bluuebunny/crossref_metadata_2025 huggingface dataset:
Systematic analysis of aberrances of ferroptosis reveals its potential functional roles in cancer
Authors: Liu Zekun , Zhao Qi , Zuo Zhi-Xiang , Yuan Shu-Qiang , Yu Kai , Zhang Qingfeng , Zhang Xiaolong , Sheng Hui , Ju Huai-Qiang , Cheng Han , Wang Feng , Xu Rui-Hua , Liu Ze-Xian
Published: September 2019

Ferroptosis is a type of cell death that related to cancer, however, the characteristics of ferroptosis in cancers are still uncertain. Based on the data in The Cancer Genome Atlas, we found that most ferroptosis regulator genes (FRGs) were differentially expressed in tumors, copy number alterations (CNA) and DNA methylation contributed to their aberrant expression. We established the ferroptosis potential index (FPI) to reveal the functional roles of ferroptosis and noticed that the FPI was higher in tumors than in normal tissues in most cancers, and was associated with subtypes and clinical features. The FPI was negatively correlated with several metabolism pathways but positively associated with several important metastasis-related pathways and immune-related pathways. Higher FPI predicted worse prognosis in several tumors, while FPI and FRGs impacted drug sensitivity. Our study presents a systematical analysis of ferroptosis and its regulatory genes, and highlights the potential of ferroptosis-based cancer therapy.
Grazing-angle reflectivity setup for the low-temperature infrared spectroscopy of two-dimensional systems
Authors: Verseils Marine , Voute Alexandre , Langerome Benjamin , Deutsch Maxime , Brubach Jean-Blaise , Kalaboukhov Alexei , Nucara Alessandro , Calvani Paolo , Roy Pascale
Published: September 2019

A new optical setup is described that allows the reflectivity at grazing incidence to be measured, including ultrathin films and two-dimensional electron systems (2DES) down to liquid-helium temperatures, by exploiting the Berreman effect and the high brilliance of infrared synchrotron radiation. This apparatus is well adapted to detect the absorption of a 2DES of nanometric thickness, namely that which forms spontaneously at the interface between a thin film of LaAlO3 and its SrTiO3 substrate, and to determine its Drude parameters.
Influence of knowledge management on product innovation by intrapreneurial firms
Authors: Bhardwaj Broto Rauth
Published: September 2019

Purpose

This paper aims to provide a study on knowledge management, facilitating new product innovation by intrapreneurial companies.

Design/methodology/approach

The methodology includes the empirical study which was conducted based on detailed questionnaire and data collection of 319 respondents from heavy engineering auto companies, such as Maruti, Honda and others. The data were analyzed to find the influence of knowledge management on new product development. Structural equation modeling method, critical path analysis and reliability were checked by Cronbach’s alpha.

Findings

The findings suggest that the innovation of a new product is critical for the companies. Also, it is very important for the companies to have knowledge management systems such as intelligence generation and dissemination process to facilitate information sharing among the various departments. Responsiveness to the market needs would be based on how authentic the customer data are and to what extent the company is able to share these data with research and product development departments to motivate new products for fulfilling these needs of the customers. This kind of process would enable the company to drive the next level of innovation within the company.

Research limitations/implications

The present study has several implications for managers and researchers. The model proposed in the study suggests the adoption and implementation of knowledge management for product innovation. The study findings also suggest that developing better methods to share knowledge and intelligence among the employees about the customers’ data would be a very critical success factor for new product innovation.

Practical implications

This paper also suggests that the researchers can study this model with respect to inter-disciplinary and inter-country study to become competitive using new product innovation.

Originality/value

The study contributes toward development of theory on creating innovation facilitated by knowledge management for enhancing innovation.
What determines customers’ continuance intention of FinTech? Evidence from YuEbao
Authors: Wang Zhenning , GUAN Zhengzhi (Gordon) , Hou Fangfang , Li Boying , Zhou Wangyue
Published: September 2019

Purpose

The purpose of this paper is to investigate the effects of trust in service and structural assurance on the continuance intention of FinTech services, and the roles of technical factors (i.e. situational normality and system quality) and social factors (i.e. herding and subjective norm) in developing trust in service and structural assurance. YuEbao is selected as the subject as it is a representative example of FinTech services in China.

Design/methodology/approach

A survey questionnaire was deployed and a ten-point sliding scale with two-decimal points was applied to improve the accuracy of the questionnaire. Partial least squares structural equation modeling was used to analyze the data.

