Low Flow versus No Flow: Ischaemia Reperfusion Injury Following Different Experimental Models in the Equine Small Intestine.

In experimental studies investigating strangulating intestinal lesions in horses, different ischaemia models have been used with diverging results. Therefore, the aim was to comparatively describe ischaemia reperfusion injury (IRI) in a low flow (LF) and no flow (NF) model. Under general anaesthesia, 120 min of jejunal ischaemia followed by 120 min of reperfusion was induced in 14 warmbloods.

Caco-2/HT29-MTX co-cultured cells as a model for studying physiological properties and toxin-induced effects on intestinal cells.

Infectious gastrointestinal diseases are frequently caused by toxins secreted by pathogens which may impair physiological functions of the intestines, for instance by cholera toxin or by heat-labile enterotoxin. To obtain a functional model of the human intestinal epithelium for studying toxin-induced disease mechanisms, differentiated enterocyte-like Caco-2 cells were co-cultured with goblet cell-like HT29-MTX cells. These co-cultures formed a functional epithelial barrier, as characterized by a high electrical resistance and the presence of physiological intestinal properties such as glucose transport and chloride secretion which could be demonstrated electrophysiologically and by measuring protein expression.

cAMP triggers Na absorption by distal airway surface epithelium in cystic fibrosis swine.

A controversial hypothesis pertaining to cystic fibrosis (CF) lung disease is that the CF transmembrane conductance regulator (CFTR) channel fails to inhibit the epithelial Na channel (ENaC), yielding increased Na reabsorption and airway dehydration. We use a non-invasive self-referencing Na-selective microelectrode technique to measure Na transport across individual folds of distal airway surface epithelium preparations from CFTR (CF) and wild-type (WT) swine. We show that, under unstimulated control conditions, WT and CF epithelia exhibit similar, low rates of Na transport that are unaffected by the ENaC blocker amiloride.

The effect of ischaemic postconditioning on mucosal integrity and function in equine jejunal ischaemia.

Background: Ischaemic postconditioning (IPoC) has been shown to ameliorate ischaemia reperfusion injury in different species and tissues.

Objectives: To assess the feasibility of IPoC in equine small intestinal ischaemia and to assess its effect on histomorphology, electrophysiology and paracellular permeability.

Study Design: Randomised in vivo experiment.

Evaluation of ustekinumab trough levels during induction and maintenance therapy with regard to disease activity status in difficult to treat Crohn disease patients.

Ustekinumab (UST) is approved for the treatment of moderate and severe Crohn disease (CD). Therapeutic drug monitoring (TDM) can help monitor the therapeutic effects of biologics. Therefore, the aim of this study was to evaluate the clinical outcomes of UST-treated CD patients and to determine the UST trough level in clinical and corticosteroid-free remission.

Modulation of Intestinal Phosphate Transport in Young Goats Fed a Low Phosphorus Diet.

The intestinal absorption of phosphate (P) takes place transcellularly through the active NaPi-cotransporters type IIb (NaPiIIb) and III (PiT1 and PiT2) and paracellularly by diffusion through tight junction (TJ) proteins. The localisation along the intestines and the regulation of P absorption differ between species and are not fully understood. It is known that 1,25-dihydroxy-vitamin D (1,25-(OH)D) and phosphorus (P) depletion modulate intestinal P absorption in vertebrates in different ways.

Transcatheter Closure of Patent Ductus Arteriosus in Infants With Weight Under 1,500 Grams.

Persistent patent ductus arteriosus (PDA) is very common in preterm infants, especially in extremely preterm infants. Despite significant advances in management of these vulnerable infants, there has been no consensus on management of PDA-when should we treat, who should we treat, how should we treat and in fact there is no agreement on how we should define a hemodynamically significant PDA. Medical management with non-steroidal anti-inflammatory drugs (NSAIDs) remains the first line of therapy with moderate success rate in closing the PDA.

Results of a randomized trial of treatment modalities in patients with low or early-intermediate risk prostate cancer (PREFERE trial).

Purpose: The optimal treatment for patients with low to early-intermediate risk prostate cancer (PCa) remains to be defined. The randomized PREFERE trial (DRKS00004405) aimed to assess noninferiority of active surveillance (AS), external-beam radiotherapy (EBRT), or brachytherapy by permanent seed implantation (PSI) vs. radical prostatectomy (RP) for these patients.

In-hospital interstage improves interstage survival after the Norwood stage 1 operation.

Objectives: The interstage mortality rate after a Norwood stage 1 operation remains 12-20% in current series. In-hospital interstage facilitates escalation of care, possibly improving outcome.

Methods: A retrospective study was designed for hypoplastic left heart syndrome (HLHS) and HLHS variants, offering an in-hospital stay after the Norwood operation until the completion of stage 2.

Termination rates and histological reclassification of active surveillance patients with low- and early intermediate-risk prostate cancer: results of the PREFERE trial.

Purpose: Active surveillance (AS) strategies for patients with low- and early intermediate-risk prostate cancer are still not consistently defined. Within a controlled randomized trial, active surveillance was compared to other treatment options for patients with prostate cancer. Aim of this analysis was to report on termination rates of patients treated with AS including different grade groups.

Cone reconstruction is feasible in babies under 2 kg of weight.

Symptomatic neonates with Ebstein anomaly present with intractable heart failure. We present the first successful cone reconstruction in an ex 30 + 4-week premature below 2 kg with a favourable outcome.

Mitigating Latent Threats Identified through an Embedded Simulation Program and Their Comparison to Patient Safety Incidents: A Retrospective Review.

Objective: To assess the impact of service improvements implemented because of latent threats (LTs) detected during simulation.

Design: Retrospective review from April 2008 to April 2015.

