bluuebunny/crossref_metadata_2025 huggingface dataset:
Mechanical Ventilation Boot Camp: A Simulation-Based Pilot Study
Authors: Yee Jennifer , Fuenning Charles , George Richard , Hejal Rana , Haines Nhi , Dunn Diane , Gothard M. David , Ahmed Rami A.
Published: February 2016

Objectives. Management of mechanically ventilated patients may pose a challenge to novice residents, many of which may not have received formal dedicated critical care instruction prior to starting their residency training. There is a paucity of data regarding simulation and mechanical ventilation training in the medical education literature. The purpose of this study was to develop a curriculum to educate first-year residents on addressing and troubleshooting ventilator alarms.Methods. Prospective evaluation was conducted of seventeen residents undergoing a twelve-hour three-day curriculum. Residents were assessed using a predetermined critical action checklist for each case, as well as pre- and postcurriculum multiple-choice cognitive knowledge questionnaires and confidence surveys.Results. Significant improvements in cognitive knowledge, critical actions, and self-reported confidence were demonstrated. The mean change in test score from before to after intervention was +26.8%, and a median score increase of 25% was noted. The ARDS and the mucus plugging cases had statistically significant improvements in critical actions,p<0.001. A mean increase in self-reported confidence was realized (1.55 to 3.64),p=0.049.Conclusions. A three-day simulation curriculum for residents was effective in increasing competency, knowledge, and confidence with ventilator management.
Long-Term Follow-Up of a Revascularized Immature Necrotic Tooth Evaluated by CBCT
Authors: She C. M. L. , Cheung G. S. P. , Zhang C. F.
Published: February 2016

This case study reports the successful treatment of an immature upper premolar with periapical pathosis and sinus tract using revascularization technique. Clinical and radiographic examination demonstrated the recovery of vitality, continued root development, and periapical healing at the 7-month follow-up. In addition, severe calcification of the canal was noted at the 36-month follow-up. At the 66-month follow-up, cone-beam computed tomography (CBCT) revealed complete periapical healing, apical closure, increase in root length and thickness of dentin, and severe calcification of the root canal. Even though the nature of tissue within the root canal is unknown, revascularization appears to give good clinical and radiographic success. This case report highlights that severe calcification of the canal is one of the long-term outcomes of revascularized root canals.
Soy Isoflavone Protects Myocardial Ischemia/Reperfusion Injury through Increasing Endothelial Nitric Oxide Synthase and Decreasing Oxidative Stress in Ovariectomized Rats
Authors: Tang Yan , Li Shuangyue , Zhang Ping , Zhu Jinbiao , Meng Guoliang , Xie Liping , Yu Ying , Ji Yong , Han Yi
Published: February 2016

There is a special role for estrogens in preventing and curing cardiovascular disease in women. Soy isoflavone (SI), a soy‐derived phytoestrogen, has similar chemical structure to endogenous estrogen‐estradiol. We investigate to elucidate the protective mechanism of SI on myocardial ischemia/reperfusion (MI/R) injury. Female SD rats underwent bilateral ovariectomy. One week later, rats were randomly divided into several groups, sham ovariectomy (control group), ovariectomy with MI/R, or ovariectomy with sham MI/R. Other ovariectomy rats were given different doses of SI or 17β‐estradiol (E2). Four weeks later, they were exposed to 30 minutes of left coronary artery occlusion followed by 6 or 24 hours of reperfusion. SI administration significantly reduced myocardial infarct size and improved left ventricle function and restored endothelium‐dependent relaxation function of thoracic aortas after MI/R in ovariectomized rats. SI also decreased serum creatine kinase and lactate dehydrogenase activity, reduced plasma malonaldehyde, and attenuated oxidative stress in the myocardium. Meanwhile, SI increased phosphatidylinositol 3 kinase (PI3K)/Akt/endothelial nitric oxide synthase (eNOS) signal pathway. SI failed to decrease infarct size of hearts with I/R in ovariectomized rats if PI3K was inhibited. Overall, these results indicated that SI protects myocardial ischemia/reperfusion injury in ovariectomized rats through increasing PI3K/Akt/eNOS signal pathway and decreasing oxidative stress.
Quartz Enhanced Photoacoustic Spectroscopy for Detection of Improvised Explosive Devices and Precursors
Authors: Viola Roberto , Liberatore Nicola , Luciani Domenico , Mengali Sandro
Published: February 2016

A compact portable and standalone point sensor has been developed for the detection and identification of precursors of improvised explosive devices (IEDs) and to be part of a network of sensors for the discovery of hidden bomb factories in homeland security applications. The sensor is based on quartz enhanced photoacoustic spectroscopy (QEPAS), and it implements a broadly tunable external cavity quantum cascade laser source (EC-QCL). It makes use of an optical cell purposely designed with a miniaturized internal volume, to achieve fast response and high sensitivity, and that can also be heated to improve sensitivity towards less volatile compounds. The sensor has been assembled and successfully tested in the lab with several compounds, including IED’s precursors such as acetone, nitromethane, nitric acid, and hydrogen peroxide. The identification capability and limits of detection near the ppm level have been estimated for all these compounds.
Vibration Effects of Nonclassically Damped Building-Piping Systems Subjected to Extreme Loads
Authors: Ryu YongHee , Jung WooYoung , Ju BuSeog
Published: February 2016

