bluuebunny/crossref_metadata_2025_split huggingface dataset:
Extracorporeal membrane oxygenation for the anesthetic management of a patient with a massive intrathoracic goiter causing severe tracheal obstruction with positional symptoms
Authors: Jeong Young-Il , Jun In-Gu , Ha Seung-Soo , Kwon Hyun-Jung , Lee Yu-Mi 
Published: October 2019

Abstract

Introduction:
Perioperative anesthetic management in cases of severe airway obstruction with positional symptoms can be associated with difficulties in ventilation or intubation, with a risk of acute respiratory decompensation at every stage of anesthesia.

Patient concerns:
Here we describe the anesthetic management of a 67-year-old man with a massive intrathoracic goiter causing severe tracheal obstruction with positional symptoms. The patient presented with progressive dyspnea that was aggravated in the supine position and was scheduled for total thyroidectomy.

Diagnosis:
Preoperative computed tomography showed a large goiter extending into the thoracic cavity, with diffuse segmental tracheal narrowing for 6 cm. The diameter at the narrowest portion of the trachea was 4.29 mm.

Interventions:
Before the induction of general anesthesia, we applied extracorporeal membrane oxygenation (ECMO) in preparation for potential difficulties in securing the airway during general anesthesia. Subsequently, anesthesia was successfully induced and maintained.

Outcomes:
After the surgical procedure, fiberoptic bronchoscopy and chest radiography showed resolution of the tracheal narrowing. ECMO was weaned 2 hours after the surgery, and the patient was extubated on the first postoperative day. He was discharged without any complication.

Conclusion:
The findings from this case suggest that the use of ECMO before the induction of general anesthesia is a safe method for maintaining oxygenation in patients with severe tracheal obstruction.
Neonatal Sepsis Alters the Excitability of Regular Spiking Cells in the Nucleus of the Solitary Tract in Rats
Authors: Eftekhari Golnar , Shojaei Amir , Raoufy Mohammad R. , Azizi Hossein , Semnanian Saeed , Mani Ali R. 
Published: October 2019

ABSTRACT

Objective:
Sepsis is a leading cause of mortality and morbidity in infants. Although the measures of autonomic dysfunction (e.g., reduced heart rate variability) predict mortality in sepsis, the mechanism of sepsis-induced autonomic dysfunction has remained elusive. The nucleus of the solitary tract (NTS) is a vital structure for the integrated autonomic response to physiological challenges. In the present study we hypothesized that sepsis alters the excitability of NTS neurons in a rat model of neonatal sepsis (14-day-old rats).

Methods and Results:
Sepsis was induced by intraperitoneal injection of cecal slurry (CS) in rat neonates. The presence of autonomic dysfunction was confirmed by observing a significant reduction in both short-term and long-term heart rate variably following CS injection. We investigated the effect of polymicrobial sepsis on the electrophysiological properties of the medial NTS neurons using a whole cell patch clamp recording. Our results showed that the resting membrane potential in regular spiking neurons was significantly less polarized in the septic group (−37.6 ± 1.76 mv) when compared with the control group (−54.7 ± 1.73 mv, P < 0.001). The number of spontaneous action potentials in the septic group was also significantly higher than the control group (P < 0.05). In addition, the frequency and amplitude of the spontaneous excitatory post synaptic potentials was significantly higher in neurons recorded in the septic group (P < 0.001). Interestingly, regular spiking cells in the CS group exhibited a rebound action potential following hyperpolarization. Injection of depolarizing currents was associated with lower first spike latency and changes in rise slope of action potential (P < 0.001).

