bluuebunny/crossref_metadata_2025_split huggingface dataset:
Achieving the Optimal Epinephrine Effect in Wide Awake Hand Surgery using Local Anesthesia without a Tourniquet
Authors: Mckee Daniel E. , Lalonde Donald H. , Thoma Achilleas , Dickson Lisa 
Published: April 2015

Background In our experience, for all surgeries in the hand, the optimal epinephrine effect from local anesthesia—producing maximal vasoconstriction and visualization—is achieved by waiting significantly longer than the traditionally quoted 7 min from the time of injection. Methods In this prospective comparative study, healthy patients undergoing unilateral carpal tunnel surgery waited either 7 min or roughly 30 min, between the time of injection of 1 % lidocaine with 1:100,000 epinephrine and the time of incision. A standardized incision was made through dermis and into the subcutaneous tissue followed by exactly 60 s of measuring the quantity of blood loss using sterile micropipettes. Results There was a statistically significant reduction in the mean quantity of bleeding in the group that waited roughly 30 min after injection and before incision compared to the group that waited only 7 min (95 % confidence intervals of 0.06+–0.03 ml/cm of incision, compared to 0.17+–0.08 ml/cm, respectively) (P=0.03). Conclusions Waiting roughly 30 min after injection of local anesthesia with epinephrine as oppose to the traditionally taught 7 min, achieves an optimal epinephrine effect and vasoconstriction. In the hand, this will result in roughly a threefold reduction in bleeding—making wide awake local anesthesia without tourniquet (WALANT) possible. This knowledge has allowed our team to expand the hand procedures that we can offer using WALANT. The benefits of WALANT hand surgery include reduced cost and waste, improved patient safety, and the ability to perform active intraoperative movement examinations.
Prehospital personnel’s attitudes to pain management
Authors: Castrèn Maaret , Lindström Veronica , Branzell Jenny Hagman , Niemi-Murola Leila 
Published: April 2015

Abstract

Objectives
Pain is one of the most common reasons for patients to seek acute medical care. The management of pain is often inadequate both in the prehospital setting and in the emergency department. Our aim was to evaluate the attitudes towards pain management among prehospital personnel in two Scandinavian metropolitan areas.

Methods
A questionnaire with 36 items was distributed to prehospital personnel working in Helsinki, Finland (n=70) and to prehospital personnel working in Stockholm, Sweden (n=634). Each item was weighted on a five-level Likert scale. Factor loading of the questionnaire was made using maximum likelihood analysis and varimax rotation. Six scales were constructed (Hesitation, Encouragement, Side effects, Evaluation, Perceptions, Pain metre). A Student’s t-test, ANOVA, and Pearson Correlation were used for analysis of significance.

Results
: The response rate among the Finnish prehospital personnel was 66/70 (94.2%) while among the Swedish personnel it was 127/634 (20.0%). The prehospital personnel from Sweden showed significantly more Hesitation to administer pain relief compared to the Finnish personnel (mean 2.01 SD 0.539 vs. 1.67 SD 0.530, p < 0.001). Those who had received pain education at their workplace showed significantly less Hesitation than those who had not participated in education. There was a significant negative correlation (p < 0.01) between Hesitation and Side effects. There was also astatistically significant(p < 0.01) correlation between Perceptions and Hesitation, indicating that a stoic attitude towards pain was associated with indifference to possible Side effects of pain medication (p < 0.05).

Conclusions
The results show that there was a significant correlation between the extent of education and the prehospital personnel’s attitudes to pain management. Gender and age among the prehospital personnel also affected the attitudes to pain management. The main discrepancy between the Swedish and Finnish personnel was that the participants from Stockholm showed statistically significantly more hesitation about administering pain medication compared to the participants from Helsinki.

