bluuebunny/crossref_metadata_2025_split huggingface dataset:
Evaluation of intraoperative analgesia provided by incisional lidocaine and bupivacaine in cats undergoing ovariohysterectomy
Authors: Vicente David , Bergström Annika 
Published: October 2017

Objectives The objective of this study was to assess the intraoperative analgesic effect of preoperative infiltration of the incision site with lidocaine or a mixture of lidocaine with bupivacaine in cats undergoing ovariohysterectomy (OHE). Methods This was a prospective, randomised clinical study. Healthy female intact cats (n = 75) undergoing OHE under medetomidine–ketamine–buprenorphine anaesthesia were assigned randomly into three treatment groups (n = 25 per group) to receive one of two local anaesthesia protocols or placebo preoperatively in the midline incision: lidocaine 1.5 mg/kg (group GL) or mixture of lidocaine 1 mg/kg and bupivacaine 1 mg/kg (group GLB) or sodium chloride 0.9% (control group). Blood pressure, heart and respiratory rate, temperature, muscle tonus and pupillary reflex were registered during surgery. During recovery, the cats were observed for side effects. Postoperative analgesia was provided with meloxicam (0.2 mg/kg). Most cats were rechecked 2 weeks postoperatively to remove skin sutures. Results There was no significant difference between groups regarding breed, age, body weight, surgical time and postoperative complication rate. The majority of the cats (60%) included in the control group received a supplemental bolus of propofol during surgery, when compared with 43% and 44% of the cats included in the GL and GLB groups, respectively. Heart rate was significantly higher ( P <0.05) in the control group at the time of excision of the second ovary and the uterine body. Mean arterial pressure (MAP) was stable in both treatment groups; in contrast, it tended to increase in the control group. Heart rate and MAP were similar between treatment groups. Conclusions and relevance Preoperative incisional block with only lidocaine or combined with bupivacaine seems to produce a similar intraoperative analgesia in cats undergoing OHE. Despite the similar intraoperative analgesic effect between treatment groups, the combination of lidocaine and bupivacaine reduced the required doses, and had a faster onset of action and prolonged effect.
Allopurinol in combination with thiopurine induces mucosal healing and improves clinical and metabolic outcomes in IBD
Authors: Moreau Brigitte , Clement Pierre , Theoret Yves , Seidman Ernest G. 
Published: October 2017

Background: Thiopurines, azathioprine (AZA) and 6-mercaptopurine (6-MP) are common maintenance medications for inflammatory bowel disease (IBD). Excessive methylation via thiopurine methyltransferase (TPMT) frequently causes therapeutic failure. Allopurinol reduces excessive 6-methyl-mercaptopurine (6-MMP) while enhancing 6-thioguanine (6-TGN) levels. The aim of this study was to evaluate clinical, metabolic and endoscopic impact of allopurinol in combination with low-dose thiopurine in IBD. Methods: Retrospective review of consecutive cases treated with allopurinol. Metabolites and their ratios (6-MMP/6-TGN) were compared pre- and post-allopurinol. Clinical and endoscopic remission were assessed. Results: Allopurinol ( n = 66) reduced mean dose of AZA by 70% ( p < 0.01). Baseline levels (SD) 6-TGN, 6-MMP and 6-MMP/6-TGN were 165 (64), 9388 (5234) and 59.8 (30.3), respectively. These values improved on allopurinol to 297 (102), 896 (1031) and 3.4 (4.0), respectively ( p < 0.0001). Therapeutic 6-TGN level (>235) was achieved in 49/58 cases on allopurinol combination therapy, versus 9/58 monotherapy ( p = 0.0001). Among the thiopurine failure group (40 patients), clinical remission or response was observed in 65% and 22% of patients, respectively. In the asymptomatic group with excessive 6-MMP, 11/14 achieved sustained remission on allopurinol. Repeat colonoscopy ( n = 28) showed mostly endoscopic remission (67.9%) or improvement (17.8%). Few had unimproved lesions (14.3%). Importantly, 46% of cases had complete mucosal healing. Two patients had cancer on combination therapy (de novo pancreatic cancer and fatal recurrence of metastatic testicular cancer). Elevated transaminases were reduced on allopurinol (48.2 versus 6.9%) ( p < 0.001); no change in leukopenic or infectious events occurred. Conclusion: Allopurinol in combination with low-dose thiopurine corrected excessive 6-MMP levels, resulting in clinical remission and mucosal healing in the majority of cases. The potential cancer risk of allopurinol and thiopurine combination therapy needs further research.
Silicone Oil Droplets are More Common in Fluid From BD Insulin Syringes as Compared to Other Syringes
Authors: Emerson Geoffrey G. 
Published: October 2017

