bluuebunny/crossref_metadata_2025_split huggingface dataset:
Antibiotic use in critical illness
Authors: Stewart Samuel D. , Allen Sarah 
Published: April 2019

AbstractObjectiveTo provide a review on the current use of antimicrobials with a discussion on the pharmacokinetic and pharmacodynamic profiles of antimicrobials in critically ill patients, the challenges of drug resistance, the use of diagnostic testing to direct therapy, and the selection of the most likely efficacious antimicrobial protocol.EtiologyPatients in the intensive care unit often possess profound pathophysiologic changes that can complicate antimicrobial therapy. Although many antimicrobials have known pharmacodynamic profiles, critical illness can cause wide variations in their pharmacokinetics. The two principal factors affecting pharmacokinetics are volume of distribution and drug clearance. Understanding the interplay between critical illness, drug pharmacokinetics, and antimicrobial characteristics (ie, time‐dependent vs concentration‐dependent) may improve antimicrobial efficacy and patient outcome.DiagnosisUtilizing bacterial culture and susceptibility can aid in identifying drug resistant infections, selecting the most appropriate antimicrobials, and hindering the future development of drug resistance.TherapyHaving a basic knowledge of antimicrobial function and how to use diagnostics to direct therapeutic treatment is paramount in managing this patient population. Diagnostic testing is not always available at the time of initiation of antimicrobial therapy, so empiric selections are often necessary. These empiric choices should be made based on the location of the infection and the most likely infecting bacteria.PrognosisStudies have demonstrated the importance of moving away from a “one dose fits all” approach to antimicrobial therapy. Instead there has been a move toward an individualized approach that takes into consideration the pharmacokinetic and pharmacodynamic variabilities that can occur in critically ill patients.
Prevention of catheter-associated urinary tract infection in neurological post-operation patients: a best practice implementation project
Authors: Liang Ching-Chuan , Huang Tzyy-Jen , Yang Shu-Hua , Su Jui Yuan , Mu Pei-Fan , Curia Marianne 
Published: April 2019

ABSTRACT

Objective:
The objective of this evidence based implementation project was to promote evidence based practice in the prevention of catheter-associated urinary tract infection (CAUTI) in the neurology and neurosurgery units of a Taipei hospital.

Introduction:
Catheter-associated urinary tract infection has been associated with increased morbidity, mortality, hospital costs and length of stay. Urinary drainage systems are often reservoirs of infection in patients, thus effective prevention of CAUTI requires an evidence-based approach. The CAUTI incidence in the neurosurgery units of the hospital was 1.86–2.69% urinary catheter days, which ranked as medium when compared to the entire hospital.

Method:
A clinical audit was undertaken using the Joanna Briggs Institute Practical Application of Clinical Evidence System tool, based on eight audit criteria that represented best practice recommendations for CAUTI. A baseline audit of the neurology and neurosurgery units was performed, followed by the implementation of multiple strategies throughout a 20-week period. A follow-up audit was undertaken after this to assess changes in practice.

Results:
The post strategy implementation audit results indicated that compliance with clinical guideline recommendations improved considerably. Proper utilization of an appropriate closed drainage system and training of persons maintaining catheters achieved 100% compliance. The guideline recommendation that catheter and drainage bags be changed only when clinically indicated reached 94% compliance. Catheters removed within 24 hours postoperatively improved by more than 50% compliance. Compliance with systemic antimicrobials being clinically indicated and their use justified improved by 25% and documentation on a clinically appropriate indication for ongoing urinary catheterization improved by almost 33.3%.

Conclusions:
The implementation project was successful in improving nurses’ knowledge and skills related to the prevention of CAUTI. A variety of strategies, such as an education program, simple and clear instruments, collaboration with physicians in caring for patients with a high risk of CAUTI, and multiple educational materials can facilitate implementation of evidence based procedures in clinical practice.
Combined treatment of dipeptidyl peptidase‐4 inhibitor and exercise training improves lipid profile in KK/Ta mice
Authors: Tanimura Yuko , Aoi Wataru , Mizushima Katsura , Higashimura Yasuki , Naito Yuji 
Published: April 2019

New Findings
What is the central question of this study?
Exercise for type 2 diabetes patients treated with insulin therapy involves the risk of hypoglycaemia. Dipeptidyl peptidase‐4 (DPP‐4) inhibitors can be effective in combination with exercise because they reduce the incidence of hypoglycaemia. We evaluated the effect of this combination of treatments on hepatic lipid metabolism in diabetic KK/Ta mice.

