bluuebunny/crossref_metadata_2025 huggingface dataset:
Effects of acute psychological stress on placebo and nocebo responses in a clinically relevant model of visceroception
Authors: Roderigo Till , Benson Sven , Schöls Margarita , Hetkamp Madeleine , Schedlowski Manfred , Enck Paul , Elsenbruch Sigrid
Published: May 2017

There is evidence to suggest a role of emotions in placebo and nocebo effects, but whether acute psychological stress changes the magnitude of placebo or nocebo responses has not been tested. In a clinically relevant model of visceroception, we assessed effects of acute psychological stress on changes in urgency and pain in response to positive or negative treatment suggestions. In 120 healthy volunteers, perceived urge-to-defecate and pain in response to individually calibrated rectal distensions were measured with visual analogue scales during a BASELINE. Participants then underwent the Trier Social Stress Test (N = 60) or a simple cognitive task (control, N = 60) and were randomized to positive (placebo), negative (nocebo), or neutral treatment information regarding intravenous administration of saline. The series of distensions was repeated, and changes in visual analogue scales from BASELINE to TEST were compared between groups using analysis of covariance and planned post hoc tests. Treatment information emerged as a main factor (P <0.001), supporting treatment information effects for both urgency and pain. Effects for urgency were modulated by stress (interaction effect: P <0.05): Positive information reduced urgency (P = 0.025), while negative information increased urgency (P = 0.026) only in stressed groups. For pain, effects of stress emerged for nocebo responses, which were only evident in stressed groups (P = 0.009). This is the first experimental study supporting effects of acute psychological stress on placebo and nocebo responses in visceroception. Results call for mechanistic as well as patient studies to assess how psychological stress shapes patients' treatment expectations and thereby affects health outcomes.
Improving Staffing and Nurse Engagement in a Neuroscience Intermediate Unit
Authors: Nadolski Charles , Britt Pheraby , Ramos Leah C.
Published: May 2017

The neuroscience intermediate unit is a 23-bed unit that was initially staffed with a nurse-to-patient ratio of 1:4 to 1:5. In time, the unit’s capacity to care for the exceeding number of progressively acute patients fell short of the desired goals in the staff affecting the nurse satisfaction. The clinical nurses desired a lower nurse-patient ratio. The purpose of this project was to justify a staffing increase through a return on investment and increased quality metrics. Methods: This initiative used mixed methodology to determine the ideal staffing for a neuroscience intermediate unit. The quantitative section focused on a review of the acuity of the patients. The qualitative section was based on descriptive interviews with University Healthcare Consortium nurse managers from similar units. Design: The study reviewed the acuity of 9,832 patient days to determine the accurate acuity of neuroscience intermediate unit patients. Nurse managers at 12 University Healthcare Consortium hospitals and 8 units at the Medical University of South Carolina were contacted to compare staffing levels. Discussion: The increase in nurse staffing contributed to an increase in many quality metrics. There were an 80% decrease in controllable nurse turnover and a 75% reduction in falls with injury after the lowered nurse-patient ratio. These 2 metrics established a return on investment for the staffing increase. In addition, the staffing satisfaction question on the Press Ganey employee engagement survey increased from 2.44 in 2013 to 3.72 in 2015 in response to the advocacy of the bedside nurses.
The Experiences of Medical Marijuana Patients: A Scoping Review of the Qualitative Literature
Authors: Ryan Jennie , Sharts-Hopko Nancy
Published: May 2017

Medical marijuana is now legal in more than half of the United States but remains federally prohibited and classified as a schedule 1 drug. The chemical compounds in marijuana are known neuroprotectants; however, their clinical efficacy and safety have not been proven. Many healthcare providers remain unaware of the therapeutic potential of marijuana and its adverse effects. The conflicting laws and lack of guidance from healthcare professionals can lead to confusion and frustration for patients seeking this medication. Multiple factors contribute to the unique and varied experiences of medical marijuana patients. Because more individuals with neurological disorders seek therapeutic marijuana, it is important for healthcare professionals to understand their distinctive experiences. Qualitative research methodology is ideal to capture the thick descriptions of these experiences. This review examines the qualitative research exploring the experiences of medical marijuana patients and discusses common themes across all studies.
Complication Rates of 3% Hypertonic Saline Infusion Through Peripheral Intravenous Access
Authors: Perez Claudia Andira , Figueroa Stephen A.
Published: May 2017

Introduction: Hyperosmolar therapy with hypertonic saline (HTS) is a cornerstone in the management of intracranial hypertension and hyponatremia in the neurological intensive care unit. Theoretical safety concerns remain for infiltration, thrombophlebitis, tissue ischemia, and venous thrombosis associated with continuous 3% HTS administered via peripheral intravenous (pIV) catheters. It is common practice at many institutions to allow only central venous catheter infusion of 3% HTS. Methods: Hospital policy was changed to allow the administration of 3% HTS via 16- to 20-gauge pIVs to a maximum infusion rate of 50 mL/h in patients without central venous access. We prospectively monitored patients who received peripheral 3% HTS as part of a quality improvement project. We documented gauge, location, maximum infusion rate, and total hours of administration. Patients were assessed for infiltration, erythema, swelling, phlebitis, thrombosis, and line infection. Results: There were 28 subjects across 34 peripheral lines monitored. Overall, subjects received 3% HTS for a duration between 1 and 124 hours with infusion rates of 30 to 50 mL/h. The rate of complications observed was 10.7% among all subjects. Documented complications included infiltration (n = 2), with an incidence of 6%, and thrombophlebitis (n = 1), with an incidence of 3%. Conclusions: There has been a long concern among healthcare providers, including nursing staff, in regard to pIV administration of prolonged 3% HTS infusion therapy. Our study indicates that peripheral administration of 3% HTS carries a low risk of minor, nonlimb, or life-threatening complications. Although central venous infusion may reduce the risk of these minor complications, it may increase the risk of more serious complications such as large vessel thrombosis, bloodstream infection, pneumothorax, and arterial injury. The concern regarding the risks of pIV administration of 3% HTS may be overstated and unfounded.
Lifestyle Counseling Intervention Effects on Counseling Quality in Patients With Stroke and Transient Ischemic Attack
Authors: Oikarinen Anne , Engblom Janne , Kyngäs Helvi , Kääriäinen Maria
Published: May 2017