Purpose: During 2016 and 2017, numerous retina specialists reported silicone oil droplets after intravitreal injection, primarily associated with insulin syringes with a fixed needle. By contrast, adverse events were relatively rare for tuberculin syringes. We hypothesized that fixed-needle syringe injections have more silicone droplets due to the lack of dead space at the syringe–needle junction. Methods: Fluid from Becton Dickenson (BD) insulin syringes, BD tuberculin syringes, Henke Sass Wolf (HSW) insulin syringes, and HSW silicone-free syringes was examined microscopically for silicone oil droplets. Fluid was sampled at the beginning, middle, and end of injection; and droplets were photographed and quantified. Results: Silicone oil droplets were identified in 30% of the BD insulin syringes, measuring 0.9 ± 0.2 mm3; no oil droplets were found in BD tuberculin syringes or HSW silicone-free syringes (analysis of variance, P < .05). All 6 samples with silicone oil droplets were from the end of injection (full depression of the plunger), while samples from the beginning and middle of injections did not have droplets. Challenging syringes with extra silicone oil resulted in increased droplets for fixed-needle syringes (but not for syringes with detachable needles). Conclusion: Significant silicone oil droplets were present in BD insulin syringes and were expressed at the end of injection (with plunger depressed maximally), supporting the hypothesis that insulin syringe injections have more droplets due to the lack of dead space where the plunger meets the hub of the needle. However, there are additional factors such as the amount or type of silicone lubricant in a syringe.
SETD2 alterations impair DNA damage recognition and lead to resistance to chemotherapy in leukemia
Authors: Mar Brenton G. , Chu S. Haihua , Kahn Josephine D. , Krivtsov Andrei V. , Koche Richard , Castellano Cecilia A. , Kotlier Jacob L. , Zon Rebecca L. , McConkey Marie E. , Chabon Jonathan , Chappell Ryan , Grauman Peter V. , Hsieh James J. , Armstrong Scott A. , Ebert Benjamin L. 
Published: October 2017

Key Points
Alterations of SETD2, a histone 3 lysine 36 trimethyl (H3K36me3) transferase leads to resistance to DNA damaging-chemotherapy in leukemia. Low H3K36me3 levels impair DNA damage response and increase mutation rate, which may be targeted by H3K36me3 demethylase inhibition.
Fertility with early reduction of ovarian reserve: the last straw that breaks the Camel’s back
Authors: Rasool Sabahat , Shah Duru 
Published: October 2017

AbstractDiminished fertility and poor ovarian response pose a conundrum to the experts in the field of reproductive medicine. There is limited knowledge about the risk factors of diminished ovarian reserve other than the iatrogenic ones. One of the leading causes of infertility in women today is diminished ovarian reserve (DOR). DOR is characterized by a low number of eggs in a woman’s ovaries and/or with poor quality of the remaining eggs, which boils down to impaired development of the existing eggs, even with assisted reproductive techniques. A good number of such women with low ovarian reserve may conceive with their own eggs, if they are given individualized treatment that is tailored for their profile. Such patients should be counseled appropriately for an aggressive approach towards achieving fertility. The sooner the treatment is started, the better the chances of pregnancy.
Hypothesis: stimulation of trained immunity as adjunctive immunotherapy in cancer
Authors: Netea Mihai G , Joosten Leo A B , van der Meer Jos W M 
Published: October 2017

AbstractCancer immunotherapy has steadily progressed during the past decades, with checkpoint inhibitor therapy becoming the latest and one of the most promising treatments. Despite the progress, most of the patients do not respond or develop resistance, and novel additional approaches are needed to improve the clinical effectiveness of immunotherapy. Trained immunity (TI) has been described recently as a process of epigenetic and metabolic reprogramming that induces a long-term enhanced function of innate immune cells. TI is considered to have beneficial effects in improving host response to infections and vaccination, and increasing evidence suggests that TI-mediated mechanisms also have useful and potent antitumor effects. We hypothesized that novel and more effective approaches for immunotherapy in cancer may involve induction of TI, alone or in combination with current immunotherapies.
Synthesis and Photophysical Properties of Eu(III) Complexes with Phosphine Oxide Ligands including Metal Ions
Authors: Yamamoto Masanori , Nakanishi Takayuki , Kitagawa Yuichi , Seki Tomohiro , Ito Hajime , Fushimi Koji , Hasegawa Yasuchika 
Published: October 2017