Findings

Trust in service and structural assurance can encourage continuance intention of FinTech service. System quality, situational normality and subjective norm can boost the development of trust in service. Both herding and subjective norm can affect structural assurance significantly.

Research limitations/implications

The study highlights the important roles played by technical factors (i.e. situational normality and system quality) and social factors (i.e. herding and subjective norm) in developing the two levels of trust (i.e. trust in service and structural assurance). It also validates the influences of trust in service and structural assurance on encouraging customers’ continuance intention in the novel context of FinTech.

Practical implications

The findings of this study can be used by practitioners to encourage customers to continue using their FinTech services. To encourage continuance, service providers can improve the quality of their system, design the system to be aligned with customers’ using habits and show customers that their close friends are also using the service.

Originality/value

This study adds to the existing body of trust literature by investigating the direct effects of trust in service and structure assurance on continuance intention and how these two levels of trust are developed from technical and social aspects. It generates interesting insights into customers’ continuance behavior of FinTech services.
Sequential auction based parking space sharing and pricing mechanism in the era of sharing economy
Authors: Tan Bing Qing , Xu Su Xiu , Zhong Ray , Cheng Meng , Kang Kai
Published: September 2019

Purpose

The purpose of this paper is to design a parking space management platform to alleviate the parking problem and a two-stage solution for sharing and allocating parking spaces.

Design/methodology/approach

The market design mechanism and auction mechanism are integrated to solve the problem of parking space sharing and allocation. In the first stage, the market design mechanism with two rules is applied for making the good use of idle parking spaces. In the second stage, two sequential auction mechanisms are designed by extending first/second-price sealed bid auction mechanism to allocate both private and public parking spaces, which are received in previous stage and owned by the platform. Two stages are connected through a forecasted price which is calculated through the exponential smoothing method.

Findings

First, we prove three important properties of the proposed sequential auction mechanisms, namely, incentive compatibility, revenue equivalence and individual rationality. Second, a simulation study is used to verify the effectiveness of the mechanisms through numerical analysis. The impact of the system on three parts, namely, agents (private parking space suppliers), bidders (parking space customers) and the platform, is examined. Third, the results show that the sharing mechanism with monetrary incentive will attract a number of agents to join in the platform. The bidders are also able to obtain considerable utility, as compared with the (average) market parking fees. The platform can thus effectively allocate parking spaces with reasonable prices.

Originality/value

This paper combines the classical sequential auction mechanisms with the market design mechanism for the parking space sharing and allocation problem. The modeling and analysis method can also be used to address the similar allocation and pricing problems of other resources like bicycle sharing.
Assessing determinants of sustainable upgrade of existing buildings
Authors: Dadzie John , Runeson Goran , Ding Grace
Published: September 2019

Purpose

Estimates show that close to 90% of the buildings we will need in 2050 are already built and occupied. The increase in the existing building stock has affected energy consumption thereby negatively impacting the environment. The purpose of this paper is to assess determinants of sustainable upgrade of existing buildings through the adoption and application of sustainable technologies. The study also ranks sustainable technologies adopted by the professionals who participated in the survey with an in-built case study.

Design/methodology/approach

As part of the overall methodology, a detailed literature review on the nature and characteristics of sustainable upgrade and the sustainable technologies adopted was undertaken. A survey questionnaire with an in-built case study was designed to examine all the sustainable technologies adopted to improve energy consumption in Australia. The survey was administered to sustainability consultants, architects, quantity surveyors, facility managers and engineers in Australia.

Findings

The results show a total of 24 technologies which are mostly adopted to improve energy consumption in existing buildings. A factor analysis shows the main components as: lighting and automation, heating, ventilation and air conditioning (HAVC) systems and equipment, envelope, renewable energy and passive technologies.

Originality/value

The findings bridge the gap in the literature on the adoption and application of sustainable technologies to upgrade existing buildings. The technologies can be adopted to reduce the excessive energy consumption patterns in existing buildings.
Within‐ and between‐group dynamics in an obligate cooperative breeder
Authors: Woodroffe Rosie , O'Neill Helen M. K. , Rabaiotti Daniella
Published: September 2019

Cooperative behaviour can have profound effects on demography. In many cooperative species, components of fitness (e.g. survival, reproductive success) are diminished in smaller social groups. These effects (termed group‐level component Allee effects) may lead smaller groups to grow relatively slowly or fail to persist (termed group‐level demographic Allee effects).

