bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comparative Effects of Sodium Bicarbonate and Intravenous Lipid Emulsions on Reversing Bupivacaine-Induced Electrophysiological Toxicity in a Porcine Experimental Model
Authors: Zaballos Matilde , Callejo David , Sevilla Raul , Quintela Oscar , López-Menchaca Ramiro , Melone Arturo , Varela Olalla , Anadón Baselga Mª José , Almendral Jesús 
Published: October 2018

BACKGROUND:
Bupivacaine cardiotoxicity mainly manifests as inhibition of the cardiac sodium channel, which slows conduction, particularly at the ventricular level. Experimental studies have demonstrated that intravenous lipid emulsions (ILEs) can reduce the cardiotoxic effects of bupivacaine, but the extent of these effects is controversial. Sodium bicarbonate (B) represents the standard treatment of toxicity related to sodium channel–blocking drugs. The aim of this study was to compare the effects of ILEs and B on the speed of recovery from bupivacaine-induced effects on the electrocardiographic parameters.

METHODS:
Bupivacaine 4 mg/kg was administered to 24 anesthetized pigs. Three minutes after delivering the bupivacaine bolus, the animals were given the following: ILE 1.5 mL/kg followed by 0.25 mL/kg/min (ILE group) and B 2 mEq/kg followed by 1 mEq/kg/h (B group). Controls (C group) were given saline solution, 50 mL followed by 1 mL/kg/h. Electrophysiological parameters were evaluated in sinus rhythm and during right ventricular pacing at several time intervals up to 30 minutes. Data were analyzed as the area under the curve (AUC) for the first 10 minutes (AUC10) or 30 minutes (AUC30).

RESULTS:
Bupivacaine increased the sinus cycle length, PR interval, and QRS duration. AUC30 of the sinus rhythm QRS duration after antidote administration was significantly different among the 3 groups (P = .003). B group experienced faster recovery from intoxication than the C group (AUC10, P = .003; AUC30, P = .003) or the ILE group (AUC10, P = .018). During the first minute, 50% of the B group (versus 0% of the ILE and C groups) had recovered >30% of QRS duration (P = .011). The trend toward faster recovery in the ILE group than in the C group did not reach significance (AUC10, P = .23; AUC30, P = .06). Effects on the paced QRS duration at a rate of 150 bpm were more intense but with similar results (B versus C group: AUC10, P = .009; AUC30, P = .009; B versus ILE: AUC10, P = .015; AUC30, P = .024). The recovery process of the paced QRS tended to be slower for all antidotes.

CONCLUSIONS:
In a closed-chest swine model, B was an effective treatment for electrophysiological alterations caused by established bupivacaine toxicity. At clinical doses, B ameliorated bupivacaine electrocardiographic toxicity faster than ILE. Use-dependent effects of bupivacaine are prominent and delay the effects of both antidotes, but B produces faster recovery than ILE.
Pharmacokinetics of Cefazolin and Vancomycin in Infants Undergoing Open-Heart Surgery With Cardiopulmonary Bypass
Authors: Ingrande Jerry , Gutierrez Kathleen , Lemmens Hendrikus J. , Verma Archana , Nicolau David P. , Sutherland Christina A. , Ramamoorthy Chandra 
Published: October 2018

BACKGROUND:
Gram-positive bacteria account for nearly three-quarters of all surgical site infections. Antibiotic prophylaxis against these bacteria with cephalosporins or, in select circumstances, with vancomycin is considered standard of care for prevention of surgical site infections. There is little evidence to describe the optimal dosing regimen for surgical site infection prophylaxis in infants undergoing cardiac surgery, and a great deal of institutional variability exists in dosing prophylactic antibiotics. We designed this study to describe an optimal dose regimen for cephalosporin and vancomycin based on pharmacokinetic evidence for infant open-heart surgery on cardiopulmonary bypass.

METHODS:
Two separate cohorts of infants undergoing cardiac surgery with cardiopulmonary bypass were evaluated. Plasma concentrations of vancomycin (cohort 1, N = 10) and cefazolin (cohort 2, N = 10) were measured, and mixed-effects pharmacokinetic models were constructed for each drug. Simulations of various dosing regimens were performed to describe an appropriate dosing regimen necessary to maintain antibiotic concentrations above the susceptibility cutoff for staphylococci.