Background: Studies have shown that counseling about risk factor–related lifestyle habits can produce significantly beneficial changes in the lifestyle habits of patients with stroke. However, it is not sufficient only to provide a patient with appropriate information, but the quality of lifestyle counseling is also essential. The aim of the study was to investigate the effects of a lifestyle counseling intervention on lifestyle counseling quality in patients with stroke and transient ischemic attack. Methods: Posttest control group design was used. Patients with stroke and transient ischemic attack (n = 98), divided into intervention and control groups, completed the Counseling Quality Questionnaire after receiving lifestyle counseling at the hospital (January 2010 to October 2011). Data were analyzed with an analysis of variance. Results: The patients rated lifestyle counseling quality quite high in terms of all sum variables except patient centeredness. Counseling quality except for counseling resources was estimated to be significantly better by the intervention group. Conclusions: Lifestyle counseling quality at the hospital can be enhanced by a counseling intervention. More attention to factors that promote patient centeredness of counseling is required because patient centeredness has repeatedly been recognized as the weakest aspect of counseling by both patients with stroke and other patient groups.
Management of different types of gastric varices with band ligation: a 3-year experience
Authors: Seleem Waseem M. , Hanafy Amr S.
Published: May 2017

Background and aim

Gastric varices (GVs) occur with an incidence of 20% in patients with portal hypertension. The aim of this study was to evaluate the efficacy of endoscopic band ligation (BL) as an option in the management of small-to-moderate nonbleeding GVs in cirrhotic patients.

Patients and methods

A total of 50 patients (GOV2; n=6, IGV1; n=34, IGV2; n=10) with nonbleeding small-to-moderate-sized GVs without local risk signs of bleeding, such as large size, red-colored elevated areas or red wales, and systemic factors of bleeding risk such as an international normalized ratio of at least 2 and a platelet count of 80 000/µl or less were subjected to endoscopic BL. The patients were followed up every 2 weeks for 1 month and then every 1.5 months for 6 months. The primary outcome was GV eradication, detection of complications such as postprocedural bleeding ulceration and mortality.

Results

The mean number of BL sessions was 2.2±0.8; post-BL ulceration occurred in two (4%) patients (n=2 in IGV1, P=0.61), bleeding occurred in one (2%) patient (n=1 in IGV1, P=0.79), and epigastric pain occurred in six (12%, n=4 in GOV2, n=2 in IGV1) patients. There was no mortality reported among patients treated with BL.

Conclusion

Endoscopic BL resulted in better outcome and a lower incidence of complications when used to treat small-to-medium-sized nonbleeding GVs. Further, early eradication can save effort and cost, thus avoiding the future risk of treatment of large or risky GVs with sclerotherapy.
Prevalence of intestinal complications in inflammatory bowel disease: a comparison between paediatric-onset and adult-onset patients
Authors: Herzog Denise , Fournier Nicolas , Buehr Patrick , Rueger Vanessa , Koller Rebekka , Heyland Klaas , Nydegger Andreas , Braegger Christian P.
Published: May 2017

Introduction

Intestinal complications in inflammatory bowel disease indicate active inflammation and typically result in the intensification of therapy.

Aim

To analyse whether the rates of intestinal complications were associated with age at disease onset.

Patients and methods

Data from 1506 individuals with Crohn’s disease (CD) and 1201 individuals with ulcerative colitis (UC) were obtained from the Swiss inflammatory bowel disease cohort study database, classified into groups on the basis of age at diagnosis (<10, <17, <40 and >40 years of age), and retrospectively analysed.

Results

In CD patients, the rates of stricturing (29.1–36.2%), abdominal penetrating disease (11.9–18.2%), resectional surgery (17.9–29.8%) and perianal disease (14.7–34.0%) were correlated with disease duration, but not age at diagnosis. However, paediatric-onset CD was associated with higher rates of multiple, rectal and anal strictures and earlier colon surgery. In addition, perianal disease occurred earlier, required earlier surgical intervention, and was more often combined with stricturing and penetrating disease. Finally, anal fissures were more prevalent among younger patients. In UC patients, the rates of progression or extension of disease (0–25.8%) and colectomy (3.0–8.7%) were dependent on disease duration, but not age at disease onset. Paediatric-onset disease was associated with a higher rate of extensive colitis at diagnosis and earlier progression or extension of disease, and nonsurgically treated patients with the youngest ages at onset more frequently required antitumour necrosis factor-α treatments.