Setting: Paediatric Intensive Care Unit in a specialist tertiary hospital.

The application of rumen simulation technique (RUSITEC) for studying dynamics of the bacterial community and metabolome in rumen fluid and the effects of a challenge with Clostridium perfringens.

The rumen simulation technique (RUSITEC) is a well-established semicontinuous in vitro model for investigating ruminal fermentation; however, information on the stability of the ruminal bacterial microbiota and metabolome in the RUSITEC system is rarely available. The availability of high resolution methods, such as high-throughput sequencing and metabolomics improve our knowledge about the rumen microbial ecosystem and its fermentation processes. Thus, we used Illumina MiSeq 16S rRNA amplicon sequencing and a combination of direct injection mass spectrometry with a reverse-phase LC-MS/MS to evaluate the dynamics of the bacterial community and the concentration of several metabolites in a RUSITEC experiment as a function of time and in response to a challenge with a pathogenic Clostridium perfringens (C.

Cystic fibrosis swine fail to secrete airway surface liquid in response to inhalation of pathogens.

Cystic fibrosis is caused by mutations in the gene encoding the cystic fibrosis transmembrane conductance regulator (CFTR) channel, which can result in chronic lung disease. The sequence of events leading to lung disease is not fully understood but recent data show that the critical pathogenic event is the loss of the ability to clear bacteria due to abnormal airway surface liquid secretion (ASL). However, whether the inhalation of bacteria triggers ASL secretion and whether this is abnormal in cystic fibrosis has never been tested.

An RFID-Based Smart Structure for the Supply Chain: Resilient Scanning Proofs and Ownership Transfer with Positive Secrecy Capacity Channels.

The National Strategy for Global Supply Chain Security published in 2012 by the White House identifies two primary goals for strengthening global supply chains: first, to promote the efficient and secure movement of goods, and second to foster a resilient supply chain. The Internet of Things (IoT), and in particular Radio Frequency Identification (RFID) technology, can be used to realize these goals. For product identification, tracking and real-time awareness, RFID tags are attached to goods.

RFID Ownership Transfer with Positive Secrecy Capacity Channels.

RFID ownership transfer protocols (OTPs) transfer tag ownership rights. Recently, there has been considerable interest in such protocols; however, guaranteeing privacy for symmetric-key settings without trusted third parties (TTPs) is a challenge still unresolved. In this paper, we address this issue and show that it can be solved by using channels with positive secrecy capacity.

Mitral valve replacement in neonatal endocarditis: time to discuss prevention strategies for Group B streptococcus disease.

Group B streptococcus (GBS) is recognised as one of the leading organisms in early-onset neonatal sepsis but is also a cause of late-onset GBS septicaemia, meningitis and rarely, infective endocarditis (IE). We report a case of a healthy term neonate who developed GBS septicaemia and meningitis having presented with parental concern and poor feeding. Subsequent identification and treatment of GBS resulted in the requirement for long-line intravascular access in order to administer antibiotic therapy.

Interprofessional team management in pediatric critical care: some challenges and possible solutions.

Background: Aiming for and ensuring effective patient safety is a major priority in the management and culture of every health care organization. The pediatric intensive care unit (PICU) has become a workplace with a high diversity of multidisciplinary physicians and professionals. Therefore, delivery of high-quality care with optimal patient safety in a PICU is dependent on effective interprofessional team management.

Inter-professional in-situ simulated team and resuscitation training for patient safety: Description and impact of a programmatic approach.

Background: Inter-professional teamwork is key for patient safety and team training is an effective strategy to improve patient outcome. In-situ simulation is a relatively new strategy with emerging efficacy, but best practices for the design, delivery and implementation have yet to be evaluated. Our aim is to describe and evaluate the implementation of an inter-professional in-situ simulated team and resuscitation training in a teaching hospital with a programmatic approach.

Contrary seasonal changes of rates of nutrient uptake, organ mass, and voluntary food intake in red deer (Cervus elaphus).

Northern ungulates acclimatize to winter conditions with restricted food supply and unfavorable weather conditions by reducing energy expenditure and voluntary food intake. We investigated in a study on red deer whether rates of peptide and glucose transport in the small intestines are also reduced during winter as part of the thrifty phenotype of winter-acclimatized animals, or whether transport rates are increased during winter in order to exploit poor forage more efficiently. Our results support the latter hypothesis.

The impact of docetaxel-related toxicities on health-related quality of life in patients with metastatic cancer (QoliTax).

Background: Docetaxel is a widely used cytotoxic agent. This study evaluates the impact of docetaxel toxicities on patient's health-related quality of life (QoL).

Patients And Methods: We conducted a multicenter, prospective, non-interventional trial, in which the QoL was assessed using the EORTC QLQ-C30 questionnaires at baseline and every 4 weeks up to 40 weeks in patients receiving a docetaxel-based chemotherapy for metastatic disease.

Optimisation of simulated team training through the application of learning theories: a debate for a conceptual framework.

Background: As a conceptual review, this paper will debate relevant learning theories to inform the development, design and delivery of an effective educational programme for simulated team training relevant to health professionals.

Discussion: Kolb's experiential learning theory is used as the main conceptual framework to define the sequence of activities. Dewey's theory of reflective thought and action, Jarvis modification of Kolb's learning cycle and Schön's reflection-on-action serve as a model to design scenarios for optimal concrete experience and debriefing for challenging participants' beliefs and habits.

Reliability of team-based self-monitoring in critical events: a pilot study.

Background: Teamwork is a critical component during critical events. Assessment is mandatory for remediation and to target training programmes for observed performance gaps.

Methods: The primary purpose was to test the feasibility of team-based self-monitoring of crisis resource management with a validated teamwork assessment tool.