The international multidisciplinary consensus conference on multimodality monitoring in neurocritical care: evidentiary tables : a statement for healthcare professionals from the neurocritical care society and the European society of intensive care medicine.

A variety of technologies have been developed to assist decision-making during the management of patients with acute brain injury who require intensive care. A large body of research has been generated describing these various technologies. The Neurocritical Care Society (NCS) in collaboration with the European Society of Intensive Care Medicine (ESICM), the Society for Critical Care Medicine (SCCM), and the Latin America Brain Injury Consortium (LABIC) organized an international, multidisciplinary consensus conference to perform a systematic review of the published literature to help develop evidence-based practice recommendations on bedside physiologic monitoring. This supplement contains a Consensus Summary Statement with recommendations and individual topic reviews on physiologic processes important in the care of acute brain injury. In this article we provide the evidentiary tables for select topics including systemic hemodynamics, intracranial pressure, brain and systemic oxygenation, EEG, brain metabolism, biomarkers, processes of care and monitoring in emerging economies to provide the clinician ready access to evidence that supports recommendations about neuromonitoring.

The international multidisciplinary consensus conference on multimodality monitoring in neurocritical care: a list of recommendations and additional conclusions : a statement for healthcare professionals from the neurocritical care society and the European society of intensive care medicine.

Careful patient monitoring using a variety of techniques including clinical and laboratory evaluation, bedside physiological monitoring with continuous or non-continuous techniques and imaging is fundamental to the care of patients who require neurocritical care. How best to perform and use bedside monitoring is still being elucidated. To create a basic platform for care and a foundation for further research the Neurocritical Care Society in collaboration with the European Society of Intensive Care Medicine, the Society for Critical Care Medicine and the Latin America Brain Injury Consortium organized an international, multidisciplinary consensus conference to develop recommendations about physiologic bedside monitoring. This supplement contains a Consensus Summary Statement with recommendations and individual topic reviews as a background to the recommendations. In this article, we highlight the recommendations and provide additional conclusions as an aid to the reader and to facilitate bedside care.

A founder CEP120 mutation in Jeune asphyxiating thoracic dystrophy expands the role of centriolar proteins in skeletal ciliopathies.

Jeune asphyxiating thoracic dystrophy (JATD) is a skeletal dysplasia characterized by a small thoracic cage and a range of skeletal and extra-skeletal anomalies. JATD is genetically heterogeneous with at least nine genes identified, all encoding ciliary proteins, hence the classification of JATD as a skeletal ciliopathy. Consistent with the observation that the heterogeneous molecular basis of JATD has not been fully determined yet, we have identified two consanguineous Saudi families segregating JATD who share a single identical ancestral homozygous haplotype among the affected members. Whole-exome sequencing revealed a single novel variant within the disease haplotype in CEP120, which encodes a core centriolar protein. Subsequent targeted sequencing of CEP120 in Saudi and European JATD cohorts identified two additional families with the same missense mutation. Combining the four families in linkage analysis confirmed a significant genome-wide linkage signal at the CEP120 locus. This missense change alters a highly conserved amino acid within CEP120 (p.Ala199Pro). In addition, we show marked reduction of cilia and abnormal number of centrioles in fibroblasts from one affected individual. Inhibition of the CEP120 ortholog in zebrafish produced pleiotropic phenotypes characteristic of cilia defects including abnormal body curvature, hydrocephalus, otolith defects and abnormal renal, head and craniofacial development. We also demonstrate that in CEP120 morphants, cilia are shortened in the neural tube and disorganized in the pronephros. These results are consistent with aberrant CEP120 being implicated in the pathogenesis of JATD and expand the role of centriolar proteins in skeletal ciliopathies.

A Potential Contributory Role for Ciliary Dysfunction in the 16p11.2 600 kb BP4-BP5 Pathology.