Piping leakage can occur at T-joint, elbows, valves, or nozzles in nuclear power plants and nonnuclear power plants such as petrochemical plants when subjected to extreme loads and such leakage of piping systems can also lead to fire or explosion. For example, leakage of sodium, toxic gases, or nitrogen in hospitals can cause man-made hazards. The primary objective of this research is to understand the vibration effects due to classical/nonclassical damping with building-piping systems under extreme loads. The current evaluation employed finite-element analysis to calculate the effects of the responses of classically and nonclassically damped building-piping systems. Classical and nonclassical damping matrices for a coupled primary-secondary system were developed based on the Rayleigh equation. A total of 10 selected ground motions were applied to single degree of freedom (SDOF) primary-SDOF secondary (2-DOF coupled) systems in which the ratios of the natural frequencies between the primary and secondary systems ranged between 0.9 and 1.1. It revealed that the vibration effect of nonclassical damping was significant where the natural frequencies of the two systems were nearly tuned. For piping-material nonlinearity, the effects of nonclassical damping on the result forces of piping systems were not significantly different from those of classical damping.
Efficacy and Safety of Novel Agent-Based Therapies for Multiple Myeloma: A Meta-Analysis
Authors: Wang Xiaoxue , Li Yan , Yan Xiaojing
Published: February 2016

This study aimed at comparing bortezomib, thalidomide, and lenalidomide in patients with multiple myeloma (MM) for safety and efficacy using meta-analysis. This meta-analysis identified 17 randomized controlled trials (RCTs) including 6742 patients. These RCTs were separated according to the different agent-based regimens and to autologous stem-cell transplantation (ASCT). Complete response (CR), progression-free survival (PFS), overall survival (OS), and adverse events (AE) were combined. The total weighted risk ratio (RR) of CR was 3.29 [95% confidence interval (95% CI): 2.22–4.88] (P<0.0001) for the novel agent-based regimens. These novel agent-based regimens showed greater benefit in terms of PFS of all subgroups irrespective of whether the patient received ASCT or not. The hazard ratio (HR) for PFS was 0.64 [95% CI: 0.60–0.69] (P<0.00001). Improvements of OS could be found only in the bortezomib- and thalidomide-based regimens without ASCT. The pooled HRs were 0.74 [95% CI: 0.65–0.86] (P<0.0001) and 0.80 [95% CI: 0.70–0.90] (P=0.0004), respectively. Several AEs were shown more frequently in the novel agent-based regimens compared with controls such as hematologic events (neutropenia, anemia, and thrombocytopenia), gastrointestinal infection, peripheral neuropathy, thrombosis, and embolism events. In conclusion, in spite of the AEs, novel agent-based regimens are safe and effective for the treatment of MM.
Enrichment of the Glycyrrhizic Acid from Licorice Roots (Glycyrrhiza glabraL.) by Isoelectric Focused Adsorptive Bubble Chromatography
Authors: Karaoğul Eyyüp , Parlar Perihan , Parlar Harun , Alma M. Hakkı
Published: February 2016

The main aim of this study was to enrich glycyrrhizic acid ammonium salt known as one of the main compounds of licorice roots (Glycyrrhiza glabraL.) by isoelectric focused adsorptive bubble separation technique with different foaming agents. In the experiments, four bubble separation parameters were used withβ-lactoglobulin, albumin bovine, and starch (soluble) preferred as foaming agents and without additives. The enrichment of glycyrrhizic acid ammonium salt into the foam was influenced by different additive substances. The results showed that highest enrichment values were obtained fromβ-lactoglobulin as much as 368.3 times. The lowest enrichment values (5.9 times) were determined for the application without additive. After enrichment, each experiment of glycyrrhizic acid ammonium salt confirmed that these substances could be quantitatively enriched into the collection vessel with isoelectric focused adsorptive bubble separation technique. The transfer of glycyrrhizic acid ammonium salt into the foam from standard solution in the presence of additive was more efficient than aqueous licorice extract.
On Graphs of the Cone Decompositions for the Min-Cut and Max-Cut Problems
Authors: Bondarenko Vladimir , Nikolaev Andrei
Published: February 2016

We consider maximum and minimum cut problems with nonnegative weights of edges. We define the graphs of the cone decompositions and find a linear clique number for the min-cut problem and a superpolynomial clique number for the max-cut problem. These values characterize the time complexity in a broad class of algorithms based on linear comparisons.
Systemic Chromosome Instability Resulted in Colonic Transcriptomic Changes in Metabolic, Proliferation, and Stem Cell Regulators in Sgo1
−/+ Mice
Authors: Rao Chinthalapally V. , Sanghera Saira , Zhang Yuting , Biddick Laura , Reddy Arun , Lightfoot Stan , Janakiram Naveena B. , Mohammed Altaf , Dai Wei , Yamada Hiroshi Y.
Published: February 2016

