bluuebunny/crossref_metadata_2025_split huggingface dataset:
Efficacy of Malignant Hyperthermia Association of the United States–Recommended Methods of Preparation for Malignant Hyperthermia-Susceptible Patients Using Dräger Zeus Anesthesia Workstations and Associated Costs
Authors: Neira Victor Manuel , Al Madhoun Waleed , Ghaffari Kamyar , Barrowman Nicholas , Berrigan Patrick , Splinter William 
Published: May 2018

BACKGROUND:
The objective of this study was to assess the efficacy and cost of Malignant Hyperthermia Association of the United States–recommended methods for preparing Dräger Zeus anesthesia workstations (AWSs) for the malignant hyperthermia-susceptible patient.

METHODS:
We studied washout profiles of sevoflurane, isoflurane, and desflurane in 3 Zeus AWS following 3 preparation methods. AWS was primed with 1.2 minimum alveolar concentration anesthetic for 2 hours using 2 L/min fresh gas flow, 500 mL tidal volume, and 12/min respiratory rate. Two phases of washout were performed: high flow (10 L/min) until anesthetic concentration was <5 parts per million (ppm) for 20 minutes and then low flow (3 L/min) for 20 minutes to identify the rebound effect. Preparation methods are as follows: method 1 (M1), changing disposables (breathing circuit, soda lime, CO2 line, and water traps); method 2 (M2), M1 plus replacing the breathing system with an autoclaved one; and method 3 (M3), M1 plus mounting 2 activated charcoal filters on respiratory limbs. Primary outcomes are as follows: time to obtain anesthetic concentration <5 ppm in the high-flow phase, peak anesthetic concentrations in the low-flow phase, and for M3 only, peak anesthetic concentration after 70 minutes of low-flow phase, when activated charcoal filters are removed. Secondary outcomes are as follows: cost analysis of time and resources to obtain anesthetic concentration <5 ppm in each method and a vapor-free Zeus AWS. Sensitivity analyses were performed using alternative assumptions regarding the costs and the malignant hyperthermia-susceptible caseload per year.

RESULTS:
Primary outcomes were as follows: M3 instantaneously decreased anesthetic concentration to <1 ppm with minimal impact of low-flow phase. M1 (median, 88 minutes; 95% confidence interval [CI], 69–112 minutes) was greater than M2 (median, 11 minutes; 95% CI, 9–15 minutes). Means of peak rebound anesthetic concentrations in M1, M2, and M3 were 15, 6, and 1 ppm, respectively (P < .001). Anesthetic concentration increased 33-fold (95% CI, 21–50) after removing charcoal filters (from 0.7 to 20 ppm). The choice of anesthetic agents did not impact the results. Secondary outcomes were as follows: M3 was the lowest cost when the cost of lost operating room (OR) time due to washout was included, and M1 was the lowest cost when it was not included. When the cost of lost OR time due to washout was considered the estimated cost/case of M3 was US $360 (M1, US $2670; M2, US $969; and a “vapor-free” Zeus AWS was US $930). The OR time and equipment costs represent the largest differentiators among the methods.

CONCLUSIONS:
Institutions in which demand for OR time has exceeded capacity should consider M3, and institutions with surplus OR capacity should consider M1.
The Effect of Labor Epidural Analgesia on Breastfeeding Outcomes: A Prospective Observational Cohort Study in a Mixed-Parity Cohort
Authors: Orbach-Zinger Sharon , Landau Ruth , Davis Atara , Oved Oren , Caspi Liron , Fireman Shlomo , Fein Shai , Ioscovich Alexander , Bracco Danielle , Hoshen Moshe , Eidelman Leonid A. 
Published: May 2018

BACKGROUND:
The effect of labor epidural analgesia (LEA) on successful breastfeeding has been evaluated in several studies with divergent results. We hypothesized that LEA would not influence breastfeeding status 6 weeks postpartum in women who intended to breastfeed in an environment that encourages breastfeeding.

METHODS:
In this prospective observational cohort study, a total of 1204 women intending to breastfeed, delivering vaginally with or without LEA, were included; breastfeeding was recorded at 3 days and 6 weeks postpartum. Primary outcome was breastfeeding at 6 weeks, and the χ2 test was used for comparisons between women delivering with and without LEA, according to parity status and previous breastfeeding experience. Total epidural fentanyl dose and oxytocin use (yes/no) were recorded. A multivariable logistic regression was performed to assess factors affecting breastfeeding at 6 weeks.

