bluuebunny/crossref_metadata_2025 huggingface dataset:
Adaptation to care dependency in community care
Authors: Vingare Emme-Li , Umb Carlsson Õie
Published: November 2017

Purpose

The purpose of this paper is to explore the lived experiences of adapting to care dependency among adults receiving health and social care in ordinary housing.

Design/methodology/approach

This was done by conducting a phenomenological study by interviewing ten adults, receiving home care services in ordinary housing.

Findings

Participants not only adapted by becoming a “good patient” but they had four strategies they used: sociability, distance, competence and compliance, contributing to a sense of dignity and personal safety.

Research limitations/implications

Further research is needed regarding how to preserve quality of care with adults with various ways of adapting to care dependency.

Practical implications

The relationship between professionals and adults in care dependency is a dynamic process where a need for understanding different modes of adaptation is vital. Good treatment and quality care may be different things to different adults, depending on what aspects of the process of adaptation concern them the most, and depending on their individual adaptation strategy.

Originality/value

This paper contributes to the understanding of modes of adaptation to care dependency from the perspective of adults indicating that working person centered may include respecting strategies not traditionally being associated with “the good patient.”
Phylogeny and genomics of SAUL, an enigmatic bacterial lineage frequently associated with marine sponges
Authors: Astudillo‐García Carmen , Slaby Beate M. , Waite David W. , Bayer Kristina , Hentschel Ute , Taylor Michael W.
Published: November 2017

Many marine sponges contain dense and diverse communities of associated microorganisms. Members of the ‘sponge‐associated unclassified lineage’ (SAUL) are frequently recorded from sponges, yet little is known about these bacteria. Here we investigated the distribution and phylogenetic status of SAUL. A meta‐analysis of the available literature revealed the widespread distribution of this clade and its association with taxonomically varied sponge hosts. Phylogenetic analyses, conducted using both 16S rRNA gene‐based phylogeny and concatenated marker protein sequences, revealed that SAUL is a sister clade of the candidate phylum ‘Latescibacteria’. Furthermore, we conducted a comprehensive analysis of two draft genomes assembled from sponge metagenomes, revealing novel insights into the physiology of this symbiont. Metabolic reconstruction suggested that SAUL members are aerobic bacteria with facultative anaerobic metabolism, with the capacity to degrade multiple sponge‐ and algae‐derived carbohydrates. We described for the first time in a sponge symbiont the putative genomic capacity to transport phosphate into the cell and to produce and store polyphosphate granules, presumably constituting a phosphate reservoir for the sponge host in deprivation periods. Our findings suggest that the lifestyle of SAUL is symbiotic with the host sponge, and identify symbiont factors which may facilitate the establishment and maintenance of this relationship.
Ecological and evolutionary dynamics of a model facultative pathogen: Agrobacterium and crown gall disease of plants
Authors: Barton Ian S. , Fuqua Clay , Platt Thomas G.
Published: November 2017

Many important pathogens maintain significant populations in highly disparate disease and non‐disease environments. The consequences of this environmental heterogeneity in shaping the ecological and evolutionary dynamics of these facultative pathogens are incompletely understood. Agrobacterium tumefaciens, the causative agent for crown gall disease of plants has proven a productive model for many aspects of interactions between pathogens and their hosts and with other microbes. In this review, we highlight how this past work provides valuable context for the use of this system to examine how heterogeneity and transitions between disease and non‐disease environments influence the ecology and evolution of facultative pathogens. We focus on several features common among facultative pathogens, such as the physiological remodelling required to colonize hosts from environmental reservoirs and the consequences of competition with host and non‐host associated microbiota. In addition, we discuss how the life history of facultative pathogens likely often results in ecological tradeoffs associated with performance in disease and non‐disease environments. These pathogens may therefore have different competitive dynamics in disease and non‐disease environments and are subject to shifting selective pressures that can result in pathoadaptation or the within‐host spread of avirulent phenotypes.
Use of Xylazine in Drug‐Facilitated Crimes
Authors: Krongvorakul Jatupon , Auparakkitanon Saranya , Trakulsrichai Satariya , Sanguanwit Pitsucha , Sueajai Jetjamnong , Noumjad Nantida , Wananukul Winai
Published: November 2017

Human xylazine poisoning is uncommon. This report describes the use of xylazine for intentional poisoning with criminal intent. Two incidents occurred within 3 weeks: the first involved one victim, and the second involved two victims. The clinical presentations were brief coma, bradycardia, hypotension, and hyperglycemia. The victims recalled having been given a drink from a stranger in a hospital waiting room before loss of consciousness. In the first case, general drug screening by gas chromatography/mass spectrometry (MS) revealed xylazine in the gastric contents, but liquid chromatography–tandem MS (LC‐MS/MS) of serum did not. In the second incident, LC‐MS/MS screening of both victims’ urine and serum samples revealed an unknown peak in the total ion chromatograms, which a molecular mass database identified as morantel or xylazine. The latter was confirmed by comparison with a xylazine standard. Based on this report, we suggest that xylazine should be classified as a controlled drug.
Enhanced Visualization of Latent Fingermarks on Rough Aluminum Surfaces Using Sequential Au and Zn/ZnS/ZnO Depositions
Authors: Tiwari Anjani Kumar , Alaoui Ismail Mekkaoui , Guddala Sriram , Ramakrishna S. Anantha
Published: November 2017