RESULTS:
Both cefazolin and vancomycin plasma concentration versus time profiles were characterized by a 2-compartment model. Subject weight was a significant covariate for V1 for vancomycin. Subject age was a significant covariate for V1 for cefazolin. Cardiopulmonary bypass did not influence concentration versus time profiles. Simulations demonstrated that a 1-hour vancomycin infusion (15 mg·kg−1), repeated every 12 hours and a 10-minute infusion of cefazolin (30 mg·kg−1), repeated every 4 hours maintained plasma concentrations above 4 μg·mL−1 and 16 μg·mL−1, for vancomycin and cefazolin, respectively. Both concentrations are above the minimum inhibitory concentration 90 for most susceptible staphylococci.

CONCLUSIONS:
Prophylactic treatment of vancomycin 15 mg·kg−1 infused >1 hour with 12-hour redosing and cefazolin 30 mg·kg−1 infused >10 minutes with 4-hour redosing will maintain serum levels of each antibiotic above the susceptibility cut-offs for susceptible staphylococci in infants undergoing cardiac surgery. Cefazolin levels may be adequate for some, but not all, Gram-negative bacteria. The effect of cardiopulmonary bypass on pharmacokinetics is negligible.
A novel mutation in the NADH dehydrogenase (ubiquinone) 1 alpha subcomplex 4 (Ndufa4) gene links mitochondrial dysfunction to the development of diabetes in a rodent model
Authors: Yagil Chana , Varadi-Levi Ronen , Yagil Yoram 
Published: October 2018

ABSTRACT
The mechanisms underlying diabetes remain unresolved. The Cohen diabetic rat represents a model of diet-induced diabetes, in which the disease is induced after exposure to a diabetogenic diet (DD) in the diabetes-sensitive (CDs/y) but not in the -resistant (CDr/y) strain. Diet imposes a metabolic strain that leads to diabetes in the appropriate genetic background. We previously identified, through whole-genome linkage analysis, a diabetes-related quantitative trait locus on rat chromosome 4 (RNO4), which incorporates NADH dehydrogenase (ubiquinone) 1 alpha subcomplex 4 (Ndufa4), a nuclear gene that affects mitochondrial function. Here, we sequenced the gene and found a major deletion in CDs/y that leads to lack of expression of the NDUFA4 protein that has been reported to be involved in the activities of mitochondrial complexes I and IV. In the absence of NDUFA4 in the diabetic CDs/y on DD, complex I activity is reduced in comparison to that in nondiabetic CDs/y on regular diet and CDr/y on either diet; complex IV activity is reduced in both strains provided DD, and thus as a result of diet and unrelated to the gene mutation. ATP fails to increase in diabetic CDs/y in response to DD, in comparison to nondiabetic CDr/y on DD. Plasma malondialdehyde levels are elevated in CDs/y on DD, whereas SOD1 and SOD2 levels fail to increase, indicating increased oxidative stress and inability of the pancreas to generate an appropriate antioxidative stress response. These findings suggest that the Ndufa4 mutation in CDs/y on DD is directly associated with mitochondrial dysfunction, which we attribute to the lack of expression of NDUFA4 and to diet, and which prevents the anticipated increase in ATP production. The resulting enhanced oxidative stress impairs the ability of the pancreas to secrete insulin, leading to the development of diabetes. This is the first demonstration of an inherited mutation in a nuclear gene that adversely affects mitochondrial function and promotes diet-induced diabetes.
Principals’ utilization of external stakeholders in entrepreneurship education – Evidence from the general education
Authors: Hämäläinen Minna , Ruskovaara Elena , Pihkala Timo 
Published: October 2018