What is the main finding and its importance?
The combination of a DPP‐4 inhibitor and exercise, which lowers the risk of hypoglycaemia, is useful for improving insulin resistance by inhibiting excess insulin secretion and decreasing hepatic lipid accumulation, validated by downregulated CD36.

AbstractThe role of exercise training in prevention of diabetes and/or dyslipidaemia has been firmly established. Dipeptidyl peptidase‐4 (DPP‐4) inhibitors improve insulin sensitivity and have attracted attention as therapeutics for hepatic lipid accumulation. The effect of a combination of DPP‐4 inhibitor and exercise training on the prevention and treatment of hepatic lipid accumulation is unclear. Here, we investigated whether alogliptin, a DPP‐4 inhibitor, enhances the preventive effect of exercise‐induced hepatic lipid accumulation in diabetic mice. Balb/c and KK/Ta mice were fed a high‐fat diet. Mice were divided into the following five groups: B, Balb/c mice; K, KK/Ta mice; K‐A, KK/Ta mice with alogliptin (0.01%); K‐Ex, KK/Ta mice with exercise training (3 days week−1, 15–20 m min−1 for 30 min); and K‐Ex+A, KK/Ta mice with alogliptin and exercise training (n = 8 or 9 mice per group). After 8 weeks, glucose, insulin and triglyceride concentrations in the blood and triglyceride levels in the liver were significantly lower in the K‐Ex+A group than in the K group. The liver expression level of PPAR‐γ in the K group was significantly higher than that in the other groups. Additionally, the liver CD36 expression level was significantly lower in the K‐Ex+A and B groups than in the K group. Thus, combined therapy of a DPP‐4 inhibitor with exercise training was effective against high‐fat diet‐induced hepatic lipid accumulation in KK/Ta mice. The results of this study provide useful support for the practice of safe exercise therapy even in diabetic patients who require treatment with a DPP‐4 inhibitor.
Long‐term depression of presynaptic cannabinoid receptor function at parallel fibre synapses
Authors: Yang Ying , Kreko‐Pierce Tabita , Howell Rebecca , Pugh Jason R. 
Published: April 2019

Key points
Inhibition of synaptic responses by activation of presynaptic cannabinoid type‐1 (Cb1) receptors is reduced at parallel fibre synapses in the cerebellum following 4 Hz stimulation.
Activation of adenylyl cyclase is necessary and sufficient for down‐regulation of Cb1 receptors induced by 4 Hz stimulation.
4 Hz stimulation reduces Cb1 receptor function by (i) increasing the rate of endocannabinoid clearance from the synapse and (ii) decreasing expression of Cb1 receptors.
AbstractCannabinoid type‐1 receptors (Cb1R) are expressed in the presynaptic membrane of many synapses, including parallel fibre‐Purkinje cell synapses in the cerebellum, where they are involved in short‐ and long‐term plasticity of synaptic responses. We show that Cb1R expression itself is a plastic property of the synapse regulated by physiological activity patterns. We made patch clamp recordings from Purkinje cells in cerebellar slices and assessed Cb1R activity by measuring depolarization‐induced suppression of excitation (DSE). We find that DSE is normally stable at parallel fibre synapses but, following 4 Hz stimulation, DSE is persistently reduced and recovers more rapidly. Using a combination of electrophysiology, pharmacology and biochemistry, we show that changes in DSE are a result of the reduced expression of Cb1Rs and increased degradation of endocannabinoids by monoacylglycerol lipase. Long‐term changes in presynaptic Cb1R expression may alter other forms of Cb1R‐dependent plasticity at parallel fibre synapses, priming or inhibiting the circuit for associative learning.
Non-accidental harms (‘abuse’) in athletes with impairment (‘para athletes’): a state-of-the-art review
Authors: Tuakli-Wosornu Yetsa A , Sun Qisi , Gentry Mark , Ona Ayala Kimberly E , Doolan Fiona C , Ottesen Taylor D , Caldwell Blake , Naushad Nida , Huang Patrick , Kirby Sandi 
Published: April 2019