Detection and visualization of fingermarks on rough and diffuse surfaces is a relatively challenging task. We succeeded in developing latent fingermarks on scratched and rough aluminum surfaces by sequential deposition of a thin layer of gold followed by one of zinc or zinc‐based compounds on the fingermarks. The best image enhancement was achieved with sequential Au and ZnS depositions. Using this combination, we could enhance the visualization of latent fingermarks aged over 65 days in normal conditions. The optical reflectance from the fingermarks with the deposited layers of metal/dielectric is analyzed as a stratified medium. Significant contrast in the reflectance from the regions of the ridges and the valleys of the fingermark would enhance the visualization. Our results show that the Au and ZnS bi‐layer combination can have a large reflection contrast and improved fingermark visualization at wavelengths corresponding to the green light for specific thickness of ZnS.
Myocarditis and Kawasaki disease
Authors: Dionne Audrey , Dahdah Nagib
Published: November 2017

Kawasaki disease (KD) is the most common vasculitis of childhood. Coronary artery aneurysms and myocarditis are common cardiovascular complications of KD. While evidence of myocarditis can be found in all patients with KD on histology specimens, only a minority of patients are clinically symptomatic. Occasionally children can present with KD shock syndrome and hemodynamic instability as a result of decreased systolic function and vasoplegia. Several children with KD have depressed shortening fraction on echocardiography. Increased end‐systolic and end‐diastolic dimensions, strain abnormalities and diastolic dysfunction are also found in a significant proportion of patients. Echocardiographic signs of myocarditis improve after the acute phase and do so more quickly in patients who have received intravenous immunoglobulins, as opposed to those given only aspirin. Normalization of systolic function is typically observed over long‐term follow‐up; however, more subtle abnormalities (strain, diastolic function) may persist. It is noteworthy that myocarditis associated with KD can occur in absence of coronary artery abnormalities. KD myocarditis can result in long‐term sequelae.
An Exploration of Nursing Students’ Clinical Decision‐Making Process
Authors: Zaybak Ayten , Özdemir Handan , Erol Ahmet , Ismailoğlu Elif Günay
Published: November 2017

PURPOSE

This study was carried out descriptively and retrospectively with the purpose of determining nursing diagnoses used by intern students in their clinical practice.

METHODS

The study data were obtained by checking the care plans of the internship files of 248 students studying at a nursing faculty.

FINDINGS

The students determined 77 different nursing diagnoses in 13 domains of North American Nursing Diagnosis Association (NANDA)‐I taxonomy II. The total number of nursing diagnosis used in the care plans was 1,469.

CONCLUSION

Most of the diagnoses determined by the students were in the “safety/ protection” domain; however, they determined no diagnoses in the “life principles” domain.
Specific anesthesia‐induced lung volume changes from induction to emergence: a pilot study
Authors: Kostic P. , LoMauro A. , Larsson A. , Hedenstierna G. , Frykholm P. , Aliverti A.
Published: November 2017

Background

Studies aimed at maintaining intraoperative lung volume to reduce post‐operative pulmonary complications have been inconclusive because they mixed up the effect of general anesthesia and the surgical procedure. Our aims were to study: (1) lung volume during the entire course of anesthesia without the confounding effects of surgical procedures; (2) the combination of three interventions to maintain lung volume; and (3) the emergence phase with focus on the restored activation of the respiratory muscles.

Methods

Eighteen ASA I–II patients undergoing ENT surgery under general anesthesia without muscle relaxants were randomized to an intervention group, receiving lung recruitment maneuver (LRM) after induction, 7 cmH2O positive end‐expiratory pressure (PEEP) during anesthesia and continuous positive airway pressure (CPAP) during emergence with 0.4 inspired oxygen fraction (FiO2) or a control group, ventilated without LRM, with 0 cmH2O PEEP, and 1.0 FiO2 during emergence without CPAP application. End‐expiratory lung volume (EELV) was continuously estimated by opto‐electronic plethysmography. Inspiratory and expiratory ribcage muscles electromyography was measured in a subset of seven patients.

Results

End‐expiratory lung volume decreased after induction in both groups. It remained low in the control group and further decreased at emergence, because of active expiratory muscle contraction. In the intervention group, EELV increased after LRM and remained high after extubation.

Conclusion

A combined intervention consisting of LRM, PEEP and CPAP during emergence may effectively maintain EELV during anesthesia and even after extubation. An unexpected finding was that the activation of the expiratory muscles may contribute to EELV reduction during the emergence phase.
Outcomes after cancelled helicopter emergency medical service missions due to concurrencies: a retrospective cohort study
Authors: Østerås Ø. , Heltne J.‐K. , Tønsager K. , Brattebø G.
Published: November 2017

Background

Appropriate dispatch criteria and helicopter emergency medical service (HEMS) crew decisions are crucial for avoiding over‐triage and reducing the number of concurrencies. The aim of the present study was to compare patient outcomes after completed HEMS missions and missions cancelled by the HEMS due to concurrencies.

Methods

Missions cancelled due to concurrencies (AMB group) and completed HEMS missions (HEMS group) in Western Norway from 2004 to 2013 were assessed. Outcomes were survival to hospital discharge, physiology score in the emergency department, emergency interventions in the hospital, type of department for patient admittance, and length of hospital stay.