Abstract
Lanthanide (Ln3+) complexes composed of luminescent Eu3+ complex and joint metal blocks (Al3+, Zn2+ and Pd2+ complexes) are reported. The Eu3+ complexes [Eu(hfa)3(dppy)2PdCl2]n (Eu-Pd), [Eu(hfa)3(dppy)2ZnCl2]n (Eu-Zn) and [Eu(hfa)3(dppy)4AlCl3]n (Eu-Al) (hfa: hexafluoroacetylacetonato, dppy: 4-pyridyldiphenylphosphine oxide) were synthesized by the complexation of [Eu(hfa)3(H2O)2] with [MCln(dppy)m] (M = Pd2+, Zn2+ and Al3+). These predicted structures were estimated using single-crystal X-ray structural analyses and DFT calculations. Photophysical properties of these complexes were evaluated based on the emission lifetimes and emission quantum yields. The emission quantum yields are dependent on the moiety of the joint metal blocks. Eu-Al complex shows the largest emission quantum yield (Φff = 72%). In contrast, the emission quantum yield of Eu-Pd is found to be 1.3%. The structures and photophysical properties of Eu3+ complexes linked with joint metal blocks are demonstrated.
Development of pulmonary arterial hypertension and diffuse alveolar damage in 2-month old Holstein dairy calves following an acute episode of bloody scours
Authors: Gonyeau Kerry , Subbiah Seenivasan , Klein David , Church Dee , Neary Joseph M. 
Published: October 2017

Background: The goal of this study was to evaluate the effect of hypoxia on intestinal permeability and cardiopulmonary physiology in 2-month old calves.Methods: Calves were exposed to normoxic (975 m altitude; controls) or hypoxic (4,570 m altitude) conditions for 2 weeks. Pulmonary arterial pressures and intestinal permeability to mannitol and lactulose were assessed on Days 0 and 14. Calves were euthanized on Day 15. Two control calves shed occult fecal blood on Day 3; consequently, all calves were treated for coccidiosis.Results: Control calves tended to have greater mean pulmonary arterial pressure than hypoxic calves at Day 0 (P =0.17), but there was no difference between groups at Day 14 (P =0.47). On average, mean pulmonary arterial pressure increased by 16 ± 2 mm Hg from Day 0 to 14 (P <0.001). Serum lactulose was 0.8 ± 0.4 mg/L greater in the control group than the hypoxic group on Days 0 and 14 (P =0.08). Serum mannitol was 2.0 ± 0.8 mg/L greater in control calves than hypoxic calves on Day 0 (P =0.009) but there was no difference between groups at Day 14 (P =0.61).Conclusions: Hypoxia did not affect intestinal permeability, but the results were confounded by intestinal disease. Interestingly, the two calves that had bloody scours had the greatest pulmonary arterial pressures and diffuse alveolar damage. The findings of this study provide preliminary evidence that intestinal disease may contribute to the development of pulmonary diseases in cattle.
Production and Capacity Management with Internal Financing
Authors: Ning Jie , Sobel Matthew J. 
Published: October 2017

We formulate and analyze a stylized dynamic model of a price-taking firm that manages production and capacity, uses only internal financing, and faces stochastic market environments. The firm has two operationally independent production facilities, each of which makes two products, and a cash reserve that finances all operations and dividend issuance. Each period the firm chooses the amount of dividend to issue, and at each facility it chooses production quantities and amounts of capacity to augment or divest. Relevant market data are exogenous and evolve stochastically. We completely characterize the optimal policy and the endogenous values of the capacities and cash reserve, and show that they invite a real-option interpretation. We find that internal financing creates a spillover between the endogenous values of the two operationally independent facilities, and we specify how this leads to interdependence of their optimal policies. We show that an “invest/stay put/divest” (ISD) policy remains optimal for partially irreversible investments, but internal financing changes the ISD thresholds. If the exogenous data are intertemporally independent, an internally financed firm is less likely to issue dividends or to expand capacity than if it were in a perfect capital market. As the market becomes more volatile, the endogenous values of capacities and cash increase, and the firm becomes more reluctant to issue dividends. The online appendix is available at https://doi.org/10.1287/msom.2017.0655 . This paper has been accepted for the Manufacturing & Service Operations Management Special Issue on Interface of Finance, Operations, and Risk Management.
A review of midwifery leadership
Authors: Bannon Elizabeth Maria , Alderdice Fiona , McNeills Jennifer 
Published: October 2017