Artikli eesmärk on uurida koolijuhtide tegevust ettevõtlusõpet toetavate võrgustike arendamisel. Uurimuses keskendume sellele osale koolijuhtide tegevusest, mis on seotud ettevõtlusõppe arendamisega koolides. Täpsemalt öeldes vaatleme, kuidas kaasavad koolijuhid väliseid huvirühmi koolide tegevusse. Uurimuse ajendiks sai asjaolu, et kuigi ettevõtlusõpet toetavad välised huvirühmad on olemas, ei kasuta koolijuhid ja koolid pakutavaid võimalusi täiel määral ära. Meie arvates võib kooliväliste huvirühmade kaasamine sõltuda koolijuhtide isikuomadustest, mistõttu uurime, kas ja kuidas mõjutab koolijuhtide taust kooliväliste huvirühmade kaasamist. Sellele lisaks proovime selgusele jõuda, kuidas mõjutab koolijuhtide osalemine ettevõtlusõppekoolitusel kooliväliste huvirühmade kaasamist. Uurimismeetodina kasutame dispersioonanalüüsi ja lineaarset regressioonanalüüsi. Valim koosneb 173 Soome üldhariduskooli koolijuhist. Artikliga täiendame ettevõtlusõppele pühendatud teaduskirjandust, analüüsides ettevõtlusõpet toetavaid kooliväliseid huvirühmi. Keskendume eeskätt koolijuhi rollile selles protsessis. Artikkel pakub empiirilisi tõendeid selle kohta, kuivõrd olulist osa täidab koolijuhtide koolitamine väliste huvirühmade kaasamisel ettevõtlusõppesse.
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Conservation management for forest fungi in Estonia: the case of polypores
Authors: Lõhmus Asko , Vunk Eike , Runnel Kadri 
Published: October 2018

Conservation management for fungi has lagged behind animal and plant conservation, and remains largely restricted to protecting known locations of few conspicuous threatened species. We used Estonian polypores as an example of how conservation options can be systematically screened, based on the Red List of threatened species and in co-operation with practitioners. For a total of 61 species, we identified a broad range of management options representing diverse approaches (site protection; prescriptions of land use; protection of individuals; special management; protection via umbrella species). The results demonstrated the merits of systematic and multi-disciplinary assessments for fungal conservation and setting related research priorities. Our assessment also supported a theoretical expectation that some ecosystem conservation strategies should be explicitly designed based on functionally important groups of fungi. The advancement of fungal conservation appears largely dependent on co-operation between mycologists, conservationists and managers.

Eesti metsade seenestiku looduskaitsevõtted torikseente näitel Seenestiku looduskaitseks kasutatav võttestik on märksa halvemini välja arendatud kui loomade ja taimede puhul ning hõlmab peamiselt silmatorkavate ohustatud liikide leiukohtade kaitset. Töös kirjeldatakse Eesti torikseente näitel, kuidas sobivaid looduskaitsevõtteid saab süstemaatiliselt valida – lähtuvalt ohustatud liikide nimestikust ja koostöös looduskaitsepraktikutega. Kokku eristati 61 ohustatud torikseeneliigi kaitseks lai valik võtteid, mis hõlmasid erinevaid võimalusi alade kaitseks, üldisi maakasutusjuhiseid, isendite kaitset, intensiivseid kaitsevõtteid ja kaitset teiste liikide (katusliikide) kaudu.Tulemused näitavad süstemaatilise ja multidistsiplinaarse analüüsi efektiivsust seente kaitse ja sellega seotud uuringute planeerimisel. Analüüs kinnitas ka teoreetilist, torikseente funktsionaalsest tähtsusest lähtuvat eeldust, et mõned ökosüsteemide kaitse võttestikud tuleks kujundada just seente ökoloogiast lähtuvalt. Seenestiku looduskaitse peamine edenemistingimus paistab niisiis olevat koostöö mükoloogide, looduskaitseteadlaste ja -praktikute vahel.
A lesson in urban mycology: Critically Endangered polypore Trametes suaveolens (Basidiomycota) re-discovered in Estonia
Authors: Runnel Kadri , Järve Sulev , Lõhmus Asko 
Published: October 2018

The conspicuous, mostly willow-inhabiting polypore Trametes suaveolens is a threatened species in Northern Europe. In Estonia it is listed as Critically Endangered, and has not been found since 1984. We report an apparently viable population discovered in Central Tallinn, inhabiting old Salix fragilis and S. alba trees and stumps along ca. 1.5 km of the Baltic seashore. The host trees are prone to removal due to city development and park care reasons. We discuss potential conservation measures for sustaining this unique population in the urban conditions.

