in terms of their geological, biological and cultural values. They contain some of the world's oldest rocks, are an important source of water, often contain aboriginal heritage sites and are refuges for many rare and endangered flora and fauna.
Integrating demographic and genetic studies of the Greater Glider Petauroides volans in fragmented forests: predicting movement patterns and rates for future testing
Authors: B. Lindenmayer D. , C. Lacy R. , Tyndale-Biscoe H. , C. Taylor A. , L. Viggers K. , L. Pope M.
Published: May 2016

Habitat loss and habitat fragmentation can have major effects on the distribution and abundance of species (Saunders et al. 1987), often in unpredictable ways (Klein 1989; Tilman et al. 1994; Lacy and Lindenmayer 1995; Cunningham and Moritz 1998). An understanding of responses of species, which lead to persistence or extinction in such disturbed systems, is important for the effective management of many taxa in fragmented multi-use landscapes. One way to examine population dynamics in fragmented systems is to analyse the genetic characteristics of subpopulations in remnant habitat patches (Sarre 1995), borrowing from the population genetics literature for the interpretation of key effects. For example, it is well established that a small, completely isolated population will lose genetic variation rapidly due to genetic drift (Lacy 1987). However, loss of genetic variation within, and increasing differentiation between, subpopulations will be counteracted by inter-population dispersal. Theoretical models of metapopulation structure which describe connectivity and stability can be examined using various demographic input parameters. Importantly, such models can also produce predictions for genetic structuring, making the combined use of modelling and empirical genetic data an extremely powerful tool in examining the effects of habitat fragmentation. On this basis, we have recently commenced a series of integrated demographic and genetic studies of the Greater Glider Petauroides volans at Tumut in southern New South Wales. The study area near Tumut in southeastern New South Wales is characterized by an array of remnant patches of eucalypt forest (0.2?125 ha in size) that were created 15?65 years ago by the establishment of an extensive (50 000 ha) plantation of exotic softwood, Radiata Pine Pinus radiata and known as the Buccleuch State Forest (Routley and Routley 1975). Large areas of continuous native eucalypt forest occur at the boundaries of the plantation (Fig. 1), including those within the Brindabella and Kosciuszko National Parks, and the Bondo and Bungongo State Forests.
Effects of habitat and introduced mammalian predators on the breeding success of Yellow-eyed Penguins Megadyptes antipodes, South Island, New Zealand
Authors: Ratz Hiltrun , Murphy Brian
Published: May 2016

The endemic Yellow-eyed Penguin Megadyptes antipodes is threatened by habitat loss and introduced predators on mainland New Zealand. Nine colonies in the Catlins (south-east coast of South Island) were studied to measure breeding success, penguin abundance, and predator abundance in three successive breeding seasons (1991/92 to 1993/94). Nest numbers increased in all nine colonies in the three years despite predation (probably by Stoats Mustefa erminea) being the most important cause of breeding failure. Larger colonies with higher breeding success were in small gullies with limited shrubs and bushes rather than in the most intact mature forest colonies hitherto assumed to be optimal habitat for the birds. Penguin nests were concentrated near the forest edge, but predators were not, so the predation risk was not elevated near the forest edge. Fragmentation of the original forest habitat had no observable adverse effect on breeding success. Stoats dominated the predator guild, while Ferrets M. furo and Feral Cats Felis catus were rare. Trapping to kill predators early in the season had no marked effect on subsequent predation losses, but trapping intervention when a predation outbreak occurred curtailed further chick deaths. A simple population model predicts that Yellow-eyed Penguins populations will grow provided the average total chicks loss is less than 43% per season, or at least 0.85 chick per nest fledges each year. This requires predation losses to be less than 34%.
Response
Authors: C. Calver M. , S. Bradley J. , W. Wright I.
Published: May 2016

In a recent paper we suggested means for quantifying the precautionary principle and aiding resolution of disagreement in cases calling for its application. In his commentary on this paper, Goodall (1999) makes four important points: (i) that it is reasonable to ask proponents of a disturbance to demonstrate that any possible consequence will lie within specified and acceptable limits, (ii) that a null hypothesis is worth disproving only if it is credible, (iii) that one should beware of asking the wrong question when framing environmental studies, and (iv) that scientific proof as generally understood does not apply to the precautionary principle. We are in substantial agreement with all these arguments. However, as explained below, we differ in our assessment of their implications.
COPY: A new technique for evaluation of biodiversity protection projects
Authors: Cullen R. , A. Fairburn G. , F. D. Hughey K.
Published: May 2016