RESULTS:
The overall breastfeeding rate at 6 weeks was 76.9%; it was significantly lower among women delivering with LEA (74.0%) compared with women delivering without LEA (83.4%; P < .001). Among 398 nulliparous women, 84.9% delivered with LEA, compared with 61.8% of multiparous women (P < .001). Multiparous women (N = 806) were more likely to breastfeed at 6 weeks (80.0% vs 70.6% nullipara; P < .001). Using multivariable logistic regression that accounted for 14 covariates including parity, and an interaction term between parity and LEA use, LEA was significantly associated with reduced breastfeeding at 6 weeks (odds ratio, 0.60; 95% confidence interval, 0.40–0.90; P = .015). In a modified multivariable logistic regression where parity was replaced with previous breastfeeding experience, both as a covariate and in the interaction term, only previous breastfeeding experience was associated with increased breastfeeding at 6 weeks (odds ratio, 3.17; 95% confidence interval, 1.72–5.80; P < .001).

CONCLUSIONS:
In our mixed-parity cohort, delivering with LEA was associated with reduced likelihood of breastfeeding at 6 weeks. However, integrating women’s previous breastfeeding experience, the breastfeeding rate was not different between women delivering with and without LEA among the subset of multiparous women with previous breastfeeding experience. Therefore, our findings suggest that offering lactation support to the subset of women with no previous breastfeeding experience may be a simple approach to improve breastfeeding success. This concept subscribes to the notion that women at risk for an undesired outcome be offered tailored interventions with a personalized approach.
A two-phase response of endothelial cells to hydrostatic pressure
Authors: Prystopiuk Valeria , Fels Benedikt , Simon Caroline Sophie , Liashkovich Ivan , Pasrednik Dzmitry , Kronlage Cornelius , Wedlich-Söldner Roland , Oberleithner Hans , Fels Johannes 
Published: May 2018

ABSTRACT
The vascular endothelium is exposed to three types of mechanical forces: blood flow-mediated shear stress, vessel diameter-dependent wall tension and hydrostatic pressure. Despite considerable variations of blood pressure during normal and pathological physiology, little is known about the acute molecular and cellular effects of hydrostatic pressure on endothelial cells. Here, we used a combination of quantitative fluorescence microscopy, atomic force microscopy and molecular perturbations to characterize the specific response of endothelial cells to application of pressure. We identified a two-phase response of endothelial cells with an initial response to acute (1 h) application of pressure (100 mmHg) followed by a different response to chronic (24 h) application. While both regimes induce cortical stiffening, the acute response is linked to Ca2+-mediated myosin activation, whereas the chronic cell response is dominated by increased cortical actin density and a loss in endothelial barrier function. GsMTx-4 and amiloride inhibit the acute pressure response, which suggests that the ENaC Na+ channel is a key player in endothelial pressure sensing. The described two-phase pressure response may participate in the differential effects of transient changes in blood pressure and hypertension.
A genome-wide RNAi screen identifies MASK as a positive regulator of cytokine receptor stability
Authors: Fisher Katherine H. , Fragiadaki Maria , Pugazhendhi Dhamayanthi , Bausek Nina , Arredondo Maria A. , Thomas Sally J. , Brown Stephen , Zeidler Martin P. 
Published: May 2018

ABSTRACT
Cytokine receptors often act via the Janus kinase and signal transducer and activator of transcription (JAK/STAT) pathway to form a signalling cascade that is essential for processes such as haematopoiesis, immune responses and tissue homeostasis. In order to transduce ligand activation, cytokine receptors must dimerise. However, mechanisms regulating their dimerisation are poorly understood. In order to better understand the processes regulating cytokine receptor levels, and their activity and dimerisation, we analysed the highly conserved JAK/STAT pathway in Drosophila, which acts via a single receptor, known as Domeless. We performed a genome-wide RNAi screen in Drosophila cells, identifying MASK as a positive regulator of Domeless dimerisation and protein levels. We show that MASK is able to regulate receptor levels and JAK/STAT signalling both in vitro and in vivo. We also show that its human homologue, ANKHD1, is also able to regulate JAK/STAT signalling and the levels of a subset of pathway receptors in human cells. Taken together, our results identify MASK as a novel regulator of cytokine receptor levels, and suggest functional conservation, which may have implications for human health.
This article has an associated First Person interview with the first author of the paper.
Successful CRISPR/Cas9 mediated homologous recombination in a chicken cell line
Authors: Antonova Ekaterina , Glazova Olga , Gaponova Anna , Eremyan Aykaz , Zvereva Svetlana , Grebenkina Natalya , Volkova Natalya , Volchkov Pavel 
Published: May 2018

