bluuebunny/crossref_metadata_2025 huggingface dataset:
Our Sunshine place: A collective narrative and reflection on the experiences of a mental health crisis leading to an admission to a psychiatric inpatient unit
Authors: Wyder Marianne , Roennfeldt Helena , Rosello Rise Faith , Stewart Bridie , Maher John , Taylor Rosslyn , Pfeffer Amanda , Bell Peter , Barringham Neil ,   others who preferred to withhold their names
Published: June 2018

Acute mental health inpatient units are complex environments where tensions between clinical and personal recovery can be amplified. The focus for mental health staff is often centred on providing clinical care, whereas from the patient perspective, the admission can represent a profound existential crisis. There are very few user‐led accounts of their experiences of psychiatric inpatient unit. This project was developed in the traditions of Analytic Auto‐Ethnography, a research methodology which provides a systematic process to reflect on our own experience while still producing trustworthy findings. Through this process, a collective narrative and critical reflection of a group of over 20 individuals with experiences of either providing or receiving care in an acute psychiatric inpatient unit was developed. The narrative developed shows that for some the hospital admission was a time of healing; for others, the inpatient unit represented an alien and unsafe environment, which accentuated the strangeness of the experiences of mental ill health. Common themes among the group were that of an overarching need to make sense of what happened leading up to the admissions and to come to terms with the potential impact of the illness on identity and future. This journey can be best described as a process of healing and moving towards ‘wholeness’. Safety, connection, autonomy and control were identified as factors which either facilitated or hindered the process of successfully integrating the various experiences.
Polar domain structural evolution under electric field and temperature in the (Bi0.5Na0.5)TiO3‐0.06BaTiO3 piezoceramics
Authors: Zhao Jinyan , Zhang Nan , Ren Wei , Niu Gang , Walker David , Thomas Pamela A. , Wang Lingyan , Ye Zuo‐Guang
Published: June 2018

Lead‐free bismuth sodium titanate and related compounds are of great interest as promising candidates for piezoelectric applications. However, the full understanding of this family of materials is still a challenge partly because of their structural complexity and different behaviors with or without the application of an external electric field. Here, piezoresponse force microscopy is used to gain insight into the mesoscopic‐scale domain structure of the morphotropic phase boundary (MPB) composition of (1‐x)Bi0.5Na0.5TiO3‐xBaTiO3 solid solution at x = 0.06 (abbreviated as BNT‐6BT). The evolution of the domains with the changes of the electric field and temperature has been thoroughly examined in conjunction with the crystal structure analysis and dielectric studies. It is found that ferroelectric domains with size of hundreds of nanometers are embedded in a relaxor state without visible domains on a mesoscopic scale, which are considered to contribute to the tetragonal and cubic phases in the material, respectively. Temperature‐independent domain configuration is observed in the unpoled sample from room temperature to 200°C. While, temperature‐dependent domain configuration is observed in the poled sample. The homogenously poled state breaks into the mixed domain configuration containing polydomain structure and invisible state around the so‐called depoling temperature. The structural changes on different length scales are also discussed. This work provides an in‐depth understanding of the structural and domain changes under an electric field and the temperature‐dependent domain evolution in both unpoled and poled states in the BNT‐BT solid solution of the MPB composition.
Exploring barriers and facilitators in the implementation and use of guideline recommendations on antipsychotic drug prescriptions for people with intellectual disability
Authors: Ramerman Lotte , Hoekstra Pieter J. , de Kuijper Gerda
Published: June 2018

Background

It is unknown why professionals’ adherence to guideline recommendations on antipsychotic drug prescription in the intellectual disabilities care is insufficient. This study aimed to explore barriers and facilitators in the implementation and use of these recommendations.

Methods

In‐depth interviews with four intellectual disability physicians, two psychiatrists and five behavioural scientists were used to explore the implementation and use of guideline recommendations.

Results

Barriers in adhering to recommendations were lack of collaboration of different disciplines involved in the treatment of psychiatric and behavioural disorders and lack of enforcement of an appropriate monitoring of side‐ and treatment effects. When guideline recommendations were translated into organizational policies, clinicians were able to divide responsibilities and tasks, needed to appropriately implement guideline recommendations in daily clinical practice.

Conclusions

To facilitate the use of guideline recommendations, organizations should translate recommendations into organization‐specific policies, involving physicians and behavioural scientists in this process, while simultaneously creating more practical and technological support.
The interplay of riverscape features and exotic introgression on the genetic structure of the Mexican golden trout (Oncorhynchus chrysogaster), a simulation approach
Authors: Escalante Marco Alejandro , García‐De León Francisco J. , Ruiz‐Luna Arturo , Landguth Erin , Manel Stéphanie
Published: June 2018

Aim

We explored the factors between riverscape features and exotic introgression of cultured rainbow trout (Oncorhynchus mykiss) that drive the current genetic structure in the endemic Mexican golden trout (Oncorhynchus chrysogaster) using a riverscape genetics simulator.

Location

Sierra Madre Occidental, Northwest Mexico, North America.