Despite frequent reports criticising leadership skills in the profession, midwives have dedicated many years to increasing representation at the highest level. Elizabeth Maria Bannon, Fiona Alderdice and Jennifer McNeill explore the many decades of progress The ineffectiveness of leadership across maternity services in England has been a recurrent theme over a number of years, with reports continuing to identify the same issues. These reports reflect the concerns previously identified by the Healthcare Commission in its review of maternity services in England, which drew attention to the links between poor morale and ineffective or authoritarian leadership, as well as highlighting the overemphasis on financial pressures, all of which were concluded to be detrimental to the care provided for women. This article will explore the history of midwifery leadership, examining the reasons why midwives in particular have been perceived as failing to have developed the necessary skills to lead and manage maternity services.
Sustainability and transformation plans: translating the perspectives
Authors: Thakrar Sonali V , Bell Diane 
Published: October 2017

Each local health economy has been tasked with producing a sustainability and transformation plan. A health economy is a system that controls and contributes to health-care resource and the effects of health services on its population. This includes commissioners, acute providers, primary care providers, community services, public health and the voluntary sector. Sustainability and transformation plans represent a shift in the way health care is planned for in England. The aim of each sustainability and transformation plan is to deliver care within existing resource limits by improving quality of care, developing new models of care and improving efficiency of care provision. The tight timescales for production of sustainability and transformation plans mean that in most cases there has been limited clinical engagement; as a result many clinicians have limited sight, understanding or ownership of the proposals within sustainability and transformation plans. As sustainability and transformation plans move into the implementation phase, this article explores the role of the clinician in the ongoing design and delivery of the local sustainability and transformation plans. By finding the common ground between the perspectives of the clinician, the commissioner and system leaders, the motivation of clinicians can be aligned with the ambitions of the sustainability and transformation plan. The common goal of a sustainability and transformation plan and the necessary collaboration required to make it successful is discussed. Ultimately, such translation is essential: clinicians are intelligent, adaptive and motivated individuals who must have a lead role in constructing and implementing plans that transform health and social care.
Comparison of functional exercises on lower limb and trunk muscle activation in people with chronic ankle instability
Authors: Jung Ye-ji , Yi Chung-hwi , Baek Yun-jeong , Son Jae-ik , Lim One-bin 
Published: October 2017

Background/Aims: The aim of this research was to investigate muscle activation in the lower limbs and trunk during five functional exercises: forward lunge, rotational lunge, anterior direction one-legged standing exercise, posteriomedial direction one-legged standing exercise, and posteriolateral one-legged standing exercise in subjects with chronic ankle instability. Methods: Twenty-four subjects (10 males and 14 females) with chronic ankle instability participated in this study. Surface electromyography was used to measure the muscle activities of the peroneus longus, lateral head of the gastrocnemius, gluteus medius, and erector spinae. Normalised muscle activities are presented as percentage of MVIC (%MVIC). One-way repeated measures analysis of variance was used at a significance level of p<0.05. Findings: The peroneus longus and the lateral head of the gastrocnemius muscle activities significantly higher in anterior direction one-legged standing exercise than in the other exercises (forward lunge: p=0.005; rotational lunge: p=0.006; posteriomedial direction one-legged standing exercise: p=0.007; posteriolateral one-legged standing exercise: p=0.008; forward lunge, rotational lunge, posteriomedial direction one-legged standing exercise, posteriolateral one-legged standing exercise: p<0.001, respectively). The muscle activity of gluteus medius significantly lower in rotational lunge than in the other exercises (forward lunge: p=0.001, one-legged standing: p<0.001). Among the one-legged standing exercises, the muscle activity of the gluteus medius was lowest in the anterior direction one-legged standing exercise. The muscle activity of the erector spinae was significantly lower in the forward lunge and anterior direction one-legged standing exercise than in the other exercises (posteriomedial direction one-legged standing exercise and posteriolateral one-legged standing exercise: p<0.001). Conclusions: The anterior direction one-legged standing exercise, which activates the peroneus longus and the lateral head of the gastrocnemius muscle and reduces other muscles' activation proximally, would be an effective exercise to activate ankle muscles in the rehabilitation of people with chronic ankle instability.
Paramedic attitudes towards DNACPR orders
Authors: Armitage Ewan , Jones Colin 
Published: October 2017