If these group‐level effects were to propagate to the population level, small populations would grow slowly or decline to extinction (termed population‐level demographic Allee effects). However, empirical studies have revealed little evidence of such population‐level effects.

Theoretical studies suggest that dispersal behaviour could either cause or prevent the propagation of group‐level Allee effects to the population level. We therefore characterized within‐ and between‐pack dynamics in a population of African wild dogs (Lycaon pictus) to test these contrasting model predictions.

Larger wild dog packs produced more pups, and their members experienced higher survival than those in smaller packs. Nevertheless, larger packs grew more slowly than smaller packs, because natal adults dispersed away from them. Most packs either died out in whole‐pack death events or broke up when their founders died, irrespective of pack size. Overall, packs showed negative density dependence rather than group‐level demographic Allee effects.

Larger packs produced more, but not larger, dispersal groups and hence generated more, but not larger, new packs. Larger packs thus contributed more than smaller packs to the number of packs in the population, but their large size did not propagate to their daughter packs. This pattern helps to explain the absence of population‐level Allee effects in this species.

Dispersal behaviour, itself driven by natural selection on individual reproductive strategies, played a pivotal role in population dynamics, leading to the formation of new packs and limiting the size of established packs. Understanding dispersal processes is likely to be important to understanding the population dynamics of other cooperatively breeding species.
Functional form and interactions of the drivers of understory non‐native plant invasions in northern US forests
Authors: Golivets Marina , Woodall Christopher W. , Wallin Kimberly F.
Published: September 2019

The number and rate of non‐native plant invasions in forests have been steadily increasing over the last century with profound consequences for the composition, structure and functioning of these ecosystems. While multiple regional, landscape and local environmental factors are known to drive the spread of non‐native invasive plant species (NNIPS) into forests, such factors have rarely been analysed within a unified analytical framework allowing for the assessment of their relative importance, possible non‐linear behaviour and interactions. Obtaining such knowledge would improve the understanding and allow prediction of forest plant invasions and help prioritize actions for effective NNIPS control and mitigation.

We used boosted regression trees and Bayesian non‐linear regression to analyse forest inventory data spanning 14 northern US states in combination with data on climate, land use and disturbance. Within each framework, we assessed the magnitude, direction and functional form of the effects of 18 regional to local environmental factors and their interactions on the probability of presence and richness of NNIPS in the forest understory, while controlling for sampling intensity, data collection time and spatial autocorrelation.

The studied drivers together captured nearly 50% of the variation in NNIPS occurrence and richness and were sufficient to obtain sensible predictions. Most drivers exhibited monotonic non‐linear individual effects and several drivers showed non‐additive combined effects. Temperature and landscape openness were the two major determinants of NNIPS presence and richness, but their effects were to a different degree moderated by elevation, climatic and topographic wetness, and stand age. Stand age was a more important predictor of NNIPS invasion than stand productivity. Deer density tended to be positively associated with NNIPS, whereas gypsy moth outbreaks possibly have increased resistance to plant invasions.

Synthesis and applications. To optimize non‐native invasive plant species (NNIPS) control efforts in forests, it is important to explicitly account for the functional form and interactions among the factors operating across spatial and temporal scales. Increasing the average stand age at the landscape and regional levels is essential for buffering against further invasions. Recurrent canopy disturbance likely slowed down NNIPS invasion previously, yet whether this holds under higher propagule pressure remains unknown.
Improving links between environmental accounting and scenario‐based cumulative impact assessment for better‐informed biodiversity decisions
Authors: Mokany Karel , Harwood Thomas D. , Ferrier Simon
Published: September 2019

Increasing attention is being given to understanding how intensifying human activities combine over space and time to influence persistence of biodiversity. Two types of biodiversity assessment in particular are attracting growing interest: one focused on understanding past‐to‐present change (environmental accounting) and another focused on understanding likely present‐to‐future changes under proposed scenarios of future actions (cumulative impact assessment of scenarios).

Here we highlight the potential benefits of improving the links between environmental accounting and scenario‐based cumulative impact assessment for biodiversity, using a case study for subterranean fauna in the Pilbara region of Australia. Using a flexible and comprehensive model‐based analytical approach, we assessed expected change in biodiversity persistence given past development, and likely change to 2100 under a proposed development scenario for the region.