Methods

We created a system model for Mexican golden trout to test various scenarios for the effect of riverscape resistance and rainbow trout introgression on the native genetic structure of the Mexican golden trout. Individual genotypes were used to initialize the model and were based upon empirical allele frequencies from three genetically and spatially distinct groups in the study area. The geographical location of the simulated populations was defined using a species distribution model. We included hypotheses for movement of riverine distance and riverscape resistance. We evaluated model performance by conducting population and landscape genetics analyses on the simulation outputs.

Results

The most plausible scenario included riverscape resistance without introgression, which presented a spatial genetic structure matching the observed riverscape genetic structure and fitting expected general life‐history patterns for high elevation trout streams. In addition, temperature, precipitation, hydrology and topography were the most important variables influencing species occurrence and dispersal.

Main conclusion

This work presents one of the first empirically derived simulation studies of introgression. It highlights the importance of considering riverscape resistance (i.e. hydroclimatic and topographical gradient effects) in models of spatial genetic structure and introgression. Moreover, our modelling suggests that what we characterize as riverscape resistance is acting as a boundary against exotic introgression. The results of this study could help to develop management strategies that preserve native gene pools.
Corilagin inhibits breast cancer growth via reactive oxygen species‐dependent apoptosis and autophagy
Authors: Tong Yinping , Zhang Gongye , Li Yang , Xu Jiajia , Yuan Jiahui , Zhang Bing , Hu Tianhui , Song Gang
Published: June 2018

Corilagin is a component of Phyllanthus urinaria extract and has been found of possessing anti‐inflammatory, anti‐oxidative, and anti‐tumour properties in clinic treatments. However, the underlying mechanisms in anti‐cancer particularly of its induction of cell death in human breast cancer remain undefined. Our research found that corilagin‐induced apoptotic and autophagic cell death depending on reactive oxygen species (ROS) in human breast cancer cell, and it occurred in human breast cancer cell (MCF‐7) only comparing with normal cells. The expression of procaspase‐8, procaspase‐3, PARP, Bcl‐2 and procaspase‐9 was down‐regulated while caspase‐8, cleaved PARP, caspase‐9 and Bax were up‐regulated after corilagin treatment, indicating apoptosis mediated by extrinsic and mitochondrial pathways occurred in MCF‐7 cell. Meanwhile, autophagy mediated by suppressing Akt/mTOR/p70S6K pathway was detected with an increase in autophagic vacuoles and LC3‐II conversion. More significantly, inhibition of autophagy by chloroquine diphosphate salt (CQ) remarkably enhanced apoptosis, while the caspase inhibitor z‐VAD‐fmk failed in affecting autophagy, suggesting that corilagin‐induced autophagy functioned as a survival mechanism in MCF‐7 cells. In addition, corilagin induced intracellular reactive oxygen species (ROS) generation, when reduced by ROS scavenger NAC, apoptosis and autophagy were both down‐regulated. Nevertheless, in SK‐BR3 cell which expressed RIP3, necroptosis inhibitor Nec‐1 could not alleviate cell death induced by corilagin, indicating necroptosis was not triggered. Subcutaneous tumour growth in nude mice was attenuated by corilagin, consisting with the results in vitro. These results imply that corilagin inhibits cancer cell proliferation through inducing apoptosis and autophagy which regulated by ROS release.
Methodology for the damage assessment of vehicles exposed to flooding in urban areas
Authors: Martínez‐Gomariz Eduardo , Gómez Manuel , Russo Beniamino , Sánchez Pablo , Montes Josep‐Anton
Published: June 2018

Within urban areas, humans carry out a great diversity of activities, and some of them require the use of vehicles. Floods, especially in urban areas, can generate significant tangible direct damages to vehicles themselves and to the urban elements in case of loss of stability and collision, which cannot be dismissed. In this paper, after a state‐of‐the‐art review on damage curves for vehicles, a methodology to assess the direct economic impact for vehicles exposed to flooding has been described, and applied within a study carried out in the framework of the BINGO H2020 EU Project. Only three different studies focused on damages to vehicles in contact with floodwater have been found. Contrasting damage curves for vehicles are found when comparing the three approaches, however, the ones proposed by the U.S. Army Corps of Engineers (USACE) offer a high level of completeness and accuracy. Moreover, USACE's development is the most current research and all the steps for the development of the damage curves are comprehensively described. Finally, after the description of a detailed methodology for flood damage mapping for vehicles, a procedure to evaluate the Expected Annual Damage for vehicles is offered.
A unified model of the excitability of mouse sensory and motor axons
Authors: Makker Preet G. S. , Matamala José M. , Park Susanna B. , Lees Justin G. , Kiernan Matthew C. , Burke David , Moalem‐Taylor Gila , Howells James
Published: June 2018