Conclusion

The higher rates of intestinal complications, including those of the small and large bowel and in the anal region, in paediatric-onset CD patients point towards a level of inflammation that is more difficult to control. Similar findings were also evident in UC patients.
Diabetic status and grade of nonalcoholic fatty liver disease are associated with lower baroreceptor sensitivity in patients with nonalcoholic fatty liver disease
Authors: Singh Akanksha , Kumar Mavidi S. , Jaryal Ashok K. , Ranjan Piyush , Deepak Kishore K. , Sharma Sanjay , Lakshmy Ramakrishnan , Pandey Ravindra M. , Vikram Naval K.
Published: May 2017

Objectives

Baroreceptor sensitivity (BRS), a functional consequence of vascular stiffness, may be affected by the presence of diabetes mellitus (DM) and nonalcoholic fatty liver disease (NAFLD). The present study was designed to assess the effect of diabetic status and NAFLD grade on the BRS in patients with NAFLD.

Methods

Seventy-five individuals (25 NAFLD without DM, 25 NAFLD with DM and 25 controls) were recruited for the study who underwent anthropometric and body composition analysis along with estimation of plasma glucose, serum insulin and serum lipids. BRS and blood pressure variability (BPV) analysis was carried out in both time and frequency domains. Carotid–radial and carotid–dorsalis pedis artery pulse wave velocity, and radial artery augmentation index were computed as measures of arterial stiffness.

Results

BRS was found to be lower in the NAFLD with DM group as well those with grade II NAFLD compared with the controls. Correlation analysis showed a negative correlation of BRS with postprandial blood glucose level (r=−0.39) and BMI (r=−0.467). The diabetic status and grade of NAFLD were associated independently with a decrease in BRS as well as the low-frequency component of diastolic BPV. The augmentation index and carotid–distal pulse wave velocity were higher in the NAFLD with DM group compared with controls.

Conclusion

Both the diabetic status and grade of NAFLD were shown to have an independent effect on the decrease in the BRS with a consequent effect on BPV, with a greater influence of diabetic status rather than NAFLD grade on arterial stiffness.
Assessment of liver fibrosis with acoustic radiation force impulse imaging versus liver histology in patients with chronic hepatitis C: a pilot study
Authors: Kohla Mohamed A.S. , Abbasy Mohamed , Abozeid Mai , El-Abd Osama , Ezzat Sameera , Kohla Samah , Abdel-Rahman Mohamed
Published: May 2017

Background

Acoustic radiation force impulse imaging (ARFI) involves the mechanical excitation of tissues using short-duration acoustic pulses to generate localized displacements in tissue. The displacements results in shear-wave propagation, tracked by ultrasonography (US) correlation-based methods and recorded in meters per seconds.

Aim

To compare (ARFI) integrated into a conventional US with the standard histological examination of liver biopsy specimens for the assessment of liver fibrosis.

Materials and methods

Histological fibrosis staging with standard liver biopsy using the Metavir scoring system as well as fibrosis assessment using ARFI were performed to 80 patients with chronic hepatitis C over a 3-month period.

Results

ARFI findings were identical to the biopsy findings in 61 (76.25%) patients.

Fifty-eight (67.5%) patients with an early fibrosis stage (F0, F1, and F2) by histology had identical fibrosis stages using ARFI.

Only 20 out of 26 patients with an advanced fibrosis stage (F3 and F4) using ARFI had advanced fibrosis histologically. In the advanced fibrosis stages, the sensitivity of ARFI was 70% and specificity was 80%, with positive and negative predictive values of 53.8 and 88.9%, respectively. The accuracy of detection of advanced fibrosis by ARFI was 77.5%.

Conclusion

ARFI imaging is a promising noninvasive US-based method for the assessment of liver fibrosis.
Impact of gastroesophageal reflux disease symptoms on the quality of life in pregnant women: a prospective study
Authors: Fill Malfertheiner Sara , Seelbach-Göbel Birgit , Costa Serban-Dan , Ernst Wolfgang , Reuschel Edith , Zeman Florian , Malfertheiner Peter , Malfertheiner Maximilian V.
Published: May 2017

Objective

Pregnant women often suffer from gastroesophageal reflux disease (GERD). GERD symptoms are known to influence the quality of life; however, there is a lack of data in pregnant women. The aim of this study was to establish the impact of GERD symptoms on health-related quality of life (HRQOL) during pregnancy.

Participants and methods

A prospective longitudinal cohort study to investigate the impact of GERD symptoms on the HRQOL was carried out in 510 pregnant women and 330 nonpregnant women as controls. Two validated questionnaires, the Reflux Disease Questionnaire and the Quality of Life in Reflux and Dyspepsia Questionnaire, were used.

Results

The study showed a significant negative impact on HRQOL in pregnant women with GERD symptoms. All five areas, emotional distress, sleep disturbance, vitality, food/drink problems, and physical/social functioning, were significantly reduced, but the most significant impact was on sleep (Quality of Life in Reflux and Dyspepsia Questionnaire score −35%). Overall, quality of life in women with GERD worsened throughout pregnancy.

