bluuebunny/crossref_metadata_2025_split huggingface dataset:
Improving the safety of remote site emergency airway management
Authors: Wijesuriya Julian , Brand Jonathan 
Published: February 2014

AbstractAirway management, particularly in non-theatre settings, is an area of anaesthesia and critical care associated with significant risk of morbidity & mortality, as highlighted during the 4th National Audit Project of the Royal College of Anaesthetists (NAP4). A survey of junior anaesthetists at our hospital highlighted a lack of confidence and perceived lack of safety in emergency airway management, especially in non-theatre settings.We developed and implemented a multifaceted airway package designed to improve the safety of remote site airway management. A Rapid Sequence Induction (RSI) checklist was developed; this was combined with new advanced airway equipment and drugs bags. Additionally, new carbon dioxide detector filters were procured in order to comply with NAP4 monitoring recommendations.The RSI checklists were placed in key locations throughout the hospital and the drugs and advanced airway equipment bags were centralised in the Intensive Care Unit (ICU). It was agreed with the senior nursing staff that an appropriately trained ICU nurse would attend all emergency situations with new airway resources upon request. Departmental guidelines were updated to include details of the new resources and the on-call anaesthetist’s responsibilities regarding checks and maintenance.Following our intervention trainees reported higher confidence levels regarding remote site emergency airway management. Nine trusts within the Northern Region were surveyed and we found large variations in the provision of remote site airway management resources.Complications in remote site airway management due lack of available appropriate drugs, equipment or trained staff are potentially life threatening and completely avoidable. Utilising the intervention package an anaesthetist would be able to safely plan and prepare for airway management in any setting. They would subsequently have the drugs, equipment, and trained assistance required to manage any difficulties or complications. We suggest that this should be the gold standard of airway resource provision and is in line with NAP4 recommendations.
Variations in specialist palliative care referrals: findings from a population-based patient cohort of acute myeloid leukaemia, diffuse large B-cell lymphoma and myeloma
Authors: Howell D A , Wang H-I , Roman E , Smith A G , Patmore R , Johnson M J , Garry A C , Howard M R 
Published: February 2014

ObjectiveTo develop and implement a methodology for capturing complete haematological malignancy pathway data and use it to identify variations in specialist palliative care (SPC) referrals.MethodsIn our established UK population-based patient cohort, 323 patients were diagnosed with acute myeloid leukaemia, diffuse large B-cell lymphoma or myeloma between May 2005 and April 2008, and died before April 2010. A day-by-day calendar approach was devised to collect pathway data, including SPC referrals, to supplement routinely collected information on clinical presentation, diagnosis, treatment, response, and date and place of death.Results155 (47.9%) of the 323 patients had at least one SPC referral. The likelihood of referral increased with survival (OR 6.58, 95% CIs 3.32 to 13.03 for patients surviving ≥1 year compared to ≤1 month from diagnosis), and varied with diagnosis (OR 1.96, CIs 1.15 to 3.35 for myeloma compared to acute myeloid leukaemia). Compared to patients dying in hospital, those who died at home or in a hospice were also more likely to have had an SPC referral (OR 3.07, CIs 1.59 to 5.93 and 4.74, CIs 1.51 to 14.81, respectively). No associations were found for age and sex.ConclusionsOur novel approach efficiently captured pathway data and SPC referrals, revealing evidence of greater integration between haematology and SPC services than previously reported. The likelihood of referral was much higher among those dying outside hospital, and variations in practice were observed by diagnosis, emphasising the importance of examining diseases individually.
Public access defibrillation remains out of reach for most victims of out-of-hospital sudden cardiac arrest
Authors: Deakin Charles D , Shewry Elizabeth , Gray Huon H 
Published: February 2014