Background: CRISPR/Cas9 system is becoming the dominant genome editing tool in a variety of organisms. CRISPR/Cas9 mediated knock out has been demonstrated both in chicken cell lines and in chicken germ cells that served to generate genetically modified birds. However, there is limited data about CRISPR/Cas9 dependent homology directed repair (HDR) for avian, even in cell culture. Few attempts have been made with integrations in safe harbor loci of chicken genome that induces constitutive expression of the inserted gene. Gene expression under an endogenous promoter would be more valuable than under a constitutive exogenous promoter, as it allows the gene expression to be tissue-specific. Methods: Three gRNAs were chosen to target chicken 3’-untranslated region of GAPDH gene. Cas9-mediated activity in the targeted locus for the gRNAs in DF-1 cells was estimated by T7E1 assay. To edit the locus, the HDR cassette was added along with CRISPR/Cas9. The inserted sequence contained eGFP in frame with a GAPDH coding sequence via P2A and Neomycin resistance gene (neoR) under cytomegalovirus promoter. Correct integration of the cassette was confirmed with fluorescent microscopy, PCR analysis and sequencing. Enrichment of modified cells was done by G418 selection. Efficiency of integration was assessed with fluorescence activated cell sorting (FACS). Results: We have established a CRISPR/Cas9 system to target an endogenous locus and precisely insert a gene under endogenous control. In our system, we used positive and negative selection to enrich modified cells and remove cells with undesirable insertions. The efficiency of CRISPR/Cas9-mediated HDR was increased up to 90% via G418 enrichment. We have successfully inserted eGFP under control of the chicken GAPDH promoter. Conclusions: The approach can be used further to insert genes of interest under control of tissue-specific promoters in primordial germ cells in order to produce genetically modified birds with useful for biotechnological purposes features.
Chemical crosslinking analysis of β-dystroglycan in dystrophin-deficient skeletal muscle
Authors: Murphy Sandra , Zweyer Margit , Mundegar Rustam R. , Swandulla Dieter , Ohlendieck Kay 
Published: May 2018

Background: In Duchenne muscular dystrophy, primary abnormalities in the membrane cytoskeletal protein dystrophin trigger the loss of sarcolemmal linkage between the extracellular matrix component laminin-211 and the intracellular cortical actin membrane cytoskeleton. The disintegration of the dystrophin-associated glycoprotein complex renders the plasma membrane of contractile fibres more susceptible to micro-rupturing, which is associated with abnormal calcium handling and impaired cellular signalling in dystrophinopathy. Methods: The oligomerisation pattern of β-dystroglycan, an integral membrane protein belonging to the core dystrophin complex, was studied using immunoprecipitation and chemical crosslinking analysis. A homo-bifunctional and non-cleavable agent with water-soluble and amine-reactive properties was employed to study protein oligomerisation in normal versus dystrophin-deficient skeletal muscles. Crosslinker-induced protein oligomerisation was determined by a combination of gel-shift analysis and immunoblotting. Results: Although proteomics was successfully applied for the identification of dystroglycan as a key component of the dystrophin-associated glycoprotein complex in the muscle membrane fraction, mass spectrometric analysis did not efficiently recognize this relatively low-abundance protein after immunoprecipitation or chemical crosslinking. As an alternative approach, comparative immunoblotting was used to evaluate the effects of chemical crosslinking. Antibody decoration of the crosslinked microsomal protein fraction from wild type versus the mdx-4cv mouse model of dystrophinopathy revealed oligomers that contain β-dystroglycan. The protein exhibited a comparable reduction in gel electrophoretic mobility in both normal and dystrophic samples. The membrane repair proteins dysferlin and myoferlin, which are essential components of fibre regeneration and counteract the dystrophic phenotype, were also shown to exist in high-molecular mass complexes. Conclusions: The muscular dystrophy-related reduction in the concentration of β-dystroglycan, which forms in conjunction with its extracellular binding partner α-dystroglycan a critical plasmalemmal receptor for laminin-211, does not appear to alter its oligomeric status. Thus, independent of direct interactions with dystrophin, this sarcolemmal glycoprotein appears to exist in a supramolecular assembly in muscle.
FUT2 secretor genotype and susceptibility to infections and chronic conditions in the ALSPAC cohort
Authors: Azad Meghan B. , Wade Kaitlin H. , Timpson Nicholas J. 
Published: May 2018

