bluuebunny/crossref_metadata_2025_split huggingface dataset:
Can we make airway management (even) safer? – lessons from national audit
Authors: Woodall N. , Frerk C. , Cook T. M. 
Published: November 2011

SummaryThe Fourth National Audit Project of the Royal College of Anaesthetists and the Difficult Airway Society (NAP4) has published an extensive report examining both current practices in the United Kingdom regarding airway management during anaesthesia and the complications of airway management during anaesthesia and in intensive care units and emergency departments. The report makes more than 160 recommendations designed to improve care of patients. These recommendations have implications for individuals, departments, organisations and potentially for national policy in terms of training, standards of practice and the need for guidelines. The report also indicates several specific areas where future research might be directed. This article focuses on the implementation phase of NAP4, emphasising the importance of taking the lessons derived from NAP4 and turning them into actions to improve the safety of airway care delivered to patients, wherever in hospital this takes place.
The history of anaesthetic equipment evaluation in the United Kingdom: lessons for developing future strategy
Authors: Wilkes A. R. , Pandit J. J. , O’Sullivan E. 
Published: November 2011

SummaryRecent guidance published by the Association of Anaesthetists of Great Britain and Ireland encourages the purchase of equipment based on evidence of safety and performance. For many years, evidence of the safety and performance of anaesthetic equipment was published by various government departments and agencies. However, these schemes were gradually eroded over time such that many devices entered the market with little or no clinical evidence of their efficacy. This recently led to the Difficult Airway Society’s issuing guidance to its members on how best to select new airway devices; guidance that was based on the available evidence. This article provides a short history of the evaluation of anaesthetic equipment in the United Kingdom.
Supraglottic airways in difficult airway management: successes, failures, use and misuse
Authors: Timmermann A. 
Published: November 2011

SummarySupraglottic airway devices (SAD) play an important role in the management of patients with difficult airways. Unlike other alternatives to standard tracheal intubation, e.g. videolaryngoscopy or intubation stylets, they enable ventilation even in patients with difficult facemask ventilation and simultaneous use as a conduit for tracheal intubation. Insertion is usually atraumatic, their use is familiar from elective anaesthesia, and compared with tracheal intubation is easier to learn for users with limited experienced in airway management. Use of SADs during difficult airway management is widely recommended in many guidelines for the operating room and in the pre‐hospital setting. Despite numerous studies comparing different SADs in manikins, there are few randomised controlled trials comparing different SADs in patients with difficult airways. Therefore, most safety data come from extended use rather than high quality evidence and claims of efficacy and particularly safety must be interpreted cautiously.
Longitudinal relationship of early life immunomodulatory T cell phenotype and function to development of allergic sensitization in an urban cohort
Authors: McLoughlin R. M. , Calatroni A. , Visness C. M. , Wallace P. K. , Cruikshank W. W , Tuzova M. , Ly N. P. , Ruiz‐Perez B. , Kattan M. , Bloomberg G. R. , Lederman H. , Gern J. E. , Gold D. R. 
Published: November 2011

