Does Pre-hospital Therapeutic Hypothermia Improve the Functional and Survival Status of Patients Post Cardiac Arrest?

OBJECTIVE: The objective of this selective EBM review is to determine whether or not prehospital therapeutic hypothermia improves the functional and survival status of post cardiac arrest patients. STUDY DESIGN: Review of three English language primary studies, two of which were published in 2007 and one in 2010. DATA SOURCES: Two randomized, controlled, clinical trials and one cohort study comparing pre-hospital therapeutic hypothermia to induction of therapeutic hypothermia upon hospital admission, and to standard normothermic post cardiac arrest care. All were found using Medline, OVID, and Cochrane Systematic databases. OUTCOMES MEASURED: An outcome measured was functional status at hospital discharge, defined by cognitive function and neurophysical outcomes. Survival status was also evaluated and based on whether patients became conscious, were discharged from the hospital alive, or whether they expired. RESULTS: Kim and Tiainen et al demonstrated that therapeutic hypothermia may improve survival status and improve functional status respectively for patients with an initial rhythm of ventricular fibrillation when compared to patients who received standard normothermic post cardiac arrest care. Both studies, however, failed to show conclusive statistical significance supporting the benefits of therapeutic hypothermia. Bernard et al reported improved functional outcomes in patients who received cooling upon hospital admission compared to pre-hospital cooling, but similarly, results were not statistically significant. All methods used were determined to be feasible for out-of-hospital use and to decrease core body temperature. Additionally, methods were not associated with adverse outcomes such as cognitive decline or pulmonary edema. CONCLUSIONS: The results of the three clinical trials show that there is inconclusive evidence that pre-hospital therapeutic hypothermia improves the functional and survival status of patients following cardiac arrest. Two of the three trials report an increased occurrence of favorable outcomes for patients treated with pre-hospital therapeutic hypothermia. This data supports that further studies with adequate sample sizes, improved compliance, and more rapid and adequate induction of cooling should be considered to determine if this treatment could significantly improve patient outcomes

Relating Planner Task Performance for Container Terminal Operations to Multi-Tasking Skills and Personality Type

Planning the operations within a container terminal is a complex task. It requires planners to demonstrate adaptive behavior while handling stressful, complex, and unexpected situations in today’s dynamic and technology dependent workplace. This paper aims at investigating the role of multi-tasking ability, moderated by an individual’s personality type, in predicting planner task performance using simulation gaming methods. Hierarchical regression analysis results demonstrate that the direct effect of multi-tasking ability on performance is positive and significant. With one exception, the personality traits do not significantly intensify or lessen the impact of multi-tasking in predicting task performance. The personality trait, openness to experience, significantly lessens the impact of multi-tasking ability on performance. Our results suggest that container terminal operators may benefit by considering the above-mentioned results while allocating planning tasks to their employees and new recruits. The instruments used in this research could also be used for evaluating and training candidate planners

One-pot three-step thioconjugate addition-oxidation-Diels–Alder reactions of ethyl propiolate

Ethyl propiolate undergoes one-pot three-step thioconjugate addition-oxidation-Diels–Alder cycloaddition when treated with a variety of thiols in the presence of catalytic base, meta-chloroperbenzoic acid, lithium perchlorate, and cyclopentadiene. The reaction of S‑aryl thiols is catalyzed by trialkylamines, and the reaction of aliphatic thiols requires catalytic alkoxide base. Yields of the major diastereomer of the conveniently functionalized bicyclic products range from 47 to 81% depending upon the thiol reactant, which compares favorably to yields observed when the entire synthesis is performed step by step

One-pot synthesis of (Z)-B-sulfonyl enoates from ethyl propiolate

B-Sulfonyl enoates may be synthesized through a one-pot two-step sequence from ethyl propiolate with good to excellent selectivity for the Z isomer. Trialkylamines catalyze thioconjugate additions of aryl thiols, and alkoxides catalyze the addition of aliphatic thiols. Addition of meta-chloroperbenzoic acid (mCPBA) and LiClO4 to the reaction mixture provides rapid access to the sulfonyl enoates. Yields of the pure Z isomer range from 51 – 90%

Cell-specific occupancy of an extended repertoire of CREM and CREB binding loci in male germ cells