Conclusion

GERD is frequently seen in pregnant women and has a negative impact on HRQOL, especially in late pregnancy. Therefore, there is a need for adequate therapy of GERD in pregnant women and HRQOL could be an adequate monitoring tool in this population.
Cardiac Dysrhythmias Associated With Substitutive Use of Loperamide: A Systematic Review
Authors: Riaz Irbaz Bin , Khan Muhammad Shahzeb , Kamal Muhammad Umar , Sipra Qurat-ul-Ain Riaz , Riaz Anum , Zahid Umar , Bhattacharjee Sandipan
Published: May 2017

Background:

Recently, several deaths secondary to cardiac arrhythmias have been reported in association with substitutive use of loperamide. Therefore, we conducted a systematic review of all reported cases to overview the epidemiologic patterns and clinical outcomes to better elucidate loperamide-induced cardiac complications.

Areas of Uncertainty:

Association between substitutive use of loperamide and cardiac arrhythmias.

Data Sources:

A comprehensive literature search was conducted across 6 databases using variety of keywords to identify all reports of cardiac side effects associated with loperamide abuse. Only original case reports of cardiac toxicity or cardiac arrhythmias after loperamide abuse or overuse were included. Data were extracted by 2 authors independently using a structured template from the selected reports. Quality assessment of the reports was performed by using a high-quality evaluation tool.

Results:

Thirteen reports describing 19 cases were included in our review. Except for coronary artery spasm in one case, cardiac arrhythmias were the major reported cardiac adverse event. The average age of patients was 31 years with majority being men (79%). The most common presentation was syncope (63%). All cases were reported in US except for 1 case. Three patients were concomitantly taking cimetidine, which is known to cause inhibition of CYP3A4 and CYP2C8 leading to increased levels of loperamide. Thirteen of 19 patients were successfully treated and discharged in a stable condition.

Conclusions:

Our results indicate that measures such as restricting over-the-counter availability of loperamide and increasing awareness regarding loperamide's toxicity are imperative to prevent deaths associated with loperamide abuse.
Application of Population Pharmacokinetic Modeling for Individualized Infliximab Dosing Strategies in Crohn Disease
Authors: Frymoyer Adam , Hoekman Daniël R. , Piester Travis L. , de Meij Tim G. , Hummel Thalia Z. , Benninga Marc A. , Kindermann Angelika , Park K.T.
Published: May 2017

Objectives:

The pharmacokinetics of infliximab (IFX) is highly variable in children with Crohn disease (CD), and a one-size-fits-all approach to dosing is inadequate. Model-based drug dosing can help individualize dosing strategies. We evaluated the predictive performance and clinical utility of a published population pharmacokinetic model of IFX in children with CD.

Methods:

Within a cohort of 34 children with CD who had IFX trough concentrations measured, the pharmacokinetics of each patient was estimated in NONMEM using a published population pharmacokinetic model. Infliximab concentrations were then predicted based on each patient's dosing history and compared with actual measured concentrations (n = 59). In addition, doses 5 to 10 mg/kg and dosing intervals every 4 to 8 weeks were simulated in each patient to examine dose-trough relationships.

Results:

Predicted concentrations were within ±1.0 μg/mL of actual measured concentrations for 88% of measurements. The median prediction error (ie, measure of bias) was −0.15 μg/mL (95% confidence interval −0.37 to −0.05 μg/mL) and absolute prediction error (ie, measure of precision) was 0.26 μg/mL (95% confidence interval 0.15 to 0.40 μg/mL). At standard maintenance dosing of 5 mg/kg every 8 weeks, a trough >3 μg/mL was predicted to be achieved in 32% of patients. To achieve a trough >3 μg/mL, a dosing interval ≤every 6 weeks was predicted to be required in 29% of patients.

Conclusions:

A published IFX population pharmacokinetic model demonstrated accurate predictive performance in a pediatric CD population. Individualized IFX dosing strategies in children with CD will be critical to consistently achieve trough concentrations associated with optimal outcomes.
ELNEC-APRN: Meeting the Needs of Advanced Practice Nurses Through Education
Authors: Dahlin Constance M. , Coyne Patrick J. , Paice Judith , Malloy Pamela , Thaxton Cheryl Ann , Haskamp Amy
Published: May 2017

As care providers across the health continuum for patients with serious illness, advanced practice registered nurses (APRNs) are essential to quality palliative care. Many APRNs, however, lack palliative care education and training. To promote palliative-specific education for practicing APRNs, the End-of-Life Nursing Education Consortium (ELNEC) created an APRN curriculum and developed a 2-day course on clinical issues and program development in palliative care pertinent to APRN practice. In the past 3 years, more than 940 APRNs representing the spectrum of disease specialties, populations, and health care settings have attended this national course. Completion of precourse and postcourse surveys demonstrated that the course has improved their knowledge and their practice. ELNEC-APRN is an essential educational forum for APRNs to provide high-quality palliative care for patients with serious illness. Advanced practice registered nurses can incorporate content into their practice, integrate content into other educational forums, and use principles to build palliative care services.
Palliative Care at the Doorstep
Authors: Jackson Molly J. , Mecklenburg Janice , Feshzion Abraham
Published: May 2017

Palliative care is a growing specialty striving to improve quality of life in patients and families facing advanced illness, with demonstrated benefits. Outcomes regarding patients receiving community-based palliative care have not been extensively studied, with most focusing on patients with advanced cancer diagnoses. This article describes a community-based palliative care program, developed to provide care to patients with advanced illness. The mission, model of care, and program evolution are outlined; patient demographics, care settings, and comorbid diseases are reported. The average and median lengths of stay for patients who eventually transitioned to hospice care from 2012 to 2015 are compared with the affiliated hospice’s total population and with national averages. Patients receiving community-based palliative care for a diagnosis of advanced illnesses who later transitioned to hospice had an increased median and total length of hospice stay as compared with other hospice referral sources and with national averages. For patients with advanced illnesses of many types, palliative care provided in the community setting may lead to earlier identification and referral to hospice as opposed to patients not receiving palliative care, with greater support at end of life.
Investigating the Short-term Effect of Eyelid Massage on Corneal Topography
Authors: Riede-Pult Britta H. , Evans Katharine , Pult Heiko
Published: May 2017

Purpose

The aim of this study was to evaluate the short-term effect of eyelid massage, after the use of warm compresses, on corneal topography.