New Zealand, like many other countries, is troubled by introduced animal and plant species which attack, damage, or displace indigenous species. Considerable amounts of taxpayer funds are spent each year attempting to combat these invasive species and some research has been conducted into the "cost effectiveness" and the efficiency of various conservation activities. Research into the cost effectiveness of biodiversity protection projects is hindered by the absence of satisfactory measures of output. A new output measure, Conservation Output Protection Years (COPY) is proposed for use in a cost utility evaluation of biodiversity protection projects. This paper outlines this approach and reports on the use of COPY in evaluation of six New Zealand biodiversity protection projects. The paper demonstrates that COPY provides a practical output measure, and reports on the comparative output per dollar spent on each biodiversity protection project.
Linkages in the Landscape: The Role of Corridors and Connectivity in wildlife Conservation
Authors: Norwood Chris
Published: May 2016

Increasing demand for resources through a growing world population and the development of consumer led economies has led to large-scale habitat modification. One of the most disturbing aspects of these changes is the loss of biodiversity. Conservation biology as a discipline seeks to counteract or minimize the loss of biodiversity. Management is an Important aspect in achieving this goal. One concept used in Wildlife management and conservation is that of landscape linkages. Linkages are aimed at faclhtatmg .the connectivity for species, communities or ecological processes. There are many types of linkages in the landscape; both natural and human induced. Covered in this book are linkages such as greenways, dispersal corridors, riparian remnants, wildlife corridors, stepping stones, hedgerows and road underpasses. Linkages range in scale from small patches of old-growth forest in a forest mosaic to migratory routes for birds across and between continents.
Reproductive biology, ecology and conservation of Carmichaelia williamsii (Fabaceae), a vulnerable legume from New Zealand
Authors: B. Heenan Peter , J. De Lange Peter
Published: May 2016

Carmichaelia williamsii is a threatened leguminous shrub that is most common on the Poor Knights Islands and Aldermen Islands, northern New Zealand. Flower morphology and structure of C. williamsii is suited to a bird pollination syndrome as the floral parts are stout, the petals yellow, the nectar source is distant from the stigma, and the flowers lack scent. The stigma is covered by a protective cuticle that prevents pollination until it is ruptured, which would usually be by foraging birds. Experimental self- and cross-pollinations demonstrated that if the cuticle is not ruptured fertilization will not occur, and that the species is self-compatible. Field observations on Aorangi Island, Poor Knights Islands, confirmed that C. williamsii is probably bird pollinated as plants in full flower were being systematically worked by the native passerine honeyeater the Bellbird (Anthornis me/anura; Meliphagidae). C. williamsii mainly grows in seral habitats, and populations often comprise plants of a similar height class. Introduced rats and the loss of pollinating birds could pose conservation and management problems for the species.
Multiensemble Markov models of molecular thermodynamics and kinetics
Authors: Wu Hao , Paul Fabian , Wehmeyer Christoph , Noé Frank
Published: May 2016

Significance

Molecular dynamics simulations can provide mechanistic understanding of biomolecular processes. However, direct simulation of slow transitions such as protein conformational transitions or protein–ligand dissociation are unfeasible with commonly available computational resources. Two typical strategies are (i) conducting large ensembles of short simulations and estimating the long-term kinetics with a Markov state model, and (ii) speeding up rare events by bias potentials or higher temperatures and estimating the unbiased thermodynamics with reweighting estimators. In this work, we introduce the transition-based reweighting analysis method (TRAM), a statistically optimal approach that combines the best of both worlds and estimates a multiensemble Markov model (MEMM) with full thermodynamic and kinetic information at all simulated ensembles.
VEX1 controls the allelic exclusion required for antigenic variation in trypanosomes
Authors: Glover Lucy , Hutchinson Sebastian , Alsford Sam , Horn David
Published: May 2016

Significance

Despite intense interest over a period of decades, mechanisms of allelic exclusion have remained unsolved mysteries in the field of eukaryotic gene expression control. Parasitic African trypanosomes express variant surface glycoproteins (VSGs) in a monoallelic fashion and have long been a paradigm for studies in this area. We used an RNA interference screen for loss of exclusion and identified and characterized VSG exclusion 1 (VEX1). VEX1 sequestration restricts expression and prevents the simultaneous establishment of more than one active
VSG
gene. VEX1 also appears to reinforce sequestration-based exclusion through homology-dependent repression. Our results indicate a “winner-takes-all” mechanism that allows parasitic trypanosomes to express just one
VSG
gene at a time.
Growth hormone is permissive for neoplastic colon growth
Authors: Chesnokova Vera , Zonis Svetlana , Zhou Cuiqi , Recouvreux Maria Victoria , Ben-Shlomo Anat , Araki Takako , Barrett Robert , Workman Michael , Wawrowsky Kolja , Ljubimov Vladimir A. , Uhart Magdalena , Melmed Shlomo
Published: May 2016