Background: CREB and CREM are closely related factors that regulate transcription in response to various stress, metabolic and developmental signals. The CREMτ activator isoform is selectively expressed in haploid spermatids and plays an essential role in murine spermiogenesis.Results: We have used chromatin immunoprecipitation coupled to sequencing (ChIP-seq) to map CREM and CREB target loci in round spermatids from adult mouse testis and spermatogonia derived GC1-spg cells respectively. We identify more than 9000 genomic loci most of which are cell-specifically occupied. Despite the fact that round spermatids correspond to a highly specialised differentiated state, our results show that they have a remarkably accessible chromatin environment as CREM occupies more than 6700 target loci corresponding not only to the promoters of genes selectively expressed in spermiogenesis, but also of genes involved in functions specific to other cell types. The expression of only a small subset of these target genes are affected in the round spermatids of CREM knockout animals. We also identify a set of intergenic binding loci some of which are associated with H3K4 trimethylation and elongating RNA polymerase II suggesting the existence of novel CREB and CREM regulated transcripts.Conclusions: We demonstrate that CREM and CREB occupy a large number of promoters in highly cell specific manner. This is the first study of CREM target promoters directly in a physiologically relevant tissue in vivo and represents the most comprehensive experimental analysis of CREB/CREM regulatory potential to date

City Know-How

Human health and planetary health are influenced by city lifestyles, city leadership, and city development. For both, worrying trends are leading to increasing concern and it is imperative that human health and environmental impacts become core foci in urban policy. Changing trajectory will require concerted action; the journal Cities & Health is dedicated to supporting the flow of knowledge, in all directions, to help make this happen. We wish to foster communication between researchers, practitioners, policy-makers, communities, and decision-makers in cities. This is the purpose of the City Know-how section of the journal. ‘Research for city practice’ disseminates lessons from research by explaining key messages for city leaders, communities, and the professions involved in city policy and practice. ‘City shorts’ provide glimpses of what is being attempted or achieved ‘on the ground’ and ’case studies’ are where you will find evaluations of interventions. Last, ‘Commentary and debate’ extends conversations we are having to develop and mobilize much needed new thinking. Join in these conversations. In order to strengthen the community of interest, we would like to include many and varied voices, including those from younger practitioners and researchers who are supporting health and health equity in everyday urban lives

A deep learning approach to photo–identification demonstrates high performance on two dozen cetacean species

We thank the countless individuals who collected and/or processed the nearly 85,000 images used in this study and those who assisted, particularly those who sorted these images from the millions that did not end up in the catalogues. Additionally, we thank the other Kaggle competitors who helped develop the ideas, models and data used here, particularly those who released their datasets to the public. The graduate assistantship for Philip T. Patton was funded by the NOAA Fisheries QUEST Fellowship. This paper represents HIMB and SOEST contribution numbers 1932 and 11679, respectively. The technical support and advanced computing resources from University of Hawaii Information Technology Services—Cyberinfrastructure, funded in part by the National Science Foundation CC* awards # 2201428 and # 2232862 are gratefully acknowledged. Every photo–identification image was collected under permits according to relevant national guidelines, regulation and legislation.Peer reviewedPublisher PD

New genetic loci link adipose and insulin biology to body fat distribution.

Body fat distribution is a heritable trait and a well-established predictor of adverse metabolic outcomes, independent of overall adiposity. To increase our understanding of the genetic basis of body fat distribution and its molecular links to cardiometabolic traits, here we conduct genome-wide association meta-analyses of traits related to waist and hip circumferences in up to 224,459 individuals. We identify 49 loci (33 new) associated with waist-to-hip ratio adjusted for body mass index (BMI), and an additional 19 loci newly associated with related waist and hip circumference measures (P < 5 × 10(-8)). In total, 20 of the 49 waist-to-hip ratio adjusted for BMI loci show significant sexual dimorphism, 19 of which display a stronger effect in women. The identified loci were enriched for genes expressed in adipose tissue and for putative regulatory elements in adipocytes. Pathway analyses implicated adipogenesis, angiogenesis, transcriptional regulation and insulin resistance as processes affecting fat distribution, providing insight into potential pathophysiological mechanisms

Developmental dyscalculia: a dysconnection syndrome?

Numerical understanding is important for everyday life. For children with developmental dyscalculia (DD), numbers and magnitudes present profound problems which are thought to be based upon neuronal impairments of key regions for numerical understanding. The aim of the present study was to investigate possible differences in white matter fibre integrity between children with DD and controls using diffusion tensor imaging. White matter integrity and behavioural measures were evaluated in 15 children with developmental dyscalculia aged around 10 years and 15 matched controls. The main finding, obtained by a whole brain group comparison, revealed reduced fractional anisotropy in the superior longitudinal fasciculus in children with developmental dyscalculia. In addition, a region of interest analysis exhibited prominent deficits in fibres of the superior longitudinal fasciculus adjacent to the intraparietal sulcus, which is thought to be the core region for number processing. To conclude, our results outline deficient fibre projection between parietal, temporal and frontal regions in children with developmental dyscalculia, and therefore raise the question of whether dyscalculia can be seen as a dysconnection syndrome. Since the superior longitudinal fasciculus is involved in the integration and control of distributed brain processes, the present results highlight the importance of considering broader domain-general mechanisms in the diagnosis and therapy of dyscalculia