Colon cancer is the second most lethal cancer and is predicted to claim 49,700 lives in the United States this year. Chromosome instability (CIN) is observed in 80% to 90% of colon cancers and is thought to contribute to colon cancer progression and recurrence. To investigate the impact of CIN on colon cancer development, we developed shugoshin-1 (Sgo1) haploinsufficient (−/+) mice, an animal model focusing on mitotic error–induced CIN. In this study, we analyzed signature changes in the colonic transcriptome of Sgo1−/+ mice to examine the molecular events underlying the altered carcinogenesis profiles in Sgo1−/+ mice. We performed next-generation sequencing of normal-looking colonic mucosal tissue from mice treated with the carcinogen azoxymethane after 24 weeks. Transcriptome profiling revealed 349 hits with a 2-fold expression difference threshold (217 upregulated genes, 132 downregulated genes, P < 0.05). Pathway analyses indicated that the Sgo1-CIN tissues upregulated pathways known to be activated in colon cancer, including lipid metabolism (z score 4.47), Notch signaling (4.47), insulin signaling (3.81), and PPAR pathways (3.75), and downregulated pathways involved in immune responses including allograft rejection (6.69) and graft-versus-host disease (6.54). Notably, stem cell markers were also misregulated. Collectively, our findings demonstrate that systemic CIN results in transcriptomic changes in metabolism, proliferation, cell fate, and immune responses in the colon, which may foster a microenvironment amenable to cancer development. Therefore, therapeutic approaches focusing on these identified pathways may be valuable for colon cancer prevention and treatment. Cancer Res; 76(3); 630–42. ©2016 AACR.
2013 HIPAA Changes Provide Opportunities and Challenges for Researchers: Perspectives from a Cancer Center
Authors: Freedman Ralph S. , Cantor Scott B. , Merriman Kelly W. , Edgerton Mary E.
Published: February 2016

In 2013, the U.S. Department of Health and Human Services modified the Health Insurance Portability and Accountability Act Privacy Rule to “strengthen privacy and security protections” while “improving workability and effectiveness to increase flexibility for and decrease burden on regulated entities.” In this article, we attempt to translate these generalized goals into the real-world implications of these changes. Under the new rules, researchers can obtain participants' permission to use their protected health information for more research activities with a single, upfront authorization (thereby reducing paperwork for participants, researchers, and institutional review boards) while providing potential participants with more information upon which to base their decisions about participation. The combined authorizations can be used in clinical trials and their optional substudies and in stand-alone biospecimen-banking research that includes authorization to permit future research use. We also suggest best practices for taking advantage of the flexibility offered by the new rules while maintaining strong privacy protections for human subjects. Clin Cancer Res; 22(3); 533–9. ©2016 AACR.
Late Presentation of Retinoblastoma in a Teen with Aicardi Syndrome
Authors: Akinfenwa Patricia Y. , Chévez-Barrios Patricia , Harper Clio A. , Gombos Dan S.
Published: February 2016

Background/Aims: Retinoblastoma (Rb) generally presents in children <8 years of age. Aicardi syndrome (AS) is a congenital, neurodevelopmental disorder that has been associated with various ophthalmic abnormalities, but no reports have related it to a delayed presentation of Rb. This report describes the late presentation of Rb in a teenage patient with AS and suggests modifications in ophthalmic screening to facilitate early detection. Methods: A chart review was conducted of a patient with AS. We examined the ophthalmic history, fundus images and B-scan ultrasonography. Histopathological analysis was conducted on globe sections. Results: The patient's ophthalmic history was consistent with normal findings of AS: fundus images and B-scan ultrasonography revealed chorioretinal lacunae and an area of retinal detachment, respectively. The patient presented with chronic irritation and mydriasis of the blind left eye. This was enucleated as treatment. Histopathology revealed a focally differentiated Rb. Immunohistochemistry demonstrated that the tumor cells were positive for synaptophysin and negative for the wild-type Rb protein, and a high Ki-67 proliferation index was shown. Conclusion: Our patient was diagnosed with Rb at age 16. AS has been associated with numerous ophthalmic findings, but this is the first report relating it to a late Rb presentation. Meticulous ophthalmic examinations should be considered through the teenage years and early adulthood of AS patients.
The Role of the Endoscopist in the Stroke Unit
Authors: Frieling Thomas
Published: February 2016

Background: Acute cerebral stroke is a common problem that is frequently associated with dysphagia resulting in an increased risk of aspiration pneumonia, complication, and mortality. Methods: A literature review was carried out using the search terms ‘stroke unit and endoscopy', ‘stroke unit and dysphagia', and ‘stroke unit and gastroenterology'. Results: Only few papers focus on the role of endoscopy in stroke units. One major role is the early detection of dysphagia by flexible endoscopic evaluation of swallowing (FEES). FEES appears to have a higher sensitivity and specificity compared to bedside tests and challenges videofluoroscopy. In contrast, other stroke-associated gastrointestinal complications requiring endoscopic diagnostic or therapeutic intervention, such as gastrointestinal bleeding, abdominal pain, or stasis, and the need to provide fluid and food via gastrostomy or jejunostomy are rarely seen in stroke units and become relevant during and after the rehabilitation phase. Conclusion: FEES should involve an interdisciplinary team comprising neurologists, speech and language pathologists and/or therapists, as well as gastroenterologic endoscopists.
Differing Microdeletion Sizes and Breakpoints in Chromosome 7q11.23 in Williams-Beuren Syndrome Detected by Chromosomal Microarray Analysis
Authors: Li Lin , Huang Linhuan , Luo Yanmin , Huang Xuan , Lin Shaobin , Fang Qun
Published: February 2016