Conclusions:
We showed that polymicrobial sepsis increases the excitability of regular spiking cells in the medial NTS. These alterations can potentially affect neural coding and thus may contribute to an abnormal homeostatic or allostatic physiological response to sepsis and systemic inflammation.
Cardiac Dysfunction in Severely Burned Patients: Current Understanding of Etiology, Pathophysiology, and Treatment
Authors: Tapking Christian , Popp Daniel , Herndon David N. , Branski Ludwik K. , Hundeshagen Gabriel , Armenta Andrew M. , Busch Martin , Most Patrick , Kinsky Michael P. 
Published: October 2019

ABSTRACT
Patients who experience severe burn injuries face a massive inflammatory response resulting in hemodynamic and cardiovascular complications. Even after immediate and appropriate resuscitation, removal of burn eschar and covering of open areas, burn patients remain at high risk for serious morbidity and mortality. As a result of the massive fluid shifts following the initial injury, along with large volume fluid resuscitation, the cardiovascular system is critically affected. Further, increased inflammation, catecholamine surge, and hypermetabolic syndrome impact cardiac dysfunction, which worsens outcomes of burn patients. This review aimed to summarize the current knowledge about the effect of burns on the cardiovascular system.
A comprehensive search of the PubMed and Embase databases and manual review of articles involving effects of burns on the cardiovascular system was conducted.
Many burn units use multimodal monitors (e.g., transpulmonary thermodilution) to assess hemodynamics and optimize cardiovascular function. Echocardiography is often used for additional evaluations of hemodynamically unstable patients to assess systolic and diastolic function. Due to its noninvasive character, echocardiography can be repeated easily, which allows us to follow patients longitudinally.
The use of anabolic and anticatabolic agents has been shown to be beneficial for short- and long-term outcomes of burn survivors. Administration of propranolol (non-selective β-receptor antagonist) or oxandrolone (synthetic testosterone) for up to 12 months post-burn counteracts hypermetabolism during hospital stay and improves cardiac function.
A comprehensive understanding of how burns lead to cardiac dysfunction and new therapeutic options could contribute to better outcomes in this patient population.
Chemoinformatic-guided engineering of polyketide synthases
Authors: Zargar Amin , Lal Ravi , Valencia Luis , Wang Jessica , Backman Tyler William H. , Cruz-Morales Pablo , Kothari Ankita , Werts Miranda , Wong Andrew R. , Bailey Constance B. , Loubat Arthur , Liu Yuzhong , Chen Yan , Benites Veronica T. , Chang Samantha , Hernández Amanda C. , Barajas Jesus F. , Thompson Mitchell G. , Barcelos Carolina , Anayah Rasha , Martin Hector Garcia , Mukhopadhyay Aindrila , Petzold Christopher J. , Baidoo Edward E.K. , Katz Leonard , Keasling Jay D. 
Published: October 2019

AbstractPolyketide synthase (PKS) engineering is an attractive method to generate new molecules such as commodity, fine and specialty chemicals. A significant challenge in PKS design is engineering a partially reductive module to produce a saturated β-carbon through a reductive loop exchange. In this work, we sought to establish that chemoinformatics, a field traditionally used in drug discovery, could provide a viable strategy to reductive loop exchanges. We first introduced a set of donor reductive loops of diverse genetic origin and chemical substrate structures into the first extension module of the lipomycin PKS (LipPKS1). Product titers of these engineered unimodular PKSs correlated with atom pair chemical similarity between the substrate of the donor reductive loops and recipient LipPKS1, reaching a titer of 165 mg/L of short chain fatty acids produced by Streptomyces albus J1074 harboring these engineered PKSs. Expanding this method to larger intermediates requiring bimodular communication, we introduced reductive loops of divergent chemosimilarity into LipPKS2 and determined triketide lactone production. Collectively, we observed a statistically significant correlation between atom pair chemosimilarity and production, establishing a new chemoinformatic method that may aid in the engineering of PKSs to produce desired, unnatural products.
The Effect of MR Image Quality on Structural and Functional Brain Connectivity: The Maastricht Study
Authors: de Jong Joost J.A. , Jansen Jacobus F.A. , Vergoossen Laura W.M. , Schram Miranda T. , Stehouwer Coen D.A. , Wildberger Joachim E. , Linden David E.J. , Backes Walter H. 
Published: October 2019