Pajutagel (Trametes suaveolens) Eestis taasleitud Peamiselt remmelgatel silmatorkavaid viljakehi moodustav pajutagel (Trametes suaveolens) on Põhja-Euroopas ohustatud liik. Eestis on selle liigi seisund hinnatud kriitiliseks ja viimane dokumenteeritud leid pärineb 1984. aastast. Siinses artiklis kirjeldatakse Tallinnast avastatud populatsiooni, mis asustab u. 1,5 km mereäärsel lõigul rabeda remmelga (Salix fragilis) ja hõberemmelga (S. alba) vanu elus puid ja kände. See asurkond oli 2018. aastal küll elujõuline, kuid tema elupaika ohustavad linna arendustegevus ja pargihooldus. Artiklis esitatakse soovitusi nii pajutagla säilitamiseks Tallinnas kui ka üldiselt puitulagundavate ohustatud seeneliikide kaitseks linnatingimustes.
El rol de la proximidad en la cooperación universidad-empresa-gobierno: el caso agroalimentario de la región de Coquimbo Chile
Authors: Chacana Ojeda Marcelo Andrés , Geldes González Cristian , Osorio Zelada Hugo 
Published: October 2018

El presente estudio propone el enfoque de la proximidad de la geografía económica sobre la base teórica del modelo de la Triple Hélice para determinar las rela­ciones de cooperación entre la Univer­sidad – Empresa – Gobierno (U-E-G), la investigación se presenta a través de un estudio de caso del sector agroalimentario de la Región de Coquimbo Chile, el que pretende ser una aproximación respecto de la importancia de la proximidad para la Triple Hélice en la vincu­lación y cooperación para la creación de nuevos conocimientos, y de actividades de innovación. Para determinar dicha relación, se utilizaron los test estadísticos Chi-cuadrado con sus correspondientes medidas de asociación para variables cualitativas y Kruskal – Wallis para variables ordinales. Se puede señalar que el principal elemento que dificulta la cooperación de la Triple Hélice es el presentar visiones y objetivos diferentes entre las distintas organizaciones. En cuanto a la dimensión de la proximidad que favorece la cooperación Universidad – Empresa – Gobierno en el sector agroalimentario de la Región de Coquimbo a un nivel de significancia de α = 0,1, resulto ser la dimensión social.
Just ask ‘could this be sepsis?’
Authors: Gillway Daniel , Cheng Leo 
Published: October 2018

It is not uncommon for patients with odontogenic and non-odontogenic infection to present in general dental practice. Untreated infection can lead to life-threatening sepsis. This article aims to advise general dental practitioners on the relevance of sepsis and highlight the recent published NICE guidelines for interpretation in the dental setting. Sepsis is defined as a life-threatening organ dysfunction due to a deregulated host response to infection. It is paramount for dental professionals to understand head and neck infection, underlying systemic infection and concepts of fascial space infection. It is also essential to know the warning signs or ‘red flags’ of emerging sepsis. CPD/Clinical Relevance: Following the recent published NICE guidelines and public awareness campaigns regarding sepsis, it is vitally important to raise awareness of the potential for sepsis to be identified in the general dental practice setting.
Fixed versus removable appliances – which one to choose?
Authors: Elhussein Mustafa , Sandler Jonathan 
Published: October 2018

The use of removable appliances in modern clinical orthodontic practice can generally be considered an out-dated treatment modality for managing malocclusions. Their use and popularity has declined considerably largely due to their inefficiency at achieving significant quality tooth movement. There are, however, a couple of specific indications where removable appliances come into their own. This article will present and discuss several clinical scenarios where one technique clearly has significant advantages over the other. CPD/Clinical Relevance: Orthodontists and general dental practitioners (GDPs) should be aware of the situations where removable appliances provide a solution in modern clinical orthodontics practice, but also when the fixed counterpart will provide a much more efficient and effective method of moving teeth.
Pre-eruptive diagnosis and management of occlusal dens evaginatus in premolar teeth
Authors: Naini Farhad B , Levisianos Ioannis , Foo Lee , Gill Daljit S 
Published: October 2018

Dens evaginatus is an uncommon dental aberration that occurs primarily on the occlusal surfaces of premolar teeth. Developmentally, it is similar to a talon cusp, though the latter manifests on the palatal or lingual surfaces of anterior teeth. Its anatomical location is often the central fossa of the associated tooth; it can vary significantly in size and can be present symmetrically in the ipsilateral and contralateral quadrants. Histologically, the enamel protuberance may contain dentinal and pulpal tissue. If early, ideally pre-eruptive diagnosis is not made, there is a significant risk that, on eruption, these protuberances will shear off under occlusal forces, exposing the pulp, and potentially leading to loss of teeth in an otherwise healthy dentition. Therefore, its clinical implications are significant to the general dental practitioner, the paediatric dentist, the orthodontist and the restorative dentist. CPD/Clinical Relevance: This review article aims to summarize the available dental literature and illustrate the appropriate management of a patient with dens evaginatus.
Communication is more than just a conversation: family members' satisfaction with end-of-life care
Authors: Jóhannesdóttir Silja , Hjörleifsdóttir Elísabet 
Published: October 2018