Our assessment shows both the times (2005–2015) and places (Fortescue sub‐region) where development activities are likely to have most strongly influenced long‐term biodiversity persistence for subterranean fauna in the Pilbara region. Although mining development has often occurred in areas that have a high value for subterranean fauna diversity, our linked environmental accounting and cumulative impact assessment suggest relatively modest impacts on long‐term persistence for this component of biodiversity.

Synthesis and applications. Our study provides an effective demonstration of the capacity and potential benefits of better linking environmental accounting with scenario‐based cumulative impact assessment. Improving the links between these two perspectives on biodiversity assessment will create benefits for both, providing a consistent basis for cumulative impact assessments and enhancing the usefulness of environmental accounting.
Measuring Uncertainty for New Zealand Using Data‐Rich Approach
Authors: Tran Trung Duc , Vehbi Tugrul , Wong Benjamin
Published: September 2019

This paper develops two state‐of‐the‐art uncertainty indices for New Zealand by exploiting two separate data‐rich environments. The first index follows the methodology outlined in Jurado, Ludvigson and Ng (2015) to construct an estimate of uncertainty based on a large New Zealand macro dataset. The second index is constructed based on freely accessible and real time Google Trends data to provide a real‐time and freely‐accessible measure of uncertainty as in Castelnuovo and Tran (2017) and Shields and Tran (2018). Both indices do a reasonable job measuring uncertainty in New Zealand. VAR evidence documents significant impacts of uncertainty shocks on GDP in New Zealand.
Ethno‐National Narratives of Human Rights: The Northern Ireland Policing Board
Authors: Martin Richard
Published: September 2019

Policing in Northern Ireland has undergone one of the world's most extensive human rights reform programmes. The challenge has been whether the human rights paradigm can serve as a mutual basis for the region's sparring ethno‐national communities to deliberate over long‐contested issues of policing, accountability and justice. This article focuses on the Northern Ireland Policing Board as an arena to examine the contemporary political attitudes and agendas that animate the Board's statutory duty to monitor policing on the basis of human rights. Marshalling qualitative data and drawing on legal anthropology, this article offers an account of the ‘social life’ of human rights and policing in the context of Northern Ireland's imperfect peace. It argues that, irrespective of legal standards, human rights oversight harbours deep sentiments and concerns, at the heart of which are communities’ own historical engagements with rights, competing legacies of the conflict and divergent understandings of contemporary policing.
Data breach remediation efforts and their implications for hospital quality
Authors: Choi Sung J. , Johnson M. Eric , Lehmann Christoph U.
Published: September 2019

Objective

To estimate the relationship between breach remediation efforts and hospital care quality.

Data Sources

Department of Health and Human Services’ (HHS) public database on hospital data breaches and Medicare Compare's public data on hospital quality measures for 2012‐2016.

Materials and Methods

Data breach data were merged with the Medicare Compare data for years 2012‐2016, yielding a panel of 3025 hospitals with 14 297 unique hospital‐year observations.

Study Design

The relationship between breach remediation and hospital quality was estimated using a difference‐in‐differences regression. Hospital quality was measured by 30‐day acute myocardial infarction mortality rate and time from door to electrocardiogram.

Principal Findings

Hospital time‐to‐electrocardiogram increased as much as 2.7 minutes and 30‐day acute myocardial infarction mortality increased as much as 0.36 percentage points during the 3‐year window following a breach.

Conclusion

Breach remediation efforts were associated with deterioration in timeliness of care and patient outcomes. Thus, breached hospitals and HHS oversight should carefully evaluate remedial security initiatives to achieve better data security without negatively affecting patient outcomes.
Global Concerns with B Vitamin Statuses: Biofortification, Fortification, Hidden Hunger, Interactions, and Toxicity
Authors: Titcomb Tyler J. , Tanumihardjo Sherry A.
Published: September 2019