Non‐invasive nerve excitability techniques have provided valuable insight into the understanding of neurological disorders. The widespread use of mice in translational research on peripheral nerve disorders and by pharmaceutical companies during drug development requires valid and reliable models that can be compared to humans. This study established a novel experimental protocol that enables comparative assessment of the excitability properties of motor and sensory axons at the same site in mouse caudal nerve, compared the mouse data to data for motor and sensory axons in human median nerve at the wrist, and constructed a mathematical model of the excitability of mouse axons. In a separate study, ischaemia was employed as an experimental manoeuvre to test the translational utility of this preparation. The patterns of mouse sensory and motor excitability were qualitatively similar to human studies under normal and ischaemic conditions. The most conspicuous differences between mouse and human studies were observed in the recovery cycle and the response to hyperpolarization. Modelling showed that an increase in temperature in mouse axons could account for most of the differences in the recovery cycle. The modelling also suggested a larger hyperpolarization‐activated conductance in mouse axons. The kinetics of this conductance appeared to be much slower raising the possibility that an additional or different hyperpolarization‐activated cyclic‐nucleotide gated (HCN) channel isoform underlies the accommodation to hyperpolarization in mouse axons. Given a possible difference in HCN isoforms, caution should be exercised in extrapolating from studies of mouse motor and sensory axons to human nerve disorders.
Does Herding Behavior Reveal Skill? An Analysis of Mutual Fund Performance
Authors: JIANG HAO , VERARDO MICHELA
Published: June 2018

We uncover a negative relation between herding behavior and skill in the mutual fund industry. Our new, dynamic measure of fund‐level herding captures the tendency of fund managers to follow the trades of the institutional crowd. We find that herding funds underperform their antiherding peers by over 2% per year. Differences in skill drive this performance gap: Antiherding funds make superior investment decisions even on stocks not heavily traded by institutions, and can anticipate the trades of the crowd; furthermore, the herding‐antiherding performance gap is persistent, wider when skill is more valuable, and larger among managers with stronger career concerns.
Rankings and Risk‐Taking in the Finance Industry
Authors: KIRCHLER MICHAEL , LINDNER FLORIAN , WEITZEL UTZ
Published: June 2018

Rankings are omnipresent in the finance industry, yet the literature is silent on how they impact financial professionals' behavior. Using lab‐in‐the‐field experiments with 657 professionals and lab experiments with 432 students, we investigate how rank incentives affect investment decisions. We find that both rank and tournament incentives increase risk‐taking among underperforming professionals, while only tournament incentives affect students. This rank effect is robust to the experimental frame (investment frame vs. abstract frame), to payoff consequences (own return vs. family return), to social identity priming (private identity vs. professional identity), and to professionals' gender (no gender differences among professionals).
Asset Management within Commercial Banking Groups: International Evidence
Authors: FERREIRA MIGUEL A. , MATOS PEDRO , PIRES PEDRO
Published: June 2018

We study the performance of equity mutual funds run by asset management divisions of commercial banking groups using a worldwide sample. We show that bank‐affiliated funds underperform unaffiliated funds by 92 basis points per year. Consistent with conflicts of interest, the underperformance is more pronounced among those affiliated funds that overweight the stock of the bank's lending clients to a great extent. Divestitures of asset management divisions by banking groups support a causal interpretation of the results. Our findings suggest that affiliated fund managers support their lending divisions’ operations to reduce career concerns at the expense of fund investors.
Systemic Risk in Financial Markets: How Systemically Important Are Insurers?
Authors: Kaserer Christoph , Klein Christian
Published: June 2018

This study investigates how insurers contribute to systemic risk in the global financial system. In a modeling framework embracing publicly traded and nonpublic firms, the financial system is represented by 201 major banks and insurers over the period from 2004 through 2014. In the aggregate, the insurance sector contributes relatively little to systemic losses; during the financial crisis and the European sovereign debt crisis, its risk share averaged 9 percent. Individually, however, several multi‐line and life insurers appear to be as systemically risky as the riskiest banks. Our results, therefore, affirm that some insurers are systemically important and indicate that insurers’ level of systemic risk varies by line of business. We discuss several important implications of our results for managing systemic risk in insurance, arguing for a combination of entity‐ and activity‐based regulation.
Social deontics: A nano‐level approach to human power play
Authors: Stevanovic Melisa
Published: June 2018

The notion of “deontic rights”—the capacity of an individual to determine action—is described as a tool to analyze human power plays in the turn‐by‐turn unfolding of social interaction. Drawing on various bodies of literature, the paper portrays the organization of the adjacency‐pair sequence as the key locus of negotiation over deontic rights. How such negotiations happen in practice is also considered. Two deontic patterns instantiating themselves in sequential relations—deontic congruence and deontic incongruence—are discussed. Negotiations of deontic rights are suggested to take place specifically in and through three different forms of deontic incongruence, each of which involves a subtle mismatch between the claims of deontic rights of the first speaker and the recipient's treatment of these claims. These implicit power plays easily escape the eye and are therefore difficult to reflect upon and counteract by the participants themselves, which makes a thorough understanding of these mechanisms important.
Differential arterial and venous endothelial redox responses to oxidative stress
Authors: Shrestha Bandana , Prasai Priya K. , Kaskas Amir M. , Khanna Ankur , Letchuman Vijay , Letchuman Sunjay , Alexander Jonathan Steven , Orr A. Wayne , Woolard Matthew D. , Pattillo Christopher B.
Published: June 2018

Objective

Oxidative stress is a central event linked with endothelial dysfunction and inflammation in several vascular pathologies, marked by over‐production of ROS and concomitant decreases in antioxidants, for example GSH. Here, we distinguish endothelial oxidative stress regulation and associated functional disparities in the two main vascular conduits, (arteries and veins) following decreases in GSH.