Methods

Corneal topography was evaluated on 20 subjects (mean age, 47.0 [SD ±17.3] years) using the Oculus Keratograph (Oculus, Wetzlar, Germany). Corneal eccentricity (Epsilon) was compared between topography measurements before eyelid warming (using warm compresses) (T1), after eyelid warming (T2), directly after eyelid massage (T3), and 30 minutes after eyelid massage (T4). Differences in corneal eccentricity between the enrolment measurement (T1) and consecutive measurements (T1-4) were analyzed. The contralateral eye—treated by warm compresses, but not by eyelid massage—was the control. Visual acuity (decimal), bulbar conjunctival hyperemia, and corneal staining (Cornea and Contact Lens Research Unit grading scale) were evaluated at T1 and T4 to assess clinical safety.

Results

No significant differences were found between consecutive eccentricity measurements overall and with the central radii (repeated-measures analysis of variance, P > .238 (massaged eyelid: Epsilon T1: 0.48 [95% confidence interval, ±0.07], T2: 0.49 [±0.05], T3: 0.49 [±0.06], T4: 0.48 [±0.06]; horizontal radii T1: 7.76 [±0.13] mm, T2: 7.74 [±0.13] mm, T3: 7.75 [±0.13] mm, T4: 7.76 [±0.13] mm; vertical radii T1: 7.56 [±0.12] mm, T2: 7.55 [±0.10] mm, T3: 7.54 [±0.10] mm, T4: 7.58 [±0.11] mm). Decimal visual acuity significantly improved at the end of the study (massaged eyelid: T1: 1.1 [±0.1]; T4: 1.3 [±0.1]; P < .032). No significant differences were detected between the consecutive evaluation of corneal staining (Wilcoxon test; P > .285). Redness was not significantly different between time points (repeated-measures analysis of variance; P = .187) in the colateral eyes. Hyperemia was significantly reduced in the massaged eyes (T1: 2.0 grade units [±0.3]; T4: 1.9 [±0.3]; P = .021).

Conclusions

Eyelid warming followed by eyelid massage appears to be a safe procedure, without any clinically relevant short-term effects on the cornea.
Paradoxical Effect of Cardiac Output on Arterial Enhancement at Computed Tomography: Does Cardiac Output Reduction Simply Result in an Increase in Aortic Peak Enhancement?
Authors: Kidoh Masafumi , Nakaura Takeshi , Funama Yoshinori , Shimonobo Toshiaki , Shirasaka Takashi , Hatemura Masahiro , Utsunomiya Daisuke , Oda Seitaro , Yuki Hideaki , Namimoto Tomohiro , Higaki Toru , Awai Kazuo , Yamashita Yasuyuki
Published: May 2017

Objective

The aim of this study was to evaluate the effect of cardiac output (CO) on aortic peak enhancement using protocols with different contrast material (CM) injection durations.

Methods

We used a flow phantom that simulated the human circulatory system. Contrast material was injected at a rate of 4.0 mL/s for a period of 2.5, 5, 10, 15, or 20 seconds for a CO of 2.8, 4.2, and 5.6 L/min. Single-level serial computed tomography scans of the simulated aorta were acquired after the start of CM delivery, and aortic peak enhancement was recorded under the different injection protocols.

Results

Under a long injection duration protocol (20 seconds), a decrease in CO increased aortic peak enhancement proportionally (CO of 2.8 L/min, 420 Hounsfield units [HU]; CO of 4.2 L/min, 365 HU; CO of 5.6 L/min, 291 HU). However, this effect was decreased under shorter injection duration protocols (5, 10, and 15 seconds); under the shortest (2.5-second) injection duration protocol, a decrease in CO resulted in a decrease in aortic peak enhancement (CO of 2.8 L/min, 36 HU; CO of 4.2 L/min, 51 HU; CO of 5.6 L/min, 55 HU).

Conclusions

The magnitude of the effect of CO on aortic peak enhancement depends on the CM injection duration.
Protection by the Eph–Ephrin System Against Mesenteric Ischemia-Reperfusion Injury
Authors: Vivo Valentina , Zini Irene , Cantoni Anna Maria , Grandi Andrea , Tognolini Massimiliano , Castelli Riccardo , Ballabeni Vigilio , Bertoni Simona , Barocelli Elisabetta
Published: May 2017

Mesenteric ischemia-reperfusion (I/R)-induced injury targets primarily endothelial and epithelial cells, leading to a cascade of inflammatory events, eventually culminating in life-threatening syndromes. Hitherto, the role of Eph, the largest family of tyrosine kinase receptors, and of their cell-bound ephrin ligands, whose interaction generates a bidirectional signaling, is still debated in I/R injury. The aim of the present work was therefore to investigate the effects produced by unidirectional activation of forward signaling (administration of chimeric protein ephrinA1-Fc), of reverse signaling (EphA2-Fc), or inhibition of both signals (monomeric EphA2 and the protein-protein interaction inhibitor UniPR1331) on the local and systemic inflammatory responses triggered by mesenteric I/R in mice.