Results

Survival to discharge was similar in the two groups. One‐third of the primary missions in the HEMS group and 13% in the AMB group were patients with pre‐hospital conditions posing an acute threat to life. In a sub group analysis of these patients, HEMS patients were younger, more often admitted to an intensive care unit, and had an increased survival to discharge. In addition, the HEMS group had a greater proportion of patients with deranged physiology in the emergency department according to an early warning score.

Conclusion

Patients in the HEMS group seemed to be critically ill more often and received more emergency interventions, but the two groups had similar in‐hospital mortality. Patients with pre‐hospital signs of acute threat to life were younger and presented increased survival in the HEMS group.
Cortical Thickness in Adolescents with a Family History of Alcohol Use Disorder
Authors: Henderson Kate E. , Vaidya Jatin G. , Kramer John R. , Kuperman Samuel , Langbehn Douglas R. , O'Leary Daniel S.
Published: November 2017

Background

Individuals with a family history (FH+) of alcohol use disorder (AUD) have a higher risk for developing an AUD than those with no family history (FH−) of AUD. In addition, FH+ individuals tend to perform worse on neuropsychological measures and show heightened impulsivity, which may be due to underlying differences in brain structure such as cortical thickness. The primary aim of this study was to investigate differences in cortical thickness in FH+ compared to FH− adolescents. Secondary aims were to (i) investigate differences in executive functioning and impulsivity, and (ii) examine associations between brain structure and behavior.

Methods

Brain scans of 95 FH− and 93 FH+ subjects aged 13 to 18 were obtained using magnetic resonance imaging. FH+ subjects were required to have at least 1 biological parent with a history of an AUD. FH+ and FH− individuals had limited or no past alcohol use, thereby minimizing potential effects of alcohol. Subjects were evaluated on impulsivity and executive functioning tasks. Thicknesses of cortical lobes and subregions were analyzed using FreeSurfer. Regions showing group differences were examined for group‐by‐age interactions and correlations with neuropsychological and personality measures.

Results

FH+ adolescents had thinner cortices in frontal and parietal lobes, notably in the medial orbitofrontal, lateral orbitofrontal, and superior parietal cortices. The difference in cortical thickness between family history groups was strongest among the youngest subjects. FH+ subjects were also more impulsive and had poorer performance on a spatial memory task.

Conclusions

These findings demonstrate frontal and parietal structural differences in FH+ adolescents that might underlie cognitive and behavioral characteristics associated with AUD risk.
Salticidae (Arachnida: Araneae) inhabiting islands off Australia re‐visited
Authors: Żabka Marek , Patoleta Barbara , Trębicki Łukasz
Published: November 2017

The jumping spider fauna of 99 Australian islands of coral, volcanic, continental and mixed origin was investigated in terms of taxonomic diversity, origin (source), dispersal and habitat preferences. A total of 110 taxa were recorded; with 18 taxa found on at least five islands. Barrow, Horn, Fitzroy, Fraser, Murray and Moa Islands appeared the most diverse, each with at least 10 species. On all islands combined the most speciose genera were Cytaea (16 species), Cosmophasis (8), ‘Lycidas’/Jotus (5), Simaetha (4) and Holoplatys (4). The island faunas appeared to be a less diverse version of the mainland (mostly eastern coast) and showed no evidence of local radiation and endemism.
Effect of sufentanil on bispectral index in the elderly
Authors: de Valence T. , Elia N. , Czarnetzki C. , Dumont L. , Tramèr M. R. , Lysakowski C.
Published: November 2017

We examined the impact of adding sufentanil during anaesthesia induction with propofol on bispectral index values in elderly patients (≥ 65 years). Patients were randomly assigned to receive a target‐controlled sufentanil infusion (effect‐site concentration of 0.3 ng.ml−1) or matching placebo, followed by a target‐controlled propofol induction (initial effect‐site concentration of 0.5 μg.ml−1; step‐wise increase of 0.5 μg.ml−1) until loss of consciousness defined as an Observer's Assessment of Alertness/Sedation score < 2. Seventy‐one patients (sufentanil 35, placebo 36) completed the study. Mean (SD) age was 72.3 (5.8) years; 41% were women. At loss of consciousness, mean (SD) bispectral index value was 75.0 (8.6) with sufentanil and 70.0 (8.0) with placebo; mean difference −5.0 (95% confidence interval −8.9 to −1.1), p = 0.013. Post‐hoc analyses suggest that the difference was significant in men only (mean difference −7.3 (−11.8 to −2.6), p = 0.003). Sufentanil co‐induction with propofol results in higher bispectral index values at loss of consciousness in elderly patients.
Development of a Pediatric Cardiac Mechanical Support Program
Authors: Kashyap Abhishek , Turek Joseph W. , Wagner Samantha J. , Felderman Laura , Jaggers Elizabeth A. , Gruber Peter J. , Edens R. Erik
Published: November 2017