Williams-Beuren syndrome (WBS) manifests as supravalvular aortic stenosis, intellectual disability, developmental delay and characteristic facial features. The common WBS deletion region ranges from 1.55 to 1.84 Mb and primarily contains the ELN gene. We analyzed 10 patients diagnosed with 7q11.23 microdeletion syndrome by chromosomal microarray analysis. The clinical features of these patients varied from classic WBS to normal phenotype. All 10 patients exhibited different sizes and breakpoints of chromosome microdeletions ranging from 44 kb to 9.88 Mb. The hemizygosity of the ELN gene was detected in 7 patients, while a normal ELN gene was present in 3 other patients with small deletions. We observed that the phenotypic features of WBS varied in fetuses, children and adults, influenced by the genes, deletion size and breakpoint. Our findings provide more information on the genotype-phenotype correlations of WBS. However, further research is needed to explore the size and breakpoint effect and functions of the genes on chromosome 7q11.23.
Involvement of Fibroblast Growth Factors and Their Receptors in Epididymo-Testicular Descent and Maldescent
Authors: Hadziselimovic Faruk
Published: February 2016

Maldescent of the epididymo-testicular unit can occur as an isolated event or as a component of various syndromes. When part of a syndrome, crypto-epididymis is usually accompanied by other genital and/or extragenital features. Epididymis development is primarily regulated by androgens, and successful epididymo-testicular unit development and descent requires an intact hypothalamic-pituitary-gonadal axis. The developing gonadotropin-releasing hormone system is essential for epididymo-testicular descent and is highly sensitive to reduced fibroblast growth factor (FGF) signaling. Our understanding of the impact of FGFR1 in the process of epididymo-testicular descent has recently improved. At later stages of embryonic development, the undifferentiated epididymal mesenchyme is a specific domain for FGFR1 expression. The majority of individuals with syndromic crypto-epididymis, as well as individuals with isolated maldescent of the epididymo-testicular unit, exhibit some disturbance of FGF, FGFR1 and/or genes involved in hypothalamic-pituitary-gonadal axis regulation. However, the mechanisms underlying FGF dysregulation may differ between various syndromes.
Macrothemis meurgeyi Daigle, 2007, from Guadeloupe is a junior synonym of Macrothemis celeno (Selys in Sagra, 1857) (Odonata; Libellulidae)
Authors: Meurgey FRANÇOIS
Published: February 2016

The genus Macrothemis consists of 40 Neotropical species (Garrison et al. 2006). Recently, a new species, Macrothemis meurgeyi from Guadeloupe (French West Indies), was described based on specimens from Habitation Deravin, Basse-Terre (Daigle 2007).
A new species of Polyplectropus Ulmer 1905 (Trichoptera: Polycentropodidae) from Minas Gerais State, southeastern Brazil
Authors: ROCHA ISABELA CRISTINA , DUMAS LEANDRO LOURENÇO , NESSIMIAN JORGE LUIZ
Published: February 2016

The adult male of a new species of the genus Polyplectropus Ulmer 1905a is described and illustrated based on specimens collected in Parque Nacional da Serra da Canastra, southeastern Brazil. Polyplectropus canastra sp. nov. can be distinguished from other Polyplectropus species by the shape of sternum IX, by the thumb-like mesolateral process of each preanal appendage, by the rectangular ventral branch of each inferior appendage in ventral view, and by the curved claw-like spines of the endothecal membrane. Among all species in the P. annulicornis Group, P. canastra is the only one with a bifid dorsolateral process of each preanal appendage and bearing spinules on the distal half of the rod-like lateral branch.
Clinical Practice Guideline
Authors: Rosenfeld Richard M. , Shin Jennifer J. , Schwartz Seth R. , Coggins Robyn , Gagnon Lisa , Hackell Jesse M. , Hoelting David , Hunter Lisa L. , Kummer Ann W. , Payne Spencer C. , Poe Dennis S. , Veling Maria , Vila Peter M. , Walsh Sandra A. , Corrigan Maureen D.
Published: February 2016

The American Academy of Otolaryngology—Head and Neck Surgery Foundation has published a supplement to this issue of Otolaryngology—Head and Neck Surgery featuring the updated “Clinical Practice Guideline: Otitis Media with Effusion.” To assist in implementing the guideline recommendations, this article summarizes the rationale, purpose, and key action statements. The 18 recommendations developed emphasize diagnostic accuracy, identification of children who are most susceptible to developmental sequelae from otitis media with effusion, and education of clinicians and patients regarding the favorable natural history of most otitis media with effusion and the lack of efficacy for medical therapy (eg, steroids, antihistamines, decongestants). An updated guideline is needed due to new clinical trials, new systematic reviews, and the lack of consumer participation in the initial guideline development group.
Plain Language Summary
Authors: O’Connor Sarah S. , Coggins Robyn , Gagnon Lisa , Rosenfeld Richard M. , Shin Jennifer J. , Walsh Sandra A.
Published: February 2016

Objective

This plain language summary serves as an overview in explaining otitis media with effusion (pronounced Oh‐TIE‐tis ME‐dee‐uh with Ef‐YOO‐zhun), abbreviated “OME” and often called “ear fluid.” The summary applies to children aged 2 months through 12 years with OME and is based on the 2015 “Clinical Practice Guideline: Otitis Media with Effusion (Update).” The evidence‐based guideline includes research to support more effective diagnosis and treatment of OME in children. The guideline was developed as a quality improvement opportunity for managing OME by creating clear recommendations to use in medical practice.
Parents’ Choice Function for Wards’ School Continuation in Rural India: A Case Study in West Bengal
Authors: Thakur Debdulal , Mukherjee Shrabani
Published: February 2016

In this article, we present a choice function of a rural household relating to her/his ward’s schooling. It makes an empirical evaluation on the basis of a simple theoretical framework using a primary data set surveyed from two backward districts of West Bengal. It explores the underlying causes of wards’ discontinuation of school by examining the choice function of the parents using ordered probit analysis. The likelihood of dropout is higher at the primary level for low-income households and significantly depends on parents’ attributes, which are mostly endogenous in an educational production function, and other exogenous difficulties in accessing school. It is also triggered by a lack of expectation about the future impact of education on a child’s life.

