bluuebunny/crossref_metadata_2025_split huggingface dataset:
Is the use of negative pressure wound therapy for a malignant wound legitimate in a palliative context? “The concept of NPWT ad vitam”: A case series
Authors: Riot Samuel , de Bonnecaze Guillaume , Garrido Ignacio , Ferron Gwenaël , Grolleau Jean-Louis , Chaput Benoit 
Published: December 2014

Background: The management of malignant wounds remains particularly difficult. They are often malodorous, highly exuding, and painful. In this context, the use of negative pressure wound therapy is usually not recommended. It is, however, an effective procedure for maintaining a good quality of life in certain palliative situations. Case presentation: Five patients underwent negative pressure wound therapy for a malignant wound in our unit. Three had sarcomas, one patient had a parietal recurrence of breast carcinoma, and one patient had melanoma. They were in a metastatic palliative situation and were no longer receiving specific treatment. Case management and outcomes: The patients reported a decrease in odor and exudates with negative pressure wound therapy, compared with conventional dressings. No patients complained of pain associated with the suction system itself. Fewer dressing changes reduced the pain and encouraged the resumption of social interactions. The average duration of negative pressure wound therapy before the death of the patients was 49 days. No complications or bleeding were observed. The duration of the patients’ stay was shortened by implementing negative pressure wound therapy at home. Conclusion: We report on our experiences with five patients for whom manufacturers and health authorities contraindicated the use of negative pressure wound therapy because of its potential to encourage tumor growth, although it was considered to be beneficial for all of these patients. This procedure may offer an alternative to conventional wound dressings at the end of life and improve the quality of life of patients by controlling the three most disabling elements: the odor, exudate, and pain associated with changing the dressings. Miniaturization and lower costs could promote the systematic use of negative pressure wound therapy.
ERCP‐related perforations in the new millennium: A large tertiary referral center 10‐year experience
Authors: Kodali Sudha , Mönkemüller Klaus , Kim Hwasoon , Ramesh Jayapal , Trevino Jessica , Varadarajulu Shyam , Wilcox C Mel 
Published: December 2014

IntroductionEndoscopic retrograde cholangiopancreatography (ERCP) is an important diagnostic and therapeutic modality for pancreatic and biliary disorders. Perforation is one of the most dreaded complications of ERCP. Since it is uncommon, there has been little study of incidence, risk factors, and outcomes of management.ObjectivesWe aim to assess the incidence of ERCP‐related perforations and outcomes at a large tertiary referral center.MethodsWe undertook a review of an ERCP database for all perforations from 2002 to December 2012.ResultsThe cumulative incidence of ERCP‐related perforations was 0.14% (12 out of 8264), and sphincterotomy‐related perforations constituted the most common cause. The mean age of these 12 patients was 58.6 years and majority were female (83.3%). The most common indications for ERCP were: suspected sphincter of Oddi dysfunction (SOD) 41%, and common bile duct stones (CBD stones) 41%. Nine of the 12 patients (75%) had a leak and were managed medically, and four who had a perforation had surgical repair (25%).ConclusionsIn our study, leaks were much more common than perforations and the majority of patients were successfully managed with conservative therapy alone. We report a very low perforation rate and most perforations can be managed conservatively with a good outcome.
Changes in serum ghrelin level in relation to meal‐time in patients with functional dyspepsia
Authors: Kazemi MH , Eshraghian A , Hamidpour L , Taghavi SA 
Published: December 2014