IntroductionPublic access defibrillation (PAD) prior to ambulance arrival is a key determinant of survival from out-of-hospital (OOH) cardiac arrest. Implementation of PAD has been underway in the UK for the past 12 years, and its importance in strengthening the chain of survival has been recognised in the government's recent ‘Cardiovascular Disease Outcomes Strategy’. The extent of use of PAD in OOH cardiac arrests in the UK is unknown. We surveyed all OOH cardiac arrests in Hampshire over a 12-month period to ascertain the availability and effective use of PAD.MethodsA retrospective review of all patients with OOH cardiac arrest attended by South Central Ambulance Service (SCAS) in Hampshire during a 1-year period (1 September 2011 to 31 August 2012) was undertaken. Emergency calls were reviewed to establish the known presence of a PAD. Additionally, a review of all known PAD locations in Hampshire was undertaken, together with a survey of public areas where a PAD may be expected to be located.ResultsThe current population of Hampshire is estimated to be 1.76 million. During the study period, 673 known PADs were located in 278 Hampshire locations. Of all calls confirmed as cardiac arrest (n=1035), the caller reported access to an automated external defibrillator (AED) on 44 occasions (4.25%), successfully retrieving and using the AED before arrival of the ambulance on only 18 occasions (1.74%).ConclusionsDespite several campaigns to raise public awareness and make PADs more available, many public areas have no recorded AED available, and in those where an AED was available it was only used in a minority of cases by members of the public before arrival of the ambulance. Overall, a PAD was only deployed successfully in 1.74% OOH cardiac arrests. This weak link in the chain of survival contributes to the poor survival rate from OOH cardiac arrest and needs strengthening.
Provenance, characterization and decay of a porous calcarenite of the Puglia region (‘Pietra Gentile’)
Authors: Calia A. , Sileo M. , Matera L. 
Published: February 2014

Abstract
Conservation of the built heritage requires knowledge of the characteristics and use of the constituent materials and their state of conservation. Knowledge of the material's source is important for laboratory studies and stone replacement, but it also has historic-cultural significance with respect to the exploitation of stone resources in the past. In this sense, we present a study of ‘Pietra Gentile’, a traditional building material of southern Italy, through which we aimed to acquire knowledge concerning the quarries, characteristics of extracted materials, use and decay features within buildings. Ancient and active quarries were identified and the petrographical, chemical-mineralogical and physical features of the quarry materials were studied. The use of the stone was documented in many historic towns in the area, including monuments and minor buildings, and the main decay morphologies were detected by field activities and laboratory analyses. The high susceptibility of the stone to the actions of water and salts was highlighted. Field and laboratory data of quarries and artefacts were organized into a database as a source of knowledge useful for the evaluation, preservation and promotion of cultural heritage.
Antitumor Effects in Gastrointestinal Stromal Tumors Using Photodynamic Therapy with a Novel Glucose-Conjugated Chlorin
Authors: Tanaka Mamoru , Kataoka Hiromi , Yano Shigenobu , Ohi Hiromi , Moriwaki Kazuhiro , Akashi Haruo , Taguchi Takahiro , Hayashi Noriyuki , Hamano Shingo , Mori Yoshinori , Kubota Eiji , Tanida Satoshi , Joh Takashi 
Published: February 2014

Abstract
Gastrointestinal stromal tumors (GIST) are the most common mesenchymal tumors of the gastrointestinal tract. Except for surgical resection, no effective treatment strategies have been established. Photodynamic therapy (PDT) consists of intravenous administration of a photosensitizer, activated by a specific wavelength of light, which produces reactive oxygen species that directly kill tumor cells. We analyzed the efficacy of PDT using a newly developed photosensitizer, 5,10,15,20-tetrakis [4-[β-d-glucopyranosylthio-2,3,5,6-tetrafluorophenyl]-2,3,[methano[N-methyl] iminomethano] chlorin (H2TFPC-SGlc), for the GIST treatment. Various photosensitizers were administered in vitro to GIST (GIST-T1) and fibroblast (WI-38) cells, followed by irradiation, after which cell death was compared. We additionally established xenograft mouse models with GIST-T1 tumors and examined the accumulation and antitumor effects of these photosensitizers in vivo. In vitro, the expression of the glucose transporters GLUT1, GLUT3, and GLUT4, the cellular uptake of H2TFPC-SGlc, and apoptosis mediated by PDT with H2TFPC-SGlc were significantly higher in GIST-T1 than in WI-38 cells. In vivo, H2TFPC-SGlc accumulation was higher in xenograft tumors of GIST-T1 cells than in the adjacent normal tissue, and tumor growth was significantly suppressed following PDT. PDT with novel H2TFPC-SGlc is potentially useful for clinical applications about the treatment of GIST. Mol Cancer Ther; 13(4); 767–75. ©2014 AACR.
Ponatinib Induces Apoptosis in Imatinib-Resistant Human Mast Cells by Dephosphorylating Mutant D816V KIT and Silencing β-Catenin Signaling
Authors: Jin Bei , Ding Ke , Pan Jingxuan 
Published: February 2014

