bluuebunny/crossref_metadata_2025 huggingface dataset:
Biomarkers of Recent Cannabis Use in Blood, Oral Fluid and Breath
Authors: Hubbard J A , Hoffman M A , Ellis S E , Sobolesky P M , Smith B E , Suhandynata R T , Sones E G , Sanford S K , Umlauf A , Huestis M A , Grelotti D J , Grant I , Marcotte T D , Fitzgerald R L
Published: June 2021

Proving driving under the influence of cannabis (DUIC) is difficult. Establishing a biomarker of recent use to supplement behavioral observations may be a useful alternative strategy. We determined whether cannabinoid concentrations in blood, oral fluid (OF) or breath could identify use within the past 3 h—likely the period of the greatest impairment. In a randomized trial, 191 frequent (≥4/week) and occasional (<4/week) cannabis users smoked one cannabis (placebo [0.02%], or 5.9% or 13.4% Δ9-tetrahydrocannabinol [THC]) cigarette ad libitum. Blood, OF and breath samples were collected prior to and up to 6 h after smoking. Samples were analyzed for 10 cannabinoids in OF, 8 in blood and THC in breath. Frequent users had more residual THC in blood and were more likely to be categorized as ‘recently used’ prior to smoking; this did not occur in OF. Per se limits ranging from undetectable to 5 ng/mL THC in blood offered limited usefulness as biomarkers of recent use. Cannabinol (CBN, cutoff = 1 ng/mL) in blood offered 100% specificity but only 31.4% sensitivity, resulting in 100% positive predictive value (PPV) and 94.0% negative predictive value (NPV) at 4.3% prevalence; however, CBN may vary by cannabis chemovar. A 10 ng/mL THC cutoff in OF exhibited the overall highest performance to detect its use within 3 h (99.7% specificity, 82.4% sensitivity, 92.5% PPV and 99.2% NPV) but was still detectable in 23.2% of participants ∼4.4 h post-smoking, limiting specificity at later time points. OF THC may be a helpful indicator of recent cannabis intake, but this does not equate to impairment. Behavioral assessment of impairment is still required to determine DUIC. This study only involved cannabis inhalation, and additional research evaluating alternative routes of ingestion (i.e., oral) is needed.
On three-stage temperature dependence of elastic wave velocities for rocks
Authors: Li Nianqi , Fu Li-Yun , Yang Jian , Han Tongcheng
Published: June 2021

For most rocks, the typical temperature behavior of elastic wave velocities generally features a three-stage nonlinear characteristic that could be expressed by a reverse S-shape curve with two inflexion points. The mechanism regulating the slow-to-fast transition of elastic constants remains elusive. The physics of critical points seems related to the multimineral composition of rocks with differentiated thermodynamic properties. Based on laboratory experiments for several rocks with different levels of heterogeneity in compositions, we conduct theoretical and empirical simulations by nonlinear thermoelasticity methods and a S-shape model, respectively. The classical theory of linear thermoelasticity based on the Taylor expansion of strain energy functions has been widely used for crystals, but suffers from a deficiency in describing thermal-associated velocity variations for rocks as a polycrystal mixture. Current nonlinear thermoelasticity theory describes the third-order temperature dependence of velocity variations by incorporating the fourth-order elastic constants. It improves the description of temperature-induced three-stage velocity variations in rocks, but involves with some divergences around two inflexion points, especially at high temperatures. The S-shape model for empirical simulations demonstrates a more accurate depiction of thermal-associated three-stage variations of P-wave velocities. We investigate the physics of the parameters ${a_1}$ and ${b_1}$ in the S-shape model. These fitting parameters are closely related to thermophysical properties by being proportional to the specific heat and thermal conductivity of rocks. We discuss the mechanism that regulates the slow-to-fast transition in the three-stage nonlinear behavior for various rocks.
Anisotropic frequency-dependent characteristics of PP- and PS-waves in partially saturated double-porosity rocks
Authors: Qin Xilin , Gui Zhixian , Yang Fei , Liu Yuanyuan
Published: June 2021

Most frequency-dependent AVO inversions are currently based on an approximate equation derived using an isotropic medium. However, actual reservoirs usually show anisotropy, such as shale reservoirs, tight sandstone reservoirs and fractured reservoirs. We propose a joint frequency-dependent AVO (JFAVO) inversion in an anisotropic medium based on a periodic layered double-porosity medium. This JFAVO will allow us to quantitatively study the influence of fluids on the dispersion of PP- and PS-wave velocities and anisotropic parameters. First, we used a double-porosity medium to analyse the frequency-dependent characteristics of velocities and anisotropy parameters. We found that the anisotropic parameters show obvious dispersions, similar to those of velocities. Then, we derived the JFAVO inversion based on Rüger's equation to extract the dispersion of velocities and anisotropic parameters. Finally, we analysed the stability and applicability of the inversion algorithm, and used three sets of models to analyse the sensitivity of dispersion properties to fluids. The numerical analysis results show that PP-wave velocity dispersion and anisotropic parameter δ dispersion are sensitive to fluids, whereas, the velocity dispersion of the PS-wave is not. When saturation exceeds 80%, the velocity dispersion and anisotropic parameter dispersion properties are not sensitive to fluids.
An Application of Damped Diffusion for Modeling Volatility Dynamics
Authors: Hung Mao-Wei , Ko Yi-Chen , Wang Jr-Yan
Published: June 2021