Background: The FUT2 (fucosyltransferase 2) gene encodes alpha (1,2) fucosyltransferase, which determines blood group secretor status. Being homozygous for the inactive “non-secretor” rs601338(A) allele appears to confer resistance to certain infections (e.g. Norovirus, Rotavirus and Helicobacter pylori) and susceptibility to others (e.g. Haemophilus influenza and Streptococcus pneumonia). Non-secretors also have an increased risk of type 1 diabetes and inflammatory bowel disease. We aimed to determine the association of the FUT2 secretor genotype with infections and chronic conditions in the population-based Avon Longitudinal Study of Parents and Children (ALSPAC). Methods: This study included 7,582 pregnant women from the ALSPAC pregnancy cohort. Personal history of infections (measles, mumps, chicken pox, whooping cough, cold sores, meningitis, genital herpes, gonorrhea and urinary infections) and chronic conditions (kidney disease, hypertension, diabetes, rheumatism, arthritis, psoriasis, hay fever, asthma, eczema and various allergies) were self-reported by standardized questionnaire. FUT2 secretor status was determined from the rs601338 genotype. Results: Overall, 1920 women (25.3%) were homozygous for the FUT2 non-secretor allele (AA). Secretor status was associated with mumps, with 68% of non-secretors experiencing this infection, compared to 48% of secretors (RR, 1.40; 95% CI, 1.34–1.46; p<0.0001). A weaker association was observed for measles infection (76% vs. 72%; RR, 1.05; 95% CI, 1.02–1.09; p=0.0008). Non-secretors also experienced a 39% increased risk of kidney disease (5.4% vs. 3.9%; RR, 1.39; 95% CI, 1.11–1.75; p=0.004). For some conditions, including gonorrhea and arthritis, FUT2 heterozygosity (GA) appeared to confer an intermediate phenotype. There was no strong evidence of association between FUT2 secretor status and other infections or chronic conditions, although statistical power was limited for rare outcomes. Conclusion: Our results identify an association between FUT2 secretor status and kidney disease, and confirm a recently reported association with susceptibility to mumps infection. The clinical implications of these associations warrant further investigation.
Prevention versus Clinical Management of Suicide Attempts in Adolescents: What are the Costs?
Authors: Ortegón Monroy Mónica María , Martínez Céspedes Ángela , Pérez Olmos Isabel 
Published: May 2018

Introduction: Suicide is a worldwide public health problem, and being the youth are among one of the most affected population groups. In Colombia there is no evidence available about the cost of suicide care or prevention. Or attention to those who make suicide attempts assistance or prevention of suicide. This type of analysis is necessary to guide decisions about resource distribution in mental health and to reduce suicideal rates amongst youths in our country. Thus, the purpose of this study is to estimate and compare the mean cost of in-patient care cost treatment cost of youth suicidal youth suicide attempts, with the mean cost of participation in a school-based suicide preventive prevention program in for adolescents. Materials and methods: Medical charts of adolescents hospitalized for suicideal attempts were reviewed, along with as well as registries from adolescent participants in a suicide preventive program in Bogotá in 2010. Resources used were identified and tariff costs were quantified. Results: The average in-patients cost of a teenage suicideal attempt was $1 814 000 Colombian pesos (cop) (n = 39) Colombian pesos, and of $10 307 000 cop (n = 5) Colombian pesos when intensive care was required. The average cost of participation in a prevention ve program was $113 000 cop (n = 24) Colombian pesos per high-risk teenager and of $47 000 cop (n = 101) Colombian pesos for teenagers without suicide such risk. Conclusion: With For the average in- patient cost of one suicidal suicide attempt, 16 high-risk teenagers could be enrolled in a suicide preventive prevention program.
Prevalencia de desórdenes músculo esqueléticos en trabajadores de una empresa de comercio de productos farmacéuticos
Authors: Sánchez Medina Andrés Felipe 
Published: May 2018