Methods

MAECs and VCECs were used as models of arterial and venular endothelium, respectively, and BSO (0‐100 μmol/L) was used to indirectly increase cellular oxidative stress. Inflammatory responses were measured using immune cell attachment and immunoblotting for endothelial cell adhesion molecule (ICAM‐1, VCAM‐1) expression, altered cell proliferation, and wound healing.

Results

MAECs and VCECs exhibited differential responses to oxidative stress produced by GSH depletion with VCECs exhibiting greater sensitivity to oxidative stress. Compared to MAECs, VCECs showed a significantly increased inflammatory profile and a decreased proliferative phenotype in response to decreases in GSH levels.

Conclusions

Arterial and venous endothelial cells exhibit differential responses to oxidant stress, and decreases in GSH:GSSG are more exacerbated in venous endothelial cells. Specific pathogenesis in these vascular conduits, with respect to oxidant stress handling, warrants further study, especially considering surgical interventions such as Coronary artery bypass grafting that use both interchangeably.
A Match‐Then‐Predict Method for Daily Traffic Flow Forecasting Based on Group Method of Data Handling
Authors: Song Xiang , Li Wenjing , Ma Dongfang , Wang Dianhai , Qu Licheng , Wang Yinhai
Published: June 2018

Forecasting daily traffic flow in the future is one of the most critical components in traffic management to improve operational efficiency. This article aims to address the daily traffic flow forecasting problem given historical data. Because the traffic flow pattern is strongly correlated with contextual factors, we propose a match‐then‐predict method which integrates contextual matching and time series prediction based on group method of data handling (GMDH) algorithm. From a Seattle‐based case study, we show that the contextual matching can significantly improve the prediction accuracy. We also show that the proposed method can in general outperform alternative prediction methods in daily traffic flow forecasting in terms of prediction accuracy. In addition, further analysis using data from other cities and applying the proposed method to forecast speed also support the benefits of the proposed method against alternative prediction methods.
The importance of residual kidney function in haemodialysis patients
Authors: Kong Jessica , Davies Matthew , Mount Peter
Published: June 2018

In contrast to peritoneal dialysis, residual kidney function (RKF) is commonly disregarded for haemodialysis (HD) patients and not regularly monitored or taken into account in routine clinical care. This is despite evidence that higher levels of RKF in HD patients are associated with better outcomes, including survival, total solute clearance, nutrition, inflammation and fluid balance. This review aims to summarise the clinical effects of RKF specifically in HD patients. Some level of RKF is present in over 80% of patients at the time of dialysis initiation, and while this declines over time, up to 30% of patients on HD for 5 years still have a measurable level of native kidney function. There is little evidence on how best to preserve RKF in HD patients, although it has been observed that intensive HD regimens in incident HD patients appear to accelerate RKF decline. RKF is not commonly factored into HD prescription and measures of adequacy, despite the fact that some guidelines such as Kidney Disease Outcomes Quality Initiative (KDOQI) and European Best Practice Guidelines suggest that it is reasonable to do so. This likely relates, at least in part, to perceived concerns regarding the inconvenience of timed urine collections and to the complexity and lack of consensus regarding the methods for integrating the intermittent clearance of HD with the continuous clearance of native renal function. Further research is required into how best to maintain and maximise the benefits of RKF in HD patients.
Barriers to first time parent groups: A qualitative descriptive study
Authors: Barrett Norma , Hanna Lisa , Fitzpatrick Owen Vincent
Published: June 2018

First‐time parents' groups are offered to new parents in Australia to support their transition to parenthood. Not all parents avail of the service, some cease attendance, and fathers are under‐represented. In the present descriptive, qualitative study, we examined first‐time mothers' perspectives on the barriers to parental participation in the groups. Semi‐structured interviews were conducted with a sample of eight first‐time mothers in a regional city in Victoria, Australia. Interviews revealed groups were perceived as sites strongly reinforcing traditional social norms of parenting. From this central theme, six gendered subthemes emerged as barriers to attendance. Barriers to mothers included non‐normative mothering narratives, such as experiencing stillbirth or having a disabled child, perceived dissonance in parenting ethos, and group size. Barriers to fathers, as perceived by mothers, included groups as female spaces, dads as a minority, and female gatekeeping. A multi‐faceted approach is required to change the common perception that groups are for mothers only. Groups need to be more inclusive of different parenting experiences and philosophies. Segregated groups might better address the needs of both parents. Further research is required to capture fathers' perspectives.
Calcium transport across plant membranes: mechanisms and functions
Authors: Demidchik Vadim , Shabala Sergey , Isayenkov Stanislav , Cuin Tracey A. , Pottosin Igor
Published: June 2018

ContentsSummary49I.Introduction49II.Physiological and structural characteristics of plant Ca2+‐permeable ion channels50III.Ca2+extrusion systems61IV.Concluding remarks64Acknowledgements64References64