When administered at 200 μg/kg i.v., ephrin-A1-Fc prevented intestinal and lung I/R-induced injury, decreasing in the pulmonary district leukocytes recruitment, IL-1β and TNFα levels, and EphA2 overexpression by mesenteric I/R. Blockade of Eph–ephrin signaling by equimolar EphA2 efficiently antagonized I/R-induced gut edema formation, an effect shared also by UniPR1331, mitigated lung mucosal injury, and counteracted the increase in pro-inflammatory cytokines levels. EphA2-Fc 180 μg/kg or equimolar Fc alone did not significantly modify the inflammatory responses to I/R.

Our data suggest that the Eph–ephrin system is directly involved in the development of the acute inflammatory process activated in the gut by hypoxia-reoxygenation and in its amplification to distant organs, revealing that a fine pharmacological tuning of this signaling pathway may represent an attractive strategy to contain the I/R-induced inflammatory cascade.
Laparoscopic-assisted Tranversus Abdominis Plane (TAP) Block Versus Ultrasonography-guided Transversus Abdominis Plane Block in Postlaparoscopic Cholecystectomy Pain Relief: Randomized Controlled Trial
Authors: Ravichandran Niranjan T. , Sistla Sarath C. , Kundra Pankaj , Ali S. Manwar , Dhanapal Baskaran , Galidevara Indira
Published: May 2017

Objectives:

Transversus abdominis plane (TAP) block for postoperative analgesia in laparoscopic cholecystectomy is usually given under ultrasound guidance. Laparoscopic-assisted TAP block has been suggested as an alternative to ultrasonogram (USG)-guided block as it is less time consuming and does not need extra equipments. This study was done to compare the efficacy of both the techniques.

Patients and Methods:

We conducted a randomized controlled trial between October 2012 and June 2014 involving adult patients with symptomatic gall stone disease. Patients were randomly assigned to laparoscopic or ultrasound-guided TAP block. Both groups were compared for amount of opioid consumption, postoperative pain scores, postoperative nausea and vomiting, bowel movements, peak expiratory flow rate, and time taken for administering the block.

Results:

We included 60 adult patients in our study. The groups were comparable with respect to demographic characteristics, symptomatology, comorbidities, and intraoperative complications. Amount of opioid consumption and postoperative pain relief were comparable between the 2 groups. The time taken for laparoscopy-assisted block was shorter when compared with the time taken for USG-guided block (P≤0.05). Postoperative nausea and vomiting, bowel movements, and peak expiratory flow rate were comparable between the 2 groups.

Conclusions:

Laparoscopy-assisted TAP block is faster and equally efficacious when compared with USG-guided block and has a definite role in centers where ultrasound is not available in operating rooms.
Neuroimaging “HINTS” of the Lateral Medullary Syndrome
Authors: Saber Tehrani Ali S. , DeSanto Jeffrey R. , Kattah Jorge C.
Published: May 2017

A series of neuroimaging studies illustrates many of the key findings of the lateral medullary syndrome.
Rapid Response to Electroconvulsive Therapy
Authors: Tran Duy V. , Meyer Justin P. , Farber Kate G. , Chen Xi Richard , Rosenthal Blake D. , Kellner Charles H.
Published: May 2017

Although a typical course of electroconvulsive therapy (ECT) consists of 6 to 12 treatments, remission of depression has rarely been reported after a single treatment. We present the case of a 25-year-old woman hospitalized for a major depressive episode and suicidality, in the context of bipolar 1 disorder, whose symptoms fully remitted with 1 ECT. We also review the literature on rapid response to ECT.
Effect of Atropine Premedication on Cardiac Autonomic Function During Electroconvulsive Therapy
Authors: Jadhav Tanmay , Sriganesh Kamath , Thirthalli Jagadisha , Reddy K.R. Madhusudan , Venkataramaiah Sudhir , Philip Mariamma , Naveen Kumar Channaveerachari , Armugham Shyam Sundar
Published: May 2017

Objectives

Electroconvulsive therapy (ECT) results in significant cardiovascular changes. The acute cardiac autonomic changes during ECT remain unexplored. The primary objective of this study was to compare autonomic dysfunction with and without atropine premedication during ECT and secondarily to evaluate dysautonomia across psychiatric diagnoses before and after ECT.

Methods

In this crossover study, 41 psychiatric patients were monitored during 82 ECT sessions. Patients were randomized either to receive atropine or not to receive atropine during their second ECT session and were crossed over during their third session. Heart rate, blood pressure, and oxygen saturation were continuously monitored from stimulus application until 300 seconds after ECT. Demographic characteristics and ANSiscope indices derived pre- and post-ECT were collected.

Results

Autonomic dysfunction (%) before ECT was similar between atropine and no-atropine sessions (32.4 ± 15.7 vs 32.8 ± 16.7; 95% confidence interval, −7.6 to 6.7; P = 0.90) but increased significantly after ECT to 60.9 ± 16.3 and to 47.0 ± 17.3, respectively, and this difference was significant (95% confidence interval, 6.5–21.3; P < 0.001). There was no difference in the autonomic function across psychiatric diagnoses both before (P = 0.07) and after ECT (P = 0.12).