The development of a pediatric cardiac support program is a complex, multidisciplinary project. This study describes the University of Iowa Congenital Heart Program's experience from its inception to the present. In, we examine those specific factors that have led to substantial improvements in the program, additionally identifying where further gains can be made. We retrospectively reviewed all pediatric patients who received mechanical cardiac support at the University of Iowa from the inception of the program in 1991. In total, 29 patients received mechanical support between December 1991 and December 2015 and are included in the study. Twelve patients received continuous flow devices and 17 patients received pulsatile flow devices. Median age at implant was 12.8 years (range 0.1–18.2 years). Median weight at implant was 40.5 kg (3.2–123.4 kg). Factors examined included: operating room (OR) time, intensive care unit and hospital length of stay, intubation days, blood product usage, pre‐ and post‐operative bilirubin, creatinine, natriuretic peptide B (NPPB), and device implanted. Categorical and continuous variables were compared using Chi‐squared and Wilcoxon rank‐sum tests, respectively. Of the 29 patients who received mechanical support, 17 (58.6%) were discharged home, 11 (37.9%) died during their hospitalization, and 1 (3.5%) remains hospitalized. Median length of ventricular assist device support was 59.5 days (range 1–653 days). Between December 1991 and December 2011, in‐hospital mortality was 64.3%. Following this period, significant changes were made to patient management with in‐hospital mortality decreasing to 13.3% between February 2013 and December 2015. Comparison between deceased and living patients revealed several significant factors including: median number of packed red blood cells transfused, 8 versus 4 units (P = 0.048), median OR time, 396 versus 299 min (P = 0.003), and device implanted. During the early stages of the mechanical support program, higher than expected mortality rates prompted changes in the management of pediatric cardiac patients, specifically, the development of a dedicated management team. These changes significantly improved outcomes and we suggest can be used as a model for similar cardiac support programs, especially in smaller volume programs.
Editorial: the non‐invasive diagnosis of atrophic gastritis
Authors: Malfertheiner P.
Published: November 2017

Linked Content

This article is linked to Zagari et al paper. To view this article visit https://doi.org/10.1111/apt.14248.
Letter: reproducible evidence shows that exclusive enteral nutrition significantly reduces faecal calprotectin concentrations in children with active Crohn's disease—Authors' reply
Authors: Feathers A. , Swaminath A. , Ananthakrishnan A. N. , Falzon L. , Li Ferry S.
Published: November 2017

Linked Content

This article is linked to Swaminath et al and Logan et al papers. To view these articles visit https://doi.org/10.1111/apt.14253 and https://doi.org/10.1111/apt.14351.
Letter: safety and efficacy of using statins in patients with cirrhosis—authors' reply
Authors: Bang U. C. , Benfield T. , Bendtsen F.
Published: November 2017

Linked Content

This article is linked to Zhao et al and Bang et al papers. To view these articles visit https://doi.org/10.1111/apt.14357 and https://doi.org/10.1111/apt.14243.
Ediacaran developmental biology
Authors: Dunn Frances S. , Liu Alexander G. , Donoghue Philip C. J.
Published: November 2017

Rocks of the Ediacaran System (635–541 Ma) preserve fossil evidence of some of the earliest complex macroscopic organisms, many of which have been interpreted as animals. However, the unusual morphologies of some of these organisms have made it difficult to resolve their biological relationships to modern metazoan groups. Alternative competing phylogenetic interpretations have been proposed for Ediacaran taxa, including algae, fungi, lichens, rhizoid protists, and even an extinct higher‐order group (Vendobionta). If a metazoan affinity can be demonstrated for these organisms, as advocated by many researchers, they could prove informative in debates concerning the evolution of the metazoan body axis, the making and breaking of axial symmetries, and the appearance of a metameric body plan. Attempts to decipher members of the enigmatic Ediacaran macrobiota have largely involved study of morphology: comparative analysis of their developmental phases has received little attention. Here we present what is known of ontogeny across the three iconic Ediacaran taxa Charnia masoni, Dickinsonia costata and Pteridinium simplex, together with new ontogenetic data and insights. We use these data and interpretations to re‐evaluate the phylogenetic position of the broader Ediacaran morphogroups to which these taxa are considered to belong (rangeomorphs, dickinsoniomorphs and erniettomorphs). We conclude, based on the available evidence, that the affinities of the rangeomorphs and the dickinsoniomorphs lie within Metazoa.
The clinical relevance of lipid transfer protein
Authors: Asero R. , Piantanida M. , Pinter E. , Pravettoni V.
Published: November 2017

Despite a huge number of studies, many aspects of the lipid transfer protein (LTP) syndrome, the most frequent primary food allergy in Mediterranean countries, remain unclear. Its peculiar geographical distribution, along with the extreme variability of its clinical expression, makes this type of food allergy something unique in the panorama of IgE‐mediated food‐induced allergic reactions. This review article tried to summarize the current knowledge about the most important aspects of LTP sensitization and allergy, along with the importance of positive and negative co‐factors in the clinical expression of the syndrome as well as the issues regarding the cross‐reactivity between LTPs present in botanically related and unrelated foods. Further, the possible absence of the protein from some plant foods is discussed.
Enhanced antigen presenting and T cell functions during late‐phase allergic responses in the lung
Authors: Liu M. C. , Xiao H. Q. , Breslin L. M. , Bochner B. S. , Schroeder J. T.
Published: November 2017

Background

Allergic inflammation is a common feature of asthma and may contribute to both development and perpetuation of disease. The interaction of antigen‐presenting cells (APC) with sensitized helper T lymphocytes (TC) producing Th2 cytokines may determine the inflammatory response. Recruitment of APC and TC to the lung during allergic responses has been demonstrated, but functional studies in humans have been limited.