Calcium is an essential structural, metabolic and signalling element. The physiological functions of Ca2+are enabled by its orchestrated transport across cell membranes, mediated by Ca2+‐permeable ion channels, Ca2+‐ATPases and Ca2+/H+exchangers. Bioinformatics analysis has not determined any Ca2+‐selective filters in plant ion channels, but electrophysiological tests do reveal Ca2+conductances in plant membranes. The biophysical characteristics of plant Ca2+conductances have been studied in detail and were recently complemented by molecular genetic approaches. Plant Ca2+conductances are mediated by several families of ion channels, including cyclic nucleotide‐gated channels (CNGCs), ionotropic glutamate receptors, two‐pore channel 1 (TPC1), annexins and several types of mechanosensitive channels. Key Ca2+‐mediated reactions (e.g. sensing of temperature, gravity, touch and hormones, and cell elongation and guard cell closure) have now been associated with the activities of specific subunits from these families. Structural studies have demonstrated a unique selectivity filter inTPC1, which is passable for hydrated divalent cations. The hypothesis of aROS‐Ca2+hub is discussed, linking Ca2+transport toROSgeneration.CNGCinactivation by cytosolic Ca2+, leading to the termination of Ca2+signals, is now mechanistically explained. The structure–function relationships of Ca2+‐ATPases and Ca2+/H+exchangers, and their regulation and physiological roles are analysed.
Meiotic chromosome stability of a newly formed allohexaploid wheat is facilitated by selection under abiotic stress as a spandrel
Authors: Bian Yao , Yang Chunwu , Ou Xiufang , Zhang Zhibin , Wang Bin , Ma Weiwei , Gong Lei , Zhang Huakun , Liu Bao
Published: June 2018

Polyploidy is a prominent route to speciation in plants; however, this entails resolving the challenges of meiotic instability facing abrupt doubling of chromosome complement. This issue remains poorly understood.

We subjected progenies of a synthetic hexaploid wheat, analogous to natural common wheat, but exhibiting extensive meiotic chromosome instability, to heat or salt stress. We selected stress‐tolerant cohorts and generated their progenies under normal condition. We conducted fluorescent in situ hybridization/genomic in situ hybridization‐based meiotic/mitotic analysis, RNA‐Seq and virus‐induced gene silencing (VIGS)‐mediated assay of meiosis candidate genes.

We show that heritability of stress tolerance concurred with increased euploidy frequency due to enhanced meiosis stability. We identified a set of candidate meiosis genes with altered expression in the stress‐tolerant plants vs control, but the expression was similar to that of common wheat (cv Chinese Spring, CS). We demonstrate VIGS‐mediated downregulation of individual candidate meiosis genes in CS is sufficient to confer an unstable meiosis phenotype mimicking the synthetic wheat.

Our results suggest that heritable regulatory changes of preexisting meiosis genes may be hitchhiked as a spandrel of stress tolerance, which significantly improves meiosis stability in the synthetic wheat. Our findings implicate a plausible scenario that the meiosis machinery in hexaploid wheat may have already started to evolve at its onset stage.
Exposure to hypoglycemia and risk of stroke
Authors: Smith Logan , Chakraborty Diya , Bhattacharya Pallab , Sarmah Deepaneeta , Koch Sebastian , Dave Kunjan R.
Published: June 2018

In the treatment of both type 1 and type 2 diabetes mellitus, maintaining a euglycemic state represents one of the key challenges. Improper dosing and administration of glucose‐lowering drugs is associated with an increased risk of recurrent hypoglycemia episodes. In addition, the risk of adverse cardiovascular events in diabetic patients, particularly myocardial infarctions and strokes, is well established. Current research indicates a potential link between the baseline risk of cardio/cerebrovascular events in diabetic patients and exposure to hypoglycemia. In this review of the literature, we aim to determine if a relationship exists between recurrent hypoglycemia and adverse neurovascular events.
Telemedicine as a tool for digital medical education: a 15‐year journey inside the RAFT network
Authors: Randriambelonoro Mirana , Bagayoko Cheick‐Oumar , Geissbuhler Antoine
Published: June 2018

This paper presents the evolution and growth of continuous medical education through the Réseau en Afrique Francophone pour la Télémédecine (RAFT) network. RAFT is a telemedicine network present on four continents and built through years of experience, with the goal of supporting isolated healthcare professionals by providing them with the right expertise at the right time using affordable, low‐bandwidth technologies. Much more than a platform to share and exchange knowledge, RAFT has put in place a solid local infrastructure to ensure the sustainability and maintenance of the network. From experience gained with South–South collaboration to top‐down and bottom‐up approaches and various certification models, much know‐how has been acquired and different perspectives for improvement have been proposed. The results we have collected from these 15 years of practice are presented in this paper through lessons learned and key takeaways. Perspectives for future development supported by concrete examples conclude the paper.
Time to consider the contact force during photoplethysmography measurement during pediatric anesthesia: A prospective, nonrandomized interventional study
Authors: Lee Ji‐Hyun , Yang Seungman , Park Jonghyun , Kim Hee Chan , Kim Eun‐Hee , Jang Young‐Eun , Kim Jin‐Tae , Kim Hee‐Soo
Published: June 2018

Background

Respiratory variations in photoplethysmography amplitude enable volume status assessment. However, the contact force between the measurement site and sensor can affect photoplethysmography waveforms. We aimed to evaluate contact force effects on respiratory variations in photoplethysmography waveforms in children under general anesthesia.