ObjectivePara athletes reap significant health benefits from sport but are vulnerable to non-accidental harms. Little is known about the types and impacts of non-accidental harms Para athletes face. In this literature review, we summarise current knowledge and suggest priorities for future research related to non-accidental harms in Para athletes.DesignSix electronic databases were searched between August and September 2017. 2245 articles were identified in the initial title/abstract review, and 202 records were selected for full-text review following preliminary screening. Two independent examiners evaluated each full text, and eight citations were selected based on inclusion/exclusion criteria.Data sourcesMEDLINE, Embase, PsycInfo, Cumulative Index to Nursing and Allied Health Literature, Scopus and Academic Search Premier.Eligibility criteria for selecting studiesInclusion criteria: (A) human participants; (B) written in English; (C) descriptive, cohort and case series, case–control, qualitative, mixed methods studies and all clinical trials; and (D) data pertain to harassment/abuse of youth, recreational, collegiate, national-level and/or elite-level athletes with a physical and/or intellectual impairment.ResultsMost studies focused on young, visually impaired athletes and approximately half of all studies described high rates of bullying and its social implications. One study confirmed remarkably high rates of psychological, physical and sexual harms in Para athletes, compared with able-bodied peers.ConclusionsBullying in young, visually impaired athletes is described most commonly in the available literature. Due to the limited amount of data, the prevalence of non-accidental harms in Para athletes remains unclear and information on trends over time is similarly unavailable.
Radiofrequency ablation of genicular nerves prior to total knee replacement has no effect on postoperative pain outcomes: a prospective randomized sham-controlled trial with 6-month follow-up
Authors: Walega David , McCormick Zachary , Manning David , Avram Michael 
Published: April 2019

Background and objectivesRefractory chronic knee pain from osteoarthritis (OA) is commonly treated with total knee arthroplasty (TKA). TKA can be associated with severe postoperative pain and persistent postsurgical knee pain. Poorly controlled postoperative pain can negatively effect functional outcomes following TKA, and effective opioid-sparing analgesia is key to the ideal recovery. Genicular nerve radiofrequency ablation (GN-RFA) has been shown in several trials to be clinically effective in patients with severe refractory knee pain from OA. We aimed to assess if preoperative GN-RFA would improve postoperative pain outcomes following TKA.MethodsThis was a sham-control prospective clinical trial in which blinded participants were randomized to image-guided GN-RFA or a simulated sham procedure 2-6 weeks prior to elective TKA. Outcomes were assessed at 48 hours and 1, 3 and 6 months following TKA.ResultsSeventy participants enrolled in this study. As compared with sham controls, GN-RFA had no treatment effect on postoperative opioid consumption, pain or functional measures at any time point.ConclusionsCooled RFA of the superior lateral, superior medial and inferomedial genicular nerves, when performed 2–6 weeks prior to elective TKA as part of a multimodal postoperative pain management regime, had no measurable effect on postoperative opioid use, analgesia use or function in the 48 hours following surgery. In addition, we found no longer term effect on outcome measures 1, 3 and 6 months after TKA.Trial registration numberNCT02746874.
Genioglossal response to mechanical vibrations of the mandible and the submandibular muscles
Authors: Erdogan Ferhat , Sahin Mesut 
Published: April 2019

The extrinsic tongue muscles are activated in coordination with pharyngeal muscles to dilate the airways as needed during breathing. The genioglossus (GG) activity is known to be modulated by several reflexes evoked via the mechanoreceptors of the upper airways. The primary objective of this paper was to investigate the effectiveness of activating these reflex pathways using mechanical stimulation of the mandible or the submandibular muscles. In eight healthy subjects, 3-s long, 5-mm vertical mechanical vibrations were delivered at 8 and 12 Hz to the lower jaw in a seated position, while the GG EMG was recorded using a custom-made sublingual electrode, along with the activity of the masseter (MS) and mylohyoid (MH). All three muscle activities were significantly higher during stimulation compared with the baseline ( P < 0.02), and the increase was larger at 12 Hz versus 8 Hz ( P < 0.02). All three muscle responses had components that synchronized with the mechanical stimuli, but those of MS were much more strongly phase-locked to the vibrational cycle. In 10 healthy subjects, we also applied mechanical vibrations to the submandibular muscles at three different stimulation intensities, while subjects were lying in a supine position. The GG activity increased significantly above the baseline ( P = 0.026) in 9 out of 10 subjects, and the elevated activity persisted after termination of the stimulus for a few seconds. The results demonstrate that GG muscle responses can be evoked with mechanical vibrations applied to the lower jaw or the submandibular muscles in healthy subjects during wakefulness. NEW & NOTEWORTHY The evoked responses observed in the genioglossus (GG) activity during mechanical vibrations of the lower jaw or the submandibular muscles may lead to therapeutic applications for improving the patency of airways during sleep. The presence of these GG reflexes may also explain a mechanism by which the vibrations produced during snoring can help the airways stay open in individuals who may otherwise have obstructed airways in sleep.
Unreliable Estimation of Aortic Pulse Wave Velocity Provided by the Mobil‐O‐Graph Algorithm‐Based System in Marfan Syndrome
Authors: Salvi Paolo , Furlanis Giulia , Grillo Andrea , Pini Alessandro , Salvi Lucia , Marelli Susan , Rovina Matteo , Moretti Francesco , Gaetano Raffaella , Pintassilgo Inês , Faini Andrea , Fabris Bruno , Carretta Renzo , Parati Gianfranco 
Published: April 2019