Implications
The results of the study highlight the need for continuous medical education (CME) for prehospital personnel. CME and discussions among prehospital personnel may help to make a change in the personnel’s attitudes towards pain and pain management in the prehospital context.
BELIEF IS PRIOR TO KNOWLEDGE
Authors: Rose David 
Published: April 2015

AbstractOrthodoxy has it that knowledge is a composite of belief and non-mental factors. However, Timothy Williamson suggests that orthodoxy implies that the concept of belief is acquired before the concept of knowledge, whereas developmental data suggest the reverse. More recently, Jennifer Nagel reviews the psychological evidence, building a psychological case that the concept of knowledge emerges prior to belief. I assess the psychological state of the art and find support for the opposite conclusion. Overall the empirical evidence supports the orthodox view that the concept of belief is prior to the concept of knowledge.
Royal Losses, Symbolic Politics and Media Events in Interwar Europe: Responses to the Accidental Deaths of King Albert I and Queen Astrid of Belgium (1934–1935)
Authors: DE SPIEGELEER CHRISTOPH 
Published: April 2015

AbstractThis article examines the public and private responses to the accidental deaths of King Albert I and Queen Astrid of Belgium in 1934 and 1935. The public and private mourning for Albert and Astrid and the impact of their deaths and funerals can only be understood when we analyse these events against the background of structural transformations in national identity, international and national politics and media culture in interwar Europe. The analysis of the responses to these events thus offers unique insights into the relationship between the Belgian monarchy, politics and modern mass media in the 1930s. The memory of the war experience permeated both funerals through the massive presence of war veterans. Condolence letters to the royal court show how Astrid's popularity made the Belgian monarchy more human and approachable than it had ever been, while their sudden deaths simultaneously stimulated the mystification of both royal figures. Albert's funeral even constituted an event of symbolic significance in the interstate relations of Belgium with France. The meaning of both these high-profile deaths was negotiated within the mass media.
Democratic Politics and the League of Nations: The Labour and Socialist International as a Protagonist of Interwar Internationalism
Authors: LAQUA DANIEL 
Published: April 2015

AbstractThe Labour and Socialist International (LSI) was a major vehicle for transnational socialist cooperation during the interwar years and thus seemed to continue the traditions of socialist internationalism. In the realm of international relations, however, it championed key tenets of liberal internationalism. The LSI supported the idea of a League of Nations and embraced the notion of a world order based upon democratic nation-states. While it criticised some aspects of the international system, its overall emphasis was on reform rather than revolution. The article sheds light on the wider phenomenon of interwar internationalism by tracing the LSI's relationship with the League of Nations, with the politics of peace more generally and with the competing internationalism of the communists.
CLP(H):Constraint logic programming for hedges
Authors: DUNDUA BESIK , FLORIDO MÁRIO , KUTSIA TEMUR , MARIN MIRCEA 
Published: April 2015

AbstractCLP(H) is an instantiation of the general constraint logic programming scheme with the constraint domain of hedges. Hedges are finite sequences of unranked terms, built over variadic function symbols and three kinds of variables: for terms, for hedges, and for function symbols. Constraints involve equations between unranked terms and atoms for regular hedge language membership. We study algebraic semantics of CLP(H) programs, define a sound, terminating, and incomplete constraint solver, investigate two fragments of constraints for which the solver returns a complete set of solutions, and describe classes of programs that generate such constraints.
Analgesia and unwanted benzodiazepine effects in point-mutated mice expressing only one benzodiazepine-sensitive GABAA receptor subtype
Authors: Ralvenius William T. , Benke Dietmar , Acuña Mario A. , Rudolph Uwe , Zeilhofer Hanns Ulrich 
Published: April 2015

AbstractAgonists at the benzodiazepine-binding site of GABAA receptors (BDZs) enhance synaptic inhibition through four subtypes (α1, α2, α3 and α5) of GABAA receptors (GABAAR). When applied to the spinal cord, they alleviate pathological pain; however, insufficient efficacy after systemic administration and undesired effects preclude their use in routine pain therapy. Previous work suggested that subtype-selective drugs might allow separating desired antihyperalgesia from unwanted effects, but the lack of selective agents has hitherto prevented systematic analyses. Here we use four lines of triple GABAAR point-mutated mice, which express only one benzodiazepine-sensitive GABAAR subtype at a time, to show that targeting only α2GABAARs achieves strong antihyperalgesia and reduced side effects (that is, no sedation, motor impairment and tolerance development). Additional pharmacokinetic and pharmacodynamic analyses in these mice explain why clinically relevant antihyperalgesia cannot be achieved with nonselective BDZs. These findings should foster the development of innovative subtype-selective BDZs for novel indications such as chronic pain.
A role for Kalirin-7 in nociceptive sensitization via activity-dependent modulation of spinal synapses
Authors: Lu Jianning , Luo Ceng , Bali Kiran Kumar , Xie Rou-Gang , Mains Richard E. , Eipper Betty A. , Kuner Rohini 
Published: April 2015