Methods

Children aged 3‐5 years were enrolled. After anesthetic induction, mechanical ventilation commenced at a tidal volume of 10 mL/kg. Photoplethysmographic signals were obtained in the supine position from the index finger using a force sensor–integrated clip‐type photoplethysmography sensor that increased the contact force from 0‐1.4 N for 20 respiratory cycles at each force. The AC amplitude (pulsatile component), DC amplitude (nonpulsatile component), AC/DC ratio, and respiratory variations in photoplethysmography amplitude were calculated.

Results

Data from 34 children were analyzed. Seven contact forces at 0.2‐N increments were evaluated for each patient. The normalized AC amplitude increased maximally at a contact force of 0.4‐0.6 N and decreased with increasing contact force. However, the normalized DC amplitude increased with a contact force exceeding 0.4 N. ΔPOP decreased slightly and increased from the point when the AC amplitude started to decrease as contact force increased. In a 0.2‐1.2 N contact force range, significant changes in the normalized AC amplitude, normalized DC amplitude, AC/DC ratio, and respiratory variations in photoplethysmography amplitude were observed.

Conclusion

Respiratory variations in photoplethysmography amplitude changed according to variable contact forces; therefore, these measurements may not reflect respiration‐induced stroke volume variations. Clinicians should consider contact force bias when interpreting morphological data from photoplethysmography signals.
Downregulation of CD5 and dysregulated CD8+ T‐cell activation
Authors: Wada Taizo
Published: June 2018

CD5 is a cell surface molecule that is expressed on most circulating T cells and a small population of B cells, and is involved in modulation of antigen‐specific receptor‐mediated activation. Downregulation of CD5 on CD8+ T cells is a poorly understood but increasingly recognized phenomenon that may be associated with dysregulated T‐cell activation. An increased subpopulation of activated CD8+ T cells with downregulation of CD5 has recently been described in patients with Epstein–Barr virus‐associated hemophagocytic lymphohistiocytosis (HLH) and familial HLH caused by perforin deficiency and Munc 13‐4 deficiency. These cells were detectable only in the acute phase of HLH, in which patients exhibited hypercytokinemia, and declined progressively after successful treatment in parallel with improvement of systemic inflammation. It is unknown whether CD8+ T cells from HLH with other causes have similar profiles. Assessment of CD5 expression on T cells has the potential to assist in the understanding of the diagnosis and pathogenesis of human inflammatory diseases such as HLH.
Hepatosplenic γδ T‐cell lymphoma of two adolescents: Case report and retrospective literature review in children, adolescents, and young adults
Authors: McThenia Sheila S. , Rawwas Jawhar , Oliveira Jennifer L. , Khan Shakila P. , Rodriguez Vilmarie
Published: June 2018

HSTCL is a highly aggressive malignancy with a poor prognosis. Case series and accounts have reported the use of different chemotherapy regimens with diverse patient outcomes. Most long‐term survivors had undergone high‐dose chemotherapy with autologous or allogeneic HCT. We describe two pediatric patients with HSTCL who were treated with chemotherapy followed by allogeneic HCT. Both patients are alive and in complete remission 2 and 8 years after therapy. Multiagent chemotherapy followed with allogeneic HCT seems to provide patients who have chemotherapy‐sensitive disease a long‐term disease‐free survival.
Education, enjoyment, and empowerment: Outcomes of an adolescent transplant camp (I own it)
Authors: Kesavarapu Keerthana , Palle Sirish K. , Dugan Molly , Antinerella Shannon , Luetkemeyer Shannon , Gupta Nitika
Published: June 2018

Peer group camping experiences have a positive influence on adolescents with chronic illnesses, but the data in solid organ transplant recipients are lacking. The aim of this study was to evaluate the outcomes of adolescent transplant attendees of an educational camp. A weekend camp, “I own it” was organized which provided educational training regarding career and health choices, money matters, and managing medications following which a knowledge assessment was performed. The ACLSA questionnaire was also administered. To test the adolescents’ medication knowledge, they were asked to provide written documentation of their medications, which was compared with their medical records. In the ACLSA questionnaire, 32% reported deficiency in work/study, 46% in housing/money management, and 3% in the remaining categories. A significant improvement in knowledge was noted in areas of career choices, money matters, and managing medications, but not in healthy choices. In the medication recall, 75% did not know their medication list, and 92% could not recall dosages or frequencies. In conclusion, adolescents showed quantitative improvements in certain areas while identifying deficiencies in others, areas which were targeted in future initiatives. Prospective longitudinal studies addressing the impact of camps on post‐transplant outcomes should be conducted to better alter the course post‐transplant.
Selective T cell‐depleted haploidentical hematopoietic stem cell transplantation for relapsed/refractory neuroblastoma
Authors: Liu Anthony P. Y. , Lee Pamela P. W. , Kwok Janette S. Y. , Leung Rock Y. Y. , Chiang Alan K. S. , Ha Shau‐Yin , Cheuk Daniel K. L. , Chan Godfrey C. F.
Published: June 2018