SummaryBackgroundImmunomodulatory T cells are thought to influence development of allergy and asthma, but early life longitudinal data on their phenotype and function are lacking.ObjectivesAs part of the Urban Environment and Childhood Asthma (URECA) study, we investigated the development of immunomodulatory T cell phenotype and function, and characterized their relation to allergic disease progression from birth through to 2 years of age.MethodsImmunomodulatory T cell phenotype and function in cord blood mononuclear cells (CBMC) and peripheral blood mononuclear cells (PBMC) at 1 and 2 years of age were characterized by analysing CD25bright and FoxP3+ expression, proliferative responses and cytokine production. The relation of immunomodulatory T cell characteristics to allergic sensitization and disease at 1‐ and 2‐years of age was investigated.ResultsThe proportion of CD4+CD25bright and CD4+CD25+FoxP3+ T cells (n = 114, 83, 82 at birth, 1‐ and 2‐years respectively) increased significantly, whereas there were no significant changes in the suppressive function of CD25+ T cells (n = 78, 71, 81 at birth, 1‐ and 2‐years respectively). Birth immunomodulatory T cell characteristics were not related to subsequent allergic sensitization or disease. However, increases in the numbers of CD4+CD25bright cells and their ability to suppress lymphoproliferative responses at 1 year of age were associated with reduced allergic sensitization at 1 (P = 0.03) and 2 (P = 0.02) years of age. Production of the anti‐inflammatory cytokine IL‐10 by CD25+ T cells appeared to mediate this protective suppressive function. In contrast, by 2 years of age, we observed the emergence of a positive association of CD4+CD25+FoxP3+ T cell numbers with allergic sensitization (P = 0.05) and eczema (P = 0.02).Conclusions and clinical relevanceThese findings suggest that the relationship between immunomodulatory T cell subsets, allergic sensitization and eczema is developmentally regulated. In the first year of life, CD4+CD25+ IL‐10 producing T cells are associated with a reduced incidence of allergic sensitization. Once allergic sensitization or eczema is established, CD4+CD25+FoxP3+ T‐reg cells expand to potentially counteract the allergic inflammatory response. Understanding the relationship between development of immunoregulatory T cells and early onset atopy could lead to new preventive strategies for allergic diseases.
Environmental variability and the ecological effects of spawning Pacific salmon on stream biofilm
Authors: RÜEGG JANINE , CHALONER DOMINIC T. , LEVI PETER S. , TANK JENNIFER L. , TIEGS SCOTT D. , LAMBERTI GARY A. 
Published: November 2011

Summary1. Variation in resource subsidies can create or reinforce heterogeneity in recipient ecosystems. Related activities of organisms delivering resource subsidies, such as ecosystem engineering by Pacific salmon spawners (Oncorhynchus spp.), also alter heterogeneity. We studied whether heterogeneity in stream environmental conditions and spawner abundances were reflected in the net ecological effects of salmon (i.e. enrichment by resource subsidies and disturbance by ecosystem engineering) on benthic biofilm.2. We sampled seven Southeast Alaska streams over 3 years, both before and during the salmon run. In each stream and year, stream environmental characteristics and their influence on responses of benthic biofilm [mean and coefficient of variation of chlorophyll a (chl a), ash‐free dry mass (AFDM) and autotrophic index (AFDM:chl a)] to spawners were assessed.3. Streams and periods before and during the salmon run were distinct based on their environmental characteristics. The responses of most biofilm metrics to spawners were stream‐ and year‐specific, suggesting that the ecological effect of spawners ranged from net enrichment to net disturbance depending on the stream or year studied. The environmental context, especially temperature, large wood, and sediment size, explained >50% of biofilm variability during the run, but <30% over the entire study, suggesting that salmon can alter environmental constraints.4. Precision of biofilm estimates improved by increasing either the number of streams or the number of years sampled (i.e. spatial or temporal replication). However, combining data from different North Pacific Rim ecoregions inflated the confidence interval as compared with a single ecoregion, indicating the importance of regional environmental contexts for net salmon effects.5. Our results suggest that biofilm responses to salmon can vary greatly, even within a single ecoregion, and that environmental conditions can modify net salmon effects. Consequently, generalisations about biofilm responses across the native range of salmon may be challenging.
Effects of livestock exclusion on in‐stream habitat and benthic invertebrate assemblages in montane streams
Authors: HERBST DAVID B. , BOGAN MICHAEL T. , ROLL SANDRA K. , SAFFORD HUGH D. 
Published: November 2011