BackgroundGhrelin is a peptide hormone that is involved in gastrointestinal motility and secretion; and therefore, may play a role in functional dyspepsia.ObjectivesTo compare the change of serum ghrelin level in relation to meal‐time, between patients with functional dyspepsia and a control group.Materials and methodsIn a cross‐sectional study, 18 subjects with functional dyspepsia according to the Rome III criteria were enrolled in our study. Blood samples were collected five times: 30 minutes (min) before a standard breakfast; at the time as serving breakfast; and 30, 60 and 90 min after breakfast. Serum ghrelin concentration was measured in these patients and compared with eight normal individuals, as controls.ResultsThe serum ghrelin level 30 minutes after breakfast was significantly higher in dyspepsia patients, compared to controls (751 ± 171.84 pg/ml versus 576.9 ± 195.62 pg/ml, p  = 0.033). Although patients had a higher mean serum ghrelin level 30 minutes before, exactly at the time of serving breakfast and 60 min after breakfast there was no statistically significant difference between patients and controls. The shape of the curve was also different between the two groups, from 30 min until 90 min after breakfast, which is the time that most dyspeptic symptoms usually occur, although this difference was not significant (p  > 0.05).ConclusionThe significantly different ghrelin levels between dyspeptic patients and the normal population showed that ghrelin may have an important role in inducing symptoms, in functional dyspeptic patients.
Lourdes: A Uniquely Catholic Approach to Medicine
Authors: Dichoso Travis Jon 
Published: December 2014

As an American medical student, I spent the summer break between my first and second year in Lourdes, France, the site where the Immaculate Conception appeared eighteen times to St. Bernadette in 1858 as proclaimed approved by the Catholic Church and whose water is associated with over seven thousand unexplained cures. During this time I volunteered with St. Joseph's Service and Poste Secour, followed several medical teams taking care of large pilgrim groups, and shadowed Dr. Alessandro de Franciscis the president of Le Bureau des Constations Médicales, the office in Lourdes charged with investigating claims of miracles. Through my experiences, I found the mission of medicine in Lourdes to be twofold: to provide the critical care needed to give sick persons the chance to transform their experience of disease through their faith; and secondly, through the efforts of the Medical Bureau, to be an instrument by which we can comprehend the wonders of the work of God. I conclude that this twofold mission should inform the work of every Catholic in health care or research, and Lourdes provides the venue par excellence to cultivate this mission. Lay Summary: Lourdes is a pilgrimage site in southern France that has been associated with medical miracles for the past 150 years. The site is unique in that throughout its history, physicians, of any or no faith, have been invited to participate in the proceedings of the investigations of each claimed cure. The investigations have formalized into a process handled by the Lourdes Medical Bureau and the Lourdes International Medical Association. Travis Dichoso, an American medical student, writes about his experiences as part of this process.
Thromboelastometry and organ failure in trauma patients: a prospective cohort study
Authors: Müller Marcella CA , Balvers Kirsten , Binnekade Jan M , Curry Nicola , Stanworth Simon , Gaarder Christine , Kolstadbraaten Knut M , Rourke Claire , Brohi Karim , Goslings J Carel , Juffermans Nicole P 
Published: December 2014

Abstract
Introduction
Data on the incidence of a hypercoagulable state in trauma, as measured by thromboelastometry (ROTEM), is limited and the prognostic value of hypercoagulability after trauma on outcome is unclear. We aimed to determine the incidence of hypercoagulability after trauma, and to assess whether early hypercoagulability has prognostic value on the occurrence of multiple organ failure (MOF) and mortality.

Methods
This was a prospective observational cohort study in trauma patients who met the highest trauma level team activation. Hypercoagulability was defined as a G value of ≥11.7 dynes/cm2 and hypocoagulability as a G value of <5.0 dynes/cm2. ROTEM was performed on admission and 24 hours later.

Results
A total of 1,010 patients were enrolled and 948 patients were analyzed. Median age was 38 (interquartile range (IQR) 26 to 53), 77% were male and median injury severity score was 13 (IQR 8 to 25). On admission, 7% of the patients were hypercoagulable and 8% were hypocoagulable. Altogether, 10% of patients showed hypercoagulability within the first 24 hours of trauma. Hypocoagulability, but not hypercoagulability, was associated with higher sequential organ failure assessment scores, indicating more severe MOF. Mortality in patients with hypercoagulability was 0%, compared to 7% in normocoagulable and 24% in hypocoagulable patients (P <0.001). EXTEM CT, alpha and G were predictors for occurrence of MOF and mortality.