Objective

This study examined the function of APC and TC accumulating at sites of inflammation after segmental allergen challenge (SAC).

Methods

Fifteen allergic patients underwent SAC, and cells from bronchoalveolar lavage (BAL) were collected after 24 hours. APC and TC from the blood and BAL were purified based on expression of the monocyte marker, CD14; the plasmacytoid dendritic cell (pDC) marker, BDCA4, identifying neuropilin‐1 (NRP1); and the helper T cell marker, CD4. Functional activity was assessed using allergen‐induced T cell proliferation. Flow cytometry identified cells expressing CD14 and NRP1.

Results

SAC resulted in a 12‐fold increase in mononuclear cells having the morphologic appearance of blood monocytes. Most of these cells co‐expressed CD14 and NRP1. After saline challenge, BAL mononuclear cells demonstrated little APC function. Following SAC, BAL mononuclear cells showed function equal to pDC from blood and greater than blood monocytes. Purified NRP1+ cells from BAL had even greater function than pDC cells from blood (P = .008). Using consistent sources of APC, enhanced proliferation of TC from lung compared to blood was also demonstrated (P = .002).

Conclusions

The marked increase in APC function for allergen‐specific TC proliferation during allergic inflammation is largely due to the recruitment of monocytes and dendritic cells. There is also an enhanced response in the lung TC population, consistent with recruitment of allergen‐specific T cells. Interactions between recruited APC and TC may occur as an early event promoting allergic airway inflammation.
Conversations with French medical geneticists. A personal perspective on the origins and early years of medical genetics in France
Authors: Harper P.S.
Published: November 2017

The history of the beginnings of medical genetics in France is discussed, based on the personal perspective provided by recorded interviews with 16 early French workers in the field. The weakness of French genetics overall up to the beginning of the Second World War meant that post‐war medical genetics had to start from new, with its origins largely derived from the medical fields of child health and the prevention of genetic disorders, rather than from basic science. The key people responsible for initiating these developments were Robert Debré and Maurice Lamy at Hôpital Necker in Paris and those interviewed included a number of their colleagues and successors, including Jean Frézal, Pierre Maroteaux, Josué Feingold, André and Joelle Boué, and Jean‐Claude Kaplan. A separate group of paediatricians, originally at Hôpital Trousseau under Raymond Turpin, including Jérôme Lejeune, Marthe Gautier and Roland Berger, was responsible for major advances in human cytogenetics. Outside Paris, workers were interviewed from Marseille, Strasbourg and Nancy, although not from Lyon, where Jacques‐Michel Robert was an early pioneer, particularly of genetic counselling. Challenges in the development of medical genetics in France included the advent of prenatal diagnosis with its ethical issues, the emergence of medical genetics as a distinct specialty from paediatrics, and its spread from Paris across France. These and other aspects are described by those interviewed from their own experiences, given in Appendix S1, while the fully edited transcripts for most interviews are accessible on the Web:www.genmedhist.org/interviews.
Computational modelling of the influence of substituent effects on phthalimidylazo disperse dye hydrolysis and interaction energy
Authors: Zhan Yi‐zhen , Zhao Xue , Wang Bi‐jia , Wang Wei
Published: November 2017

Six azo dyes have been synthesised using N‐substituted phthalimides as diazo components. Substitution effects on dye hydrolysis and intermolecular interactions were investigated with density functional theory (DFT) at B3LYP/6‐311G level. The results showed that the phthalimide moieties adopted a coplanar conformation in respect of the azo‐coupled phenyl rings in all six dyes. N‐Alkyl substitution had little influence on the absorption maxima. Bromo and cyano substitution on the phthalimide ring resulted in hypsochromic and bathochromic shifts of the absorption maxima respectively. Hydrolysis of the phthalimide ring was found to be largely influenced by steric effects rather than inductive effects of substituents. It was also found that π‐stacking interactions of phthalimide/phenyl and phthalimide/phthalimide dimers were promoted by substituents. The results indicated that interactions are dominated by electrostatic and even more importantly dispersion forces. The computational results were also confirmed experimentally.
Quadriceps muscle fat infiltration is associated with cardiometabolic risk in COPD
Authors: Vivodtzev Isabelle , Moncharmont Luc , Tamisier Renaud , Borel Jean‐Christian , Arbib François , Wuyam Bernard , Lévy Patrick , Maltais François , Ferretti Gilbert , Pépin Jean‐Louis
Published: November 2017

Purpose

Losses of peripheral muscle mass and ectopic fat accumulation have been associated with cardiometabolic morbidity in COPD. We aimed at identifying the relationship between quadriceps muscle fat infiltration and cardiovascular risk.

Materials and methods

From 2009 to 2014, 78 COPD patients (64 ± 8 years; 80% male) were prospectively included after having given written consent (ethical committee approval number: 2006‐A00491‐50). The cohort was divided into three groups (tertiles) according to body mass index (BMI), low [15 < BMI≤23·3], middle [23·3 < BMI≤27·6] and high [27·6 < BMI≤36] kg/m²). Measurements were respiratory function, plasmatic biomarkers and surrogate markers of cardiovascular risk (arterial stiffness and endothelial function). Mid‐thigh quadriceps muscle volume and per cent of muscle fat infiltration, as assessed by 64‐slice CT scanning, were compared between the tertiles. ANOVA or Kruskal–Wallis tests were used for statistical analyses with Bonferroni's correction for the ‘post hoc’ tests.