AbstractSynaptic plasticity is the cornerstone of processes underlying persistent nociceptive activity-induced changes in normal nociceptive sensitivity. Kalirin-7 is a multifunctional guanine-nucleotide-exchange factor (GEF) for Rho GTPases that is characterized by its localization at excitatory synapses, interactions with glutamate receptors and its ability to dynamically modulate the neuronal cytoskeleton. Here we show that spinally expressed Kalirin-7 is required for persistent nociceptive activity-dependent synaptic long-term potentiation as well as activity-dependent remodelling of synaptic spines in the spinal dorsal horn, thereby orchestrating functional and structural plasticity during the course of inflammatory pain.
HIF-inducible miR-191 promotes migration in breast cancer through complex regulation of TGFβ-signaling in hypoxic microenvironment.
Authors: Nagpal Neha , Ahmad Hafiz M. , Chameettachal Shibu , Sundar Durai , Ghosh Sourabh , Kulshreshtha Ritu 
Published: April 2015

AbstractThe molecular mechanisms of hypoxia induced breast cell migration remain incompletely understood. Our results show that hypoxia through hypoxia-inducible factor (HIF) brings about a time-dependent increase in the level of an oncogenic microRNA, miR-191 in various breast cancer cell lines. miR-191 enhances breast cancer aggressiveness by promoting cell proliferation, migration and survival under hypoxia. We further established that miR-191 is a critical regulator of transforming growth factor beta (TGFβ)-signaling and promotes cell migration by inducing TGFβ2 expression under hypoxia through direct binding and indirectly by regulating levels of a RNA binding protein, human antigen R (HuR). The levels of several TGFβ pathway genes (like VEGFA, SMAD3, CTGF and BMP4) were found to be higher in miR-191 overexpressing cells. Lastly, anti-miR-191 treatment given to breast tumor spheroids led to drastic reduction in spheroid tumor volume. This stands as a first report of identification of a microRNA mediator that links hypoxia and the TGFβ signaling pathways, both of which are involved in regulation of breast cancer metastasis. Together, our results show a critical role of miR-191 in hypoxia-induced cancer progression and suggest that miR-191 inhibition may offer a novel therapy for hypoxic breast tumors.
Serum proprotein convertase subtilisin/kexin type 9 concentration is not increased by plant stanol ester consumption in normo- to moderately hypercholesterolaemic non-obese subjects. The BLOOD FLOW intervention study
Authors: Simonen Piia , Stenman Ulf-Håkan , Gylling Helena 
Published: April 2015