Conclusions
The incidence of a hypercoagulable state after trauma is 10% up to 24 hours after admission, which is broadly comparable to the rate of hypocoagulability. Further work in larger studies should define the clinical consequences of identifying hypercoagulability and a possible role for very early, targeted use of anticoagulants.
Arterial hyperoxia and mortality in critically ill patients: a systematic review and meta-analysis
Authors: Damiani Elisa , Adrario Erica , Girardis Massimo , Romano Rocco , Pelaia Paolo , Singer Mervyn , Donati Abele 
Published: December 2014

Abstract
Introduction
The safety of arterial hyperoxia is under increasing scrutiny. We performed a systematic review of the literature to determine whether any association exists between arterial hyperoxia and mortality in critically ill patient subsets.

Methods
Medline, Thomson Reuters Web of Science and Scopus databases were searched from inception to June 2014. Observational or interventional studies evaluating the relationship between hyperoxia (defined as a supranormal arterial O2 tension) and mortality in adult intensive care unit (ICU) patients were included. Studies primarily involving patients with exacerbations of chronic pulmonary disease, acute lung injury and perioperative administration were excluded. Adjusted odds ratio (OR) of patients exposed versus those not exposed to hyperoxia were extracted, if available. Alternatively, unadjusted outcome data were recorded. Data on patients, study characteristics and the criteria used for defining hyperoxia exposure were also extracted. Random-effects models were used for quantitative synthesis of the data, with a primary outcome of hospital mortality.

Results
In total 17 studies (16 observational, 1 prospective before-after) were identified in different patient categories: mechanically ventilated ICU (number of studies (k) = 4, number of participants (n) = 189,143), post-cardiac arrest (k = 6, n = 19,144), stroke (k = 2, n = 5,537), and traumatic brain injury (k = 5, n = 7,488). Different criteria were used to define hyperoxia in terms of PaO2 value (first, highest, worst, mean), time of assessment and predetermined cutoffs. Data from studies on ICU patients were not pooled because of extreme heterogeneity (inconsistency (I2) 96.73%). Hyperoxia was associated with increased mortality in post-cardiac arrest patients (OR = 1.42 (1.04 to 1.92) I2 67.73%) stroke (OR = 1.23 (1.06 to 1.43) I2 0%) and traumatic brain injury (OR = 1.41 (1.03 to 1.94) I2 64.54%). However, these results are limited by significant heterogeneity between studies.

Conclusions
Hyperoxia may be associated with increased mortality in patients with stroke, traumatic brain injury and those resuscitated from cardiac arrest. However, these results are limited by the high heterogeneity of the included studies.
Proton pump inhibitors increase the risk for hospital-acquired Clostridium difficile infection in critically ill patients
Authors: Barletta Jeffrey F , Sclar David A 
Published: December 2014

Abstract
Introduction
Proton pump inhibitors (PPI) have been linked to Clostridium difficile infection (CDI) but there are few data specific to ICU patients. We evaluated duration of PPI exposure as a potential risk factor for hospital-acquired CDI in the ICU.

Methods
This retrospective, case-control study was conducted using the Multiparameter Intelligent Monitoring in Intensive Care II database, a large publically available database of more than 35,000 ICU patients. Adult patients with CDI were identified using the ICD-9 code for Clostridium difficile listed as a secondary diagnosis. To be included, patients had to be present in an ICU for ≥48 hours prior to Clostridium difficile acquisition. These patients were then matched to patients without CDI using the ICD-9 primary diagnosis, age (+/−5 years) and SOFA score (+/−1). Successfully matched patients were reviewed for PPI exposure and other potential confounding variables for CDI. PPI exposure was characterized as short (<2 days) or long (≥2 days). Multivariate modeling was performed to identify independent risk factors for CDI.

Results
There were 408 patients evaluated and 81% received a PPI. The percentage of patients who had a long exposure to PPIs was 83% in the CDI group compared to 73% with controls (P = 0.012). Upon inclusion of the following variables into a multivariate analysis (long PPI exposure, histamine-2-receptor antagonist administration, antibiotic administration, immunosuppression and study duration), long PPI exposure (odds ratio (OR) (95% confidence interval (CI) = 2.03 (1.23 to 3.36), P = 0.006) and antibiotic use (OR (95% CI) = 2.52 (1.23 to 5.18), P = 0.012) were identified as independent predictors of CDI.