Significance

Growth hormone (GH) excess in acromegaly is associated with increased colon polyps and cancer, whereas short-stature humans harboring a GH receptor mutation do not develop cancer. Administration of a GH receptor blocker in acromegaly patients induced colon p53. In contrast, p53 is suppressed by GH in colon cells, in vivo in colon tissue, and in induced pluripotent stem cell-derived intestinal organoids. GH excess leads to cell survival with downregulated adenomatous polyposis coli, nuclear β-catenin accumulation, and increased epithelial–mesenchymal transition factors. Because locally expressed GH is abundant in conditions predisposing to colon cancer, GH appears to be a molecular component of the milieu permissive for neoplastic colon growth. These results explain the protective effects of GH deficiency against development of neoplasms.
Reactive close field unbalance magnetron sputter deposition of titanium dioxides for potential photovoltaic applications
Authors: Zhang Z. , Shao G.
Published: May 2016

In this paper, crystallised TiO2 thin film was produced by reactive Closed Field UnBalanced Magnetron Sputter Ion Plating. Various deposition conditions were studied, including sputtering power, oxygen partial pressure and elemental doping and their effects on the resulting titania structure were characterised. Rutile or anatase titania can be obtained selectively or in combination by properly controlling the deposition conditions, i.e. rutile structure can be obtained using one titanium target with high oxygen flow (20% OEM) and be enhanced by manganese doping, and fully anatase structure can be formed by preheating the sample with an auxiliary heater and heating the sample in the reactive sputtering process.TiO2 has a wide band gap (3.2 eV for anatase and 3.0 eV for rutile) which limits its ability to absorb the light to the ultraviolet region. N and/or Mn doping in the thin titanium dioxide films was used to narrow the band gap of TiO2 to about 2.0 eV with improved electrical properties.
Higher-order oligomerization of Spc110p drives γ-tubulin ring complex assembly
Authors: Lyon Andrew S. , Morin Geneviève , Moritz Michelle , Yabut King Clyde B. , Vojnar Tamira , Zelter Alex , Muller Eric , Davis Trisha N. , Agard David A.
Published: May 2016

The microtubule (MT) cytoskeleton plays important roles in many cellular processes. In vivo, MT nucleation is controlled by the γ-tubulin ring complex (γTuRC), a 2.1-MDa complex composed of γ-tubulin small complex (γTuSC) subunits. The mechanisms underlying the assembly of γTuRC are largely unknown. In yeast, the conserved protein Spc110p both stimulates the assembly of the γTuRC and anchors the γTuRC to the spindle pole body. Using a quantitative in vitro FRET assay, we show that γTuRC assembly is critically dependent on the oligomerization state of Spc110p, with higher-order oligomers dramatically enhancing the stability of assembled γTuRCs. Our in vitro findings were confirmed with a novel in vivo γTuSC recruitment assay. We conclude that precise spatial control over MT nucleation is achieved by coupling localization and higher-order oligomerization of the receptor for γTuRC.
Conditional knockout of polarity complex (atypical) PKCι reveals an anti-inflammatory function mediated by NF-κB
Authors: Forteza Radia , Figueroa Yolanda , Mashukova Anastasia , Dulam Vipin , Salas Pedro J.
Published: May 2016

The conserved proteins of the polarity complex made up of atypical PKC (aPKC, isoforms ι and ζ), Par6, and Par3 determine asymmetry in several cell types, from Caenorhabditis elegans oocytes to vertebrate epithelia and neurons. We previously showed that aPKC is down-regulated in intestinal epithelia under inflammatory stimulation. Further, expression of constitutively active PKCι decreases NF-κB activity in an epithelial cell line, the opposite of the effect reported in other cells. Here we tested the hypothesis that aPKC has a dual function in epithelia, inhibiting the NF-κB pathway in addition to having a role in apicobasal polarity. We achieved full aPKC down-regulation in small intestine villi and colon surface epithelium using a conditional epithelium-specific knockout mouse. The results show that aPKC is dispensable for polarity after cell differentiation, except for known targets, including ROCK and ezrin, claudin-4 expression, and barrier permeability. The aPKC defect resulted in increased NF-κB activity, which could be rescued by IKK and ROCK inhibitors. It also increased expression of proinflammatory cytokines. In contrast, expression of anti-inflammatory IL-10 decreased. We conclude that epithelial aPKC acts upstream of multiple mechanisms that participate in the inflammatory response in the intestine, including, but not restricted to, NF-κB.
Iterative sorting of apical and basolateral cargo in Madin–Darby canine kidney cells
Authors: Treyer Aleksandr , Pujato Mario , Pechuan Ximo , Müsch Anne
Published: May 2016