This paper proposes a damped constant elasticity variance (CEV) stochastic volatility (DCEV) model, which remedies the possible explosive behavior of the CEV model and also accommodates the mean-reverting dynamics more appropriately than the nonlinear drift (NLD) stochastic volatility model. As the DCEV model maintains the linear drift, an analytic formula is available to efficiently infer latent variances from VIX levels, after which both its physical and risk-neutral parameters can be simultaneously estimated with the maximum-likelihood approach given S&P 500 returns and inferred variances. The DCEV model outperforms the CEV and NLD models in in-sample fitting performance and in out-of-sample variance forecasting under the physical measure. It also exhibits superior ability in out-of-sample option pricing over the CEV and Heston’s (1993) models under the risk-neutral measure. This satisfactory performance demonstrates the suitability of describing volatility dynamics with the DCEV model and the potential of applying this to study other issues.
The professional project of graphic designers and universities’ visual identities
Authors: Moldenæs Turid , Pettersen Hilde Marie
Published: June 2021

Contrary to earlier research on why universities change their visual identities from traditional to more abstract ones, resting on a demand-side approach, we offer an explanation based on a supply-side approach. We argue that universities’ change of visual identities toward abstract symbols reflects a professional logic shared by graphic designers and discuss the mechanisms and institutional agents that have fueled the professional project of graphic designers and the institutionalization of their professional logic. Simultaneously, we make visible the role of a professional group—the graphic designers—that have escaped the gaze of earlier organizational research.
Ultrasound Physics and Ultrasound Machine Functionality
Authors: Albright-Trainer Brooke
Published: June 2021

Chapter 1 reviews basic ultrasound physics and introduces ultrasound machine functionality. Ultrasound medical imaging (also known as sonography) is a diagnostic imaging tool that uses high-frequency sound waves to create images of structures in the body. It can show details that a still image like a radiograph cannot, such as blood flow or needle guidance to a nerve. Several tools and techniques are useful in acquiring the best ultrasound image. The chapter covers the functions of many ultrasound machine knobs, machine operation, ultrasound operating modes, and ultrasound image optimization. It also examines different types of ultrasound probes and their uses.
Ultrasound Guided Peripheral Intravenous Line Placement Using the Incremental Advancement Method
Authors: Clebone Anna
Published: June 2021

Chapter 4 discusses the dynamic use of ultrasound to guide the placement of a peripheral intravenous (IV) line. Ultrasound can be used to guide placement of multiple types of vascular access. Arteries and veins are sonographically similar in cross section: hyperechoic circles with hypoechoic interiors. Arteries are thicker walled and characteristically pulsatile. Veins are more susceptible to compression. Doppler or color flow can distinguish the amplitude and direction of flow. Skill with placing peripheral ultrasound guided IV lines in patients with difficult IV access can often help the practitioner avoid the need to place a central line, assuming the central line is not needed for other indications.
Special Considerations of Regional Anesthesia in Pediatric Patients
Authors: Clebone Anna
Published: June 2021

Chapter 7 reviews special considerations associated with the use of regional anesthesia in pediatric patients. The chapter covers the safety of regional anesthesia under general anesthesia, the risk for local anesthetic systemic toxicity under general anesthesia, and the safety of placing an indwelling catheter to anesthetize a peripheral nerve. The safety of regional anesthesia in children by expert practitioners is well established. Large database studies show that local anesthetic systemic toxicity and transient neurologic deficits are rare. Regional anesthesia should always be performed with all safety precautions taken, and by those practitioners with expert training in the technique.
Trauma Focused Psychodynamic Psychotherapy
Authors: Busch Fredric , Milrod Barbara , Chen Cory , Singer Meriamne
Published: June 2021

This book, which operationalizes and articulates in detail a unique, brief, tested psychodynamic psychotherapy for Post-Traumatic Stress Disorder, Trauma Focused Psychodynamic Psychotherapy [TFPP], describes how to perform this helpful treatment. The book provides tailored psychodynamic background that underpins these approaches, and explains the different phases of treatment. Additionally, it articulates common underlying dynamics of PTSD that the treatment commonly addresses in patients to bring about symptomatic relief. TFPP is being tested in two diverse populations: military Veterans with PTSD who are receiving care at three Veterans Administration Hospitals, and also among LGBTQ patients with PTSD. The book is focused on the authors’ experiences treating Veterans and many clinical examples are provided demonstrating how to work with these principles and approaches. In general, patients and therapists have found the treatment to be an extremely useful tool. Veterans have gained insight into the impact of traumatic experiences on various aspects of their lives and had improvements in dissociation, interpersonal engagement, anxiety, and anger/hostility. TFPP appears to be particularly effective for patients with prominent avoidance symptoms and those who are unwilling or unable to recount the details of their trauma directly. Patients have been found to be more affectively engaged and better connected to others (including the therapist) following treatment.
Core Psychodynamic Factors in PTSD
Authors: Busch Fredric N. , Milrod Barbara L. , Chen Cory K. , Singer Meriamne B.
Published: June 2021