Conclusions
Proton pump inhibitors are independent risk factors for the development of CDI in ICU patients. This risk is particularly exposed after two or more days of therapy.
Locomotor benefits of being a slender and slick sand-swimmer
Authors: Sharpe Sarah S. , Koehler Stephan A. , Kuckuk Robyn M. , Serrano Miguel , Vela Patricio A. , Mendelson Joseph , Goldman Daniel I. 
Published: December 2014

Abstract
Squamates classified as "subarenaceous" possess the ability to move long distances within dry sand; body elongation among sand and soil burrowers has been hypothesized to enhance subsurface performance. Using x-ray imaging, we performed the first kinematic investigation of the subsurface locomotion of the long, slender shovel-nosed snake (Chionactis occipitalis) and compared its biomechanics to those of the shorter, limbed sandfish lizard (Scincus scincus). The sandfish was previously shown to maximize swimming speed and minimize mechanical cost of transport during burial. Our measurements revealed that the snake also swims through sand by propagating traveling waves down the body, head to tail. Unlike the sandfish, the snake nearly followed its own tracks, thus swimming in an approximate tube of self-fluidized granular media. We measured deviations from tube movement by introducing a parameter, the local slip angle, βs, which measures the angle between direction of movement of each segment and body orientation. The average slip angle (β-s) was smaller for the snake than the sandfish; granular resistive force theory (RFT) revealed that the curvature utilized by each animal optimized its performance. The snake benefits from its slender body shape (and increased vertebral number) which allows propagation of a higher number of optimal curvature body undulations. The snake's low skin friction also increases performance. The agreement between experiment and RFT combined with the relatively simple properties of the granular "frictional fluid" make subarenaceous swimming an attractive system to study functional morphology and bauplan evolution.
The colony environment modulates sleep in honey bee workers
Authors: Eban-Rothschild Ada , Bloch Guy 
Published: December 2014

Abstract
One of the most important and evolutionarily conserved roles of sleep is the processing and consolidation of information acquired during wakefulness. In both insects and mammals, environmental and social stimuli can modify sleep physiology and behavior, yet relatively little is known about the specifics of the wake experiences and their relative contribution to experience-dependent modulation of sleep. Honey bees provide an excellent model system in this regard because their behavioral repertoire is well characterized and the environment they experience during the day can be manipulated while keeping an ecologically and sociobiologically relevant context. We examined whether social experience modulates sleep in honey bees, and evaluated the relative contribution of different social signals. We exposed newly emerged bees to different components of their natural social environment and then monitored their sleep behavior in individual cages in a constant lab environment. We found that rich waking experience modulates subsequent sleep. Bees that experienced the colony environment for one or two days slept more than same-age sister bees that were caged individually or in small groups in the lab. Furthermore, bees placed in mesh-enclosures in the colony, that prevented direct contact with nestmates, slept similarly to bees freely-moving in the colony. These results suggest that social signals that do not require direct or close distance interactions between bees are sufficiently rich to encompass almost the entire effect of the colony on sleep. Our findings provide a remarkable example of social-experience dependent modulation of an essential biological process.
Antiproliferative Activity of Silver Nanoplates on Human Promyelocytic Leukemia Cell Lines
Authors: Sakaguchi Tatsuya , Mine Kenta , Kudoh Fuki , Kamada Rui , Sakaguchi Kazuyasu 
Published: December 2014

Abstract
The physical and chemical properties of silver nanomaterials are highly dependent on their shape and size. Recently, Ag nanoparticles have been reported to be useful for medicinal and pharmaceutical applications including anticancer activity. In this study, we showed that Ag nanoplates possess significantly higher antiproliferative activity on human promyelocytic leukemia cells, HL-60, than spherical nanoparticles. The triangular Ag nanoplates induced apoptosis in the cells and were located in the same subcellular compartment as the spherical Ag nanoparticles.
Field research on depth distribution of normal stresses in the mass of sand base of the strip foundations with beam elements
Authors: Архипов Дмитрий , Arkhipov Dmitriy , Евтушенко Сергей , Evtushenko Sergey 
Published: December 2014