Proprotein convertase subtilisin/kexin type 9 (PCSK9) regulates low-density lipoprotein (LDL) cholesterol (LDL-C) metabolism by targeting LDL receptors for degradation. Statins increase serum PCSK9 concentration limiting the potential of statins to reduce LDL-C, whereas ezetimibe, inhibitor of cholesterol absorption, has ambiguous effects on circulating PCSK9 levels. Plant stanols also reduce cholesterol absorption, but their effect on serum PCSK9 concentration is not known. Therefore, we performed a controlled, randomized, double-blind study, in which 92 normo- to moderately hypercholesterolaemic subjects (35 males and 57 females) consumed vegetable-oil spread 20 g/day enriched (plant stanol group, n=46) or not (control group, n=46) with plant stanols 3 g/day as ester for 6 months. Fasting blood samples were drawn at baseline and at the end of the study. Serum PCSK9 concentration was analysed with Quantikine Elisa Immunoassay, serum and lipoprotein lipids enzymatically and serum non-cholesterol sterols with GLC. At baseline, PCSK9 concentration varied from 91 to 716 ng/ml with a mean value of 278±11 (S.E.M.) ng/ml with no gender difference. It correlated with serum and LDL-C, serum triglycerides, age, body mass index (BMI) and plasma glucose concentration, but not with variables of cholesterol metabolism when adjusted to serum cholesterol. Plant stanols reduced LDL-C by 10% from controls (P&lt;0.05), but PCSK9 levels were unchanged and did not differ between the groups. In conclusion, the present study demonstrated for the first time that inhibition of cholesterol absorption with plant stanol esters did not affect serum PCSK9 concentration. Thus, plant stanol esters provide an efficient dietary means to lower LDL-C without interfering with the PCSK9 metabolism and in this regard the LDL receptor-mediated cellular cholesterol uptake and removal.
Recent Advances in the Total Synthesis of Prenylflavonoid and Related Diels–Alder Natural Products
Authors: Han Jianguang , Jones Alexander , Lei Xiaoguang 
Published: April 2015

This review summarizes the application of different strategies for the key Diels–Alder cycloaddition in prenylflavonoid and related Diels–Alder natural products synthesis, highlighting the application of novel methodologies and innovative strategies in the synthesis of these natural products and their analogues.1 Introduction2 Classical Conditions for the Diels–Alder Cycloaddition2.1 Thermal Promotion2.2 High-Pressure Promotion2.3 Brønsted Acid Catalysis3 Modern Approaches to the Diels–Alder Cycloaddition3.1 Electron-Transfer Initiation3.2 Silver-Nanoparticle Catalysis3.3 Chiral-Boron-Complex Promotion4 Conclusion
Deleterious effects of obesity on physical fitness in pre‐pubertal children
Authors: Ceschia Arianna , Giacomini Stefano , Santarossa Simone , Rugo Miriam , Salvadego Desy , Da Ponte Alessandro , Driussi Caterina , Mihaleje Martina , Poser Stefano , Lazzer Stefano 
Published: April 2015

AbstractThe prevalence of obesity in children has increased dramatically during the past decades in Europe and understanding physical fitness and its components in children is critical to design and implement effective interventions. The objective of the present study was to analyse the association between physical fitness (aerobic, speed, agility, power, flexibility and balance) and body mass index (BMI) in pre‐pubertal children. A total of 2411 healthy schoolchildren (7–11 years) participated in this study. Anthropometric characteristics and body composition were assessed by skinfold thickness. Physical fitness was measured by nine physical fitness tests: endurance running, 20 m running speed, agility, handgrip strength, standing long jump and squat jump, sit and reach, medicine ball forward throw and static balance. No relevant differences were observed between boys and girls regarding anthropometric characteristics, body composition and physical fitness. However, overweight and obese children showed significantly lower physical fitness levels in endurance running, speed and agility (mean: +18.8, +5.5 and +14.5% of time to complete tasks, respectively), lower limb power normalised to body mass (−23.3%) and balance tests (number of falls: +165.5%) than their normal weight counterparts. On the other hand, obesity did not affect handgrip, throwing and flexibility. In conclusion, increased BMI was associated with lower performance capabilities limiting proper motor skill development, which directly affects the ability of children to take on sports skills. Actions undertaken to promote children's wellness and fitness should be prioritised and introduced early in life with the aim of enhancing physical fitness as well as preventing overweight and obesity.
Actors and barriers to the adoption of LCC and LCA techniques in the built environment
Authors: D'Incognito Maria , Costantino Nicola , Migliaccio Giovanni C. 
Published: April 2015