Relapsed/refractory NB carries a bleak outcome, warranting novel treatment options. HaploHSCT induces a graft‐versus‐NB effect via natural killer cell alloreactivity. Review of patients with relapsed/refractory NB who underwent haploHSCT with ex vivo T‐cell depletion in our unit from 2013 through 2018. Ten patients were identified (male=5; median age at haploHSCT=6.45 y, range: 3.49‐11.02 y). Indications were relapsed in 7 and refractoriness in 3; disease status at haploHSCT was CR in 2, PR in 6, and PD in 2. All patients received peripheral blood stem cell grafts after ex vivo T‐cell depletion (CD3/CD19‐depletion=1; TCR‐αβ/CD19‐depletion=4; CD3/CD45RA‐depletion=4; and TCR‐αβ/CD45RA‐depletion=1). Conditioning regimens were fludarabine‐based. Neutrophils engrafted on median D + 10 (range: D + 9 to +13), and platelets engrafted (≥20 × 109/L) on median D + 8 (range: D + 5 to D + 14). Early T‐ and NK‐cell recovery were evident. Of the 10 patients, acute rejection developed in 1 (who died of PD despite rescue HSCT), and 1 died of sepsis before engraftment; 8 experienced full donor‐chimerism post‐HSCT. Among the 8, 6 experienced CR, 1 died of PD, and 1 died of pulmonary hypertensive crisis before evaluation. At publication, 4 were in remission (2.8, 7.4, 28.5, and 58.9 months). No significant GvHD occurred. HaploHSCT with selective ex vivo T‐cell depletion may be a safe and useful salvage strategy for relapsed/refractory NB.
Small effort, high impact: Focus on physical activity improves oxygen uptake (VO2peak), quality of life, and mental health after pediatric renal transplantation
Authors: Thorsteinsdottir Hjørdis , Diseth Trond H. , Lie Anine , Tangeraas Trine , Matthews Iren , Åsberg Anders , Bjerre Anna
Published: June 2018

This study estimates the effects on peak oxygen uptake (VO2 peak), QoL, and mental health after the introduction of an adjusted post‐transplant follow‐up program, that is, early physiotherapy and focus on the importance of physical activity. VO2 peak was measured by a treadmill exercise test in 20 renal‐transplanted children on the adjusted post‐transplant follow‐up and compared with a group of 22 patients investigated in a previously, before the implementation of our new follow‐up routines. PedsQL and The Strengths and Difficulties Questionnaire (SDQ) were used to assess QoL and mental health in 45 patients on the new as compared to 32 patients on the previous follow‐up strategy. The patients exposed to early physiotherapy and a higher focus on physical activity had significantly higher VO2 peak (44.3 vs 33.5 mL kg−1 min−1, P = .031) in addition to improved QoL (P = .003) and mental health scores (P = .012). The cardiovascular risk profile was similar in both groups aside from significantly higher triglycerides in the present cohort. Small efforts as early physiotherapy and increased focus on physical activity after pediatric renal transplantation have significant impact on cardiorespiratory fitness, QoL, and mental health. The importance of physical activity should therefore be emphasized in follow‐up programs.
Effect of CYP3A5*1 expression on tacrolimus required dose for transplant pediatrics: A systematic review and meta‐analysis
Authors: Hendijani Fatemeh , Azarpira Negar , Kaviani Maryam
Published: June 2018

This systematic review was designed to find out optimal tacrolimus dose in pediatrics according to their CYP3A5*1 genotype by performing meta‐analysis. PubMed, Scopus, ISI web of Science, ProQuest, Cochrane library, and clinicaltrail.gov were systematically searched to find studies in which tacrolimus dose and/or blood concentration and/or concentration‐to‐dose (C/D) ratio were determined in genotype groups of CYP3A5*1 in pediatric population. Data were extracted at 14 time points post‐transplantation and meta‐analysis of mean and SD was performed. In all, 11 studies including 596 pediatric transplant recipients were entered into systematic review and meta‐analysis. Analysis of tacrolimus required dose, blood concentration, and C/D ratio in 14 time points post‐transplantation resulted in significant differences between expressers and non‐expressers of CYP3A5*1. It seems that 0.06 mg/kg/day higher tacrolimus dose in expressers can produce same blood level as non‐expressers. Using results of TDM for tacrolimus dose adjustment, it takes about 1 month for patients to reach stable and optimum tacrolimus blood concentration. This is too long time period which increases the risk of immunosuppressive over/under‐dose and drug toxicity or organ rejection. Considering our results, defining genetic profile helps to predict the individual required dose more rapidly, actually before beginning of treatment.
Antimicrobial Photodynamic Therapy as an Adjunct for Clinical Partial Removal of Deciduous Carious Tissue: A Minimally Invasive Approach
Authors: Ornellas Pâmela O. , Antunes Leonardo S. , Motta Paula C. , Mendonça Caroline , Póvoa Helvécio , Fontes Karla , Iorio Natalia , Antunes Lívia A. A.
Published: June 2018