The prevalence of undernutrition due to insufficient energy intake has been reduced by nearly 50% since 1990. This reduction is largely attributed to improved yields of staple crops, such as wheat, rice, and maize; however, these improvements did little for micronutrient deficiencies that affect an estimated two billion people worldwide. Starchy staple crops are energy dense but are often lacking in one or more B vitamins, making resource‐constrained people who consume monotonous diets comprised predominantly of these staples at risk for developing deficiency. B vitamin deficiencies occur due to a poor overall nondiversified diet and rarely occur alone. Many B vitamins are essential cofactors involved in the metabolism of other nutrients, including other B vitamins, whereby the deficiency of one B vitamin affects the metabolism and status measurements of another. Food fortification efforts have nearly eradicated diseases of extreme B vitamin deficiency, such as beriberi from thiamin deficiency and pellagra from niacin deficiency. However, subclinical deficiency, sometimes referred to as hidden hunger, is still common especially in low‐income countries. Most dietary B vitamins, due to their water‐soluble nature, are not a concern for excessive intakes, but synthetic forms used for fortification and supplements sometimes can have adverse effects when consumed in high amounts. Biofortified crops offer a long‐term sustainable method to increase the amount of dietary B vitamins for people who rely on staple crops for most of their caloric intake. Efforts have been made to improve B vitamin content of crops, especially for thiamin, vitamin B6, and folate, but none have undergone human feeding trials; therefore, more research is needed to provide sustainable and scalable solutions in many parts of the world.
Determination of Key Volatile Compounds Related to Long‐Term Fermentation of Soy Sauce
Authors: Lee Sang Mi , Kim Sa‐Bin , Kim Young‐Suk
Published: September 2019

The changes of volatile compounds in soy sauce during long‐term fermentation (12 months) were investigated using solid‐phase microextraction (SPME) and stir bar sorptive extraction (SBSE). A total of 144 and 129 compounds were identified in soy sauce with long‐term fermentation by SPME and SBSE, respectively. The contents of most compounds, such as acids, aldehydes, benzene and benzene derivatives, esters, lactones, pyrazines, pyrones, and pyrroles, showed a tendency to increase, whereas those of alcohols and ketones decreased according to long‐term fermentation. In addition, principal component analysis and partial least squares discriminant analysis were applied to discriminate soy sauce samples according to fermentation periods and determine key volatile compounds related to long‐term fermentation. The initial fermentation stages were mainly associated with some alcohols, ketones, and lactones, whereas the later stages were strongly associated with most esters, some phenols, benzene and benzene derivatives, and pyrroles. Moreover, the key volatile compounds associated with long‐term fermentation in soy sauce samples were ethyl 3‐methylbutanoate (ethyl isovalerate), ethyl pentanoate (ethyl valerate), 1‐octen‐3‐yl acetate, 3‐(methylthio)‐1‐propanol (methionol), ethyl benzoate, ethyl 2‐phenylacetate, 1‐(1H‐pyrrol‐2‐yl)ethanone (2‐acetylpyrrole), and 5‐pentyl‐2‐oxolanone (γ‐nonalactone).

Practical Application

This study investigated changes of volatile compounds in soy sauce during long‐term fermentation (12 months) using solid‐phase microextraction and stir bar sorptive extraction. In addition, the key volatile compounds associated with long‐term fermentation in soy sauce samples were determined. These results may help to predict the effective contributors related to long‐term fermentation of soy sauce and improve the quality of soy sauce during long‐term fermentation.
Antithrombotic Effect of Artemisia princeps Pampanini Extracts in Vitro and in FeCl3‐Induced Thrombosis Rats
Authors: Kim Kyeong Jin , Kim Min Seo , Seok Pu Reum , Shin Jae‐Ho , Kim Ji Yeon
Published: September 2019

Extracts of several plants possess antithrombotic effects. Herein, we examined the antithrombotic effects of different extracts of Artemisia princeps Pampanini prepared using distilled water, hot distilled water, 70% ethanol, or subcritical water. The antithrombotic effects were determined using a co‐culture system consisting of tumor necrosis factor‐alpha (TNF‐α)‐treated EA.hy926 cells and THP‐1 cells. In addition, the coagulation time of plasma collected from healthy volunteers was evaluated in terms of the prothrombin time and activated partial thromboplastin time. A carotid arterial thrombosis model was induced by ferric chloride in Sprague Dawley rats. The rats were treated with either sterile water or three different doses of the subcritical water extract for 2 weeks. The thrombus weight, gene expression of cell adhesion molecules, and histological characteristics were assessed. The results of in vitro studies revealed a significant inhibition in the adhesion of monocytes to EA.hy926 cells stimulated by TNF‐α in the subcritical water extract‐treated group. We also observed considerable suppression of the occlusion and mRNA expression of cell adhesion molecules in the in vivo experiments. This study suggests that Artemisia princeps Pampanini may have the potential to improve blood coagulation.
Efficacy of EGFR‐TKIs with or without upfront brain radiotherapy for EGFR‐mutant NSCLC patients with central nervous system metastases
Authors: Saida Yu , Watanabe Satoshi , Abe Tetsuya , Shoji Satoshi , Nozaki Koichiro , Ichikawa Kosuke , Kondo Rie , Koyama Kenichi , Miura Satoru , Tanaka Hiroshi , Okajima Masaaki , Terada Masaki , Ishida Takashi , Tsukada Hiroki , Makino Masato , Iwashima Akira , Sato Kazuhiro , Matsumoto Naoya , Yoshizawa Hirohisa , Kikuchi Toshiaki
Published: September 2019