Purpose– The purpose of this paper is to evaluate the existing barriers to the slow adoption of Life Cycle Assessment (LCA) and Life Cycle Costing (LCC) in construction, and the main responsible actors.Design/methodology/approach– The research design is based on a two-phase approach. First, the existing literature was studied through a multiple-step content analysis (CA) approach, which combined unsupervised concept mapping with computer aided CA. Using a relational CA approach, statistical-based analysis tools were initially used to identify the relationships between actors and barriers. Later, a Delphi study was administered to a panel of experts, to triangulate, validate, and refine the initial results.Findings– The study revealed that organizational culture is the most relevant barrier, and that clients and professionals are the actors that predominantly influence the adoption of LCC and LCA in projects. Technical and financial barriers, such as the lack and quality of input data and the high costs of implementation are also deemed relevant.Research limitations/implications– The CA was performed by a single rater on a sample that included 50 papers in English language. Future research may focus on enlarging the sample, extending it to other languages, and linking the source (or the expert) to their professional context to evaluate geographical differences in barriers.Originality/value– The adopted approach gives new insights on the relationships behind the rejection of LCA and LCC suggesting that solutions at the organizational level may be more effective than technical ones.
Segmenting CSA members by motivation: anything but two peas in a pod
Authors: Pole Antoinette , Kumar Archana 
Published: April 2015

Purpose
– The purpose of this paper is to seek to segment CSA members based on their motivations to join a CSA.

Design/methodology/approach
– Data obtained from an online survey of 565 members belonging to a New York state CSA were analyzed using a combined hierarchical and non-hierarchical cluster analysis.

Findings
– Based on their motivations to join a CSA results reveal four distinct types of segments among CSA members: No-Frills Member, Foodie Member, Nonchalant Member, and Quintessential Member. Results show all four clusters differ statistically across demographic characteristics including gender, political affiliation, and household income. The clusters differed across psychographic characteristics such as attitudes toward the treatment of animals, treatment of farm workers, pesticide use, the environment, food miles, and limiting factory farm purchases. Quintessential Members emerge as most concerned with food purchasing decisions while No-Frills Members are least concerned.

Research limitations/implications
– The study employs a non-random purposive sample of CSAs in New York state. Respondents were recruited indirectly to participate in an online survey. The length and complexity of the survey, absence of an email address for respondents, levels of digital fluency, and technical glitches may result in lower participation rates.

Practical implications
– This paper offers recommendations to farmers for retaining and attracting different types of CSA members.

Originality/value
– This is the first study that segments CSA members in the USA based on their motivations to subscribe to a CSA, and it differentiates CSA member clusters based on their demographics, psychographics, and food purchasing decisions.
Internationalization pathways and the performance of SMEs
Authors: Fernández Olmos Marta , Díez-Vial Isabel 
Published: April 2015

Purpose– The purpose of this paper is to examine the effect of the chosen specific internationalization pathway on the relationship between internationalization and firm performance.Design/methodology/approach– This paper analyses the internationalization pathway among small- and medium-sized enterprises which internationalize through exporting and are more limited in terms of the resources they can leverage across markets.Findings– Empirical evidence obtained from a sample of wineries in La Rioja shows that the internationalization – export performance relationship is characterized by a U-shaped curve for firms with a gradual internationalization pathway, and an S-shaped curve for firms with an accelerated internationalization pathway.Research limitations/implications– This empirical study on the impact of export intensity on performance has acknowledged the importance of costs caused by the liability of foreignness and the transaction and coordination costs involved in each market expansion process. However, it has not examined the effect of differences in absorptive and coordination capabilities at the firm level.Practical implications– The findings about the role of the specific internationalization pathway in driving export intensity and performance appear to be relevant from a public-policy perspective. Local policies aimed at promoting exports have been widely based on the argument that firms can improve their performance through increasing their level of international sales. However, empirical evidence shows that these efforts may not work as well as was thought, unless combined with the right market expansion pathway and the optimal level of exports associated with this international market expansion.Social implications– Most studies on the effect of international market expansion on firm performance have not considered the influence of the specific market expansion pathway chosen. In taking this factor into account, this paper contributes to the existing body of work by developing an integrative theoretical framework that explores how the pathway of internationalization impacts on firms’ performance.Originality/value– Most studies on the effect of international market expansion on firm performance have not considered the influence of the specific market expansion process chosen. In taking this factor into account, this paper contributes to the existing body of work by developing an integrative theoretical framework that explores how the process of international market expansion impacts on firms’ performance.