For several decades, the trans-Golgi network (TGN) was considered the most distal stop and hence the ultimate protein-sorting station for distinct apical and basolateral transport carriers that reach their respective surface domains in the direct trafficking pathway. However, recent reports of apical and basolateral cargoes traversing post-Golgi compartments accessible to endocytic ligands before their arrival at the cell surface and the post-TGN breakup of large pleomorphic membrane fragments that exit the Golgi region toward the surface raised the possibility that compartments distal to the TGN mediate or contribute to biosynthetic sorting. Here we describe the development of a novel assay that quantitatively distinguishes different cargo pairs by their degree of colocalization at the TGN and by the evolution of colocalization during their TGN-to-surface transport. Keys to the high resolution of our approach are 1) conversion of perinuclear organelle clustering into a two-dimensional microsomal spread and 2) identification of TGN and post-TGN cargo without the need for a TGN marker that universally cosegregates with all cargo. Using our assay, we provide the first evidence that apical NTRp75 and basolateral VSVG in Madin–Darby canine kidney cells still undergo progressive sorting after they exit the TGN toward the cell surface.
Evaluating the impact of a computerized surveillance algorithm and decision support system on sepsis mortality
Authors: Manaktala Sharad , Claypool Stephen R
Published: May 2016

Objective: We created a system using a triad of change management, electronic surveillance, and algorithms to detect sepsis and deliver highly sensitive and specific decision support to the point of care using a mobile application. The investigators hypothesized that this system would result in a reduction in sepsis mortality.

Methods: A before-and-after model was used to study the impact of the interventions on sepsis-related mortality. All patients admitted to the study units were screened per the Institute for Healthcare Improvement Surviving Sepsis Guidelines using real-time electronic surveillance. Sepsis surveillance algorithms that adjusted clinical parameters based on comorbid medical conditions were deployed for improved sensitivity and specificity. Nurses received mobile alerts for all positive sepsis screenings as well as severe sepsis and shock alerts over a period of 10 months. Advice was given for early goal-directed therapy. Sepsis mortality during a control period from January 1, 2011 to September 30, 2013 was used as baseline for comparison.

Results: The primary outcome, sepsis mortality, decreased by 53% (P = 0.03; 95% CI, 1.06-5.25). The 30-day readmission rate reduced from 19.08% during the control period to 13.21% during the study period (P = 0.05; 95% CI, 0.97-2.52). No significant change in length of hospital stay was noted. The system had observed sensitivity of 95% and specificity of 82% for detecting sepsis compared to gold-standard physician chart review.

Conclusion: A program consisting of change management and electronic surveillance with highly sensitive and specific decision support delivered to the point of care resulted in significant reduction in deaths from sepsis.
Neurocritical Care
Authors: Wijdicks Eelco FM , Rabinstein Alejandro A. , Hocker Sara E. , Fugate Jennifer E.
Published: May 2016

This book comprises a collection of case studies of patients with acute and critical neurological disease, along with pertinent discussion of approaches to each particular condition. Case studies provide a way to examine how difficult it is to approach these patients situated in the neurosciences intensive care unit. Some patients need close observation and management of emerging problems, others need a neurosurgical intervention or a neurointerventional procedure, a few patients are in extremis. The examples provided in this book are quintessential to the practice of neurocritical care. Some are less common conditions that need to be recognized and appropriately treated. Another purpose of this book is to introduce the reader to the field of neurocritical care and to show what goes on. The book shows the complexity of care and urgent decision-making involved in treating patients who deteriorate. Practical suggestions are included for each topic it covers. Not only is treatment of serious neurological disorders discussed but also prognostication in practice and end-of-life care discussions. In some ways this book summarizes the entire spectrum of presenting acute illness and how best to intervene.
Waking Slowly and Slurring After Surgery
Authors: Wijdicks Eelco F. M. , Rabinstein Alejandro A. , Hocker Sara E. , Fugate Jennifer E.
Published: May 2016