AbstractIn large population-based cohort studies, magnetic resonance imaging (MRI) is often used to study the structure and function of the brain. Advanced MRI techniques such as diffusion-tensor (dMRI) or resting-state functional MRI (rs-fMRI) can be used to study connections between distinct brain regions. However, brain connectivity measures are likely affected by biases introduced during MRI data acquisition and/or processing.We identified three sources that may lead to bias, i.e. signal-to-noise ratio (SNR), head motion, and spatial mismatch between MRI-based anatomy and a brain atlas. After quantifying these sources, we determined the associations between the image quality metrics and brain connectivity measures derived from dMRI and rs-fMRI in 5,110 participants of the population-based Maastricht Study.More head motion and low SNR were negatively associated with structural and functional brain connectivity, respectively, and these metrics substantially affected (>10%) associations of brain connectivity with age, sex and body mass index (BMI), whereas associations with diabetes status, educational level, history of cardiovascular disease, and white matter hyperintensities were less or not affected. In addition, age, sex, and BMI were associated with head motion, SNR, and atlas mismatch (all p < 0.001). Based on our results, we strongly advise that, in large population-based cohort neuroimaging studies, statistical analyses on structural and functional brain connectivity should adjust for potentially confounding effects of image quality.HighlightsLow MR image quality compromises brain connectivity measuresMR image quality is negatively associated with age, body mass index, and male sexStatistical analyses in large neuroimaging studies should account for image quality
Neural signatures of loss of consciousness and its recovery by thalamic stimulation
Authors: Donoghue Jacob A. , Bastos André M. , Yanar Jorge , Kornblith Simon , Mahnke Meredith , Brown Emery N. , Miller Earl K. 
Published: October 2019

AbstractWe know that general anesthesia produces unconsciousness but not quite how. We recorded neural activity from the frontal, parietal, and temporal cortices and thalamus while maintaining unconsciousness in non-human primates (NHPs) with propofol. Unconsciousness was marked by slow frequency (∼1 Hz) oscillations in local field potentials, entraining local spiking to Up states alternating with Down states of little spiking, and decreased higher frequency (>4 Hz) coherence. The thalamus contributed to cortical rhythms. Its stimulation “awakened” anesthetized NHPs and reversed the electrophysiologic features of unconsciousness. Unconsciousness thus resulted from slow frequency hypersynchrony and loss of high-frequency dynamics, partly mediated by the thalamus, that disrupts cortical communication/integration.
Ability of Bicarbonate Supplementation to Sensitize Selected Methicillin-ResistantStaphylococcus aureus(MRSA) Strains to β-Lactam Antibiotics in anEx VivoSimulated Endocardial Vegetation Model
Authors: Rose Warren E. , Bienvenida Ana M. , Xiong Yan Q. , Chambers Henry F. , Bayer Arnold S. , Ersoy Selvi C. 
Published: October 2019

ABSTRACTSupplementation of standard growth media (cation-adjusted Mueller-Hinton Broth [CAMHB]) with bicarbonate (NaHCO3) significantly increases β-lactam susceptibility of selected MRSA strains (“NaHCO3-responsive”). This “sensitization” phenomenon translated to enhanced β-lactam efficacy in a rabbit model of endocarditis. The present study evaluated NaHCO3-mediated β-lactam MRSA sensitization using anex vivopharmacodynamic model, featuring simulated endocardial vegetations (SEVs), to more closely mimic the host microenvironment. Four previously described MRSA strains were used: two each exhibitingin vitro“NaHCO3-responsive” or “NaHCO3-nonresponsive” phenotypes. Cefazolin (CFZ) and oxacillin (OXA) were evaluated in CAMHB±NaHCO3. Intra-SEV MRSA killing was determined over 72 hr exposure. In both NaHCO3-responsive strains, supplementation with 25 mM or 44 mM NaHCO3significantly reduced β-lactam MICs to below the OXA susceptibility breakpoint (≤ 4 mg/L) resulting in bactericidal activity (≥ 3 log kill) in the model for both OXA and CFZ. In contrast, neitherin vitro-defined NaHCO3-nonresponsive MRSA strains showed significant sensitization in the SEV model to either β-lactam. At both NaHCO3concentrations, the fractional time-above-MIC was >50% for both CFZ and OXA in the NaHCO3-responsive MRSA. Also, in RPMI+10% LB media (proposed as a more host-mimicking microenvironment and containing 25 mM NaHCO3), both CFZ and OXA exhibited enhanced bactericidal activity against each NaHCO3-responsive strain in the SEV model. Neither CFZ nor OXA exposures selected for high-level β-lactam-resistant mutants within SEVs. Thus, in thisex vivomodel of endocarditis, in the presence of NaHCO3supplementation, both CFZ and OXA are highly active against MRSA strains that demonstrate similar enhanced susceptibility in NaHCO3-supplemented mediain vitro.
Cdc42 GTPase regulates ESCRTs in nuclear envelope sealing and ER remodeling
Authors: Lu Michelle S. , Drubin David G. 
Published: October 2019

