bluuebunny/crossref_metadata_2025_split huggingface dataset:
Variations of Cutaneous Capnometry and Perfusion Index During a Heating Challenge is Early Impaired in Septic Shock and Related to Prognostic in Non-Septic Shock
Authors: Vallée Fabrice , Nougué Hélène , Mari Arnaud , Vodovar Nicolas , Dubreuil Guillaume , Damoisel Charles , Dépret François , Mateo Joaquim 
Published: July 2018

ABSTRACT

Introduction:
In shock, the increase in cutaneous-to-arterial carbon dioxide partial pressure (Pc-aCO2) and the decrease in the perfusion index (PI) are related to macrovascular or microvascular alterations. We hypothesized that inducing cutaneous vasodilation and local perfusion with heat could provide a noninvasive tool to monitor microvascular reactivity.

Objectives:
This study aimed to develop a noninvasive approach, the heating challenge (HC), to monitor the microvascular reactivity of patients with shock and to evaluate the potential relationship with outcome.

Methods:
After ethics committee agreement was obtained, 59 shock patients, including 37 septic shock, 22 non-septic shock (14 cardiogenic and eight hemorrhagic), 10 intensive care unit (ICU)-controls and 12 healthy volunteers, were included in this study. The HC consisted of heating the ear lobe PcCO2 sensor from 37° to 45° over 5 min and recording PcCO2 and PI variations (ΔPcCO2 and PImax/min). HC was performed on admission and during the first 48 h of hospitalization.

Results:
Pc-aCO2 was significantly higher in shock patients than ICU-controls at baseline (P < 0.05). HC led to a decrease in PcCO2 and an increase in PI in the healthy volunteers (ΔPcCO2 = −9.0 ± 4.6% and PImax/min = 5.5 ± 1.9). On admission, non-septic shock patients (cardiogenic and hemorrhagic shocks) had an HC response profile identical to that of healthy volunteers and ICU-controls. In contrast, septic shock patients had a lower ΔPcCO 2 and PImax/min compared to healthy volunteers and all other groups (P < 0.05). After the first day, the combination of a Pc-aCO2 >17 mm Hg with a positive ΔPcCO2 could predict mortality with a specificity of 82% and a sensitivity of 93%.

Conclusions:
HC appears to be a dynamic test to classify vascular reactivity alterations in shock. At baseline, HC results were impaired in septic patients and conserved in non-septic patients. After the first day, the association between Pc-aCO2 and ΔPcCO2 was strongly related to prognosis in shock patients.
Current Practices in Central Venous Catheter Position Confirmation by Point of Care Ultrasound: A Survey of Early Adopters
Authors: Ablordeppey Enyo A. , Drewry Anne M. , Theodoro Daniel L. , Tian LinLin , Fuller Brian M. , Griffey Richard T. 
Published: July 2018

ABSTRACT

Purpose:
Although routine chest radiographs (CXR) to verify correct central venous catheter (CVC) position and exclude pneumothorax are commonly performed, emerging evidence suggests that this practice can be replaced by point of care ultrasound (POCUS). POCUS is advantageous over CXR because it avoids radiation while verifying correct placement and lack of pneumothorax without delay. We hypothesize that a knowledge translation gap exists in this area. We aim to describe the current clinical practice regarding POCUS alone for CVC position confirmation and pneumothorax exclusion as compared with chest radiography.

Methods:
We used a modified Dillman technique to conduct a brief web-based survey to Critical Care Medicine and Emergency Medicine physicians (targeted group of early adopters) evaluating the current practice related to CVC position confirmation and PTX exclusion via CXR or POCUS.

Results:
Of 200 post-training clinicians contacted, 136 (68%) responded to the survey. For routine CVC confirmation and PTX evaluation, 50.7% of Critical Care Medicine physicians and 65.4% of Emergency Medicine physicians reported using CXR alone while 49.3% and 33.1% respectively reported using CXR and ultrasound together. Though 84.6% of clinicians use ultrasound for CVC insertion “most of the time” or “always,” none use ultrasound alone for CVC position confirmation, and only 1% has used ultrasound alone for PTX exclusion.