Failure to awaken fully after surgery is a common reason for consultation. In this chapter, a patient with a postoperative stroke is presented. Usually there should be an emphasis on identifying the lingering drug effect, but other causes should also be considered. For example, in stuporous patients, an ischemic stroke in the posterior circulation involving the thalamus or cerebellar infarctions can cause acute hydrocephalus from compression. Also, hyponatremia and hypoglycemia are potential causes of postoperative stupor. Hypoglycemia requires immediate correction, while hyponatremia should be corrected more slowly.
Decreasing Serum Sodium in Aneurysmal Subarachnoid Hemorrhage
Authors: Wijdicks Eelco F. M. , Rabinstein Alejandro A. , Hocker Sara E. , Fugate Jennifer E.
Published: May 2016

Hyponatremia is a very common electrolyte abnormality in the neurosciences intensive care unit and in particular after subarachnoid hemorrhage. It is often associated with intravascular volume contraction. Evaluation and treatment are discussed in this chapter. Treatment of the polyuric, hyponatremic patient should include replacement of sodium and fluid volume. The goals of fluid management in cases of aneurysmal subarachnoid hemorrhage are maintenance of normonatremia and euvolemia. How to calculate rate of infusion of fluids is also highlighted in the chapter. It is important to replace volume effectively, but being careful not to induce fluid overload. Fludrocortisone is useful to ameliorate urinary sodium loss and hyponatremia.
Goals of Care in a Comatose Teenager
Authors: Wijdicks Eelco F. M. , Rabinstein Alejandro A. , Hocker Sara E. , Fugate Jennifer E.
Published: May 2016

After a major brain injury the diagnosis of a persistent coma or vegetative state has important short-term and long-term implications. Persistent vegetative state is considered permanent 1 year after traumatic brain injury and 3 months after nontraumatic coma. The early diagnosis of persistent vegetative state is discussed in this chapter. Disorders of prolonged unconsciousness have been redefined by functional MRI, but functional MRI has not found a clinical application. Functional MRI is not able to better predict outcome or awakening with sufficient certainty. Long-term care of debilitated neurological patients requires placement of a tracheostomy and gastrostomy.
History of systemic lupus erythematosus
Authors: Ugarte-Gil Manuel F. , Alarcón Graciela S.
Published: May 2016

The first description of cutaneous ulcerations consistent with systemic lupus erythematosus (SLE) has been attributed to Hippocrates. The term lupus first appeared in English literature in the tenth century. Until the nineteenth century, however, this term was used to describe different conditions. Osler first recognized that organ involvement may occur with or without skin involvement. With the discovery of LE cells and autoantibodies, the use of lupus murine models, and the recognition of familial aggregation and the importance of genetic factors, the pathogenesis of SLE started to be unravelled and allowed the definition of classification criteria. In parallel, the discovery of cortisone, the use of immunosuppressive drugs and antimalarials, the control of hypertension, and the availability of renal replacement therapy improved the prognosis of SLE from a 4-year survival of 51% to a 5-year survival >90%. Advances in genetics and targeted therapies will lead to better intermediate and long-term outcomes.
Aetiopathogenesis of systemic lupus erythematosus
Authors: Lloyd Peter , Doaty Sarah , Hahn Bevra H.
Published: May 2016

Systemic lupus erythematosus (SLE) is an autoimmune disease characterized by the presence of immune dysregulation, autoreactive B and T cells, and the production of a broad, heterogeneous group of autoantibodies (autoAb). The pathogenesis of lupus can be divided into three stages: 1) genetic predisposition and environmental exposures, 2) loss of tolerance, and 3) immune activation. In this chapter we will discuss the aetiopathogenesis of systemic lupus erythematosus with emphasis placed on key autoantibodies, cytokines, the innate and adaptive immune system, tolerance, NETosis, genetics and epigenetics, environmental triggers and the role of gender.
Epidemiology of systemic lupus erythematosus
Authors: Gordon Caroline , Lim S. Sam
Published: May 2016

This chapter looks at the epidemiology of lupus—this disease is more common than is generally recognized and occurs most frequently in women. There is a significantly higher risk of developing lupus in people of African, Hispanic, and Asian (especially Chinese) descent, with increased incidence and prevalence in some other ethnic minority races. They appear to develop a more severe phenotype, often with renal involvement and at an earlier age than white people of North European descent. Although deaths due to lupus are now less common in North American and European countries, deaths due to renal lupus remain a significant problem in the ethnic minorities. Management should target reducing factors that increase the risk of lupus disease activity, damage, and mortality. Raising awareness of lupus, leading to early diagnosis and institution of appropriate therapy to reduce disease activity, will reduce chronic damage and the associated risk of subsequent premature death.
Laboratory tests and investigations
Authors: Isaacs Anthony , Isenberg David
Published: May 2016