AbstractSmall GTPases of the Rho family are binary molecular switches that regulate a variety of processes including cell migration and oriented cell divisions. Known Cdc42 effectors include proteins involved in cytoskeletal remodeling and kinase-dependent transcription induction, but none involved in the maintenance of nuclear envelope integrity or endoplasmic reticulum (ER) morphology. Maintenance of nuclear envelope integrity requires the EndoSomal Complexes Required for Transport (ESCRT) proteins, but how they are regulated in this process remains unknown. Here we show by live-cell imaging a novel Cdc42 localization with ESCRT proteins at sites of nuclear envelope and ER fission, and by genetic analysis, uncover a unique Cdc42 function in regulation of ESCRT proteins at the nuclear envelope and sites of ER tubule fission. Our findings implicate Cdc42 in nuclear envelope sealing and ER remodeling, where it regulates ESCRT disassembly to maintain nuclear envelope integrity and proper ER architecture.SummaryThe small Rho GTPase Cdc42 is a well-known regulator of cytoskeletal rearrangement and polarity development in all eukaryotic cell types. Here, Lu and Drubin report the serendipitous discovery of a novel Cdc42-ESCRT-nuclear envelope/endoplasmic reticulum connection.
Valence and state-dependent population coding in dopaminergic neurons in the fly mushroom body
Authors: Siju K.P. , Stih Vilim , Aimon Sophie , Gjorgjieva Julijana , Portugues Ruben , Grunwald Kadow Ilona C. 
Published: October 2019

SummaryNeuromodulation permits flexibility of synapses, neural circuits and ultimately behavior. One neuromodulator, dopamine, has been studied extensively in its role as reward signal during learning and memory across animal species. Newer evidence suggests that dopaminergic neurons (DANs) can modulate sensory perception acutely, thereby allowing an animal to adapt its behavior and decision-making to its internal and behavioral state. In addition, some data indicate that DANs are heterogeneous and convey different types of information as a population. We have investigated DAN population activity and how it could encode relevant information about sensory stimuli and state by taking advantage of the confined anatomy of DANs innervating the mushroom body (MB) of the fly Drosophila melanogaster. Using in vivo calcium imaging and a custom 3D image registration method, we find that the activity of the population of MB DANs is predictive of the innate valence of an odor as well as the metabolic and mating state of the animal. Furthermore, DAN population activity is strongly correlated with walking or running, consistent with a role of dopamine in conveying behavioral state to the MB. Together our data and analysis suggest that distinct DAN population activities encode innate odor valence, movement and physiological state in a MB-compartment specific manner. We propose that dopamine shapes innate odor perception through combinatorial population coding of sensory valence, physiological and behavioral context.
Income equality and household expenditure of fishers in the Volta Basin in Ghana
Authors: Amevenku Francis Kizito Yaw , Asravor Richard Kofi 
Published: October 2019

Purpose
The purpose of this paper is to examine the level of income inequality among fisher households in the four segments of the Volta Basin in Ghana and the determinants of small-scale fisher household welfare.