Background
Several devices have been proposed to assess arterial stiffness in clinical daily use over the past few years, by estimating aortic pulse wave velocity (PWV) from a single measurement of brachial oscillometric blood pressure, using patented algorithms. It is uncertain if these systems are able to provide additional elements, beyond the contribution carried by age and blood pressure levels, in the definition of early vascular damage expressed by the stiffening of the arterial wall.

Methods and Results

The aim of our study was to compare the estimated algorithm‐based PWV values, provided by the Mobil‐O‐Graph system, with the standard noninvasive assessment of aortic PWV in patients with Marfan syndrome (ie, in subjects characterized by premature aortic stiffening and low blood pressure values). Aortic stiffness was simultaneously evaluated by carotid‐femoral PWV with a validated arterial tonometer and estimated with an arm cuff–based ambulatory blood pressure monitoring Mobil‐O‐Graph device on 103 patients with Marfan syndrome (50 men; mean±
SD
age, 38±15 years). Aortic PWV, estimated by the Mobil‐O‐Graph, was significantly (
P
<0.0001) lower (mean±
SD,
6.1±1.3 m/s) than carotid‐femoral PWV provided by arterial tonometry (mean±
SD
, 8.8±3.1 m/s). The average of differences between
PWV
values provided by the 2 methods (±1.96×SD) was −2.7±5.7 m/s.

Conclusions
The Mobil‐O‐Graph provides PWV values related to an ideal subject for a given age and blood pressure, but it is not able to evaluate early vascular aging expressed by high PWV in the individual patient. This is well shown in patients with Marfan syndrome.
The Development of Thanatology in Japan and its Position in East Asia, with a Focus on Thanatology’s Relationship to Religion
Authors: Ikezawa Masaru 
Published: April 2019

AbstractThis article deals with the religiosity of thanatology in Japan, which was introduced under the name shiseigaku (death and life studies) in the 1980s. Although many religious believers and scholars of religious studies have been connected with this field in Japan, religions are not necessarily highlighted by studies of Japanese thanatology. The Japanese pioneers of thanatology did not have clear ideas on the positioning of religion in this field, but they unconsciously merged their own faith into their discipline. Later, other scholars tried to re-construct this field by weakening its religious orientation. The Japanese case is in contrast to Taiwanese thanatology, in which the pioneers tried to position religious beliefs as the essential element of the field. Indeed, this difference was partially influenced by the religious traditions of both societies, but other factors such as the historical processes of this academic field and the private beliefs of researchers were important causes of that difference.
“Looking for the Zohar in the New Testament”: The Lost Messias puer of Christian Knorr von Rosenroth between Kabbalah and Biblical Studies
Authors: Vileno Anna M. , Wilkinson Robert J. 
Published: April 2019

AbstractChristian Knorr von Rosenroth was the author of a work called Messias puer, which universally has been considered lost. This article seeks to demonstrate that a manuscript currently catalogued as Historiæ evangelicæ initium is, in fact, this lost work of Knorr. Knorr’s involvement in the study of the Jewish mystical tradition enabled him to develop new and original insights in his reading of the New Testament. Furthermore, his use of comparative philology points to him as a significant precursor in the development of biblical studies.
A Missed Opportunity? Unilateral Declarations by the European Union and the European Court of Justice’s Venezuelan Fisheries Judgment
Authors: Kassoti Eva , Vatsov Mihail 
Published: April 2019