Conclusions:
Though data support its utility and advantages for POCUS as a sole modality for CVC position confirmation and PTX evaluation, POCUS is rarely used for this indication. We identified several perceived barriers toward widespread utilization suggesting areas for dissemination and implementation strategy development that will benefit patient care practices.
Low-Dose Landiolol Reduces Heart Rate and Cardiac Oxygen Consumption Without Compromising Initial Hemodynamic Resuscitation in a Canine Model of Endotoxin Shock
Authors: Uemura Kazunori , Kawada Toru , Zheng Can , Li Meihua , Sugimachi Masaru 
Published: July 2018

ABSTRACT
In septic shock, it is not known whether β-blocker can be used to reduce heart rate (HR) safely during the initial phase of hemodynamic resuscitation. The purpose of this study was to experimentally investigate the effects of low-dose landiolol, a β-blocker, on initial hemodynamic resuscitation in dogs with endotoxin shock. In 13 anesthetized dogs [n = 7 in control (CT) group, n = 6 in β-blockade (BB) group], after endotoxin shock was induced by intravenous infusion of lipopolysaccharide (4 mg kg−1), we started hemodynamic resuscitation to restore mean arterial pressure (AP) and cardiac output (CO) by infusing noradrenaline (NA) and Ringer acetate solution (RiA). During 4 h of hemodynamic resuscitation, dose of NA and RiA were automatically titrated with use of a computer-controlled drug infusion system that we developed previously. In BB group, landiolol was administered at a low-dose range (1–10 μg kg−1 min−1) to lower HR to lower than 140 bpm. Hemodynamic resuscitation using the system restored AP to 70 mmHg and CO to greater than 90% of baseline level similarly in both groups. Throughout resuscitation, HR and indices of cardiac contractility were significantly lower in BB group than in CT group. However, there were no significant intergroup differences in the dose of NA and RiA. During First 2 h of resuscitation, cardiac oxygen consumption was significantly lower in BB group than in CT group. In conclusion, low-dose landiolol may reduce HR without compromising initial hemodynamic resuscitation in septic shock. To clearly establish this, large-size randomized study using animal models more relevant to septic shock is needed.
Plasma Adenylate Levels are Elevated in Cardiopulmonary Arrest Patients and May Predict Mortality
Authors: Sumi Yuka , Ledderose Carola , Li Linglin , Inoue Yoshiaki , Okamoto Ken , Kondo Yutaka , Sueyoshi Koichiro , Junger Wolfgang G. , Tanaka Hiroshi 
Published: July 2018

ABSTRACT
Cerebral and cardiac dysfunction cause morbidity and mortality in postcardiac arrest syndrome (PCAS) patients. Predicting clinical outcome is necessary to provide the optimal level of life support for these patients. In this pilot study, we examined whether plasma ATP and adenylate levels have value in predicting clinical outcome in PCAS patients. In total, 15 patients who experienced cardiac arrest outside the hospital setting and who could be reanimated were enrolled in this study. Healthy volunteers (n = 8) served as controls. Of the 15 PCAS patients, 8 died within 4 days after resuscitation. Of the 7 survivors, 2 lapsed into vegetative states, 1 survived with moderate disabilities, and 4 showed good recoveries. Arterial blood samples were drawn immediately after successful resuscitation and return of spontaneous circulation (ROSC). The concentrations of ATP and other adenylates in plasma were assessed with high-performance liquid chromatography. PCAS patients had significantly higher ATP levels than healthy controls. Plasma ATP levels correlated with lactate levels, Acute Physiology and Chronic Health Evaluation II scores, and the time it took to ROSC (time-to-ROSC). Plasma adenylate levels in patients who died after resuscitation were significantly higher than in survivors. Based on our results and receiver-operating characteristic curve analysis, we conclude that plasma adenylate levels may help predict outcome in PCAS patients.
Hippocampal Damage During Mechanical Ventilation in Trendelenburg Position: A Secondary Analysis of an Experimental Study on the Prevention of Ventilator-Associated Pneumonia
Authors: López-Aguilar Josefina , Bassi Gianluigi Li , Quílez María Elisa , Martí Joan Daniel , Ranzani Otavio T. , Xiol Eli Aguilera , Rigol Montserrat , Luque Nestor , Guillamat Raquel , Ferrer Isidre , Torres Antoni , Blanch Lluís 
Published: July 2018