After briefly reviewing the psychoanalytic view of mental life, including the influence of the unconscious on mental life and symptoms, this chapter describes the impact of trauma from the psychodynamic viewpoint. Disruptions in narrative coherence, repetition and re-experiencing, intrapsychic conflicts, dissociation, defenses, intense negative affects, and disruptions in trust that result from trauma are described. Clinical examples are presented to illuminate these factors. In addition, the relevance of the patient’s pretrauma history, their attachment style and mentalization skills, and the specific nature of traumatic experience on the impact of trauma and associated symptoms is elaborated.
Some Techniques of Psychodynamic Psychotherapy as They Apply to Treatment of Post-Traumatic Stress Disorder
Authors: Busch Fredric N. , Milrod Barbara L. , Chen Cory K. , Singer Meriamne B.
Published: June 2021

This chapter provides descriptions and clinical examples to illustrate core psychodynamic techniques as they are adapted to the work of trauma-focused psychodynamic psychotherapy (TFPP): clarification, confrontation, interpretations, and utilization of patient dreams. Clarification aids the patient in gaining distance and objectivity. Confrontation is designed to help patients recognize contradictory thoughts and feelings. Interpretations tie observed behaviors or thought patterns to the emotional dynamic factors that may give rise to them. Because a core symptom of post-traumatic stress disorder (PTSD) involves re-experiencing traumas through dreams, a focus on the approach to dreams is particularly relevant in this population, and TFPP is the only operationalized psychotherapy for PTSD that makes active use of dreams to gain an understanding of emotional causes of distress. The chapter also illustrates the use of the transference and its interpretation and describes common countertransference constellations that arise. Due to the nature of the impact of trauma, transference and countertransference reactions can be particularly intense and ways that the therapist can effectively use these reactions to guide the treatment are discussed.
Phase 2
Authors: Busch Fredric N. , Milrod Barbara L. , Chen Cory K. , Singer Meriamne B.
Published: June 2021

This chapter provides an overview of the central psychodynamic techniques of the middle phase of TFPP. Core intrapsychic conflicts that contribute to PTSD symptoms are identified and actively addressed. Interpretation of defenses aids in the elucidation of conflicts. A prominent defense in PTSD, identification with the aggressor, is described in more depth. Exploration of the transference is discussed with attention to the ways in which core conflicts emerge with the therapist. Patients with PTSD trigger particularly intense countertransference reactions, knowledge of which furthers the therapeutic process. The technique of working through is articulated, in which the therapist and patient elucidate how various conflicts and defenses emerge across a range of symptoms, contexts, and relationships. Case vignettes are used to illustrate these approaches.
An episode of giddy, irritable mood with increased energy and goal-directed activity
Authors: Smith Joshua R.
Published: June 2021

Bipolar disorder is a mood disorder characterized by episodes of mania or hypomania and major depressive episodes. The diagnostic criteria for mania require the presence of distinct periods of abnormal mood characterized by euphoria, expansiveness, or irritability. The change in mood is accompanied by increased activity or energy as well as other symptoms such as grandiosity, decreased sleep, increased speech, flight of ideas, distractibility, agitation, and increased involvement in risky behaviors. The assessment of bipolar disorder should include a detailed psychiatric history ascertaining the presence of current or previous mood symptoms. Children and adolescents are more likely to present with either rapidly fluctuating or a mixed mood state. Bipolar disorder is associated with high relapse rates, even among those receiving treatment. The first-line medication class is second-generation antipsychotics. Additional psychosocial treatments such as psychoeducation, psychotherapy, and community engagement can also be helpful.
Chronically irritable mood with frequent temper outbursts
Authors: Deaver Lauren N.
Published: June 2021

Disruptive mood dysregulation disorder (DMDD) is a new diagnostic addition to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5). The core feature of the disorder is chronic, severe, and persistent irritability that manifests as frequent temper outbursts that are inconsistent with the patient’s developmental level. The temper outbursts can be verbal or behavioral including physical aggression or property destruction. Between outbursts, the child remains persistently irritable or angry for most of the day, nearly every day. These symptoms persist across time and settings and are easily observable by others. Psychotherapeutic interventions including parent training and individual psychotherapy are critical components of a comprehensive treatment plan. Since DMDD is a new diagnosis, there are no published randomized controlled medication trials. The use of selective serotonin reuptake inhibitors (SSRIs) or second-generation antipsychotics may be considered for decreasing irritability.
Recurrent episodes of intense fear, shortness of breath, racing heart, and sweating
Authors: Macenski Christina L.
Published: June 2021

Panic disorder consists of recurrent, unexpected panic attacks accompanied by persistent worry about future attacks and/or a maladaptive change in behavior related to the attacks. A panic attack is defined as an abrupt surge of intense fear or discomfort that reaches a peak within minutes that occurs in conjunction with several other associated symptoms such as palpitations, sweating, trembling, shortness of breath, and chest pain. Features of panic disorder that are more common in adolescents than in adults include less worry about additional panic attacks and decreased willingness to openly discuss their symptoms. All patients with suspected panic disorder should undergo a medical history, physical examination, and laboratory workup to exclude medical causes of panic attacks. Cognitive behavioral therapy (CBT) including interoceptive exposures is the gold standard therapy intervention. Medications including selective serotonin reuptake inhibitors (SSRIs) and serotonin norepinephrine reuptake inhibitors (SNRIs) can also help reduce symptoms.
A girl without stranger danger
Authors: Deaver Lauren N.
Published: June 2021