Results

Intramuscular fat volume was 52% [95% CI, 43 to 60%] of total quadriceps volume in high BMI vs. 47% [38 to 55%] and 34% [29 to 38%] in the middle and low‐BMI groups, respectively (P<0·0001), without differences between groups in fat‐free muscle volumes. Elevated muscle fat infiltration correlated with lower thiol to protein ratios in the whole population reflecting impaired antioxidant capacity (r = 0·50; P = 0·009). Furthermore, muscle fat infiltration was linked to endothelial dysfunction (r = −0·49, P = 0·01) in the low‐BMI group.

Conclusion

Skeletal muscle fat infiltration may be an indicator of increased cardiometabolic risk in both obese and lean COPD patients.
Sphenopalatine ganglion stimulation induces changes in cardiac autonomic regulation in cluster headache
Authors: Barloese Mads , Petersen Anja S. , Guo Song , Ashina Messoud , Mehlsen Jesper , Jensen Rigmor H.
Published: November 2017

Introduction

Cluster headache is characterized by attacks of severe unilateral pain accompanied by cranial and systemic autonomic changes. Our knowledge of the latter is imperfect. This study aimed to investigate the effect of low‐frequency sphenopalatine ganglion stimulation on cardiac autonomic regulation.

Materials and methods

In a double‐blind, randomized, sham‐controlled crossover design, patients received low‐frequency and sham stimulation. RR intervals were recorded, and heart rate variability was analysed (time‐domain, frequency‐domain, nonlinear parameters). Headache characteristics, including cranial autonomic symptoms, were recorded at baseline and every 10 min for 60 min.

Results

Sixteen patients were included. Changes in heart rate variability from baseline in the analysed parameters differed significantly between low‐frequency and sham stimulation. Initially, during low‐frequency stimulation, there was a greater increase in heart rate compared to sham (P<0·05) and changes in the frequency, nonlinear and time domain (P<0·05) reflecting a higher sympathetic tone. These preceded the observed cranial autonomic symptoms. Ten episodes of cluster‐like attacks were reported (six following low‐frequency stimulation, four following sham). During these, parasympathetic tone (P<0·05) was higher compared to baseline.

Conclusions

In cluster headache patients subjected to low‐frequency and sham stimulation of the sphenopalatine ganglion, we found changes indicating higher sympathetic tone during low‐frequency stimulation preceding cranial autonomic symptoms or cluster pain. During cluster pain, regardless of stimulation parameters, we saw increased parasympathetic activity, congruent with previous reports. The results indicate involvement of cardiac autonomic regulation before and during cluster headache attacks.
Self‐reported injection practices among people who use drugs in French prisons: Public health implications (ANRS‐Coquelicot survey 2011–2013)
Authors: Michel Laurent , Trouiller Philippe , Chollet Aude , Molinier Marie , Duchesne Lucie , Jauffret‐Roustide Marie ,   ANRS‐Coquelicot Study Group
Published: November 2017

Introduction and Aims

The aims of this study were to describe the prevalences of injection practices and needle/syringe sharing in people who use drugs in French prisons, and to investigate associated factors.

Design and Methods

Using the ANRS‐Coquelicot survey (2011−2013), a random sample of 1718 people who used drugs in free society was included. Information regarding a history of incarceration, drug‐injection practices inside prison and needle/syringe sharing was collected during interviews.

Results

In our sample, 65.5% reported a history of injection and 57.4% had been incarcerated at least once. Among those who reported both of these conditions, 14% reported injection practices inside prison, 40.5% of whom had shared needles/syringes. In the multivariable model, the following variables were associated with injection practices inside prison: being a Russian‐speaking detainee, having spent more time in prison, and having started to inject before 1996 and especially before 1987. Being Russian speaking was also associated with needle/syringe sharing in prison.

Discussion and Conclusions

The prevalences of injection practices and needle/syringe sharing in prisons are alarmingly high. Effective interventions to prevent the transmission of infectious diseases among people who use drugs in the prison setting are essential. The implementation of international recommendations on the principle of equivalence between prisons and the community is still very limited in most countries, and should be complemented with tailored interventions for the most vulnerable prison populations, especially Russian‐speaking detainees.
rs‐local data‐mines information from spectral libraries to improve local calibrations
Authors: Lobsey C. R. , Viscarra Rossel R. A. , Roudier P. , Hedley C. B.
Published: November 2017

Diffuse reflectance spectroscopy in the visible–near infrared (vis–NIR) and mid infrared (mid‐IR) can be used to estimate soil properties, such as organic carbon (C) content. Compared with conventional laboratory methods, it enables practical and inexpensive measurements at finer spatial and temporal resolutions, which are needed to improve the assessment and management of soil and the environment. Measurements of soil properties with spectra require empirical calibration and soil spectral libraries (SSL) have been developed for this purpose at the regional, continental and global scales. Calibrations derived with these SSLs, however, are often shown to predict poorly at local sites. Here we present a new method, rs‐local, that uses a small representative set of site‐specific (or ‘local’) data and re‐sampling techniques to select a subset of data from a large vis‐NIR SSL to improve calibrations at the site. We demonstrate the implementation of rs‐local by estimating soil organic C in two fields with different soil types, one in Australia and one in New Zealand. We found that with as few as 12 to 20 site‐specific samples and the SSL, training datasets derived with rs‐local could accurately predict soil organic C concentrations. Predictions with the rs‐local data were comparable to, or better than those made with site‐specific calibrations with up to 300 samples. Our method outperformed other published ‘local’ spectroscopic techniques that we tested. Thus, rs‐local can effectively improve both the accuracy and financial viability of soil spectroscopy.