In this chapter an overview is provided of the investigations used in patients with systemic lupus erythematosus (SLE); these establish the abnormalities that can be found in each organ/system. Lupus is a very heterogeneous condition, affecting virtually every organ/system. In consequence, numerous investigations and tests are used to help make the diagnosis and define the extent of the organ/system involvement. The chapter is divided into investigations of the effects of SLE on the following systems: haematological, immunological, biochemical, renal, cardiovascular, pulmonary, gastroenterological, neurological, dermatological, and musculoskeletal. These targeted organ/system-based investigations can then be used to assess ongoing disease activity or the consequence of damage caused by previously active disease.
Management of special situations in systemic lupus erythematosus
Authors: Jorge April , Ramsey-Goldman Rosalind
Published: May 2016

In caring for patients with systemic lupus erythematosus (SLE), there are several important treatment considerations. Since many patients with SLE are female and of childbearing potential, it is important to address conception planning, contraceptive options, and the maternal and fetal risks associated with pregnancy, which are increased when there is higher SLE disease activity. It is also pertinent to address medication safety issues throughout pregnancy and lactation, as some commonly used medications can increase risks of adverse pregnancy outcomes. Additionally, patients with SLE are at higher risk for cardiovascular disease (CVD) than the general population. Therefore, these patients must undergo aggressive risk factor modification. Patients with SLE are also at increased risk for osteoporosis, and bone health is an important treatment consideration. Routine cancer screening and vaccinations are also important elements of the comprehensive treatment of the patient with SLE.
Managing the surgical ward
Authors: Cannaby Ann-Marie
Published: May 2016

Leading a clinical care environment is both a rewarding and challenging role that requires clinical expertise, experience, and leadership capability. A ward leader is required to understand a range of management techniques and principles to ensure that safe and effective care is delivered to the patients. This chapter outlines key requirements, including establishment creation, managing of rotas aligned to patient acuity and dependency, and financial management. In addition, this chapter also discusses the development of clinical governance processes to ensure robust management of incidents, issues, and care audit.
Transfer to other departments or theatre
Authors: Smith Alison
Published: May 2016

A patient’s clinical condition must be assessed to ensure that their safety is maintained at all times when transferring them to other departments or theatre. The benefits of transferring the patient must outweigh the risks involved, and there should be minimal interruptions to their planned care. This chapter provides an overview of the assessment process, the pre-operative checklist, and the communication between staff, patients, and relatives prior to transfer. This chapter also reviews the staffing and equipment required for a safe and effective patient transfer.
Ward post-operative care
Authors: Palmer Ross , Smith Alison
Published: May 2016

Standardized, evidence-based post-operative policies and procedures ensure that safe and effective person-centred care is provided, which is aimed at reducing the likelihood of post-operative complications. Close physiological monitoring is imperative and should incorporate the use of an early warning score such as the National Early Warning Score (NEWS). This ensures early recognition and response to patient deterioration, which is quickly escalated to an appropriate member of the health-care team. This chapter provides an overview of oxygen therapy, wound drains, the removal of sutures and staples, post-operative monitoring, early warning scores, escalation, documentation standards, and breaking bad news.
Infection: prevention, control, and treatment
Authors: Adams Debra , Casey Anna
Published: May 2016

Infection prevention, control, and treatment are vital elements of all healthcare environments. The nurse should have a good working knowledge of policies and procedures to ensure patients are cared for in a clean and appropriate environment. The surgical patient is at risk of developing infections, particularly surgical site infections. Most infections are preventable, and measures should be taken at every stage of a patient’s care to reduce the risk of infection.This chapter discusses infection prevention, control, and treatment, including key policies and procedures in the United Kingdom. It provides an overview of microbiology, aseptic technique, antibiotic therapy, and cleanliness standards.
Post-operative complications
Authors: Perkins Claire
Published: May 2016

Surgical patients are at risk of post-operative complications. A thorough pre-operative assessment and the implementation of appropriate care/treatment plans will reduce the likelihood of complications occurring. The surgical nurse should have a good knowledge and understanding of recognizing, preventing, and treating post-operative complications. The ABCDE approach should be used in the immediate post-operative period and if the patient becomes acutely unwell. This chapter uses body systems and the ABCDE approach to review post-operative complications.
Surgical nursing procedures
Authors: Perkins Claire
Published: May 2016

Nurses undertake extra training, so they can perform or assist with a number of surgical nursing procedures which form part of the assessment, treatment, and evaluation of a patient’s condition both pre-operatively and post-operatively. They should have a good understanding of the reasons for performing the procedure, the technique, and possible complications. This chapter reviews blood sampling, cannulation, arterial blood gases, nasogastric tubes, urinary catheters, intravenous and intramuscular injections, and the fitting of venous thromboembolism stockings.
Upper gastrointestinal and hepatobiliary surgery
Authors: Smith Alison
Published: May 2016