Disinhibited social engagement disorder (DSED) is a rare disorder of childhood affecting a small number of children who experience extreme neglect or abuse in early childhood such as institutional rearing. The characteristic feature of DSED is disinhibited, socially indiscriminate social behavior that begins prior to the age of five years. Children with DSED exhibit reduced reticence in approaching unfamiliar adults, overly familiar behavior, lack of checking back with their caregiver after venturing away, and willingness to leave with an unfamiliar adult. The assessment includes a psychiatric evaluation and observation of how the child interacts with their caregiver and unfamiliar adults. There are no medication treatments for DSED; however, psychiatric comorbidities may benefit from psychopharmacology. The cornerstone of treatment for DSED is providing the child with an emotionally available attachment figure. It may be necessary to limit the child’s exposure to strangers for several months to reduce socially indiscriminate behaviors.
Pain and immunity
Authors: Beggs Simon
Published: June 2021

The central nervous system (CNS) and immune system are inextricably linked. The complexity of their interactions is still being unraveled, but the list of processes mediated wholly or in part by neuroimmune interactions continues to grow. The influence of the immune system is crucial for normal nervous system development both pre- and postnatally, for maintaining neuronal homeostasis in the mature CNS and modulating synaptic plasticity. Aberrations in this crosstalk have been implicated in many neurodevelopmental and psychiatric disorders. It is not feasible to explore neuronal function at any point in the lifespan, in health or disease, without considering the influence of the immune system. In the adult animal it is now well established that pain chronicity is maintained by immune influence upon the neuronal nociceptive system, although, fascinatingly, there is now evidence for a marked sexual dimorphism in how the immune and nervous systems interact. This holds true for pain in early life, where the two still-developing systems provide a very different environment to mediate nociception and pain. Of particular interest is how the immune system and sex interact to early life painful events to prime pain responses in later life.
Pediatric chronic pain and mental health
Authors: Pavlova Maria , Miller Jillian Vinall , McGrath Patrick J. , Noel Melanie
Published: June 2021

Pediatric chronic pain is prevalent, disabling, and costly. Even if resolved by adulthood, chronic pain confers a heightened risk of developing mental health problems. Indeed, chronic pain is often comorbid with mental health problems, particularly anxiety, depression, and post-traumatic stress disorder. These comorbidities are tied to decreased functioning, increased suffering, and poor treatment response. Yet, mental health is rarely directly addressed in pediatric chronic pain treatments. In this chapter, we review epidemiological evidence of co-occurring chronic pain and mental health problems, relevant theoretical models to account for this co-occurrence, and proposed intrapersonal, interpersonal, and neurobiological factors that may underlie these comorbidities. An overview of existing treatments and their efficacy in addressing co-occurring pain and mental health problems is supplemented by a clinician’s perspective on treating chronic pain comorbid with psychological symptoms. We outline future research directions and advocate for an urgent need to assess and treat mental health in youth with chronic pain.
Sleep and pain in children and adolescents
Authors: de la Vega Rocío , Dudeney Joanne , Palermo Tonya M.
Published: June 2021

The purpose of this chapter is to provide an overview of sleep assessment and evidence-based treatment of sleep difficulties in children and adolescents with chronic pain. We begin with a review of sleep measures in a number of domains, providing recommendations of well-established subjective measures that have demonstrated reliability and validity in pediatric pain populations. We review the use of objective measures of sleep, including actigraphy to assess sleep patterns in youth with chronic pain, and polysomnography to assess sleep architecture and diagnose sleep disordered breathing. We describe the indications for referrals for overnight sleep studies. Because of the high prevalence of insomnia in youth with chronic pain we emphasize treatment of insomnia treatment, including an overview of the core strategies. Finally, we illustrate clinical assessment and management of sleep problems in a case example of an adolescent with chronic pain.
Pain management in major pediatric trauma and burns
Authors: Palmer Greta M. , Babl Franz E.
Published: June 2021

Pain management in major pediatric trauma and burns remains challenging. The care phases include prehospital, the Emergency Department, ward, and intensive care, with multiple operative and procedural interventions (as inpatients and, later, outpatients). Distress, anxiety, post-traumatic stress disorder (from the primary event, and in-hospital and postdischarge course), itch, deranged sleep, nociceptive and neuropathic pain occur frequently and can persist. This chapter presents the pharmacological and nonpharmacological interventions employed during the various phases to address pain and associated issues in major trauma and burns patients.
Needle procedures
Authors: Taddio Anna
Published: June 2021