Aim: The main aim of this study was to investigate family member's experiences of communicating with health professionals (HP) during end-of-life care in acute medical wards and a nursing home. Methods: A qualitative approach using 19 semi-structured interviews to collect data was used. The text was analysed using a content analysis methodology, extracting content that reflected family member's experiences of end-of-life care in acute medical wards, and a nursing home in Iceland. Results: Four themes were identified as contributing to favourable communication with HPs in end-of-life care: establishing a relationship; flow of information; environment; acceptance at the time of death. Conclusion: Findings suggested that the context of communication in end-of-life care is more than just a conversation. It includes health professional's appearances, decision-making and respect. Satisfactory communication is a necessary factor of quality of care and the fundamental aspect of the establishment of a positive interpersonal relationship.
Development and implementation of the Steps to Success Palliative Care programme in residential care homes for people with a learning disability in England
Authors: Kinley Julie , Denton Lilette , Scott Sharon 
Published: October 2018

Background: For health and social care services to meet the needs of a growing and ageing population they need to respond appropriately. This response is only going to be possible if attention is paid to the individuals within it. This includes those people living with a learning disability (LD). Aims: To develop and implement a palliative care programme that would meet the needs of people with a LD, their families and care home staff. Methods: A palliative care programme and resource folder was created following a literature review and meetings with LD and specialist palliative care experts, organisations and care home managers. This folder was further developed collaboratively throughout the programme's implementation. Findings: 39 homes were recruited and 86% completed the programme. Conclusions: This programme enabled the identification, assessment and management of the health and social care needs of people living and dying in a care home with a LD.
Periodontal exams for adult orthodontic patients
Authors: Greer Anna C , Murray Alison M , Vere Joseph W 
Published: October 2018

Adult patients are increasingly interested in having orthodontic treatment but many of these patients have periodontal problems. A periodontal examination should involve a basic periodontal examination (BPE) as well as the identification of any mobility, recession and gingival overgrowth. Each BPE code indicates different investigations and treatment. The cause of any mobility, recession and gingival overgrowth needs to be identified and then treated appropriately. Periodontal treatment may involve input from the patient's general dental practitioner or, if more complex treatment is required, referral to a specialist. Any periodontal problems identified should be addressed prior to orthodontic treatment. CPD/Clinical Relevance: This article details how to carry out a periodontal examination and considers the implications of the findings on the provision of adult orthodontic treatment.
Searching for Molecular Markers to Differentiate Bombus terrestris (Linnaeus) Subspecies in the Iberian Peninsula
Authors: Cejas Diego , Ornosa Concepción , Muñoz Irene , De la Rua Pilar 
Published: October 2018

Bumblebees (genus Bombus Latreille) are pollinator insects of great ecological and economic importance, which commercial use for pollination has increased since the 80s. However, the introduction of foreign Bombus terrestris (Linnaeus) has resulted in a decline of native bumblebee populations in Japan, Chile or Argentina among others. To study the potential introgression of commercial B. terrestris into the Iberian endemic subspecies Bombus terrestris lusitanicus Krüger, it is necessary to find a precise molecular marker that differentiates both subspecies. For this purpose, comparative analyses were carried out between B. t. lusitanicus and B. t. terrestris (Linnaeus) from Spain and from Belgium by sequencing the nuclear genes elongation factor 1-α and arginine kinase and the mitochondrial gene 16S ribosomal RNA, and genotyping with eleven microsatellite loci. No differentiation was observed at the nuclear level, but haplotypes found within the 16S sequence correlated with the morphological characterization of the subspecies. In a case study including individuals sampled before the establishment of bumblebee rearing companies and others from recent samplings, we detected hybrid individuals (those with non-matching morphological subspecies and 16S haplotype) more frequently in the south supporting the naturalization of commercial B. t. terrestris and introgression events between both subspecies. This marker should be used in Iberian populations with the aim to support management and conservation actions in endemic populations of B. t. lusitanicus.