ABSTRACT
We previously corroborated benefits of the Trendelenburg position in the prevention of ventilator-associated pneumonia (VAP). We now investigate its potential effects on the brain versus the semirecumbent position. We studied 17 anesthetized pigs and randomized to be ventilated and positioned as follows: duty cycle (TI/TTOT) of 0.33, without positive end-expiratory pressure (PEEP), placed with the bed oriented 30° in anti-Trendelenburg (control group); positioned as in the control group, with TI/TTOT adjusted to achieve an expiratory flow bias, PEEP of 5 cm H2O (IRV-PEEP); positioned in 5° TP and ventilated as in the control group (TP). Animals were challenged into the oropharynx with Pseudomonas aeruginosa. We assessed hemodynamic parameters and systemic inflammation throughout the study. After 72 h, we evaluated incidence of microbiological/histological VAP and brain injury. Petechial hemorrhages score was greater in the TP group (P = 0.013). Analysis of the dentate gyrus showed higher cell apoptosis and deteriorating neurons in TP animals (P < 0.05 vs. the other groups). No differences in systemic inflammation were found among groups. Cerebral perfusion pressure was higher in TP animals (P < 0.001), mainly driven by higher mean arterial pressure. Microbiological/histological VAP developed in 0%, 67%, and 86% of the animals in the TP, control, and IRV-PEEP groups, respectively (P = 0.003). In conclusion, the TP prevents VAP; yet, we found deleterious neural effects in the dentate gyrus, likely associated with cerebrovascular modification in such position. Further laboratory and clinical studies are mandatory to appraise potential neurological risks associated with long-term TP.
Effects of Transitional Care Management Services From an Interprofessional Team on 30-Day Readmission Rates Among Medicare Beneficiaries
Authors: Henriksen Brian , Stuckey Nathan 
Published: July 2018

Purpose:
To diminish the negative effects associated with current care transitions (medication discrepancies, poor outcomes, adverse clinical events) while also giving pharmacists and other nonphysician practitioners opportunity to display their value to the health care system.

Methods:
A retrospective medical record review was conducted on patients admitted to the hospital to observe whether a transitions of care management (TCM) services altered hospital readmission within 30 days. Sampling occurred via a convenience sample to capture all patients during the specified time frame.

Results:
There were 226 hospital admissions during the study period (April 2015-February 2016). TCM encounters were performed for 75 of them. The number of readmissions with patients who had a Transitional Care Management encounter was only 5 of 24 total readmissions while 19 of the 151 patients who had not had a Transitional Care Management encounter were readmitted (6.7% compared with 12%; P = .174). These results demonstrate a 51% relative risk reduction.

Conclusion:
The utilization of a Transitional Care Management team reduced the rate of readmission among Medicare beneficiaries by 50%. Economically, the TCM approach saves the hospital money by reducing the rate of readmissions that the hospital must reimburse.
The Value of Adding Transcutaneous Neuromuscular Electrical Stimulation (VitalStim) to Traditional Therapy for Poststroke Dysphagia
Authors: Li Lejun , Li Yumei , Wu Xiaohong , Wang Guohua , Yi Xiaojing , Zhao Yichun , Guo Mingjie , Pan Muzhi , Tang Chunlin 
Published: July 2018

Background:
Dysphagia may delay the functional recovery and substantially affects the quality of life after stroke, mainly if left untreated. Electrical stimulation has been reported as a treatment for pharyngeal dysphagia in recent studies, but the therapeutic effect of neuromuscular electrical stimulation (VitalStim) therapy lacks convincing supporting evidence and needs further clinical investigation.

Methods:
A total of 135 subjects were randomly divided into 3 groups: traditional swallowing therapy (n = 45), VitalStim therapy (n = 45), and VitalStim therapy plus traditional swallowing therapy (n = 45). The traditional swallowing therapy included basic training and direct food intake training. Electrical stimulation was applied by an occupational therapist, using a modified handheld battery-powered electrical stimulator (VitalStim Dual Channel Unit and electrodes, Chattanooga Group, Hixson, Tennessee). The surface electromyography (sEMG), standardized swallowing assessment (SSA), videofluoroscopic swallowing study (VFSS), and visual analog scale (VAS) were used to assess swallowing function before and 4 weeks after the treatment.

Results:
A total of 118 subjects with dysphagia completed the study, 40 in the traditional swallowing group and VitalStim therapy group and 38 in the VitalStim and traditional swallowing therapy group. There were significant differences in sEMG values and SSA and VFSS scores in each group after the treatment (P < .001). After 4-week treatment, sEMG value (917.1; standard deviation [SD], 91.2), SSA value (21.8; SD, 3.5), oral transit time (0.4; SD, 0.1), and pharyngeal transit time (0.8; SD, 0.1) were significantly improved in the VitalStim and traditional swallowing therapy group than in the other 2 groups (P < .001).