Summary1. Stream and riparian ecosystems in arid montane areas, like the interior western United States, are often just narrow mesic strands, but support diverse and productive habitats. Meadows along many such streams have long been used for rangeland grazing, and, while impacts to riparian areas are relatively well known, the effect of livestock grazing on aquatic life in streams has received less attention.2. Attempts to link grazing impacts to disturbance have been hindered by the lack of spatial and temporal replication. In this study, we compared channel features and benthic macroinvertebrate communities (i) between 16 stream reaches on two grazed allotments and between 22 reaches on two allotments where livestock had been completely removed for 4 years, (ii) before and after the 4‐year grazing respite at a subset of eight sites and (iii) inside and outside of small‐scale fenced grazing exclosures (eight pairings; 10+ year exclosures) in the meadows of the Golden Trout Wilderness, California (U.S.A.).3. We evaluated grazing disturbance at the reach scale in terms of the effects of livestock trampling on per cent bank erosion and found that macroinvertebrate richness metrics were negatively correlated with bank erosion, while the percentage of tolerant taxa increased.4. All macroinvertebrate richness metrics were significantly lower in grazed areas. Bank angle, temperature, fine sediment cover and erosion were higher in grazed areas, while riparian cover was lower. Regression models identified riparian cover, in‐stream substratum, bank conditions and bankfull width‐to‐depth ratios as the most important for explaining variability in macroinvertebrate richness metrics.5. Small‐scale grazing exclosures showed no improvements for in‐stream communities and only moderate positive effects on riparian vegetation. In contrast, metrics of macroinvertebrate richness increased significantly after a 4‐year period of no grazing.6. The success of grazing removal reported here suggests that short‐term removal of livestock at the larger, allotment meadow spatial scale is more effective than long‐term, but small‐scale, local riparian area fencing, and yields promising results in achieving stream channel, riparian and aquatic biological recovery.
The image of you: constructing nursing identities in YouTube
Authors: Kelly Jacinta , Fealy Gerard M. , Watson Roger 
Published: November 2011

kelly j., fealy g.m. & watson r. (2011) The image of you: constructing nursing identities in YouTube. Journal of Advanced Nursing68(6), 1804–1813.AbstractAim.  This article is a report on a descriptive study of nursing identity as constructed in the Web 2.0 site YouTube.Background.  Public images of the nurse carry stereotypes that rely on the taken for granted gender category of the nurse as woman. Nursing images represent a form of public discourse that has the capacity to construct nursing identity.Methods.  Critical discourse analysis was used to describe, analyse and explain how nurse and nursing identity were constructed in a purposive sample of ten video clips accessed on 17 and 18 July 2010.Results.  The ten most‐viewed videos depicting the nurse and nursing on YouTube offered narratives that constructed three distinct nursing identity types, namely nurse as ‘a skilled knower and doer’, nurse as ‘a sexual plaything’ and nurse as ‘a witless incompetent’ individual.Conclusion.  Nursing identities recoverable from the texts of YouTube images propagate both favourable and derogatory nursing stereotypes. To mitigate the effects of unfavourable nursing stereotypes in such areas as interprofessional working and clinical decision‐making, nursing professional bodies need to act to protect the profession from unduly immoderate representations of the nurse and to support nurses in their efforts to maximize opportunities afforded by YouTube to promote a counter discourse.
Individual‐based modelling of moth dispersal to improve biosecurity incursion response
Authors: Guichard Sylvain , Kriticos Darren J. , Leriche Agathe , Kean John M. , Worner Susan P. 
Published: November 2011

Summary1. Some biosecurity systems aimed at reducing the impacts of invasive alien species that employ sentinel trapping systems to detect the presence of unwanted organisms. Once detected, the next challenge is to locate the source population of the invasive species. Tools that can direct search efforts towards the most likely sources of a trapped invasive alien species can improve the chance of rapidly delimiting and eradicating the local population and may help to identify the original introduction pathway. Ground‐based detection and delimitation surveys can be very expensive, and methods to focus search efforts to those areas most likely to contain the target organisms can make these efforts more effective and efficient.2. An individual‐based semi‐mechanistic model was developed to simulate the spatio‐temporal dispersal patterns of an invasive moth. The model combines appetitive and pheromone anemotaxis behaviours in response to wind, temperature and pheromone conditions. The model was trained using data from a series of mark–release–recapture experiments on painted apple moth Teia anartoides.3. The model was used to create hindcast simulations by reversing the time course of environmental conditions. The ability of the model to encompass the release location was evaluated using individual trap locations as starting points for the hindcast simulations.4. The hindcast modelling generated a pattern of moth flights that successfully encompassed the origin from 86% of trap locations, representing 95% of the 1464 recaptures observed in the mark–release–recapture experiments.5. Comparing the guided search area defined using the hindcast model with the area of a simple point‐diffusion search strategy revealed an optimized search strategy that combined searching a circle of 1 km radius around the trap followed by the area indicated by hindcast model predictions.6. Synthesis and applications. Incorporating this novel moth dispersal model into biosecurity sentinel systems will allow incursion managers to direct search effort for the proximal source of the incursion towards those areas most likely to contain a local infestation. Such targeted effort should reduce the costs and time taken to detect the proximal source of an incursion.
Seasonal priority effects: implications for invasion and restoration in a semi‐arid system
Authors: Wainwright Claire E. , Wolkovich Elizabeth M. , Cleland Elsa E. 
Published: November 2011