Conclusions

Cardiac autonomic dysfunction worsens after ECT in patients with psychiatric illnesses and to a significantly greater extent with atropine premedication. The degree of dysautonomia is similar across various psychiatric diagnoses both before and after ECT. Atropine premedication during ECT should be restricted to select patients susceptible to bradyarrhythmia and could be avoided in others.
Does oxidative stress shorten telomeres?
Authors: Boonekamp Jelle J. , Bauch Christina , Mulder Ellis , Verhulst Simon
Published: May 2017

Oxidative stress shortens telomeres in cell culture, but whether oxidative stress explains variation in telomere shortening
in vivo
at physiological oxidative stress levels is not well known. We therefore tested for correlations between six oxidative stress markers and telomere attrition in nestling birds (jackdaws
Corvus monedula
) that show a high rate of telomere attrition in early life. Telomere attrition was measured between ages 5 and 30 days, and was highly variable (average telomere loss: 323 bp, CV = 45%). Oxidative stress markers were measured in blood at age 20 days and included markers of oxidative damage (TBARS, dROMs and GSSG) and markers of antioxidant protection (GSH, redox state, uric acid). Variation in telomere attrition was not significantly related to these oxidative stress markers (|
r
| ≤ 0.08,
n
= 87). This finding raises the question whether oxidative stress accelerates telomere attrition
in vivo
. The accumulation of telomere attrition over time depends both on the number of cell divisions and on the number of base pairs lost per DNA replication and, based on our findings, we suggest that in a growing animal cell proliferation, dynamics may be more important for explaining variation in telomere attrition than oxidative stress.
Form and function of the teleost lateral line revealed using three-dimensional imaging and computational fluid dynamics
Authors: Herzog Hendrik , Klein Birgit , Ziegler Alexander
Published: May 2017

Fishes sense weak water motion using the lateral line. Among the thousands of described fish species, this organ may differ in size, shape and distribution of individual mechanoreceptors or lateral line canals. The reasons for this diversity remain unclear, but are very likely related to habitat preferences. To better understand the performance of the organ in natural hydrodynamic surroundings, various three-dimensional imaging datasets of the cephalic lateral line were gathered usingLeuciscus idusas representative freshwater teleost. These data are employed to simulate hydrodynamic phenomena around the head and within lateral line canals. The results show that changes in canal dimensions alter the absolute stimulation amplitudes, but have little effect on the relation between bulk water flow and higher frequency signals. By contrast, depressions in the skin known as epidermal pits reduce bulk flow stimulation and increase the ratio between higher-frequency signals and the background flow stimulus.
Evaluating polymeric biomaterial–environment interfaces by Langmuir monolayer techniques
Authors: Schöne Anne-Christin , Roch Toralf , Schulz Burkhard , Lendlein Andreas
Published: May 2017

Polymeric biomaterials are of specific relevance in medical and pharmaceutical applications due to their wide range of tailorable properties and functionalities. The knowledge about interactions of biomaterials with their biological environment is of crucial importance for developing highly sophisticated medical devices. To achieve optimal
in vivo
performance, a description at the molecular level is required to gain better understanding about the surface of synthetic materials for tailoring their properties. This is still challenging and requires the comprehensive characterization of morphological structures, polymer chain arrangements and degradation behaviour. The review discusses selected aspects for evaluating polymeric biomaterial–environment interfaces by Langmuir monolayer methods as powerful techniques for studying interfacial properties, such as morphological and degradation processes. The combination of spectroscopic, microscopic and scattering methods with the Langmuir techniques adapted to polymers can substantially improve the understanding of their
in vivo
behaviour.
Jumping without slipping: leafhoppers (Hemiptera: Cicadellidae) possess special tarsal structures for jumping from smooth surfaces
Authors: Clemente Christofer J. , Goetzke Hanns Hagen , Bullock James M. R. , Sutton Gregory P. , Burrows Malcolm , Federle Walter
Published: May 2017

Many hemipteran bugs can jump explosively from plant substrates, which can be very smooth. We therefore analysed the jumping performance of froghoppers (Philaenus spumarius,Aphrophoridae) and leafhoppers (Aphrodes bicinctus/makarovi,Cicadellidae) taking off from smooth (glass) and rough (sandpaper, 30 µm asperity size) surfaces. On glass, the propulsive hind legs ofPhilaenusfroghoppers slipped, resulting in uncontrolled jumps with a fast forward spin, a steeper angle and only a quarter of the velocity compared with jumps from rough surfaces. By contrast,Aphrodesleafhoppers took off without their propulsive hind legs slipping, and reached low take-off angles and high velocities on both substrates. This difference in jumping ability from smooth surfaces can be explained not only by the lower acceleration of the long-legged leafhoppers, but also by the presence of 2–9 soft pad-like structures (platellae) on their hind tarsi, which are absent in froghoppers. High-speed videos of jumping showed that platellae contact the surface briefly (approx. 3 ms) during the acceleration phase. Friction force measurements on individual hind tarsi on glass revealed that at low sliding speeds, both pushing and pulling forces were small, and insufficient to explain the recorded jumps. Only when the tarsi were pushed with higher velocities did the contact area of the platellae increase markedly, and high friction forces were produced, consistent with the observed jumps. Our findings show that leafhoppers have special adhesive footpads for jumping from smooth surfaces, which achieve firm grip and rapid control of attachment/detachment by combining anisotropic friction with velocity dependence.
The circadian dynamics of small nucleolar RNA in the mouse liver
Authors: Aitken Stuart , Semple Colin A.
Published: May 2017