All children undergo needle procedures as part of routine medical care. Numerous interventions are available for relieving pain from needle procedures. These interventions can be divided into four domains (4 Ps of pain management): Procedural, pharmacological, psychological, and physical. Treating needle pain reduces pain and distress and improves satisfaction with medical care. Other potential benefits include a reduction in the development of needle fear and subsequent healthcare avoidance behavior. Adoption of the 4 Ps into routine clinical practice is feasible and should become a standard of care in the delivery of health care for children. There are various effective approaches for translating the research evidence into practice that target different stakeholders involved in children’s health care, including children, parents, health providers, and educators. This chapter is a narrative review of the current knowledge about epidemiology, pain experience, practices and attitudes, evidence-based interventions, and knowledge translation for pain management during common needle procedures.
Pain in sickle cell disease
Authors: Dampier Carlton , Sil Soumitri
Published: June 2021

Sickle cell disease (SCD) presents a potentially complex pain disorder to clinicians. Pain from vaso-occlusion of sickle erythrocytes can occur in multiple musculoskeletal locations, several internal viscera such as the spleen, and the penis. Such pain is typically intermittent in childhood, shares features of acute pain with other pain disorders, and often responds to nonsteroidal anti-inflammatory drugs and opioid analgesics. Adolescents with SCD often experience more frequent pain, and those with bone disease in spine, hips, or shoulders may experience chronic pain. Like other chronic pain disorders, this pain often responds poorly to opioids, but there is limited current clinical or research data to support alternative medications. Many cognitive behavior strategies are helpful as part of multidisciplinary pain management, particularly in adolescents, who may also benefit from psychological support to treat coexistent mood disorders, to increase coping skills, and to support appropriate school and family functioning. Future advances in pharmacological and psychological therapies are needed to ameliorate the substantial burden of pain in children and adolescents with SCD.
Postoperative pain management
Authors: Williams Glyn , Howard Richard F.
Published: June 2021

Admission to hospital for surgery is a significant and potentially traumatic event. Fear of separation, an unknown environment, anticipation of pain, painful procedures, or adverse effects are all prominent causes of anxiety and stress that can increase the perception of pain and impact on the quality of perioperative care. Postoperative pain management begins prior to surgery using a biopsychosocial approach that includes the prevention and pharmacological treatment of pain alongside a holistic and well-coordinated strategy that allays fears and anxieties, and allows children and their carers to participate in the selection and implementation of safe and suitable analgesia. A successful postoperative pain management program will include ongoing training of hospital staff, adequate preparation of children and families that provides timely verbal and written information, and the development and implementation of audited institutional analgesic protocols that ensure the safety and efficacy of pain-management strategies in a child-friendly and secure environment.
Common pain problems in the outpatient setting
Authors: Berberich F. Ralph
Published: June 2021

This chapter reviews an oft neglected aspect of pediatric pain, namely that which accumulates over time in office settings, a series of recurring “minor” insults. Relatively little attention is paid to this office-related pain as it often is considered tolerable, even acceptable, and not worthy of systematic efforts and policies to reduce it. Office pain seems to lack the weight associated with more consequent procedures carried out in hospitals. The section includes general principles addressing pain reduction, pain that accompanies normative developmental processes such as teething, colic and “growing pains”; pain resulting from infections such as otitis media and pharyngitis; and pain from office procedures such as circumcision and foreign body removal.
Neonatal and infant pain assessment
Authors: Bueno Mariana , Eriksson Mats , Stevens Bonnie J.
Published: June 2021

Pain assessment is an essential foundation to mitigate pain and its consequences in the developing child. However, pain assessment in neonates and infants is challenging and, to date, there is no “gold standard” infant pain indicator, measure, or approach. This chapter encompasses (1) a comprehensive evaluation of the most current and well validated neonatal/infant pain assessment measures; (2) an overview on biomarkers and cortical indicators on neonatal/infant pain; (3) the integration of recommendations on pain-assessment measures and practices within clinical practice guidelines, policies, and procedures; and (4) challenges associated with neonatal and infant pain assessment in terms of research, clinical, and knowledge translation issues.
Opioids in clinical practice
Authors: Meng Howard , Campbell Fiona , Strassels Scott A.
Published: June 2021

Opioid use in clinical practice has changed significantly since they were first introduced. Liberal prescribing of opioids has contributed to the opioid crisis. Recent efforts in reducing opioid-related harms have resulted in the curbing of opioid prescriptions, yet deaths continue to increase. Clinicians should be aware of the mechanism of action and the pharmacokinetic/pharmacodynamic differences between various types and formulations of opioids. These differences inform how each opioid is best used in various clinical scenarios. The benefits of opioid administration should be weighed against the risks of opioid-related harms. Clinicians should be familiar with strategies of opioid use in acute and chronic pain settings to optimize pain outcomes for children.
Procedural pain distraction
Authors: Cohen Lindsey L. , Wright Laura A. , Martin Sarah R. , Shih Sharon , Donati Matthew
Published: June 2021

This chapter focus on distraction as an intervention for children’s acute medical pain. We start by highlighting the consequences of untreated procedural pain for children. Next, we discuss the theoretical rationale for distraction and its anesthetic qualities. Subsequently, we present the literature examining the effectiveness of distraction for lowering children’s distress associated with immunizations, venous access, burn debridement, and cancer treatments. Then we synthesize the distraction for procedural pain literature, and we highlight some of the issues to consider when conducting research or applying distraction in clinical settings. We conclude the chapter with a vignette, which illustrates some of the nuances to consider when applying and personalizing distraction for a child undergoing an acute painful procedure.
Theory-informed approaches to translating pain evidence into practice
Authors: Yamada Janet , Hutchinson Alison M. , Li Shelly-Anne
Published: June 2021