Summary1. The timing of seasonal activity (i.e. phenology) may play an important role in plant invasions. In ecosystems characterized by seasonal rainfall, early‐active exotic species may pre‐empt resources and attain competitive dominance via a seasonal ‘priority advantage’. Exotic annual grasses in California are often active earlier than native species, potentially because they possess greater germination plasticity. While these problematic invaders may usually benefit from having early phenology, their flexible germination cues might be manipulated as a restoration strategy to germinate seeds far in advance of favourable growing conditions, leading to a ‘priority disadvantage’.2. We manipulated the start of the growing season in an invaded California coastal sage scrub community characterized by a Mediterranean‐type climate to (i) identify whether early‐season phenology confers a performance advantage and (ii) test whether rainfall timing could be manipulated to favour native species. We compared the performance of seeded native and exotic focal species under ambient rainfall timing (winter rains) vs. with a pre‐growing season (late‐summer) watering event.3. Under ambient rainfall timing, exotic annual grasses and forbs germinated earlier and reached higher levels of abundance than native species, consistent with a seasonal priority advantage. Many exotic annual grasses germinated with pre‐season watering, but none survived until the onset of natural rains. Observations suggest that early‐germinating seedlings suffered mortality via herbivory. The watering pulse thus depleted the exotic seedbank, fewer exotic individuals germinated with winter rains, and exotic species attained lower abundance than under the natural rainfall timing.4. Native species, whether annual or perennial, did not germinate with the pre‐season watering pulse, suggesting they may have more constrained germination cues than the exotic species.5. Synthesis and applications. Our results suggest that phenology is an important factor influencing invasion success, and that this could be manipulated to favour native species. Manipulation of the start of the growing season, for example through a pre‐growing season watering event, could be a successful restoration strategy for native species in some ecosystems.
Distinct microbial populations exist in the mucosa‐associated microbiota of sub‐groups of irritable bowel syndrome
Authors: Parkes G. C. , Rayment N. B. , Hudspith B. N. , Petrovska L. , Lomer M. C. , Brostoff J. , Whelan K. , Sanderson J. D. 
Published: November 2011

AbstractBackground  There is increasing evidence to support a role for the gastrointestinal microbiota in the etiology of irritable bowel syndrome (IBS). Given the evidence of an inflammatory component to IBS, the mucosa‐associated microbiota potentially play a key role in its pathogenesis. The objectives were to compare the mucosa‐associated microbiota between patients with diarrhea predominant IBS (IBS‐D), constipation predominant IBS (IBS‐C) and controls using fluorescent in situ hybridization and to correlate specific bacteria groups with individual IBS symptoms.Methods  Forty‐seven patients with IBS (27 IBS‐D and 20 IBS‐C) and 26 healthy controls were recruited to the study. Snap‐frozen rectal biopsies were taken at colonoscopy and bacterial quantification performed by hybridizing frozen sections with bacterial‐group specific oligonucleotide probes.Key Results  Patients with IBS had significantly greater numbers of total mucosa‐associated bacteria per mm of rectal epithelium than controls [median 218 (IQR – 209) vs 128 (121) P = 0.007], and this was chiefly comprised of bacteroides IBS [69 (67) vs 14 (41) P = 0.001] and Eubacterium rectale–Clostridium coccoides [52 (58) vs 25 (35) P = 0.03]. Analysis of IBS sub‐groups demonstrated that bifidobacteria were lower in the IBS‐D group than in the IBS‐C group and controls [24 (32) vs 54 (88) vs 32 (35) P = 0.011]. Finally, amongst patients with IBS, the maximum number of stools per day negatively correlated with the number of mucosa‐associated bifidobacteria (P < 0.001) and lactobacilli (P = 0.002).Conclusions & Inferences  The mucosa‐associated microbiota in patients with IBS is significantly different from healthy controls with increases in bacteroides and clostridia and a reduction in bifidobacteria in patients with IBS‐D.
An ATP signalling pathway in plant cells: extracellular ATP triggers programmed cell death in Populus euphratica
Authors: SUN JIAN , ZHANG CHUN‐LAN , DENG SHU‐RONG , LU CUN‐FU , SHEN XIN , ZHOU XIAO‐YANG , ZHENG XIAO‐JIANG , HU ZAN‐MIN , CHEN SHAO‐LIANG 
Published: November 2011