Design/methodology/approach
The paper investigates income inequality and the determinants of household consumption expenditure of fishers in the Volta Basin of Ghana using the Lorenz curve, Gini coefficient decomposition and the multiple linear regression technique.

Findings
The findings confirm the empirical evidence that households in the general downstream communities and their compatriots in the upstream communities were statistically different in terms of household characteristics and physical and social capital. Income inequality was highest among households in upstream communities but least amongst downstream communities. Livelihoods of the fishery households largely and strictly favored male households. Also, educational status was associated with higher levels of income which enormously help reduce food insecurity.

Research limitations/implications
The reliance on dummy variables might lead to omissions of revealed understated differences between households.

Practical implications
The study recommends that effort should be made to help increase fish production in the upstream communities. Furthermore, alternative sources of income should be introduced to households in the upstream so they do not become more disadvantaged by the construction of the dam.

Originality/value
The uniqueness of the paper is that it tries to estimate the impact of the construction of the dam on the Volta Basin by taking into consideration the effect of the construction of the dam on the upstream and downstream separately.
An integrated framework for service quality, choice overload, customer involvement and satisfaction
Authors: G. Rejikumar , Sreedharan V. Raja , Saha Raiswa 
Published: October 2019

PurposeConsumer behavior, in the context of general insurance, is worth exploring to formulate growth strategies for insurance sector in India in light of the proposed structural changes. Indian consumers attract global players due to untapped potential and favorable policy measures initiated for higher foreign direct investments. The purpose of this paper is to understand the prevailing level of service quality as perceived by insurance customers in India in the presence of certain contextual antecedents and moderators.Design/methodology/approachPerceptions about constructs like customer risk dispositions, awareness, past experiences, customer involvement, choice overload, service quality and satisfaction of 256 customers were collected using a questionnaire survey. A variance-based structural equation modeling helped to identify significant linkages among the constructs.FindingsIn order to assess service quality levels, a 15-item scale having the infrastructure, employees, agents and product dimensions was found valid and reliable. Choice overload and customer involvement were found to moderate the influence of antecedents and service quality, respectively. The influence of choice overload on quality perceptions is insignificant. The study concludes that the existing risk beliefs are insufficient, and experiences have less predictive contribution to quality perceptions.Research limitations/implicationsTheoretically, this study examined the process of satisfaction development from service quality perceptions. This study offers insights for developing theories to portray future consumer behavior where more dependence of self-service technologies is expected to dominate service delivery mechanisms in insurance. The study informs that general insurance customers in India prefer more diversified products, more customer-centric employees/agents and better technical quality.Practical implicationsThe findings of this study contribute to the understanding of the prevailing insurance consumer behavior in the general insurance sector of India and help insurance service providers in streamlining their strategies for better insurance penetration and reduced lapse rate.Originality/valueThis study helps in understanding the emerging trends in general insurance buying behavior in India.
Fault diagnosis of FDM process based on support vector machine (SVM)
Authors: Hu Huaqing , He Ketai , Zhong Tianlin , Hong Yili 
Published: October 2019

Purpose
This paper aims to propose a method to diagnose fused deposition modeling (FDM) printing faults caused by the variation of temperature field and establish a fault knowledge base, which helps to study the generation mechanism of FDM printing faults.

Design/methodology/approach
Based on the Spearman rank correlation analysis, four relative temperature parameters are selected as the input data to train the SVM-based multi-classes classification model, which further serves as a method to diagnose the FDM printing faults.

Findings
It is found that FDM parts may be in several printing states with the variation of temperature field on the surface of FDM parts. The theoretical dividing lines between different FDM printing states are put forward by traversing all the four-dimensional input parameter combinations. The relationship between the relative mean temperature and the theoretical dividing lines is found to be close and is analyzed qualitatively.

Originality/value
The multi-classes classification model, embedded in FDM printers as an adviser, can be used to prevent waste products and release much work of labors for monitoring.