Abstract
Gain-of-function mutations of membrane receptor tyrosine kinase KIT, especially gatekeeper D816V point mutation in KIT, render kinase autoactivation, disease progression, and poor prognosis. D816V KIT is found in approximately 80% of the patients with systemic mastocytosis, and is resistant to the first and second generations of tyrosine kinase inhibitors (TKI). The purpose of this investigation was aimed at exploring whether ponatinib (AP24534), a novel effective TKI against T315I Bcr-Abl, was active against D816V KIT. We discovered that ponatinib abrogated the phosphorylation of KIT harboring either V560G (sensitive to imatinib) or D816V mutation (resistant to imatinib) and the downstream signaling transduction. Ponatinib inhibited the growth of D816V KIT–expressing cells in culture and nude mouse xenografted tumor. Ponatinib triggered apoptosis by inducing the release of cytochrome c and AIF, downregulation of Mcl-1. Furthermore, ponatinib abrogated the phosphorylation of β-catenin at the site Y654, suppressed the translocation of β-catenin, and inhibited the transcription and DNA binding of TCF and the expression of its targets (e.g., AXIN2, c-MYC, and CCND1). Moreover, ponatinib was highly active against xenografted D816V KIT tumors in nude mice and significantly prolonged the survival of mice with aggressive systemic mastocytosis or mast cell leukemia by impeding the expansion and infiltration of mast cells with imatinib-resistant D814Y KIT. Our findings warrant a clinical trial of ponatinib in patients with systemic mastocytosis harboring D816V KIT. Mol Cancer Ther; 13(5); 1217–30. ©2014 AACR.
CCBE1
Enhances Lymphangiogenesis via A Disintegrin and Metalloprotease With Thrombospondin Motifs-3–Mediated Vascular Endothelial Growth Factor-C Activation
Authors: Jeltsch Michael , Jha Sawan Kumar , Tvorogov Denis , Anisimov Andrey , Leppänen Veli-Matti , Holopainen Tanja , Kivelä Riikka , Ortega Sagrario , Kärpanen Terhi , Alitalo Kari 
Published: February 2014

Background—

Hennekam lymphangiectasia–lymphedema syndrome (Online Mendelian Inheritance in Man 235510) is a rare autosomal recessive disease, which is associated with mutations in the
CCBE1
gene. Because of the striking phenotypic similarity of embryos lacking either the
Ccbe1
gene or the lymphangiogenic growth factor
Vegfc
gene, we searched for collagen- and calcium-binding epidermal growth factor domains 1 (CCBE1) interactions with the vascular endothelial growth factor-C (VEGF-C) growth factor signaling pathway, which is critical in embryonic and adult lymphangiogenesis.

Methods and Results—
By analyzing VEGF-C produced by CCBE1-transfected cells, we found that, whereas CCBE1 itself does not process VEGF-C, it promotes proteolytic cleavage of the otherwise poorly active 29/31-kDa form of VEGF-C by the A disintegrin and metalloprotease with thrombospondin motifs-3 protease, resulting in the mature 21/23-kDa form of VEGF-C, which induces increased VEGF-C receptor signaling. Adeno-associated viral vector–mediated transduction of CCBE1 into mouse skeletal muscle enhanced lymphangiogenesis and angiogenesis induced by adeno-associated viral vector–VEGF-C.

Conclusions—
These results identify A disintegrin and metalloprotease with thrombospondin motifs-3 as a VEGF-C–activating protease and reveal a novel type of regulation of a vascular growth factor by a protein that enhances its proteolytic cleavage and activation. The results suggest that CCBE1 is a potential therapeutic tool for the modulation of lymphangiogenesis and angiogenesis in a variety of diseases that involve the lymphatic system, such as lymphedema or lymphatic metastasis.
Growth Rings, Increment and Age of Trees in Inundation Forests, Savannas and a Mountain Forest in the Neotropics
Authors: Worbes Martin 
Published: February 2014