Background:Qualitative research involving paramedics and their involvement in end-of-life (EoL) care has already been published, but there have been no published attitudinal studies specifically relating to do not attempt cardiopulmonary resuscitation (DNACPR) orders and paramedics working in the pre-hospital setting in the UK.Objective:To gain an understanding of paramedic attitudes towards an increasingly common aspect of paramedic practice, focusing specifically on the pre-hospital environment and identifying any corelation between gender, length of service, and level of educational attainment.Design:A paper-based questionnaire was distributed to all paramedic grades, operational out of two ambulance stations of a regional NHS ambulance service in March 2017. The questionnaires were designed using a combination of free-text boxes and Likert scales. A total of 33 questionnaires were issued and 11 completed questionnaires were returned.Results:Respondents indicated the importance of communication in relation to DNACPR orders, as well as the role of allied health professionals and family members in the process. Respecting the patient's wishes was considered paramount, as was educational provision surrounding DNACPRs.Conclusion:The majority of respondents reported that they were comfortable incorporating DNACPR orders in their clinical practice, although more modest responses were returned regarding the level of education received in this area of paramedicine.
Remnant Cholesterol and Myocardial Infarction in Normal Weight, Overweight, and Obese Individuals from the Copenhagen General Population Study
Authors: Varbo Anette , Freiberg Jacob J , Nordestgaard Børge G 
Published: October 2017

Abstract

BACKGROUND
We tested whether high remnant cholesterol is associated with high myocardial infarction risk, independent of whether an individual is normal weight, overweight, or obese.

METHODS
A total of 106216 individuals from the Copenhagen General Population Study were followed for up to 11 years, during which 1565 experienced a myocardial infarction. Individuals were grouped by clinically meaningful remnant cholesterol concentrations of &lt;0.5 mmol/L (19 mg/dL), 0.5 to 0.99 mmol/L (19–38 mg/dL), 1.0 to 1.49 mmol/L (39–58 mg/dL), and ≥1.5 mmol/L (58 mg/dL), and by body mass index (BMI) of &lt;18.5 kg/m2 (underweight), 18.5 to 24.9 kg/m2 (normal weight), 25 to 29.9 kg/m2 (overweight), and ≥30 kg/m2 (obese).

RESULTS
Median calculated remnant cholesterol was 0.40 mmol/L [interquartile range (IQR), 0.30–0.55 mmol/L] [15 mg/dL (12–21 mg/dL)] for underweight, 0.50 mmol/L (IQR, 0.37–0.71 mmol/L) [19 mg/dL (14–27 mg/dL)] for normal weight, 0.70 mmol/L (IQR, 0.49–1.00 mmol/L) [27 mg/dL (19–39 mg/dL)] for overweight, and 0.85 mmol/L (IQR, 0.61–1.20 mmol/L) [(33 mg/dL (24–46 mg/dL)] for obese individuals. On continuous scales, remnant cholesterol was positively correlated with BMI until reaching a plateau of approximately 1 mmol/L (39 mg/dL) at BMI &gt;35 kg/m2. R2 from an unadjusted linear regression for the correlation between calculated remnant cholesterol and BMI was 12%. Stepwise higher remnant cholesterol was associated with stepwise higher myocardial infarction risk in a similar pattern for normal weight, overweight, and obese individuals. When compared with individuals with remnant cholesterol &lt;0.5 mmol/L (19 mg/dL), individuals with remnant cholesterol ≥1.5 mmol/L (58 mg/dL) had hazard ratios for myocardial infarction of 2.0 (95% CI, 1.3–3.2) for normal weight, 1.9 (95% CI, 1.4–2.6) for overweight, and 2.3 (95% CI, 1.4–3.5) for obese individuals. Directly measured remnant cholesterol increased 0.91 mmol/L (95% CI, 0.89–0.94 mmol/L) [35 mg/dL (34–36 mg/dL)] per 1 mmol/L (39 mg/dL) increase in calculated remnant cholesterol.

CONCLUSIONS
Remnant cholesterol and BMI were positively correlated; however, high remnant cholesterol was associated with higher myocardial infarction risk across the examined BMI subcategories, indicating that remnant cholesterol is a risk factor for myocardial infarction independent of overweight and obesity.