Background

Although the clinical efficacy of epidermal growth factor receptor tyrosine kinase inhibitors (EGFR‐TKIs) in EGFR‐mutant non‐small cell lung cancer (NSCLC) patients has been demonstrated, their efficacy in EGFR‐mutant NSCLCs with central nervous system (CNS) metastases and the role of radiotherapy remain unclear. This study aimed to determine if it is preferable to add upfront cranial radiotherapy to EGFR‐TKIs in patients with EGFR‐mutant NSCLC with newly diagnosed brain metastases.

Methods

We retrospectively analyzed the data of EGFR‐mutant NSCLC patients with CNS metastases who received EGFR‐TKIs as a first‐line therapy.

Results

A total of 104 patients were enrolled and 39 patients received upfront brain radiotherapy, while 65 patients received first and second generation EGFR‐TKIs first. The median time to treatment failure (TTF) was 7.8 months (95% confidence interval [CI]: 6.3–9.4). The median survival time (MST) was 24.0 months (95% CI: 20.1–30.1). The overall response rate of the CNS was 37%. The median CNS progression‐free survival (PFS) was 13.2 months (95% CI: 10.0–16.2). Brain radiotherapy prior to EGFR‐TKI prolonged TTF (11.2 vs. 6.8 months, P = 0.038) and tended to prolong CNS‐PFS (15.6 vs. 11.1 months, P = 0.096) but was not significantly associated with overall survival (MST 26.1 vs. 24.0 months, P = 0.525). Univariate and multivariate analyses indicated that poor performance status and the presence of extracranial metastases were poor prognostic factors related to overall survival.

Conclusion

EGFR‐TKI showed a favorable effect for EGFR‐mutant NSCLC patients with CNS metastases. Prolonged TTF and CNS‐PFS were observed with upfront brain radiotherapy.
Experience with a “Feed and Swaddle” program in infants up to six months of age
Authors: Templeton Leah B. , Norton Michael J. , Goenaga‐Díaz Eduardo J. , McLaughlin Douglas H. , Zapadka Michael E. , Templeton T. Wesley
Published: September 2019

Background

Feed and swaddle is a technique in which an infant is fed and allowed to fall asleep to facilitate diagnostic imaging. This study reviews our experience and diagnostic success in premature and term infants up to 6 months old undergoing brain magnetic resonance imaging (MRI) using a feed and swaddle technique and with comparable patients imaged under anesthesia.

Methods

We reviewed the charts of all infants ≤6 months who underwent brain MRI at our institution between 1 January 2013 and 31 March 2016. We recorded and analyzed demographic information, scan indication, scan length, prematurity status, anesthetic technique if used, complications, and diagnostic success or failure.

Results

One hundred and sixty‐four term infants underwent brain MRI using a feed and swaddle technique. The success rate in term infants <90 days was 91.1% (113/124) versus 95.0% (38/40) in infants ≥90 days and ≤181 days old. Fifty‐three premature infants underwent feed and swaddle for brain MRI with a diagnostic success rate of 92.5% (49/53). No complications were noted in any feed and swaddle patients. Those who received anesthesia had a diagnostic success rate of 100% (70/70) but experienced complications including hypoxemia, 14.3% (10/70); hypothermia, 18.9% (10/53); bradycardia, 10.1% (7/69); and hypotension, 4.2% (3/70).

Conclusion

Given the high rate of success and absence of complications with feed and swaddle in children ≤6 months for brain MRI and the presence of anesthesia‐related complications, most infants should undergo a trial of feed and swaddle prior to undergoing brain MRI with anesthesia.
Classical versus controlled rapid sequence induction and intubation in children with bleeding tonsils (a retrospective audit)
Authors: Kemper Melanie E. , Buehler Philipp K. , Schmitz Achim , Gysin Claudine , Nicolai Thomas , Weiss Markus
Published: September 2019

Purpose

To determine whether bag‐mask ventilation between induction of anaesthesia and tracheal intubation in children with post‐tonsillectomy bleeding reduces the incidence of hypoxaemia and difficult direct laryngoscopy without increasing perioperative respiratory complications.