The 16p11.2 600 kb copy-number variants (CNVs) are associated with mirror phenotypes on BMI, head circumference, and brain volume and represent frequent genetic lesions in autism spectrum disorders (ASDs) and schizophrenia. Here we interrogated the transcriptome of individuals carrying reciprocal 16p11.2 CNVs. Transcript perturbations correlated with clinical endophenotypes and were enriched for genes associated with ASDs, abnormalities of head size, and ciliopathies. Ciliary gene expression was also perturbed in orthologous mouse models, raising the possibility that ciliary dysfunction contributes to 16p11.2 pathologies. In support of this hypothesis, we found structural ciliary defects in the CA1 hippocampal region of 16p11.2 duplication mice. Moreover, by using an established zebrafish model, we show genetic interaction between KCTD13, a key driver of the mirrored neuroanatomical phenotypes of the 16p11.2 CNV, and ciliopathy-associated genes. Overexpression of BBS7 rescues head size and neuroanatomical defects of kctd13 morphants, whereas suppression or overexpression of CEP290 rescues phenotypes induced by KCTD13 under- or overexpression, respectively. Our data suggest that dysregulation of ciliopathy genes contributes to the clinical phenotypes of these CNVs.

Genome-wide association study of kidney function decline in individuals of European descent.

Genome-wide association studies (GWASs) have identified multiple loci associated with cross-sectional eGFR, but a systematic genetic analysis of kidney function decline over time is missing. Here we conducted a GWAS meta-analysis among 63,558 participants of European descent, initially from 16 cohorts with serial kidney function measurements within the CKDGen Consortium, followed by independent replication among additional participants from 13 cohorts. In stage 1 GWAS meta-analysis, single-nucleotide polymorphisms (SNPs) at MEOX2, GALNT11, IL1RAP, NPPA, HPCAL1, and CDH23 showed the strongest associations for at least one trait, in addition to the known UMOD locus, which showed genome-wide significance with an annual change in eGFR. In stage 2 meta-analysis, the significant association at UMOD was replicated. Associations at GALNT11 with Rapid Decline (annual eGFR decline of 3 ml/min per 1.73 m(2) or more), and CDH23 with eGFR change among those with CKD showed significant suggestive evidence of replication. Combined stage 1 and 2 meta-analyses showed significance for UMOD, GALNT11, and CDH23. Morpholino knockdowns of galnt11 and cdh23 in zebrafish embryos each had signs of severe edema 72 h after gentamicin treatment compared with controls, but no gross morphological renal abnormalities before gentamicin administration. Thus, our results suggest a role in the deterioration of kidney function for the loci GALNT11 and CDH23, and show that the UMOD locus is significantly associated with kidney function decline.Kidney International advance online publication, 10 December 2014; doi:10.1038/ki.2014.361.

Implementación de una herramienta de metabúsqueda : MetaLib y SFX

L'article presenta les característiques i funcionalitats principals de les eines MetaLib i SFX, programaris per a la gestió i accés als recursos electrònics. S'analitzen els programaris citant els diferents tipus de funcionalitats, i la gestió i el manteniment. El procés s'emmarca en l'experiència de la Universitat Oberta de Catalunya, membre del CBUC, i se n'expliquen la configuració, els reptes i les dificultats que es van produir durant la implementació dels sistemes.

Implementació d'una eina de metacerca : MetaLib i SFX

L'article presenta les característiques i funcionalitats principals de les eines MetaLib i SFX, programaris per a la gestió i accés als recursos electrònics. S'analitzen els programaris citant els diferents tipus de funcionalitats, i la gestió i el manteniment. El procés s'emmarca en l'experiència de la Universitat Oberta de Catalunya, membre del CBUC, i se n'expliquen la configuració, els reptes i les dificultats que es van produir durant la implementació dels sistemes.

Implementing a metasearch engine : Metalib and SFX

L'article presenta les característiques i funcionalitats principals de les eines MetaLib i SFX, programaris per a la gestió i accés als recursos electrònics. S'analitzen els programaris citant els diferents tipus de funcionalitats, i la gestió i el manteniment. El procés s'emmarca en l'experiència de la Universitat Oberta de Catalunya, membre del CBUC, i se n'expliquen la configuració, els reptes i les dificultats que es van produir durant la implementació dels sistemes.

Safety profile of prasugrel and clopidogrel in patients with acute coronary syndromes in Switzerland.