Highlights

We describe a new algorithm (rs‐local) for site‐specific calibration using existing spectral libraries.

rs‐local is a data driven method that makes no assumptions on spectral or sample similarities.

rs‐local improved the accuracy of soil organic carbon estimates using spectroscopy.

rs‐local improves the economic viability of soil spectroscopy.
Answering Levinas' Call in Organization Studies
Authors: Bruna Maria Giuseppina , Bazin Yoann
Published: November 2017

This article aims at answering Levinas' call for a radical ethical stance in the field of organization studies, in which he has been increasingly mentioned in the past decade. Starting with an examination of the main aspects of his phenomenology (alterity, unconditional responsibility towards the Other, diakonia), this paper outlines the potential contribution of a Levinassian perspective to refine our understanding of organizations. We question the conditions of transferability of his radical ethics to managerial practices and present two main avenues of research that could be renewed: benevolent management and organizational justice.
Design Thinking and Social Enterprises: A Solution‐Focused Strategy for Social Enterprise Research
Authors: Agafonow Alejandro
Published: November 2017

Had we had the vantage point of centuries of experimentation with social enterprises, separating the wheat (i.e., successful social enterprises) from the chaff, empirical social enterprise research could be on the verge of making a contribution. But since social enterprises as a mass phenomenon are relatively new, the output of empirical research must be taken very carefully because it may actually support doomed business models. It is thus submitted that a design thinking approach to social enterprise research that involves a solution‐focused strategy of knowledge production is needed. The latter consists of addressing the internal inconsistencies of a well‐established general theory when trying to account for social enterprises, similarly to how a designer addresses the shortcomings of an original chair design to come up with something more suitable. It is argued that a solution‐focused strategy of knowledge production will make scientific breakthroughs in the field of social enterprises possible.
Verbal memory decline from hippocampal depth electrodes in temporal lobe surgery for epilepsy
Authors: Ljung Hanna , Nordlund Arto , Strandberg Maria , Bengzon Johan , Källén Kristina
Published: November 2017

Objective

To explore whether patients with refractory mesial temporal lobe epilepsy risk aggravated verbal memory loss from intracranial electroencephalography (EEG) recording with longitudinal hippocampal electrodes in the language‐dominant hemisphere.

Methods

A long‐term neuropsychological follow‐up (mean 61.5 months, range 22–111 months) was performed in 40 patients after ictal registration with left hippocampal depth electrodes (study group, n = 16) or no invasive EEG, only extracranial registration (reference group, n = 24). The groups were equal with respect to education, age at seizure onset, epilepsy duration, and prevalence of pharmacoresistant temporal lobe epilepsy (TLE; 75%) versus seizure freedom (25%). Retrospective neuropsychological data from preoperative surgical workup (T1) and prospective follow‐up neuropsychological data (T2) were compared. A ≥1 SD intrapatient decline was considered as clinically relevant deterioration of verbal memory.

Results

Significant decline in verbal memory was seen in 56% of the patients in the study group compared to 21% in the reference group. At T1, there were no statistical between‐group differences in memory performance. At T2, between‐group comparison showed significantly greater verbal memory decline for the study group (Claeson Dahl Learning and Retention Test, Verbal Learning: p = 0.05; Rey Auditory Verbal Learning Test, Total Learning: p = 0.04; Claeson Dahl Learning and Retention Test, Verbal Retention: p = 0.04). An odds ratio (OR) of 7.1 (90% confidence interval [CI] 1.3–37.7) for verbal memory decline was seen if right temporal lobe resection (R TLR) had been performed between T1 and T2. The difference between groups remained unchanged when patients who had undergone R TLR were excluded from the analysis, with a remaining aggravated significant decline in verbal memory performance for the study group compared to the reference group.

Significance

Our results suggest a risk of verbal memory deterioration after the use of depth electrodes along the longitudinal axis of the hippocampus. Until this issue is further investigated, caution regarding depth electrodes in the language‐dominant hemisphere hippocampus seems advisable.
Thalamocortical functional connectivity in Lennox–Gastaut syndrome is abnormally enhanced in executive‐control and default‐mode networks
Authors: Warren Aaron E. L. , Abbott David F. , Jackson Graeme D. , Archer John S.
Published: November 2017

Objective

To identify abnormal thalamocortical circuits in the severe epilepsy of Lennox–Gastaut syndrome (LGS) that may explain the shared electroclinical phenotype and provide potential treatment targets.