JEL Classification: C25, C80, D19, I21, I25
Neither Seeing Nor Seen
Authors: Krumer-Nevo Michal , Elfassi Yamit , Sagy Shifra , Lavie-Ajayi Maya
Published: February 2016

Social exclusion has been identified as a prominent factor informing our understanding of young people involvement in gang life, violence and crime. While the literature on social exclusion focuses on the education and employment systems, there is a limited literature regarding the role played by correctional institutions in exacerbating social exclusion. This article explores the reciprocal relationships between young people involved in the drug trade in Israel and various educational and correctional services in their community. It focuses on a term commonly articulated by the youth, ‘not seeing with the eyes’, which they use to describe themselves as consciously, purposefully and openly ignoring and flouting societal norms. However, the educational and correctional services present a similar attitude, manifesting institutional blindness in connection with the youth and hence contributing to the double exclusion of young men. The article exposes the practices and processes through which this double exclusion takes place.
NEAT: a framework for building fully automated NGS pipelines and analyses
Authors: Schorderet Patrick
Published: February 2016

Background

The analysis of next generation sequencing (NGS) has become a standard task for many laboratories in the life sciences. Though there exists several tools to support users in the manipulation of such datasets on various levels, few are built on the basis of vertical integration. Here, we present the NExt generation Analysis Toolbox (NEAT) that allows non-expert users including wet-lab scientists to comprehensively build, run and analyze NGS data through double-clickable executables without the need of any programming experience.

Results

In comparison to many publicly available tools including Galaxy, NEAT provides three main advantages: (1) Through the development of double-clickable executables, NEAT is efficient (completes within <24 hours), easy to implement and intuitive; (2) Storage space, maximum number of job submissions, wall time and cluster-specific parameters can be customized as NEAT is run on the institution’s cluster; (3) NEAT allows users to visualize and summarize NGS data rapidly and efficiently using various built-in exploratory data analysis tools including metagenomic and differentially expressed gene analysis.

To simplify the control of the workflow, NEAT projects are built around a unique and centralized file containing sample names, replicates, conditions, antibodies, alignment-, filtering- and peak calling parameters as well as cluster-specific paths and settings. Moreover, the small-sized files produced by NEAT allow users to easily manipulate, consolidate and share datasets from different users and institutions.

Conclusions

NEAT provides biologists and bioinformaticians with a robust, efficient and comprehensive tool for the analysis of massive NGS datasets. Frameworks such as NEAT not only allow novice users to overcome the increasing number of technical hurdles due to the complexity of manipulating large datasets, but provide more advance users with tools that ensure high reproducibility standards in the NGS era. NEAT is publically available at https://github.com/pschorderet/NEAT.
Journal of Foot and Ankle Research reviewer acknowledgement 2015
Authors: Borthwick Alan , Menz Hylton
Published: February 2016

Contributing reviewers

The editors of Journal of Foot and Ankle Research would like to thank all our reviewers who have contributed to the journal in Volume 8 (2015).
Early pneumonia and timing of antibiotic therapy in patients after nontraumatic out-of-hospital cardiac arrest
Authors: Hellenkamp Kristian , Onimischewski Sabrina , Kruppa Jochen , Faßhauer Martin , Becker Alexander , Eiffert Helmut , Hünlich Mark , Hasenfuß Gerd , Wachter Rolf
Published: February 2016

Background

While early pneumonia is common in patients after out-of-hospital cardiac arrest (OHCA), little is known about the impact of pneumonia and the optimal timing of antibiotic therapy after OHCA.

Methods

We conducted a 5-year retrospective cohort study, including patients who suffered from OHCA and were treated with therapeutic hypothermia. ICU treatment was strictly standardized with defined treatment goals and procedures. Medical records, chest radiographic images and microbiological findings were reviewed.

Results

Within the study period, 442 patients were admitted to our medical ICU after successfully resuscitated cardiac arrest. Of those, 174 patients fulfilled all inclusion and no exclusion criteria and were included into final analysis. Pneumonia within the first week could be confirmed in 39 patients (22.4 %) and was confirmed or probable in 100 patients (57.5 %), without a difference between survivors and non-survivors (37.8 % vs. 23.1 % confirmed pneumonia, p = 0.125). In patients with confirmed pneumonia a tracheotomy was performed more frequently (28.2 vs. 12.6 %, p = 0.026) compared to patients without confirmed pneumonia. Importantly, patients with confirmed pneumonia had a longer ICU- (14.0 [8.5-20.0] vs. 8.0 [5.0-14.0] days, p < 0.001) and hospital stay (23.0 [11.5-29.0] vs. 15.0 [6.5-25.0] days, p = 0.016).

A positive end expiratory pressure (PEEP) > =10.5 mbar on day 1 of the hospital stay was identified as early predictor of confirmed pneumonia (odds ratio 2.898, p = 0.006). No other reliable predictor could be identified.