Despite great strides in evidence-based pain assessment and management strategies, infants and children still experience acute pain (including multiple painful procedures) and chronic pain during hospitalization. Translating best evidence on pain assessment and management into clinical practice remains a challenge. The knowledge- or evidence-to-practice gap in pain in children can be addressed by implementing strategies, underpinned by knowledge translation theories, frameworks, and models, to promote and sustain practice change. A range of factors related to the organizational context and individual behavior play a role in the adoption of new pain assessment and management practices.
Sociodemographic disparities in pediatric pain management
Authors: Huguet Anna , Ezenwa Miriam O.
Published: June 2021

The purpose of this chapter is to present a narrative review of research studies examining sociodemographic predictors of disparities in pain management in children and adolescents. Findings from this review suggest that there are racial/ethnic disparities in the management of pain, but it is still not clear whether disparities by age, sex, insurance status, and residential area exist owing to the conflicting results and/or the reduced number of studies published. For the studies in which evidence of sociodemographic disparities exist, it is not clear whether the statistically significant sociodemographic disparities were also clinically meaningful, and the goal is to determine predictors of disparities in pain management. Future studies need to focus on determining the clinical meaningfulness of other findings and systematically testing explanatory models for possible sociodemographic disparities in pediatric pain management. Adequately addressing these gaps will help to advance the science of sociodemographic disparities in pediatric pain management.
Interaction of the galactic-centre super bubbles with the gaseous disc
Authors: Sofue Yoshiaki , Kataoka Jun
Published: June 2021

The interaction of Galactic centre (GC) super bubbles (GSBs) with the gaseous disc and halo of the Milky Way is investigated using radio continuum, X-ray, H i, and CO line surveys. The radio North Polar Spur (NPS) constitutes the brightest eastern ridge of GSB, brightening towards the galactic plane and reaching l = 22○, b = +2○ at the sharpest end, where it intersects the tangential direction of the 3-kpc-expanding ring and crater. Examination of the spur ridges reveals that the entire GSB, including the NPS and its counter spurs, constitutes a GC-symmetrical Ω/ Ʊ shape. The thickness and gas density of the H i and CO discs are shown to increase sharply from the inside (lower longitude) to the outside the 3-kpc crater. Formation of crater is explained by the sweeping of the upper layer of disc gas by the shock wave from the GC by the explosion ∼10 My ago with the emitted energy of several 1055 erg. Based on the discussion, a unified view on the structure and formation mechanism of GSB is presented.
Mapping yeast mitotic 5′ resection at base resolution reveals the sequence and positional dependence of nucleases in vivo
Authors: Bazzano Dominic , Lomonaco Stephanie , Wilson Thomas E
Published: June 2021

Resection of the 5′-terminated strand at DNA double-strand breaks (DSBs) is the critical regulated step in the transition to homologous recombination. Recent studies have described a multi-step model of DSB resection where endonucleolytic cleavage mediated by Mre11 and Sae2 leads to further degradation mediated by redundant pathways catalyzed by Exo1 and Sgs1/Dna2. These models have not been well tested at mitotic DSBs in vivo because most methods used to monitor resection cannot precisely map early cleavage events. Here we report resection monitoring with high-throughput sequencing using molecular identifiers, allowing exact counting of cleaved 5′ ends at base resolution. Mutant strains, including exo1Δ, mre11-H125N and exo1Δ sgs1Δ, revealed a major Mre11-dependent cleavage position 60–70 bp from the DSB end whose exact position depended on local sequence. They further revealed an Exo1-dependent pause point approximately 200 bp from the DSB. Suppressing resection extension in exo1Δ sgs1Δ yeast exposed a footprint of regions where cleavage was restricted within 119 bp of the DSB. These results provide detailed in vivo views of prevailing models of DSB resection and extend them to show the combined influence of sequence specificity and access restrictions on Mre11 and Exo1 nucleases.
Golgi-58K can re-localize to late endosomes upon cellular uptake of PS-ASOs and facilitates endosomal release of ASOs
Authors: Liang Xue-Hai , Nichols Joshua G , De Hoyos Cheryl Li , Sun Hong , Zhang Lingdi , Crooke Stanley T
Published: June 2021