Introducción: los desórdenes músculo esqueléticos (DME) tienen origen multifactorial. En Colombia corresponden al principal grupo diagnóstico en procesos relacionados con la determinación de origen y pérdida de capacidad laboral. El objetivo es determinar la relación entre síntomas músculo esqueléticos y factores ocupacionales, sociodemográ cos y de carga física en trabajadores de una empresa de comercio de productos farmacéuticos en Bogotá, Colombia (2015). Materiales y métodos: estudio de corte transversal en 235 trabajadores. Se incluyeron variables sociodemográficas, ocupacionales, carga física y las relacionadas con los síntomas músculo esqueléticos. Se utilizó el cuestionario ERGOPAR. Para el análisis de las variables se utilizó la Prueba Exacta de Fisher, el Odds Ratio (OR) con el Intervalo de Confianza (IC) del 95%. Se realizó el análisis Multivariado con Regresión Logística Binaria. Resultados: la prevalencia de síntomas por segmento relacionados con dme fue de 79,2%, siendo más prevalente en cuello, hombros y columna dorsal (48,1%). Hubo asociación entre factores sociodemográ cos y ocupacionales. Se encontró una asociación entre síntomas en cuello, hombros y/o columna dorsal, columna lumbar, rodillas y pies con factores de carga física por fuerza, postura y movimiento. Conclusión: las posturas bípedas con y sin desplazamiento, inclinaciones de tronco y cabeza, transporte manual de cargas, sexo femenino, antigüedad en el cargo y edad están asociadas conjuntamente con el riesgo para presentar DME.
Scheduling with Testing
Authors: Levi Retsef , Magnanti Thomas , Shaposhnik Yaron 
Published: May 2018

We study a new class of scheduling problems that capture common settings in service environments, in which one has to serve a collection of jobs that have a priori uncertain attributes (e.g., processing times and priorities) and the service provider has to decide how to dynamically allocate resources (e.g., people, equipment, and time) between testing (diagnosing) jobs to learn more about their respective uncertain attributes and processing jobs. The former could inform future decisions, but could delay the service time for other jobs, while the latter directly advances the processing of the jobs but requires making decisions under uncertainty. Through novel analysis we obtain surprising structural results of optimal policies that provide operational managerial insights, efficient optimal and near-optimal algorithms, and quantification of the value of testing. We believe that our approach will lead to further research to explore this important practical trade-off. The online appendix is available at https://doi.org/10.1287/mnsc.2017.2973 . This paper was accepted by Yinyu Ye, optimization.
O Brasil e a proteção complementar humanitária | Brazil and complementary protection
Authors: De Carli Camila 
Published: May 2018

Neste trabalho busca-se compreender como a expressiva imigração de haitianos para o Brasil a partir de 2010 resultou na criação da chamada proteção complementar humanitária. Inicialmente implementada para atender à demanda específica desse grupo de imigrantes, esse tipo de visto temporário foi incorporado à nova Lei de Migração brasileira, que tem como uma de suas diretrizes a acolhida humanitária.ABSTRACTThis paper seeks to understand how the significant immigration of Haitians to Brazil as of 2010 has resulted in the creation of complementary humanitarian protection. Initially implemented to meet the specific demand of this group of immigrants, this type of temporary visa was incorporated into the new Brazilian Migration Law, which has as one of its guidelines the humanitarian reception.Keywords: Brazil, Human Rights, Migrations.Palavras-chave: Brasil, Direitos Humanos, Migrações Recebido em 29 de Janeiro de 2018 | Received January 29, 2018Aceito em 27 de Março de 2018 | Accepted on March 27, 2018DOI
Minzner, Carl. End of an Era: How China’s Authoritarian Revival is Undermining its Rise. Nova York: Oxford University Press, 2018, 255p. ISBN 978–0–19–067208–9
Authors: Carneiro Corrêa Vieira Victor 
Published: May 2018

O texto trata-se de uma resenha do livro "End of an Era: How China’s Authoritarian Revival is Undermining its Rise" de Carl Minzner, publicado pela Oxford University Press em 2018. O autor argumenta que as medidas centralizadores adotadas pelo Partido Comunista da China são um sinal de fim da era das reformas e que sabotariam o crescimento chinês.ABSTRACT Recebido em 18 de Abril de 2018 | Aceito em 09 de Maio de 2018.Received on April 18, 2018 | Accepted on May 09, 2018.DOI
How SMART are your patient goals?
Authors: Stonehouse David 
Published: May 2018

As a follow-up to ‘understanding the nursing process’ ( Stonehouse, 2017 ), this article examines the importance of goal-setting within the planning stage of the nursing process. The acronym ‘SMART’ will be explored, to help guide the support worker in making sure their patients have the correct goals in place. Relevant sections of the Code of Conduct for Healthcare Support Workers and Adult Social Care Workers in England ( Skills for Care and Skills for Health, 2013 ) will be highlighted. Once appropriate and attainable goals are set, the support worker can then deliver quality care to meet these goals in partnership with their patients.