Median time to antibiotic therapy was 8.7 [5.4-22.8] hours, without a difference between patients with or without confirmed pneumonia (p = 0.381) and without a difference between survivors and non-survivors (p = 0.264). Patients receiving antibiotics within 12 hours after admission had a shorter ICU- (8.0 [4.0-14.0] vs. 10.5 [6.0-16.0] vs. 13.5 [8.0-20.0] days, p = 0.004) and hospital-stay (14.0 [6.0-25.0] vs. 16.5 [11.0-27.0] vs. 21.0 [17.0-28.0] days, p = 0.007) compared to patients receiving antibiotics after 12 to 36 or more than 36 hours, respectively.

Conclusions

Early pneumonia may extend length of ICU- and hospital-stay after OHCA and its occurrence is difficult to predict. A delayed initiation of antibiotic therapy in OHCA patients may increase the duration of the ICU- and hospital-stay.
BET protein inhibitor JQ1 inhibits growth and modulates WNT signaling in mesenchymal stem cells
Authors: Alghamdi Saeed , Khan Irfan , Beeravolu Naimisha , McKee Christina , Thibodeau Bryan , Wilson George , Chaudhry G. Rasul
Published: February 2016

Background

Efficacy and safety of anticancer drugs are traditionally studied using cancer cell lines and animal models. The thienodiazepine class of BET inhibitors, such as JQ1, has been extensively studied for the potential treatment of hematological malignancies and several small molecules belonging to this class are currently under clinical investigation. While these compounds are well known to inhibit cancer cell growth and cause apoptosis, their effects on stem cells, particularly mesenchymal stem cells (MSCs), which are important for regeneration of damaged cells and tissues, are unknown. In this study we employed umbilical cord derived MSCs as a model system to evaluate the safety of JQ1.

Methods

Cord derived MSCs were treated with various doses of JQ1 and subjected to cell metabolic activity, apoptosis, and cell cycle analyses using MTT assay, Annexin-V/FITC and PI staining, and flow cytometry, respectively. The effect of JQ1 on gene expression was determined using microarray and quantitative real-time reverse transcriptase polymerase chain reaction analysis. Furthermore, protein expression of apoptotic and neuronal markers was carried out using western blot and immunostaining, respectively.

Results

Our results showed that JQ1 inhibited cell growth and caused cell cycle arrest in G1 phase but did not induce apoptosis or senescence. JQ1 also down-regulated genes involved in self-renewal, cell cycle, DNA replication, and mitosis, which may have negative implications on the regenerative potential of MSCs. In addition, JQ1 interfered with signaling pathways by down regulating the expression of WNT, resulting in limiting the self-renewal. These results suggest that anticancer agents belonging to the thienodiazepine class of BET inhibitors should be carefully evaluated before their use in cancer therapy.

Conclusions

This study revealed for the first time that JQ1 adversely affected MSCs, which are important for repair and regeneration. JQ1 specifically modulated signal transduction and inhibited growth as well as self-renewal. These findings suggest that perinatal MSCs could be used to supplement animal models for investigating the safety of anticancer agents and other drugs.
Cochlear implant and congenital cholesteatoma
Authors: Mierzwinski J. , Fishman AJ , Grochowski T. , Drewa S. , Drela M. , Winiarski P. , Bielecki I.
Published: February 2016

Background

The occurence of cholesteatoma and cochlear implant is rare. Secondary cholesteatomas may develop as a result of cochlear implant surgery. Primarily acquired cholesteatoma is not typically associated with congenital sensorineural hearing loss or cochlear implant in children. The occurrence of congenital cholesteatoma during cochlear implant surgery has never been reported before, partly because all patients are preoperatively submitted to imaging studies which can theoretically exclude the disease.

Case presentation

We have reported a rare case of congenital cholesteatoma, found during sequential second side cochlear implantation in a 3-year-old child. The child underwent a computed tomography (CT) scan and magnetic resonance imaging (MRI) at 12 months of age, before the first cochlear implant surgery, which excluded middle ear pathology. The mass was removed as an intact pearl, without visible or microscopic violation of the cholesteatoma capsule. All the areas where middle ear structures were touching the cholesteatoma were vaporized with a laser and the cochlear implant was inserted uneventfully. Further follow-up excluded residual disease.

Conclusion

We believe that primary, single stage placement of a cochlear implant (CI) with simultaneous removal of the congenital cholesteatoma can be performed safely. However, to prevent recurrence, the capsule of the cholesteatoma must not be damaged and complete laser ablation of the surface, where suspicious epithelial cells could remain, is recommended. In our opinion, cholesteatoma removal and cochlear implantation should be staged if these conditions are not met, and/or the disease is at a more advanced stage. It is suspected, that the incidence of congenital cholesteatoma in pediatric CI candidates is much higher that in average pediatric population.
The passing of ‘the Prof’
Authors: Parker Gordon
Published: February 2016

The archetypal professor of the 20th century is a dying breed, and now ‘the
Prof’ truly occupies emeritus status. This article seeks to remember the
Profs with fondness and consider some of the processes that led to their
extinction.
Oral ketamine for the treatment of pain and treatment-resistant depression
Authors: Schoevers Robert A. , Chaves Tharcila V. , Balukova Sonya M. , Rot Marije aan Het , Kortekaas Rudie
Published: February 2016

Background

Recent studies with intravenous (i.v.) application of ketamine show remarkable but short-term success in patients with MDD. Studies in patients with chronic pain have used different ketamine applications for longer time periods. This experience may be relevant for psychiatric indications.