Phosphorothioate (PS) modified antisense oligonucleotide (ASO) drugs can trigger RNase H1 cleavage of cellular target RNAs to modulate gene expression. Internalized PS-ASOs must be released from membraned endosomal organelles, a rate limiting step that is not well understood. Recently we found that M6PR transport between Golgi and late endosomes facilitates productive release of PS-ASOs, raising the possibility that Golgi-mediated transport may play important roles in PS-ASO activity. Here we further evaluated the involvement of Golgi in PS-ASO activity by examining additional Golgi proteins. Reduction of certain Golgi proteins, including Golgi-58K, GCC1 and TGN46, decreased PS-ASO activity, without substantial effects on Golgi integrity. Upon PS-ASO cellular uptake, Golgi-58K was recruited to late endosomes where it colocalized with PS-ASOs. Reduction of Golgi-58K caused slower PS-ASO release from late endosomes, decreased GCC2 late endosome relocalization, and led to slower retrograde transport of M6PR from late endosomes to trans-Golgi. Late endosome relocalization of Golgi-58K requires Hsc70, and is most likely mediated by PS-ASO–protein interactions. Together, these results suggest a novel function of Golgi-58K in mediating Golgi-endosome transport and indicate that the Golgi apparatus plays an important role in endosomal release of PS-ASO, ensuring antisense activity.
Characterization of systemic immunosuppression by IDH mutant glioma small extracellular vesicles
Authors: Ludwig Nils , Rao Aparna , Sandlesh Poorva , Yerneni Saigopalakrishna S , Swain Alexander D , Bullock Kristin M , Hansen Kim M , Zhang Xiaoran , Jaman Emade , Allen Jordan , Krueger Katharine , Hong Chang-Sook , Banks William A , Whiteside Theresa L , Amankulor Nduka M
Published: June 2021

Background

Gliomas are the most common primary brain tumors and are universally fatal. Mutations in the isocitrate dehydrogenase genes (IDH1 and IDH2) define a distinct glioma subtype associated with an immunosuppressive tumor microenvironment. Mechanisms underlying systemic immunosuppression in IDH mutant (mutIDH) gliomas are largely unknown. Here, we define genotype-specific local and systemic tumor immunomodulatory functions of tumor-derived glioma small extracellular vesicles (TEX).

Methods

TEX produced by human and murine wildtype and mutant IDH glioma cells (wtIDH and mutIDH, respectively) were isolated by size exclusion chromatography (SEC). TEX morphology, size, quantity, molecular profiles and biodistribution were characterized. TEX were injected into naive and tumor-bearing mice, and the local and systemic immune microenvironment composition was characterized.

Results

Using in vitro and in vivo glioma models, we show that mutIDH TEX are more numerous, possess distinct morphological features and are more immunosuppressive than wtIDH TEX. mutIDH TEX cargo mimics their parental cells, and induces systemic immune suppression in naive and tumor-bearing mice. TEX derived from mutIDH gliomas and injected into wtIDH tumor-bearing mice reduce tumor-infiltrating effector lymphocytes, dendritic cells and macrophages, and increase circulating monocytes. Astonishingly, mutIDH TEX injected into brain tumor-bearing syngeneic mice accelerate tumor growth and increase mortality compared with wtIDH TEX.

Conclusions

Targeting of mutIDH TEX represents a novel therapeutic approach in gliomas.
Significant loss of soil inorganic carbon at the continental scale
Authors: Song Xiao-Dong , Yang Fei , Wu Hua-Yong , Zhang Jing , Li De-Cheng , Liu Feng , Zhao Yu-Guo , Yang Jin-Ling , Ju Bing , Cai Chong-Fa , Huang Biao , Long Huai-Yu , Lu Ying , Sui Yue-Yu , Wang Qiu-Bing , Wu Ke-Ning , Zhang Feng-Rong , Zhang Ming-Kui , Shi Zhou , Ma Wan-Zhu , Xin Gang , Qi Zhi-Ping , Chang Qing-Rui , Ci En , Yuan Da-Gang , Zhang Yang-Zhu , Bai Jun-Ping , Chen Jia-Ying , Chen Jie , Chen Yin-Jun , Dong Yun-Zhong , Han Chun-Lan , Li Ling , Liu Li-Ming , Pan Jian-Jun , Song Fu-Peng , Sun Fu-Jun , Wang Deng-Feng , Wang Tian-Wei , Wei Xiang-Hua , Wu Hong-Qi , Zhao Xia , Zhou Qing , Zhang Gan-Lin
Published: June 2021

Widespread soil acidification due to atmospheric acid deposition and agricultural fertilization may greatly accelerate soil carbonate dissolution and CO2 release. However, to date, few studies have addressed these processes. Here, we use meta-analysis and nationwide-survey datasets to investigate changes in soil inorganic carbon (SIC) stocks in China. We observe an overall decrease in SIC stocks in topsoil (0–30 cm) (11.33 g C m–2 yr–1) from the 1980s to the 2010s. Total SIC stocks have decreased by ∼8.99 ± 2.24% (1.37 ± 0.37 Pg C). The average SIC losses across China (0.046 Pg C yr–1) and in cropland (0.016 Pg C yr–1) account for ∼17.6%–24.0% of the terrestrial C sink and 57.1% of the soil organic carbon sink in cropland, respectively. Nitrogen deposition and climate change have profound influences on SIC cycling. We estimate that ∼19.12%–19.47% of SIC stocks will be further lost by 2100. The consumption of SIC may offset a large portion of global efforts aimed at ecosystem carbon sequestration, which emphasizes the importance of achieving a better understanding of the indirect coupling mechanisms of nitrogen and carbon cycling and of effective countermeasures to minimize SIC loss.
The Agricultural Revolution in Prehistory
Authors: Barker Graeme
Published: June 2021