Methods

Twenty patients with a diagnosis of LGS (mean age = 28.5 years) and 26 healthy controls (mean age = 27.6 years) were compared using task‐free functional magnetic resonance imaging (MRI). The thalamus was parcellated according to functional connectivity with 10 cortical networks derived using group‐level independent component analysis. For each cortical network, we assessed between‐group differences in thalamic functional connectivity strength using nonparametric permutation‐based tests. Anatomical locations were identified by quantifying spatial overlap with a histologically informed thalamic MRI atlas.

Results

In both groups, posterior thalamic regions showed functional connectivity with visual, auditory, and sensorimotor networks, whereas anterior, medial, and dorsal thalamic regions were connected with networks of distributed association cortex (including the default‐mode, anterior‐salience, and executive‐control networks). Four cortical networks (left and right executive‐control network; ventral and dorsal default‐mode network) showed significantly enhanced thalamic functional connectivity strength in patients relative to controls. Abnormal connectivity was maximal in mediodorsal and ventrolateral thalamic nuclei.

Significance

Specific thalamocortical circuits are affected in LGS. Functional connectivity is abnormally enhanced between the mediodorsal and ventrolateral thalamus and the default‐mode and executive‐control networks, thalamocortical circuits that normally support diverse cognitive processes. In contrast, thalamic regions connecting with primary and sensory cortical networks appear to be less affected. Our previous neuroimaging studies show that epileptic activity in LGS is expressed via the default‐mode and executive‐control networks. Results of the present study suggest that the mediodorsal and ventrolateral thalamus may be candidate targets for modulating abnormal network behavior underlying LGS, potentially via emerging thalamic neurostimulation therapies.
Similarities and differences in neuroplasticity mechanisms between brain gliomas and nonlesional epilepsy
Authors: Bourdillon Pierre , Apra Caroline , Guénot Marc , Duffau Hugues
Published: November 2017

Objective

To analyze the conceptual and practical implications of a hodotopic approach in neurosurgery, and to compare the similarities and the differences in neuroplasticity mechanisms between low‐grade gliomas and nonlesional epilepsy.

Methods

We review the recent data about the hodotopic organization of the brain connectome, alongside the organization of epileptic networks, and analyze how these two structures interact, suggesting therapeutic prospects. Then we focus on the mechanisms of neuroplasticity involved in glioma natural course and after glioma surgery. Comparing these mechanisms with those in action in an epileptic brain highlights their differences, but more importantly, gives an original perspective to the consequences of surgery on an epileptic brain and what could be expected after pathologic white matter removal.

Results

The organization of the brain connectome and the neuroplasticity is the same in all humans, but different pathologic mechanisms are involved, and specific therapeutic approaches have been developed in epilepsy and glioma surgery. We demonstrate that the “connectome” point of view can enrich epilepsy care. We also underscore how theoretical and practical tools commonly used in epilepsy investigations, such as invasive electroencephalography, can be of great help in awake surgery in general.

Significance

Putting together advances in understanding of connectomics and neuroplasticity, leads to significant conceptual improvements in epilepsy surgery.
Feasibility study for clinical application of caspase‐3 inhibitors in Pemphigus vulgaris
Authors: Hariton William V.J. , Galichet Arnaud , Vanden Berghe Tom , Overmiller Andrew M. , Mahoney My G. , Declercq Wim , Müller Eliane J.
Published: November 2017

The potentially severe side effects of systemic corticosteroids and immunosuppressants used in Pemphigus vulgaris (PV) call for novel therapeutic approaches. In this context, pharmacological inhibition of major pathogenic signalling effectors represents a promising alternative. However, we have also shown that overinhibition of effectors required for epidermal homeostasis can exacerbate PV pathophysiology implicating transepidermal keratinocyte fragility. A feedforward target validation therefore preferentially includes studies on knockout mouse models. We previously reported on successful amelioration of PV blisters following inhibition of non‐apoptotic, low‐level caspase‐3. Here, we use conditional, keratinocyte‐specific caspase‐3‐deficient mice (casp3EKO) to demonstrate (i) absence of keratinocyte fragility upon injection of the potent Dsg3‐specific antibody AK23 and (ii) amelioration of blistering on the background of known signalling effectors. Our results provide the experimental proof of concept justifying translation of the caspase‐3 inhibitor approach into PV clinical trials.
Biomarkers related to bullous pemphigoid activity and outcome
Authors: Giusti Delphine , Le Jan Sébastien , Gatouillat Gregory , Bernard Philippe , Pham Bach Nga , Antonicelli Frank
Published: November 2017

Bullous pemphigoid (BP) is the most common autoimmune subepidermal blistering disease of the skin. Investigation of the BP‐associated pathophysiological processes during the last decades showed that the generation of autoantibodies directed against the hemidesmosome proteins BP180 and BP230, a hallmark of the BP‐associated autoimmune response, leads to the recruitment of inflammatory immune cells at the dermal‐epidermal junction, and subsequently to the release of a large amount of inflammatory molecules involved in blister formation. Analysis in transversal and longitudinal studies of autoantibodies and inflammatory molecules production both at the time of diagnosis and under treatment was mainly performed within the serum but also in the blister fluid. Some autoimmune or inflammatory molecules expression was related to the presence of clinical signs, while others were mere bystanders. In this review, we focused on the autoimmune and inflammatory molecules that have been identified as potential biomarkers of BP development and outcome.