Aims

To review the literature about the dosing regimen, duration, effects and side-effects of oral, intravenous, intranasal and subcutaneous routes of administration of ketamine for treatment-resistant depression and pain.

Method

Searches in PubMed with the terms ‘oral ketamine’, ‘depression’, ‘chronic pain’, ‘neuropathic pain’, ‘intravenous ketamine’, ‘intranasal ketamine’ and ‘subcutaneous ketamine’ yielded 88 articles. We reviewed all papers for information about dosing regimen, number of individuals who received ketamine, number of ketamine days per study, results and side-effects, as well as study quality.

Results

Overall, the methodological strength of studies investigating the antidepressant effects of ketamine was considered low, regardless of the route of administration. The doses for depression were in the lower range compared with studies that investigated analgesic use. Studies on pain suggested that oral ketamine may be acceptable for treatment-resistant depression in terms of tolerability and side-effects.

Conclusions

Oral ketamine, given for longer time periods in the described doses, appears to be well tolerated, but few studies have systematically examined the longer-term negative consequences. The short- and longer-term depression outcomes as well as side-effects need to be studied with rigorous randomised controlled trials.
Ending political abuse of psychiatry: where we are at and what needs to be done
Authors: van Voren Robert
Published: February 2016

The number of reports of political activists falling victim to the political abuse of psychiatry is increasing. When the USSR first disintegrated, this practice virtually ceased to occur. What came in its place, however, was a disturbing collection of other forms of abuses, including human rights abuses, caused by a lack of resources, outdated treatment methods, a lack of understanding of individual human rights and a growing lack of tolerance in society. The number of cases of political abuse of psychiatry has increased since the 21st century began, particularly over the past few years in Russia, Belarus and Kazakhstan.
‘Locked rehabilitation’: a need for clarification
Authors: Dye Stephen , Smyth Lucy , Pereira Stephen
Published: February 2016

Recently, the term ‘locked rehabilitation’ has spread from commissioning to now also clinical parlance. This is without any clear service description or category of patient which this service manages. Differences between this new term and an established definition of low secure services are examined and reasons for the introduction of this terminology are discussed. This is contextualised within service development, payment by results and measures of quality. It is argued that there is a need for ongoing measurements of types of patients admitted to, and treatments offered by, this ‘new’ ward, as well as those within psychiatric intensive and low secure care services.
β-cell Mass in Nondiabetic Autoantibody-Positive Subjects: An Analysis Based on the Network for Pancreatic Organ Donors Database
Authors: Diedisheim Marc , Mallone Roberto , Boitard Christian , Larger Etienne
Published: February 2016

Context:

Little information is available about β-cell mass in antibody-positive (Ab+) nondiabetic subjects.

Objective:

We have investigated whether the publicly available virtual slides of the Network for Pancreatic Organ Donors with Diabetes (nPOD) project can be used to assess β-cell mass and distribution in nondiabetic antibody-negative (Ab−) and antibody-positive (Ab+) subjects and in patients with recent-onset type 1 diabetes (T1D).

Subjects and Methods:

We developed a semi-automated quantification method and applied it to 415 insulin-stained slides from 69 Ab− subjects, 101 slides from 18 Ab+ subjects, and 46 slides from eight recent-onset (<3 y) T1D subjects. Among these subjects, 48, 17, and seven had an available pancreatic mass, respectively, and were used for the quantification of β-cell mass.

Results:

In Ab− subjects, the β-cell and endocrine mass were 0.66 ± 0.42 and 1.0 ± 0.65 g, respectively. Nonexocrine tissue represented 29% of pancreatic area, a proportion that increased with age. Proportional β-cell area relative to total pancreatic area was higher in the tail compared with head (0.83 vs 0.71%; P < .001). In Ab+ subjects, β-cell mass and β-cell area were similar to those of Ab− individuals, whereas these parameters were dramatically decreased in recent-onset T1D patients.

Conclusion:

The virtual slides of the nPOD project can be used for quantification projects. In Ab+ nondiabetic subjects, the β-cell mass was not decreased. However, as this cohort is largely composed of donors from the general population, with a single autoantibody, future studies with a larger number of donors with multiple autoantibodies and predisposing human leucocyte antigen genes are required to better define the dynamics of β-cell destruction in the preclinical phases of T1D.
The German Side of Things
Authors: Imlay Talbot
Published: February 2016

This review of recent scholarship on the German occupation of France during the Second World War discusses four subjects: the role of the German military authorities, anti-Jewish policy, economic policy, and relations between occupiers and occupied. The review argues that recent scholarship on the German occupation offers a potential complement to the scholarship on Vichy, which has been dominated by a focus on the French. There is, however, a danger of simply replacing a focus on the French with one on the Germans. The review points to the need for more exploration of the intertwined experiences of occupiers and occupied. This intertwining was evident in the economic and industrial realms and perhaps even more so in the social realm, in which significant numbers of French and Germans interacted with one another on a regular basis.