Investigations on growth zones of tropical trees were carried out and published since the beginning of our century.In tropical regions with severe annual dry seasons or inundation phases trees form annual rings. This is demonstrated for trees from Central Amazonian inundation forests and the Gran Sabana in Venezuela using a combination of several dendrochronological methods (wood anatomy, radiocarbon dating, ring width measurements).The occurrence of annual rings allows the determination of age and growth rate of trees. The growth rate depends on the growth strategy of the species and the growth conditions. At a given site growth rate shows a weak negative correlation with the specific gravity of the wood of trees from the upper story. Several reported ring width patterns are explained by the vegetation history of different forest stands.
Wood Anatomical Variation of Acacia Melanoxylon in Relation to Latitude
Authors: Wilkins A. P. , Papassotiriou Sabine 
Published: February 2014

The wood anatomy of Acacia melanoxylon samples from various locations in eastern Australia was examined and a number of characteristics were found to be significantly related to latitude. Vessel member length, proportion of fibres and proportion of multiseriate rays were positively related to latitude. Vessel frequency, vessel diameter and the abundance of crystals were negatively related to latitude as were the proportion of: uniseriate rays, vessels and axial parenchyma. Total proportion of ray tissue and basic density was not found to be associated with latitude.Anatomical features associated with lower transpirational demand appeared to be correlated with the cooler, more xeric environmental conditions accompanying increasing latitude.
Structure of Wood and Cambial Variant in the Stem of Dalbergia Paniculata Roxb.
Authors: Nair M. N. B. , Mohan Ram H. Y. 
Published: February 2014

The wood of Dalbergia paniculata is unique as it consists of concentric layers of broad xylem, alternating with bands of narrow phloem. This anomaly results from the periodic formation of successive cambia in the secondary phloem. Some phloem parenchyma cells dedifferentiate to form a discontinuous ring of cambium. Such parenchyma cells have higher succinate dehydrogenase activity than the neighbouring cells of secondary phloem. The newly differentiated cambial layer functions bidirectionally, and its products give rise to xylem internally and phloem externally. The phloem along with cambium present internal to the newly formed xylem becomes included.The wood is diffuse-porous and the intervessel pits are vestured. The phloem has welldifferentiated sieve tube members and companion cells.
The association between material living standard and psychological distress: Results from a New Zealand population survey
Authors: Foulds James , Wells J Elisabeth , Mulder Roger 
Published: February 2014

Background: People with a low material living standard experience more psychological distress than those with a high living standard, but previous studies suggest the size of this difference is modest. Aim: To measure the association between living standard and psychological distress using a multidimensional measure of living standard, the Economic Living Standard Index (ELSI). Methods: Adults aged 25–64 years ( n = 8,465) were selected from a New Zealand community survey. Logistic regression models were used to compare household income and ELSI scores as risk factors for high psychological distress, defined as a K10 score of 12 or over. Results: In the population, the prevalence of high psychological distress was 5.8%. The prevalence of high distress increased steeply with decreasing living standard. In the most deprived decile according to ELSI score, 24.3% had high distress, compared to 0.8% in the least deprived decile. For household income, high distress was present in 15.9% of people in the lowest decile and 2.2% of the highest decile. In fully adjusted models, ELSI score remained significantly associated with high distress but household income was not. Conclusion: The mental health disparity between those at opposite ends of the social spectrum is very large. Comprehensive measures such as the ELSI give a more accurate estimate of this disparity than household income.
ATV injury experience at a pediatric trauma center: A 5-year review
Authors: Hagopian Moriah M , Burkhalter Lorrie , Foglia Robert P 
Published: February 2014

Background All terrain vehicles (ATVs) have grown in size and speed, and contribute significantly to pediatric trauma injuries. We compared pediatric ATV and All Trauma injuries, and sought to determine if there has been an improvement in ATV safety. Methods We reviewed the CMCD Trauma Registry for all ATV injuries from 2007–2011, and compared data with data previously compiled for All Trauma admissions from 2006 to 2008. Results There were 197 ATV and 4473 All Trauma admissions. The two groups differed in that the ATV group had a greater number of transfers from outside hospitals, trauma activations, Injury Severity Score, and need for operation. Mortality was 0.5% for ATV and 1.3% for All Trauma injuries. 51% of children ≤10 years were drivers; only 18% wore helmets. Conclusion ATV admissions are associated with higher acuity injuries than All Trauma admissions. Pediatric ATV safety does not appear to have improved; efforts should be refocused to improve it.
The Running Athlete
Authors: Henning P. Troy 
Published: February 2014