ABSTRACTWe elucidated the extracellular ATP (eATP) signalling cascade active in programmed cell death (PCD) using cell cultures of Populus euphratica. Millimolar amounts of eATP induced a dose‐ and time‐dependent reduction in viability, and the agonist‐treated cells displayed hallmark features of PCD. eATP caused an elevation of cytosolic Ca2+ levels, resulting in Ca2+ uptake by the mitochondria and subsequent H2O2 accumulation. P. euphratica exhibited an increased mitochondrial transmembrane potential, and cytochrome c was released without opening of the permeability transition pore over the period of ATP stimulation. Moreover, the eATP‐induced increase of intracellular ATP, essential for the activation of caspase‐like proteases and subsequent PCD, was found to be related to increased mitochondrial transmembrane potential. NO is implicated as a downstream component of the cytosolic Ca2+ concentration but plays a negligible role in eATP‐stimulated cell death. We speculate that ATP binds purinoceptors in the plasma membrane, leading to the induction of downstream intermediate signals, as the proposed sequence of events in PCD signalling was terminated by the animal P2 receptor antagonist suramin.
Removal of prion infectivity by affinity ligand chromatography during OctaplasLG® manufacturing – results from animal bioassay studies
Authors: Heger A. , Bailey A. , Neisser‐Svae A. , Ertl M. , Römisch J. , Svae T.‐E. 
Published: November 2011

Background  OctaplasLG® is a 2nd‐generation virus inactivated pooled plasma for infusion. Prions are removed by the principle of chromatography, utilizing an affinity ligand gel (LG) developed for binding of prion proteins and their infectivity. The goal of this study was to verify, using the gold standard animal bioassay system, whether or not prion infectivity can be removed by the LG affinity step under conditions used in the routine manufacturing process.Materials and methods  Aliquots of pooled plasma were spiked with a microsomal/cytosolic (MIC) fraction of brain‐derived hamster‐adapted scrapie 263K and subjected to the OctaplasLG® manufacturing process. Validated Western blot tests and animal bioassays studies were performed to determine the logarithmic reduction factors (RF) and the prion infectivity binding capacity.Results  Bioassay studies demonstrated different logarithmic RFs (i.e. 1·73 and 0·76 log10) at two different plasma‐to‐resin ratios, the latter one representing the actual manufacturing ratio of 100:1, which can be explained by the differences in the study design. However, both bioassay studies showed a reproducible and high prion infectivity binding capacity of ≥5·64 log10 ID50/ml gel.Conclusion  Bioassay studies confirmed the capacity of the LG to bind brain‐derived MIC prion proteins spiked into plasma. Even through infectivity was still detected following passage over the LG, this can be attributed to the high loads used in the study design, and the binding capacity of the LG still ensures a significant safety margin – binding the prion agents at the levels of prion infectivity that might be present in plasma and beyond.
Mating Behavior and Dual‐Purpose Armaments in a Camel Cricket
Authors: Haley Estenia L. , Gray David A. 
Published: November 2011

AbstractSexual selection has often been dichotomized into intersexual and intrasexual components of selection, favoring ornaments and weapons, respectively. Here, we show that a weapon used in male–male combat is sometimes also used in a functionally similar manner for grasping females during mating. The hind legs of adult males of some species of Pristoceuthophilus camel crickets have strongly bent tibia and stout femora with two large conspicuous spines. Here, we show that (1) leg armature is positively allometric, (2) males use these leg modifications when fighting other males, (3) males sometimes use the same leg modifications in the same functional manner for grabbing and holding females for mating, (4) virgin females show more interest in males than do non‐virgin females, and (5) males are more likely to use their leg modifications to grab and hold females when paired with non‐virgin females than when paired with virgin females. We interpret these results as suggesting that males employ an alternative coercive mating strategy when paired with unreceptive females; alternative explanations are also discussed.