Methods

Medical records, anaesthesia protocols and vital sign data were analysed from February 2005 to March 2017 for patients undergoing anaesthesia for surgical revision of bleeding tonsils. Type of rapid sequence induction and intubation (RSII; classical, ie, apnoeic, vs controlled, ie, with gentle bag‐mask ventilation) was noted. Primary outcomes were incidence of moderate and severe hypoxaemia, grade of direct laryngoscopic views as well as occurrence of noted tracheal intubation difficulties. Haemodynamic alterations during RSII and perioperative adverse events such as noted gastric regurgitation, pulmonary aspiration and perioperative pulmonary morbidity were also recorded.

Results

A classical RSII was performed for 22 surgical revisions in 22 children and a controlled RSII was used for 88 surgical revisions in 81 children. Patients undergoing controlled RSII had less incidence of severe hypoxaemia (1 vs 3; P = .025), better direct laryngoscopic views (P = .048) and less hypertension (5 vs 9; P < .001) than those patients managed by classical RSII. No tracheal intubation difficulties occurred. There was no significant perioperative pulmonary morbidity reported in either group.

Conclusions

Controlled RSII had advantages over classical RSII in children with post‐tonsillectomy bleeding and may become a strategic option in these patients to avoid hypoxaemia, difficult laryngoscopy and hypertension during induction of anaesthesia and tracheal intubation. Bag‐mask ventilation in patients with bleeding tonsils did not lead to pulmonary morbidity.
Body mass index and serum lipid profile: Association with atopic dermatitis in a paediatric population
Authors: Agón‐Banzo Pedro Jesús , Sanmartin Rosalía , García‐Malinis Ana Julia , Hernández‐Martín Ángela , Puzo José , Doste Divina , Pardos Carlos , Gilaberte Yolanda
Published: September 2019

Background/Objectives

The association between atopic dermatitis, body weight and serum lipid levels is not well known, and very few studies have examined this relationship in children.

Methods

Children (n = 239) under 14 years old participated in this prospective cross‐sectional study. The following variables were recorded: age, gender, weight, height, atopic dermatitis severity, serum levels of total cholesterol, low‐density lipoprotein cholesterol, high‐density lipoprotein cholesterol and triglycerides.

Results

Mean body mass index was slightly higher in atopic dermatitis patients than healthy controls and significantly higher in atopic dermatitis patients aged 0–2 years (atopic dermatitis, 16.7 ± 4.6; controls, 15.7 ± 1.3; P = 0.04) and 12–14 years (atopic dermatitis, 24.9 ± 5.3; controls, 20.6 ± 3.4; P = 0.03). Among atopic dermatitis patients, body mass index was significantly higher in those with severe atopic dermatitis in the 9–12 (P = 0.03) and 12–14 (P = 0.01) years groups. Mean serum lipid levels were higher in patients with severe atopic dermatitis than in the atopic dermatitis group as a whole. These differences reached statistical significance for total cholesterol (P = 0.04) and triglycerides (P = 0.02).

Conclusion

The prevalence of overweight, obesity and dyslipidemia is greater in children with atopic dermatitis than in age‐matched healthy counterparts.
Acid sphingomyelinase regulates TH2 cytokine release and bronchial asthma
Authors: Böll Svenja , Ziemann Sebastian , Ohl Kim , Klemm Patricia , Rieg Annette D. , Gulbins Erich , Becker Katrin Anne , Kamler Markus , Wagner Norbert , Uhlig Stefan , Martin Christian , Tenbrock Klaus , Verjans Eva
Published: September 2019

Background

Allergic diseases and especially allergic asthma are widespread diseases with high prevalence in childhood, but also in adults. Acid sphingomyelinase (ASM) is a key regulator of the sphingolipid pathway. Previous studies defined the association of ASM with the pathogenesis of TH1‐directed lung diseases like cystic fibrosis and acute lung injury. Here, we define the role of ASM in TH2‐regulated allergic bronchial asthma.