OBJECTIVE: To assess safety up to 1 year of follow-up associated with prasugrel and clopidogrel use in a prospective cohort of patients with acute coronary syndromes (ACS). METHODS: Between 2009 and 2012, 2286 patients invasively managed for ACS were enrolled in the multicentre Swiss ACS Bleeding Cohort, among whom 2148 patients received either prasugrel or clopidogrel according to current guidelines. Patients with ST-elevation myocardial infarction (STEMI) preferentially received prasugrel, while those with non-STEMI, a history of stroke or transient ischaemic attack, age ≥75 years, or weight <60 kg received clopidogrel or reduced dose of prasugrel to comply with the prasugrel label. RESULTS: After adjustment using propensity scores, the primary end point of clinically relevant bleeding events (defined as the composite of Bleeding Academic Research Consortium, BARC, type 3, 4 or 5 bleeding) at 1 year, occurred at a similar rate in both patient groups (prasugrel/clopidogrel: 3.8%/5.5%). Stratified analyses in subgroups including patients with STEMI yielded a similar safety profile. After adjusting for baseline variables, no relevant differences in major adverse cardiovascular and cerebrovascular events were observed at 1 year (prasugrel/clopidogrel: cardiac death 2.6%/4.2%, myocardial infarction 2.7%/3.8%, revascularisation 5.9%/6.7%, stroke 1.0%/1.6%). Of note, this study was not designed to compare efficacy between prasugrel and clopidogrel. CONCLUSIONS: In this large prospective ACS cohort, patients treated with prasugrel according to current guidelines (ie, in patients without cerebrovascular disease, old age or underweight) had a similar safety profile compared with patients treated with clopidogrel. CLINICAL TRIAL REGISTRATION NUMBER: SPUM-ACS: NCT01000701; COMFORTABLE AMI: NCT00962416.

Biological impact assessment of nanomaterial used in nanomedicine. Introduction to the NanoTEST project.

Therapeutic nanoparticles (NPs) are used in nanomedicine as drug carriers or imaging agents, providing increased selectivity/specificity for diseased tissues. The first NPs in nanomedicine were developed for increasing the efficacy of known drugs displaying dose-limiting toxicity and poor bioavailability and for enhancing disease detection. Nanotechnologies have gained much interest owing to their huge potential for applications in industry and medicine. It is necessary to ensure and control the biocompatibility of the components of therapeutic NPs to guarantee that intrinsic toxicity does not overtake the benefits. In addition to monitoring their toxicity in vitro, in vivo and in silico, it is also necessary to understand their distribution in the human body, their biodegradation and excretion routes and dispersion in the environment. Therefore, a deep understanding of their interactions with living tissues and of their possible effects in the human (and animal) body is required for the safe use of nanoparticulate formulations. Obtaining this information was the main aim of the NanoTEST project, and the goals of the reports collected together in this special issue are to summarise the observations and results obtained by the participating research teams and to provide methodological tools for evaluating the biological impact of NPs.

From room for books to room for users: an old infantry barrack as an answer to the lack of space

At the beginning of the 21st century, some Catalan university libraries detected a need stemming from the lack of space and the reconversion of physical libraries within the new European educational panorama. With the same cooperative spirit that characterized previous CBUC (Consortium of Academic Libraries of Catalonia) programs and services, the Consortium set in motion a project to address this need. An initial study was commissioned in 2002, and in 2003 a suitable building (old infantry barracks) was found in Lleida. The official opening took place in 2008. GEPA (Guaranteed Space for the Preservation of Access) facility is a cooperative repository, whose objectives are to store and preserve low use documents, ensuring their future access when needed, to convert room for books into room for library users, and doing it saving both space and money. The paper presents a brief historical introduction about the physical management of collections in libraries, and a short overview about high density library repositories all over the world, as an answer to the pressing problem of lack of spaces. The main goals of the communication are to comment the architectural project and its librarian issues, and to show how the GEPA facility allowed to change the spaces in university libraries in Catalonia. On the one hand, the paper deals with the selection of an old building to be renovated, the determination of the librarian needs, the compact shelving system chosen to store the documents in the building, the relation between physical space and information management, and the logistics involved in the load of low use documents from the libraries into the facility. On the other hand, we will show some examples of physical changes in Catalan libraries after large loads of documents to GEPA.