The article presents the results of the field research on
depth distribution of normal stresses in the mass of sand base in the
transverse alignment of the foundation model with variable geometric
shape of the foundation base. Diagrams of the distribution of
normal stresses are constructed on the results of the experiments
being held, and presence of the arching phenomenon in the gap
between the extended elements of the foundation being confirmed.
Field research on distribution of vertical stresses and deformations in the sand base of the strip foundations with beam elements
Authors: Архипов Дмитрий , Arkhipov Dmitriy , Евтушенко Сергей , Evtushenko Sergey 
Published: December 2014

The article presents the results of the field research on
distribution of normal stresses and relative deformations in
the sand base along the vertical axis in the gap between the extended
beam elements of strip foundation model with variable
geometric shape of the foundation base. In the field research of
Stress-Strain Behavior (SSB) of the subfoundation of strip foundation
model based on beam elements, it is found that the height of
the soil curved arch occurring between the extended elements of
the foundation base, increases during loading and when approaching
the ultimate loading the experimental value of the arch height
tends to the theoretical value defined by the formula proposed by
M.M. Protodyakonov.
Calculation deformability of composite beams based on numerical studies in the software package Lira 9.2
Authors: Рощина Светлана , Roina Svyetlana , Лукин Михаил , Lukin Mikhail , Грибанов Алексей , Gribanov Aleksey 
Published: December 2014

The problems of calculating deformability composite
beams in the software package Lira 9.2 based on real wood work
under load are considered. The calculation in the nonlinear formulation
using the well-known Belyankin - Prager chart is performed.
Improving family carers' experiences of support at the end of life by enhancing communication: an action research study
Authors: Dosser Isabel , Kennedy Catriona 
Published: December 2014

Background This paper builds on findings from phase one of a participatory action research study, which investigated support for family carers at the end of life in an acute hospital setting in Scotland, UK ( Dosser and Kennedy, 2012 ). The research presented here is the second phase of the participatory action research study, in which nursing staff from an acute hospital ward are involved in ongoing analysis of data and ideas guided by action cycles and reflection. Methods Two key change initiatives are reported; improving nurses' communication skills and improving the environment for family carers of loved ones at the end of life within the acute hospital setting. To address these points, nurses were enrolled on a communications skills course, and a new room for family carers was integrated into the hospital. Results Data were analysed from interviews and questionnaires with the nurses, and from insights gathered in a reflective diary taken by the researcher. The changes implemented improved the confidence of participants in communicating with carers as well as patients and colleagues. Conclusion The findings highlight practical strategies and communication issues that can potentially impact on the grief experience of family carers, such as having a safe space nearby to rest in private, away from the bedside.
Synthesis of quinolinequinone derivatives and related carbocyclic compounds
Authors: Egu Samuel Attah , Okoro Uchechukwu Chris , Wirth Thomas 
Published: December 2014

Abstract
Palladium-catalyzed Buchwald-Hartwig aminations of various quinolinequinone derivatives give excellent yields of novel 6-arylamino derivatives of the disubstituted quinolinequinones and 3-arylamino derivatives of the corresponding naphthoquinones. The precursor quinolinequinones are prepared in a three-step sequence from 8-hydroxyquinoline. The transition-metal-catalyzed arylations of 6,7-dibromo-5,8-quinolinequinone, 6,7-dichloro-5,8-quinolinequinone and 2,3-dichloro-1,4-naphthoquinone are reported for the first time and offer fast and easy access to their derivatives.
Measures to minimize cross-contamination risks in Advanced Therapy Medicinal Product manufacturing
Authors: Roseti Livia , Serra Marta , Grigolo Brunella 
Published: December 2014

AbstractCurrent European regulations definein vitroexpanded cells for clinical purposes as substantially manipulated and include them in the class of Advanced Therapy Medicinal Products to be manufactured in compliance with current Good Manufacturing Practice. These quality requirements are generally thought to be elaborate and costly. However, they ensure three main product characteristics: safety, consistency, and absence of cross-contamination. The term crosscontamination is used to indicate misidentification of one cell line or culture by another. The Good Manufacturing Practice Guidelines suggest some recommendations in order to prevent cross-contaminations and require a demonstration that the implemented actions are effective. Here we report some practical examples useful both to minimize crosscontamination risks in an Advanced Therapy Medicinal Products production process and to evaluate the efficacy of the adopted measures.