The upper gastrointestinal tract consists of the oesophagus, stomach, and the duodenum, which is the first section of the small bowel where pancreatic digestive juices and bile mix with food. The term hepatobiliary refers to the liver, gall bladder, and bile ducts. This chapter provides an overview of the conditions affecting the upper gastrointestinal tract and the hepatobiliary system, including the signs and symptoms, investigations, and treatments.
Colorectal and lower gastrointestinal surgery
Authors: White Maddie
Published: May 2016

The lower gastrointestinal tract includes most of the small intestine and all of the large intestine. The patient presenting with an acute abdomen may have a bowel obstruction which could lead to ischaemia and perforation. Thorough assessment and close observation are imperative, because, if surgical intervention is indicated, this needs to be performed promptly. This chapter provides an overview of inflammatory bowel disorders, tumours, hernias, obstructions, the acute abdomen, ischaemic bowel, complications of bowel surgery, and stomas.
Trauma and orthopaedics
Authors: Harley Kim , Stock Richard
Published: May 2016

The physiological response to traumatic injury protects the individual from deterioration in their condition, conserving body fluids and providing energy to catabolic cells. The trauma patient should undergo an ABCDE assessment, and a full history is also required. An understanding of the circumstances and the various forces involved at the time of injury may give an indication of the type, severity, and location of possible injuries. This chapter covers the assessment, types of injuries, immediate management, ongoing management, and complications associated with traumatic injury. This chapter also provides an overview of orthopaedic surgery and the conditions requiring surgical intervention.
Three supernova shells around a young M33 star cluster
Authors: Camps-Fariña A. , Beckman J. E. , Font J. , Borlaff A. , Zaragoza-Cardiel J. , Amram P.
Published: May 2016

Using a specialized technique sensitive to the presence of expanding ionized gas, we have detected a set of three concentric expanding shells in an H ii region in the nearby spiral galaxy M33. After mapping the kinematics in Hα with Fabry–Perot spectroscopy, we used slit spectra to measure the intensities of the [S ii] doublet at λλ671.9, 673.1 nm and the [N ii] doublet at λλ645.8, 658.3 nm to corroborate the kinematics and apply diagnostic tests using line ratios. These showed that the expanding shells are shock dominated as would be the case if they had originated with supernova explosions. Estimating their kinetic energies, we find fairly low values, indicating a fairly advanced stage of evolution. We obtain density, mass and parent star mass estimates, which, along with the kinetic energies, are inconsistent with the simplest models of shock–interstellar medium interaction. We propose that the presence and properties of an inhomogeneous medium offer a scenario which can account for these observations, and discuss the implications. Comparing our results with data from the literature supports the combined presence of an H ii region and supernova remnant material at the observed position.
Genetics of systemic lupus erythematosus and Sjögren's syndrome: an update
Authors: Teruel Maria , Alarcón-Riquelme Marta E.
Published: May 2016

Purpose of review

To describe the recent studies on the genetics of systemic lupus erythematosus (SLE) and Sjögren's syndrome.

Recent findings

We overview the most recent findings on the genetic susceptibility of the diseases and provide information on their genetic similarities and differences.

SLE and Sjögren's syndrome are two closely related systemic autoimmune diseases that share multiple clinical and molecular aspects, including a significant number of susceptibility genes. Several genome-wide association studies were recently published in different populations that provide a better picture of their molecular mechanisms. It is becoming clear that their genetic architecture is quite well established, but more information is required on expression quantitative trait loci, epigenetic genome-wide analyses, gene × gene interactions and the role of rare variants.
Heads-up 3D Microscopy: An Ergonomic and Educational Approach to Microsurgery
Authors: Mendez Bernardino M. , Chiodo Michael V. , Vandevender Darl , Patel Parit A.
Published: May 2016