Conclusions:
Data suggest that VitalStim therapy coupled with traditional swallowing therapy may be beneficial for poststroke dysphagia.
The Effect of Leisure Activities, Purpose in Life, and Spirituality on Short-Term Outcomes of Geriatric Rehabilitation
Authors: Merims Doron , Ben Natan Merav , Seleznev Irina 
Published: July 2018

Background:
Participation in leisure activities, having purpose in life, and spirituality may act to shape individuals' attitudes toward life and life events. Possibly, they may also impact patients' rehabilitation process.

Objectives:
To examine the association between participation in leisure activities (prior to the event requiring rehabilitation), having purpose in life, spirituality, and outcomes of geriatric rehabilitation.

Methods:
Two hundred adults 65 years and older hospitalized at a large geriatric rehabilitation facility completed the Daily Spiritual Experience Scale, Purpose in Life test, and Leisure Activities Index. Multiple regression analysis was used to determine the effect of participation in leisure activities, having purpose in life, and spirituality, on the outcomes of geriatric rehabilitation (Δ Functional Independence Measure).

Results:
Participation in leisure activities was found to be a predictor of geriatric rehabilitation outcomes, although to a lesser extent than the Mini-Mental State Examination score and age. Having purpose in life was found to be associated with rehabilitation outcomes, but not as a predictor; and no association was found between spirituality and rehabilitation outcomes.

Conclusions:
Participation in leisure activities may serve as a relatively easy-to-measure predictor of geriatric rehabilitation outcomes.
Feasibility and Effectiveness of Mobile Phones in Physical Activity Promotion for Adults 50 Years and Older
Authors: Song Yayun , Qu Jia , Zhang Di , Zhang Jun 
Published: July 2018

Objective:
To determine the feasibility and effectiveness of mobile phones for promoting physical activity among adults 50 years and older.

Methods:
A systematic review was conducted. Articles were searched on April 1, 2017, in databases (Pubmed, Web of Science, Cochrane Library, Embase, and EBSCO) by 2 reviewers.

Results:
Eight articles were included. Three studies were conducted in the United States. Four studies found mobile phone interventions effective in increasing physical activity frequency. Participants found mobile phone interventions interesting, useful, and easy to use.

Conclusion:
Mobile phone interventions were effective in promoting physical activity among older adults, and well accepted despite certain barriers.
Cell morphological motif detector for high-resolution 3D microscopy images
Authors: Driscoll Meghan K. , Welf Erik S. , Dean Kevin M. , Fiolka Reto , Danuser Gaudenz 
Published: July 2018

AbstractRecent advances in light-sheet microscopy enable imaging of cell morphology and signaling with unprecedented detail. However, the analytical tools to systematically measure and visualize the intricate relations between cell morphodynamics, intracellular signaling, and cytoskeletal dynamics have been largely missing. Here, we introduce a set of computer vision and graphics methods to dissect molecular mechanisms underlying 3D cell morphogenesis and to test whether morphogenesis itself affects intracellular signaling. We demonstrate a machine learning based generic morphological motif detector that automatically finds lamellipodia, filopodia, and blebs on various cell types. Combining motif detection with molecular localization, we measure the differential association of PIP2and KrasV12with blebs. Both signals associate with bleb edges, as expected for membrane-localized proteins, but only PIP2is enhanced on blebs. This suggests that local morphological cues differentially organize and activate sub-cellular signaling processes. Overall, our computational workflow enables the objective, automated analysis of the 3D coupling of morphodynamics with cytoskeletal dynamics and intracellular signaling.
Clonal evolution and genome stability in a 2,500-year-old fungal individual
Authors: Anderson James B. , Bruhn Johann N. , Kasimer Dahlia , Wang Hao , Rodrigue Nicolas , Smith Myron L. 
Published: July 2018

AbstractIn the late 1980s, a genetic individual of the fungusArmillaria gallicathat extended over at least 37 hectares of forest floor and encompassed hundreds of tree root systems was discovered on the Upper Peninsula of Michigan. Based on observed growth rates, the individual was estimated to be at least 1500 years old with a mass of more than 105kg. Nearly three decades on, we returned to the site of individual for new sampling. We report here that the same genetic individual ofA. gallicais still alive on its original site, but we estimated that it is older and larger than originally estimated, at least 2,500 years and 4 × 105kg, respectively. We also show that mutation has occurred within the somatic cells of the individual, reflecting its historical pattern of growth from a single point. The overall rate of mutation, however, was extremely low. The large individual ofA. gallicahas been remarkably resistant to genomic change as it has persisted in place.
Modelling Intrinsically Disordered Protein Dynamics as Networks of Transient Secondary Structure
Authors: Wayment-Steele Hannah K. , Hernández Carlos X. , Pande Vijay S. 
Published: July 2018