Abstract
The EU has entered into many binding undertakings (international agreements) with third States on access to fisheries resources. In the Venezuelan Fisheries case, the ECJ was, for the first time, confronted with an EU unilateral declaration granting fishing opportunities in EU waters to Venezuela-flagged vessels. We argue, contrary to ECJ’s conclusion, that the declaration is a binding unilateral act and not an international agreement. This case is important for the burgeoning debate on the ECJ’s approach to international law. It represents a missed opportunity for the ECJ to clarify its previous case-law on the broad concept of ‘international agreement’ and align it with relevant international jurisprudence and doctrine. More fundamentally, it is a missed opportunity for the ECJ to truly develop and shape international law practice and doctrine on unilateral acts by international organisations – an omission that does not comport with the EU’s self-projection as an internationally engaged polity.
The Tightrope to Tomorrow: Reputational Security, Collective Vision and the Future of Public Diplomacy
Authors: Cull Nicholas J. 
Published: April 2019

Summary
A global crisis exists today, driven by a toxic mix of populist politics and disruptive social media. For public diplomacy to respond, it must remain true to its core principles: 1) begin by listening; 2) connect to policy; 3) do not perform for domestic consumption; 4) look for credibility and partnership; as 5) the most credible voice is not your own. 6) Public diplomacy is not always ‘about you’; but 7) is everyone’s business. These core principles must now be supplemented by the following future needs: 1) reframing soft power as a new category of reputational security, relevant to the survival of vulnerable states; 2) contest disinformation and engage in information disarmament; 3) counter victim narratives; and 4) articulate a compelling vision of the future. This article refuses to abandon an element of optimism and continues to see hope in the ability of humans to connect effectively with one another.
Introduction to the Special Issue on Journalism, Media and Religion: How News Media Ascribe Meanings to the Terms “Sacred”, “Secular” and “Authority”
Authors: Zeiler Xenia , Radde-Antweiler Kerstin 
Published: April 2019

Religious topics are increasingly addressed in journalism worldwide, including newspapers, television, radio and Internet news. The high visibility of religion in society and, inseparably connected to this, the increasing reappearance of religious themes in news media have come to the attention of recent academic research as well.This special issue offers new research material on the topic but also a new design and system of organizing the field. The novel approach of this special issue is threefold: (1) it focuses specifically and only on journalistic media; (2) it discusses a variety of religious and geographical contexts through case studies; and (3) it introduces a new structure of discussing journalism and religion by analyzing the three key concepts “sacred”, “secular” and “authority” through the lens of Laclau’s (1996, pp. 36) approach to terms as empty signifiers. The articles analyze how news media ascribe meanings to these terms.
Warm Rain Rates from AMSR-E 89-GHz Brightness Temperatures Trained Using CloudSat Rain-Rate Observations
Authors: Eastman Ryan , Lebsock Matthew , Wood Robert 
Published: April 2019

AbstractCollocated CloudSat rain rates and Advanced Microwave Scanning Radiometer for EOS (AMSR-E) 89-GHz brightness temperature Tb retrievals allow for the development of an algorithm to estimate light, warm rain statistics as a function of AMSR-E 89-GHz Tb for shallow marine clouds. Four statistics are calculated from CloudSat rainfall rate estimates within each 4 km × 6 km Tb pixel sampled by both sensors: the probability of rainfall, the mean rain rate, the mean rate when raining, and the maximum rain rate. Observations with overlying cold clouds are removed from the analysis. To account for confounding variables that modify Tb, curves are fit to the mean relationships between Tb and these four statistics within bins of constant column-integrated water vapor from AMSR-E, and sea surface temperature and wind speed from reanalysis grids. The coefficients that define these curves are then applied to all available AMSR-E Tb retrievals to estimate rain rate throughout the eastern subtropical oceans. A preliminary analysis shows strong agreement between AMSR-E rain rates and the CloudSat training dataset. Comparison with an existing microwave precipitation product shows that the new statistical product has an improved sensitivity to light rain. A climatology for the year 2007 shows that precipitation rates tend to be heavier where the sea surface is warmer and that rain is most frequent where stratocumulus transitions to trade cumulus in the subtropics.