Traditional microsurgery can lead surgeons to use postures that cause musculoskeletal fatigue, leaving them more prone to work-related injuries. A new technology from TrueVision transmits the microscopic image onto a 3-dimensional (3D) monitor, allowing surgeons to operate while sitting/standing in a heads-up position. The purpose of this study was to evaluate the feasibility of performing heads-up 3D microscopy as a more ergonomic alternative to traditional microsurgery. A feasibility study was conducted comparing heads-up 3D microscopy and traditional microscopy by performing femoral artery anastomoses on 8 Sprague-Dawley rats. Operative times and patency rates for each technology were compared. The 8 microsurgeons completed a questionnaire comparing image quality, comfort, technical feasibility, and educational value of the 2 technologies. Rat femoral artery anastomoses were successfully carried out by all 8 microsurgeons with each technology. There was no significant difference in anastomosis time between heads-up 3D and traditional microscopy (average times, 34.5 and 33.8 minutes, respectively;P= 0.66). Heads-up 3D microscopy was rated superior in neck and back comfort by 75% of participants. Image resolution, field of view, and technical feasibility were found to be superior or equivalent in 75% of participants, whereas 63% evaluated depth perception to be superior or equivalent. Heads-up 3D microscopy is a new technology that improves comfort for the microsurgeon without compromising image quality or technical feasibility. Its use has become prevalent in the field of ophthalmology and may also have utility in plastic and reconstructive surgery.
Adaptation of liver stiffness measurement depth in bariatric surgery candidates with suspected nonalcoholic fatty liver disease
Authors: Ciocan Dragos , Lebrun Amandine , Lamouri Karima , Pourcher Guillaume , Voican Cosmin , Njiké-Nakseu Micheline , Ferretti Stefano , Courie Rodi , Tranchart Hadrien , Balian Axel , Prévot Sophie , Perlemuter Gabriel , Dagher Ibrahim , Naveau Sylvie
Published: May 2016

Background and aims

A thick layer of subcutaneous adipose tissue may lead to an overestimation of liver stiffness by transient elastography. The aim of this study was to assess whether liver stiffness measurement (LSM) was overestimated using an XL probe in patients with severe obesity and, if so, to reprocess the data to the adapted depth to obtain the appropriate LSM (LSMa).

Methods

A total of 152 obese patients prospectively underwent bariatric surgery and needle liver biopsy. Liver stiffness was measured by transient elastography 15 days before. To determine whether the LSM was overestimated, an expert operator retrospectively determined whether the skin-to-capsula distance was greater than 35 mm by analyzing the hyperechogenicity of ultrasound signals and the measured slope between 35 and 75 mm. In the case of an overestimation, a deeper measurement depth was selected to calculate the LSMa.

Results

There was an overestimation of the LSM obtained between 35 and 75 mm in 76 patients (50%). Among these patients, the LSMa was obtained between 40 and 75 mm in 49 patients and between 45 and 80 mm in 27 patients. Only the percentage of steatosis was independently and positively correlated with LSM overestimation. The areas under receiver operating characteristic of LSMa was 0.82±0.04 for predicting fibrosis stage F3. The Obuchowski measure was 0.85±0.02.

Conclusion

The LSM was overestimated in severely obese patients obtained between 35 and 75 mm using an XL probe in 76 patients (50%), but LSM can be performed correctly in these patients after adapting the measurement depth to deeper beneath the patients’ skin.
Airtraq Laryngoscope Versus the Conventional Macintosh Laryngoscope During Pediatric Intubation Performed by Nurses
Authors: Szarpak Łukasz , Karczewska Katarzyna , Czyżewski Łukasz , Truszewski Zenon , Kurowski Andrzej
Published: May 2016

Objectives

We hypothesized that the Airtraq laryngoscope (Airtraq LLC, Bonita Springs, Fla) is beneficial for intubation of pediatric manikins while performing cardiopulmonary resuscitation (CPR). In the present study, we evaluated the effectiveness of the Macintosh (MAC) laryngoscope (HEINE Optotechnik, Munich, Germany) and Airtraq in 3 simulated CPR scenarios.

Methods

A randomized crossover simulation trial was designed. Eighty-three nurses intubated the trachea of a PediaSIM CPR training manikin (FCAE HealthCare, Sarasota, Fla) using the MAC and Airtraq in a normal airway scenario, normal airway with chest compression scenario, and difficult airway with chest compression scenario. The participants were directed to perform a maximum of 3 attempts in each scenario. The success rate, time to intubation, Cormack & Lehane grade, dental compression, and the ease of intubation were measured.

Results

All participants performed successful intubation with the Airtraq in all 3 scenarios. In all scenarios, the success rate was significantly higher and the time to intubation was significantly shorter with the Airtraq than with the MAC. Glottic visualization using the Cormack-Lehane scale was also better when using Airtraq in all scenarios.

Conclusions

In this manikin study, we found that the Airtraq can be used successfully for the intubation of pediatric manikins with normal and difficult airways by medical staff without previous experience in pediatric intubation. Moreover, intubation can be achieved without interrupting chest compression. The use of the Airtraq compared with the MAC led to faster time to intubation. Nevertheless, we recommend that the performance of the Airtraq and the MAC during CPR should be further evaluated in a clinical setting.