ABSTRACTDescribing the dynamics and conformational landscapes of Intrinsically Disordered Proteins (IDPs) is of paramount importance to understanding their functions. Markov State Models (MSMs) are often used to characterize the dynamics of more structured proteins, but models of IDPs built using conventional MSM modelling protocols can be difficult to interpret due to the inherent nature of IDPs, which exhibit fast transitions between disordered microstates. We propose a new method of determining MSM states from all-atom molecular dynamics simulation data of IDPs by using per-residue secondary structure assignments as input features in a MSM model. Because such secondary structure algorithms use a select set of features for assignment (dihedral angles, contact distances, etc.), they represent a knowledge-based refinement of feature sets used for model-building. This method adds interpretability to IDP conformational landscapes, which are increasingly viewed as composed of transient secondary structure, and allows us to readily use MSM analysis tools in this paradigm. We demonstrate the use of our method with the transcription factor p53 c-terminal domain (p53-CTD), a commonly-studied IDP. We are able to characterize the full secondary structure phase space observed for p53-CTD, and describe characteristics of p53-CTD as a network of transient helical and beta-hairpin structures with different network behaviors in different domains of secondary structure. This analysis provides a novel example of how IDPs can be studied and how researchers might better understand a disordered protein conformational landscape.
Transforming Insect Population Control with Precision Guided Sterile Males
Authors: Kandul Nikolay P. , Liu Junru , Sanchez C. Hector M. , Wu Sean L. , Marshall John M. , Akbariut Omar S. 
Published: July 2018

AbstractThe sterile insect technique (SIT) is an environmentally safe and proven technology to suppress wild populations. To further advance its utility, a novel CRISPR-based technology termed “precision guided SIT” (pgSIT) is described. PgSIT mechanistically relies on a dominant genetic technology that enables simultaneous sexing and sterilization, facilitating the release of eggs into the environment ensuring only sterile adult males emerge. Importantly, for field applications, the release of eggs will eliminate burdens of manually sexing and sterilizing males, thereby reducing overall effort and increasing scalability. To demonstrate efficacy, we systematically engineer multiple pgSIT systems inDrosophilawhich consistently give rise to 100% sterile males. Importantly, we demonstrate that pgSIT-generated males are fit and competitive. Using mathematical models, we predict pgSIT will induce substantially greater population suppression than can be achieved by currently-available self-limiting suppression technologies. Taken together, pgSIT offers to transform our ability to control insect agricultural pests and disease vectors.
Increased α-2,8-sialyltransferase 8B (ST8SIA2) expression in schizophrenia superior temporal gyrus
Authors: Mueller Toni M. , Yates Stefani D. , Meador-Woodruff James H. 
Published: July 2018

AbstractReduced polysialylation of neural cell adhesion molecule (NCAM) in schizophrenia has been suggested to contribute to abnormal neuroplasticity and neurodevelopmental features of this illness. The posttranslational addition of sialic acid is mediated by sialyltransferases, and polysialylation (the addition of ≥ 8 α -2,8-linked sialic acid residues) is catalyzed by three enzymes: ST8SIA2 (also called STX), ST8SIA4 (also called PST), and/or ST8SIA3. ST8SIA2 and ST8SIA4 are the primary mediators of NCAM polysialylation. The gene encoding ST8SIA2 maps to schizophrenia risk locus 15q26, and single nucleotide polymorphisms (SNPs) and SNP haplotypes of the ST8SIA2 gene have been associated with schizophrenia in multiple populations. The current study in elderly schizophrenia (N = 16) and comparison (N = 14) subjects measured the protein expression of NCAM, polysialylated-NCAM (PSANCAM), and three poly-α-2,8-sialyltransferases (ST8SIA2, ST8SIA3, and ST8SIA4) in postmortem superior temporal gyrus. Although expression of NCAM, PSA-NCAM, ST8SIA3, and ST8SIA4 were not different in schizophrenia, increased protein levels of ST8SIA2 were identified. It has been reported that ST8SIA2 mutations associated with increased schizophrenia risk impair PSA-NCAM synthesis, suggesting that increased protein expression of ST8SIA2 may represent a compensatory mechanism in the face of impaired enzyme function. This interpretation is further supported by our finding that the relationship between ST8SIA2 enzyme expression and PSA-NCAM levels are different between schizophrenia and comparison subjects. Together these findings suggest a possible neurodevelopmentally-regulated mechanism which could contribute to abnormal synaptic plasticity evident in schizophrenia.