This study aimed to evaluate the use of antimicrobial photodynamic therapy (aPDT) as an adjunct for minimally invasive treatment (partial removal of carious tissue—PRCT) of deciduous carious tissue evaluating its efficacy in reducing microorganisms. For that, a clinical study was design including children with deciduous molars with active deep caries lesions (DCL). PRCT was performed and remaining dentin was treated with 100 μg mL−1 methylene blue solution (5 min) and than irradiated with a low power laser emitting red light (InGaAIP—indium gallium aluminum phosphide; λ = 660 nm; 100 mW; 300 J cm−2; 90 s; 9 J). The colony forming units (CFU) count after PRCT and after PRCT + aPDT/mg of dentin were compared for total microorganisms, including Candida spp., the mutans streptococci group, Streptococcus spp. and Lactobacillus spp. The dentin was classified (color, consistency and humidity). The microbial reduction varied from 69.88% to 86.29% and was significantly observed for total microorganisms, mutans streptococci, Streptococcus spp. and Lactobacillus spp (P < 0.001). The dentin type did not influence reduction of microorganisms (P > 0.05). The aPDT presents a promising future for clinical use as an adjunct for the reduction of microorganisms in PRCT of DCL in all kinds of dentin.
Control of root meristem establishment in conifers
Authors: Brunoni Federica , Ljung Karin , Bellini Catherine
Published: June 2018

The evolution of terrestrial plant life was made possible by the establishment of a root system, which enabled plants to migrate from aquatic to terrestrial habitats. During evolution, root organization has gradually progressed from a very simple to a highly hierarchical architecture. Roots are initiated during embryogenesis and branch afterward through lateral root formation. Additionally, adventitious roots can be formed post‐embryonically from aerial organs. Induction of adventitious roots (ARs) forms the basis of the vegetative propagation via cuttings in horticulture, agriculture and forestry. This method, together with somatic embryogenesis, is routinely used to clonally multiply conifers. In addition to being utilized as propagation techniques, adventitious rooting and somatic embryogenesis have emerged as versatile models to study cellular and molecular mechanisms of embryo formation and organogenesis of coniferous species. Both formation of the embryonic root and the AR primordia require the establishment of auxin gradients within cells that coordinate the developmental response. These processes also share key elements of the genetic regulatory networks that, e.g. are triggering cell fate. This minireview gives an overview of the molecular control mechanisms associated with root development in conifers, from initiation in the embryo to post‐embryonic formation in cuttings.
Annual Southeast Asia haze increases respiratory admissions: A 2‐year large single institution experience
Authors: Ming Chew R. , Ban Yu‐Lin Andrea , Abdul Hamid Mohammad F. , Latif Mohd T. , Mohammad Nurashikin , Hassan Tidi
Published: June 2018

Background and objective

The Southeast Asia (SEA) haze is an annual problem and at its worst could produce respirable particles of concentrations up to 500 μg/m3 which is five times the level considered as ‘unhealthy’. However, there are limited reports examining the direct clinical impact of the annual haze. This study examines the effects of the SEA haze on respiratory admissions.

Methods

Data from all respiratory admissions in Universiti Kebangsaan Malaysia Medical Centre (UKMMC) from 1st January 2014 to 31st December 2015 were collected retrospectively from chart and electronic database. A total of 16 weeks of haze period had been formally dated by the Department of Environment using the definition of weather phenomenon leading to atmospheric visibility of less than 10 km. Multivariable regression analyses were performed to estimate rate ratios and 95% CI.

Results

There were 1968 subjects admitted for respiratory admissions in UKMMC during the study period. Incidence rates per week were significantly different between the two groups with 27.6 ± 9.2 cases per week during the haze versus 15.7 ± 6.7 cases per week during the non‐haze period (P < 0.01). A total of 4% versus 2% was admitted to the intensive care unit in the haze and the non‐haze groups, respectively (P = 0.02). The mean ± SD lengths of stay was 12.1 ± 5.2 days; the haze group had a longer stay (18.2 ± 9.7 days) compared to the non‐haze groups (9.7 ± 3.9) (P < 0.001).

Conclusion

The annual SEA haze is associated with increased respiratory admissions.
Bayesian Analysis of Air Emission Violations from Waste Incineration and Coincineration Plants
Authors: Paleologos Evan K. , Elhakeem Mohamed , Amrousi Mohamed El
Published: June 2018

Waste incineration and coincineration plants in most European countries have frequently updated their flue gas cleaning systems, surpassing in most cases E.U. air emission standards. At the same time, in most developing countries, cement and other coincineration facilities follow less stringent emission regulations and have a mixed record of protecting air quality. The European Union, the United States, and Canada have established penalties for air emission violations that account for the harm done to the environment and to human health and aiming to remove the economic benefit reaped as a result of noncompliance. Despite their legal completeness, these regulations do not adequately address the probabilistic nature of air pollution. This article recasts the issue of air pollution penalties in a Bayesian decision‐making framework with the aspiration that the assessment of penalties on a rigorous mathematical framework can assist in alleviating the mistrust by sections of the public on the effectiveness of air pollution regulations. Integration of economic analyses into risk assessments of emission violations can help clarify to policymakers the effect of environmental policies. Our analysis indicates that the penalty structure of the United States appears to favor the update of emission systems more often than the corresponding European Commission's penalties. Our study advances the use of the loss function as a risk analysis tool that can be used as a public policy instrument to promote environmentally friendlier air emission choices. A parabolic, compared to a linear, loss function was seen to justify higher expenses in gas cleaning systems.