Context: Pelvic stress fractures, osteitis pubis, and snapping hip syndrome account for a portion of the overuse injuries that can occur in the running athlete. Evidence Acquisition: PubMed searches were performed for each entity using the following keywords: snapping hip syndrome, coxa sultans, pelvic stress fracture, and osteitis pubis from 2008 to 2013. Topic reviews, case reports, case series, and randomized trials were included for review. Study Design: Clinical review. Level of Evidence: Level 4. Results: Collectively, 188 articles were identified. Of these, 58 were included in this review. Conclusion: Based on the available evidence, the majority of these overuse injuries can be managed non-operatively. Primary treatment should include removal from offending activity, normalizing regional muscle strength/length imbalances and nutritional deficiencies, and mitigating training errors through proper education of the athlete and training staff. Strength of Recommendation Taxonomy: C
An introductory course in urology: results of a novel course for foundation doctors and medical students
Authors: Abboudi Hamid , Chetwood Andrew , Nair Rajesh , Bolgeri Marco , Coker Charles , Larner Tim , Green James 
Published: February 2014

Objective: The objective of this article is to critically assess the value of a medical student and junior doctor weekend introduction to urology course. Materials and methods: All UK medical students and foundation doctors were invited to attend an introductory course held at The Royal Society of Medicine, London, organised by the Section of Urology. The course included consultant-delivered lectures, practical skills sessions and an academic competition. Pre- and post-course feedback questionnaires were used to assess (a) perceptions of urology as a specialty, (b) career aspirations and (c) confidence performing basic urological surgical skills. Results: Sixty delegates attended from a variety of UK medical schools and hospitals. Seventy-three per cent of respondents were more likely to pursue a career in urology post-course. The most common negative perceptions included being a competitive career with long training and lacking glamour. Confidence in suturing, knot tying, suprapubic catheterisation, basic laparoscopy and cystoscopy were significantly improved following this course ( p < 0.005). Conclusion: A short urology course should be offered to medical students by urology departments and surgical societies; it will benefit students as well as the specialty. It is important that medical students are exposed early to urology given both positive and negative perceptions. Such initiatives may help strengthen the positive perceptions and dispel negative perceptions while increasing delegates’ desire to pursue a urology career.
hGH promotes megakaryocyte differentiation and exerts a complementary effect with c-Mpl ligands on thrombopoiesis
Authors: Xu Yang , Wang Song , Shen Mingqiang , Zhang Zhou , Chen Shilei , Chen Fang , Chen Mo , Zeng Dongfeng , Wang Aiping , Zhao Jinghong , Cheng Tianmin , Su Yongping , Wang Junping 
Published: February 2014

Key PointshGH has a distinct capacity to promote the differentiation, especially the terminal differentiation of human primary megakaryocytes. hGH exerts a complementary and synergistic effect with c-Mpl ligands on thrombopoiesis.
PI3K p110δ uniquely promotes gain-of-function Shp2-induced GM-CSF hypersensitivity in a model of JMML
Authors: Goodwin Charles B , Li Xing Jun , Mali Raghuveer S. , Chan Gordon , Kang Michelle , Liu Ziyue , Vanhaesebroeck Bart , Neel Benjamin G. , Loh Mignon L. , Lannutti Brian J. , Kapur Reuben , Chan Rebecca J. 
Published: February 2014

Key PointsCompared with ubiquitously expressed PI3K p110α, genetic inhibition of PI3K p110δ uniquely normalizes mutant Shp2-induced GM-CSF hypersensitivity. Potent pharmacologic inhibitors of PI3K p110δ cooperate with MEK inhibition to reduce mutant Shp2-induced hyperproliferation.
GpIbα-VWF blockade restores vessel patency by dissolving platelet aggregates formed under very high shear rate in mice
Authors: Le Behot Audrey , Gauberti Maxime , Martinez De Lizarrondo Sara , Montagne Axel , Lemarchand Eloïse , Repesse Yohann , Guillou Sylvain , Denis Cécile V. , Maubert Eric , Orset Cyrille , Vivien Denis 
Published: February 2014

Key Points
Following endothelial damage, platelet cross-linking during closure of the vessel lumen is mediated by GpIbα-VWF interactions. Disruption of GpIbα-VWF interactions restores vessel patency by specifically disaggregating the external layer of occlusive thrombi.