Cet article passe en revue plusieurs études récentes sur l'histoire de l'occupation allemande de la France pendant la Deuxième Guerre mondiale. Il traite de quatre sujets en particulier: le rôle des autorités militaires allemandes; la politique antisémite; la politique économique; et les rapports entre les occupés et les occupants. L'argument de l'article est que les études récentes sur l'occupation offrent un éventuel complément aux études sur Vichy, qui sont marquées par une concentration sur les Français. En même temps, il est à craindre que les études récentes remplacent tout simplement une concentration sur les Français par une autre sur les Allemands. L'article avance la nécessité d'examiner les rapports entrecroisés des occupés et des occupants. Cet entrecroisement était évident dans les domaines de l'économie et de l'industrie et peut-être davantage dans celui du social—un domaine dans lequel un grand nombre de Français et Allemands ont dû s'affronter au quotidien.
Double-Fluorescent-Labeled Single-Chain Antibodies Showing Antigen-Dependent Fluorescence Ratio Change
Authors: Yoshikoshi Kensuke , Watanabe Takayoshi , Hohsaka Takahiro
Published: February 2016

Fluorescence ratio probes are useful tools for quantitative detection of target molecules even if the concentration of probe molecules is unknown. However, a general and widely applicable method for design and synthesis of fluorescence ratio probes has never been established. Here, we developed double-labeled single-chain antibody fragment (scFv) derivatives showing antigen-dependent fluorescence ratio change based on fluorescence resonance energy transfer (FRET) and antigen-dependent fluorescence quenching. Double-labeled scFvs were synthesized by incorporating fluorescent nonnatural amino acids labeled with TAMRA and Rhodamine Green (RhG) as a FRET donor and acceptor pair into N- and C-termini of scFv, respectively, using four-base and amber codons in a cell-free translation system. The resulting double-labeled antibody fragments showed significant fluorescence ratio change upon the antigen-binding. This result was explained by FRET occurring from RhG to TAMRA but TAMRA being quenched by Trp residues in the absence of antigen. The binding of the antigen canceled the quenching of TAMRA without changing FRET efficiency. Double-labeled antibody fragments developed here will be useful as diagnostic and imaging tools.
Is there a Link between Supply Chain Strategies and Firm Performance? Evidence from Large-Scale Manufacturing Firms in Kenya
Authors: Nyaoga Richard Bitange , Magutu Peterson Obara , Aduba Josiah
Published: February 2016

The purpose of this study was to establish the relationship between supply chain strategies and performance of large-scale manufacturing firms in Kenya by addressing three primary gaps in the literature. The research gaps include the research findings and results on the relationship between supply chain strategies and firm performance that have been contradicting and no attempt to clear the contradictions; biased and unbalanced analysis of the different measures of firm performance, and failure to use weighted scores to measure firm performance. Resource-Based View guided this study. A sample of one hundred and thirty-eight (138) firms was drawn using proportionate sampling from a population of six hundred and twenty-seven (627) large-scale manufacturing firms in Kenya. The response rate was seventy-five (75) percent. The correlation analysis and regression analysis models were used to test the hypotheses. The study findings indicate that Supply chain strategies are useful predictors of the firm’s performance as supply chain strategies explain 76.7 % of the changes in the firm’s performance.DOI:10.12660/joscmv8n2p1-22 URL: http://dx.doi.org/10.12660/joscmv8n2p1-22
Building Resilient Supply Chains Through Flexibility: a Case Study in Healthcare
Authors: Bradaschia Marcelo , Pereira Susana Carla Farias
Published: February 2016

This research seeks to understand how the capability of flexibility manifests itself for the formation of resilience in service supply chains. The survey was conducted through a single case study of a hospital chain that was impacted by the H1N1 pandemic in 2009. This analyzed chain was formed by the hospital, doctors, nurses, the Ministry of Health, State Secretary of Health of São Paulo and the pharmaceutical industry. As a result, the following categories of flexibility manifestation were identified: redesign, alteration/creation, prioritization, redundancy/availability/robustness and elimination.
The Development of Logistics Services in the United States
Authors: Yang Yeonglin H
Published: February 2016

This research studies third party logistics (3PL) providers in the United States to investigate how the industry has strategically developed its service offerings in response to the customers’ growing needs in managing global supply chains. Logistics management has significant impacts on various aspects of supply chains such as response time, total supply chain cost, sourcing risk, customer service, security, etc. The results show that 3PL services vary based on industry served, region served, and asset ownership structure. Over the years logistics services providers have served more industry sectors, became asset light, and provided broader services. Two of the five service categories, technology services and special services, have been evolved and expanded rapidly. The development has strengthened the capabilities of the logistics service providers and sustained the growth of the industry.DOI:10.12660/joscmv8n2p23-35URL: http://dx.doi.org/10.12660/joscmv8n2p23-35
Characterization of cross-functional integration level: A multi case study in Agribusiness Organizations
Authors: Ferreira Ana Cristina , Pimenta Marcio Lopes , Bertan Franciele Olivo
Published: February 2016

A point that has generated discussion in the literature is the level of integration required for the coordination of activities between areas. However, there is a lack of theoretical definitions and field studies that explain this phenomenon in depth. Thus, this study aims to characterize the level of cross-integration, the factors that generate it and the impacts on organizational performance. For this, interviews with managers of Operations, R&D and Marketing/Commercial areas, from two multinational companies based in Minas Gerais were performed. The results indicate that the level of integration can be analyzed as a combination of three factors: 1) absence of overlapping of perceptions about integration factors over the processes, balance between formality and informality, and absence of manifest conflicts of interest. This is a setting that provides a deeper definition than those obtained in the studied literature, which basically present integration mechanisms, without detailing how these should be applied in order to generate higher levels of integration. DOI:10.12660/joscmv8n2p36-51URL: http://dx.doi.org/10.12660/joscmv8n2p36-51