The Agricultural Revolution in Prehistory addresses one of the most debated and least understood revolutions in the history of our species, the change from hunting and gathering to farming. Graeme Barker takes a global view, and integrates a massive array of information from archaeology and many other disciplines, including anthropology, botany, climatology, genetics, linguistics, and zoology. Against current orthodoxy, Barker develops a strong case for the development of agricultural systems in many areas as transformations in the life-ways of the indigenous forager societies, and argues that these were as much changes in social norms and ideologies as in ways of obtaining food. With a large number of helpful line drawings and photographs as well as a comprehensive bibliography, this authoritative study will appeal to a wide general readership as well as to specialists in a variety of fields.
INVESTIGATIONS OF OCCUPATIONAL RADIATION DOSE INCIDENTS RELATED TO MEDICAL PRACTICES IN SAUDI ARABIA
Authors: Shubayr N , Alashban Y
Published: June 2021

This study aimed to investigate national incidents related to medical radiation practices in Saudi Arabia from 2015 to 2019, and the actions taken to deal with these cases. The radiation protection program of the Saudi Ministry of Health monitors occupational doses for medical staff. When the radiation doses exceed the assigned investigation levels, an investigation protocol should be followed to identify the reasons and present recommendations. A total of 96 cases of radiation doses were above the investigation levels; 70% above level I, and 30% above level II. These cases were found to be 44% overload exposure, 32% intentional exposure, 8% accidental/unintentional exposure and 16% dosimeter misadventure. The majority of cases (80%) were in 2015 and 2016 with a significant drop in cases following these 2 years mainly due to continuing education and training. Investigations of incidents and the actions taken contributed to improving the radiation protection program.
“Could We Just Breathe for 30 Seconds?”: Social Worker Experiences of Holistic Engagement Practice Training
Authors: Pyles Loretta , Cosgrove Darren T , Gardner Erin , Raheim Salome , Adam Gwendolyn J , Chakravarty Sreyashi , Cooke Collina
Published: June 2021

Given the still emerging evidence base about the effectiveness of practices, such as mindfulness, somatics, and integrative body-mind-spirit social work, there is a need to know more about the impacts that training in such areas can have on social workers and their professional work. This mixed-methods article reports on a pilot study that explored practitioners’ perceptions regarding the impact of learning holistic engagement practice (HEP) skills on their service delivery and well-being. The research inquires into the perceptions of social workers who received the training, particularly in relation to their quality of presence and the therapeutic relationship; HEP as a form of self-care and a facilitator of compassion satisfaction; the impact it has on social work practice and settings; and the facilitators and barriers to using holistic engagement. Implications from the findings focus on the need for additional research, training, organizational change, and communities of practice to facilitate changes that could promote more effective social work practice, greater levels of empathy, and compassion satisfaction.
Screening for colorectal cancer in people ages 45–49: research gaps, challenges and future directions for research and practice
Authors: Hyams Travis , Mueller Nora , Curbow Barbara , King-Marshall Evelyn , Sultan Shahnaz
Published: June 2021

We explore challenges for implementing new recommendations to begin screening for colorectal cancer in people ages 45–49. Challenges include the costs, limited evidence, and ensuring health equity. We also offer solutions and recommendations for researchers and practitioners to include this new age group into screening programs. Finally, we conclude with suggesting areas for future work to address colorectal cancer in people under the age of 50.
Variation in resistance to oxidative stress in Oregon-(R)R-flare and Canton-S strains of Drosophila melanogaster
Authors: Sigrist-Flores Santiago Cristobal , Castañeda-Partida Laura , Campos-Aguilar Myriam , Santos-Cruz Luis Felipe , Miranda-Gutierrez Aranza , Gallardo-Ortíz I A , Villalobos-Molina R , Dueñas-García Irma Elena , Heres-Pulido María Eugenia , Piedra-Ibarra Elías , Rosales-García Víctor Hugo , Jimenez-Flores Rafael , Ponciano-Gómez Alberto
Published: June 2021

All aerobic organisms are susceptible to damage by reactive oxygen species (ROS). ROS-induced damage has been associated with aging and diseases such as metabolic syndrome and cancer. However, not all organisms develop these diseases, nor do they age at the same rate; this is partially due to resistance to oxidative stress, a quantitative trait attributable to the interaction of factors including genetics and environmental. Drosophila melanogaster represents an ideal system to study how genetic variation can affect resistance to oxidative stress. In this work, oxidative stress (total and mitochondrial ROS), antioxidant response, and Cap 'n' collar isoform C and Spineless gene expression, one pesticide resistant (Oregon R(R)-flare) and wild-type (Canton-S) strains of D. melanogaster, were analyzed to test resistance to basal oxidative stress. ROS, catalase, and superoxide dismutase were determined by flow cytometry, and Cap 'n' collar isoform C and Spineless expression by qRT-PCR. The intensity of oxidative stress due to the pro-oxidant zearalenone in both was evaluated by flow cytometry. Data confirm expected differences in oxidative stress between strains that differ in Cyp450s levels. The Oregon (R)R-flare showed greater ROS, total and mitochondrial, compared to Canton-S. Regarding oxidative stress genes expression Cap 'n' collar isoform C and Spineless (Ss), Oregon R(R)-flare strain showed higher expression. In terms of response to zearalenone mycotoxin, Canton-S showed higher ROS concentration. Our data show variation in the resistance to oxidative stress among these strains of D. melanogaster.