The circadian regulation of gene expression allows plants and animals to anticipate predictable environmental changes. While the influence of the circadian clock has recently been shown to extend to ribosome biogenesis, the dynamics and regulation of the many small nucleolar RNA that are required in pre-ribosomal RNA folding and modification are unknown. Using a novel computational method, we show that 18S and 28S pre-rRNA are subject to circadian regulation in a nuclear RNA sequencing time course. A population of snoRNA with circadian expression is identified that is functionally associated with rRNA modification. More generally, we find the abundance of snoRNA known to modify 18S and 28S to be inversely correlated with the abundance of their target. Cyclic patterns in the expression of a number of snoRNA indicate a coordination with rRNA maturation, potentially through an upregulation in their biogenesis, or their release from mature rRNA at the end of the previous cycle of rRNA maturation, in antiphase with the diurnal peak in pre-rRNA. Few cyclic snoRNA have cyclic host genes, indicating the action of regulatory mechanisms in addition to transcriptional activation of the host gene. For highly expressed independently transcribed snoRNA, we find a characteristic RNA polymerase II and H3K4me3 signature that correlates with mean snoRNA expression over the day.
Advection by ocean currents modifies phytoplankton size structure
Authors: Font-Muñoz Joan S. , Jordi Antoni , Tuval Idan , Arrieta Jorge , Anglès Sílvia , Basterretxea Gotzon
Published: May 2017

Advection by ocean currents modifies phytoplankton size structure at small scales (1–10 cm) by aggregating cells in different regions of the flow depending on their size. This effect is caused by the inertia of the cells relative to the displaced fluid. It is considered that, at larger scales (greater than or equal to 1 km), biological processes regulate the heterogeneity in size structure. Here, we provide observational evidence of heterogeneity in phytoplankton size structure driven by ocean currents at relatively large scales (1–10 km). Our results reveal changes in the phytoplankton size distribution associated with the coastal circulation patterns. A numerical model that incorporates the inertial properties of phytoplankton confirms the role of advection on the distribution of phytoplankton according to their size except in areas with enhanced nutrient inputs where phytoplankton dynamics is ruled by other processes. The observed preferential concentration mechanism has important ecological consequences that range from the phytoplankton level to the whole ecosystem.
Greater than the sum of its parts? Modelling population contact and interaction of cultural repertoires
Authors: Creanza Nicole , Kolodny Oren , Feldman Marcus W.
Published: May 2017

Evidence for interactions between populations plays a prominent role in the reconstruction of historical and prehistoric human dynamics; these interactions are usually interpreted to reflect cultural practices or demographic processes. The sharp increase in long-distance transportation of lithic material between the Middle and Upper Palaeolithic, for example, is seen as a manifestation of the cultural revolution that defined the transition between these epochs. Here, we propose that population interaction is not only a reflection of cultural change but also a potential driver of it. We explore the possible effects of inter-population migration on cultural evolution when migrating individuals possess core technological knowledge from their original population. Using a computational framework of cultural evolution that incorporates realistic aspects of human innovation processes, we show that migration can lead to a range of outcomes, including punctuated but transient increases in cultural complexity, an increase of cultural complexity to an elevated steady state and the emergence of a positive feedback loop that drives ongoing acceleration in cultural accumulation. Our findings suggest that population contact may have played a crucial role in the evolution of hominin cultures and propose explanations for observations of Palaeolithic cultural change whose interpretations have been hotly debated.
The early response during the interaction of fungal phytopathogen and host plant
Authors: Shen Yilin , Liu Na , Li Chuang , Wang Xin , Xu Xiaomeng , Chen Wan , Xing Guozhen , Zheng Wenming
Published: May 2017

Plants can be infected by a variety of pathogens, most of which can cause severe economic losses. The plants resist the invasion of pathogens via the innate or acquired immune system for surviving biotic stress. The associations between plants and pathogens are sophisticated beyond imaging and the interactions between them can occur at a very early stage after their touching each other. A number of researchers in the past decade have shown that many biochemical events appeared even as early as 5 min after their touching for plant disease resistance response. The early molecular interactions of plants and pathogens are likely to involve protein phosphorylation, ion fluxes, reactive oxygen species (ROS) and other signalling transduction. Here, we reviewed the recent progress in the study for molecular interaction response of fungal pathogens and host plant at the early infection stage, which included many economically important crop fungal pathogens such as cereal rust fungi, tomato
Cladosporium fulvum
, rice blast and so on. By dissecting the earlier infection stage of the diseases, the avirulent/virulent genes of pathogen or resistance genes of plant could be defined more clearly and accurately, which would undoubtedly facilitate fungal pathogenesis study and resistant crop breeding.
Sex-specific but not sexually explicit: pupillary responses to dressed and naked adults
Authors: Attard-Johnson Janice , Bindemann Markus
Published: May 2017

Dilation of the pupils is an indicator of an observer's sexual interest in other people, but it remains unresolved whether this response is strengthened or diminished by sexually explicit material. To address this question, this study compared pupillary responses of heterosexual men and women to naked and dressed portraits of male and female adult film actors. Pupillary responses corresponded with observers' self-reported sexual orientation, such that dilation occurred during the viewing of opposite-sex people, but were comparable for naked and dressed targets. These findings indicate that pupillary responses provide a sex-specific measure, but are not sensitive to sexually explicit content.