Use and availability of scholarly journals in Catalan academic libraries

This paper presents the results of a survey of academics affiliated to the universities that are members of the Consortium of Academic Libraries of Catalonia (CBUC) and an analysis of the availability in the libraries of these universities of the references cited in a sample of articles published by these academics. The results reflect the major importance that researchers assign to scholarly journals as the main source of scientific information. Most state that they use electronic journals either exclusively or in any case more than print journals, a preference that is higher among younger scholars. With regard to frequency of reading, four out of ten researchers state that they read journals virtually every day, while nine out of ten report that they do so at least once a week. Scholars claim that the obstacles they face when trying to download an article are related to the lack of subscriptions. However, the availability study showed that most of the articles cited in their publications are available at least at one of the CBUC libraries. Though most researchers keep a copy of the articles they consult, just over a third of them use some kind of reference management software.

Forecasting a language shift based on cellular automata

Language extinction as a consequence of language shifts is a widespread social phenomenon that affects several million people all over the world today. An important task for social sciences research should therefore be to gain an understanding of language shifts, especially as a way of forecasting the extinction or survival of threatened languages, i.e., determining whether or not the subordinate language will survive in communities with a dominant and a subordinate language. In general, modeling is usually a very difficult task in the social sciences, particularly when it comes to forecasting the values of variables. However, the cellular automata theory can help us overcome this traditional difficulty. The purpose of this article is to investigate language shifts in the speech behavior of individuals using the methodology of the cellular automata theory. The findings on the dynamics of social impacts in the field of social psychology and the empirical data from language surveys on the use of Catalan in Valencia allowed us to define a cellular automaton and carry out a set of simulations using that automaton. The simulation results highlighted the key factors in the progression or reversal of a language shift and the use of these factors allowed us to forecast the future of a threatened language in a bilingual community.

Toimintolaskennan sovellettavuus koulutusorganisaation ohjauksessa Case: Päijät-Hämeen koulutuskonserni

Oppilaitoksiin kohdistuvaa lainsäädäntöä on muutettu siten, että omistajayhteisöjen vastuuta on huomattavasti lisätty. Tämän vuoksi oppilaitosten omistajayhteisöt joutuvat etsimään uusia keinoja toimintansa ohjaamiseksi. Tällöin tukeudutaan teollisuuden ohjausjärjestelmiin, joiden toimivuutta oppilaitosten ohjauksessa ei tunneta. Tämän työn tavoitteena on tutkia toimintolaskennan soveltuvuutta koulutusorganisaation ohjaukseen. Toimintolaskentaa käytetään nykyisin hyvin yleisesti teollisuudessa. Myös jotkut nonprofit-organisaatiot ovat ottaneet sen käyttöön. Tutkimus on kohdennettu Päijät-Hämeen koulutuskonserniin, jossa tutkittiin Opetushallituksen kustannuslaskentajärjestelmän sopivuutta toiminnan ohjaukseen. Tutkimuksen tuloksena voidaan todeta, että Opetushallituksen kustannuslaskentajärjestelmä voi olla toimintolaskentajärjestelmän pohjana, koska se kuvaa hyvin oppilaitosten toimintaa ja on helppo käyttää. Se soveltuu kohtuullisesti myös tasapainotetun mittariston osaksi.

A method for decision making with the OWA operator

A new method for decision making that uses the ordered weighted averaging (OWA) operator in the aggregation of the information is presented. It is used a concept that it is known in the literature as the index of maximum and minimum level (IMAM). This index is based on distance measures and other techniques that are useful for decision making. By using the OWA operator in the IMAM, we form a new aggregation operator that we call the ordered weighted averaging index of maximum and minimum level (OWAIMAM) operator. The main advantage is that it provides a parameterized family of aggregation operators between the minimum and the maximum and a wide range of special cases. Then, the decision maker may take decisions according to his degree of optimism and considering ideals in the decision process. A further extension of this approach is presented by using hybrid averages and Choquet integrals. We also develop an application of the new approach in a multi-person decision-making problem regarding the selection of strategies.