Methods

To determine the role of Asm under baseline conditions, wild‐type (WT) and Asm−/− mice were ventilated with a flexiVent setup and bronchial hyperresponsiveness was determined using acetylcholine. Flow cytometry and cytokine measurements in bronchoalveolar lavage fluid and lung tissue were followed by in vitro TH2 differentiations with cells from WT and Asm−/− mice and blockade of Asm with amitriptyline. As proof of principle, we conducted an ovalbumin‐induced model of asthma in WT‐ and Asm−/− mice.

Results

At baseline, Asm−/− mice showed better lung mechanics, but unaltered bronchial hyperresponsiveness. Higher numbers of Asm−/− T cells in bronchoalveolar lavage fluid released lower levels of IL‐4 and IL‐5, and these results were paralleled by decreased production of typical TH2 cytokines in Asm−/− T lymphocytes in vitro. This phenotype could be imitated by incubation of T cells with amitriptyline. In the ovalbumin asthma model, Asm−/− animals were protected from high disease activity and showed better lung functions and lower levels of eosinophils and TH2 cytokines.

Conclusion

Asm deficiency could induce higher numbers of TH2 cells in the lung, but those cells release decreased TH2 cytokine levels. Hereby, Asm−/− animals are protected from bronchial asthma, which possibly offers novel therapeutic strategies, for example, with ASM blockade.
The effect of needle tip tracking on procedural time of ultrasound‐guided lumbar plexus block: a randomised controlled trial
Authors: Kåsine T. , Romundstad L. , Rosseland L. A. , Ullensvang K. , Fagerland M. W. , Kessler P. , Bjørnå E. , Sauter A. R.
Published: September 2019

Technology that facilitates performance of deep peripheral nerve blocks is of clinical interest. The Onvision™ is a new device for ultrasonographic needle tip tracking that incorporates an ultrasound sensor on the needle tip that is then represented by a green circle on the ultrasound screen. The primary aim of this study was to investigate the effect of needle tip tracking on procedural time in the first human volunteer study. Secondary outcome measures included: number of hand movements; hand movement path length; block success rate; block onset time; block duration; discomfort experienced by the volunteers; and the anaesthetists’ confidence as to whether their block would be successful. Two anaesthetists performed ultrasound‐guided lumbar plexus blocks with an out‐of‐plane technique, with and without the use of needle tip tracking. In total, data from 25 volunteers were studied. Mean (SD) procedural time was 163 (103) s with needle tip tracking and 216 (117) s without (p = 0.10). Hand motion analysis showed that needle tip tracking was associated with a significant decrease in the mean (SD) number of intended needling hand movements (39 (29) vs. 59 (36); p = 0.03) and path lengths (3.2 (3.1) m vs. 5.5 (4.5) m; p = 0.03). No differences were found for any other secondary outcomes. The use of Onvision needle tip tracking did not reduce procedural time for out‐of‐plane ultrasound‐guided lumbar plexus block but did reduce the number of hand movements and path lengths. This may indicate improved needle control but further studies are needed to confirm this finding.
An initial evaluation of the effect of a novel regional block needle with tip‐tracking technology on the novice performance of cadaveric ultrasound‐guided sciatic nerve block
Authors: McLeod G. A. , McKendrick M. , Taylor A. , Sadler A. , Halcrow J. , Mustafa A. , Seeley J. , Raju P. , McKendrick G.
Published: September 2019

Visibility of the needle tip is difficult to maintain during ultrasound‐guided nerve block. A new needle has been developed that incorporates a piezo element 2–2.3 mm from the tip, activated by ultrasound. The electrical signal manifests as a coloured circle surrounding the needle tip, and allows real‐time tracking. We hypothesised that novice regional anaesthetists would perform nerve block better with the tracker turned on rather than off. Our primary objective was to evaluate the new needle by measuring the performance of novice anaesthetists conducting simulated sciatic block on the soft embalmed Thiel cadaver. Training consisted of a lecture, scanning in volunteers and practice on cadavers. Testing entailed scanning the sciatic nerve of a cadaver and conducting 20 in‐plane sciatic blocks in the mid‐to‐upper thigh region. Subjects were randomised equally, in groups of five, according to the sequence: tracker on/off/on/off; or tracker off/on/off/on. Video recordings were assessed by six raters for steps performed correctly and errors committed. Eight subjects were recruited and 160 videos were analysed. Using the tracking needle, five correct steps improved and one error reduced. The benefits included: better identification of the needle tip before advancing the needle, OR (95%CI) 3.4 (1.6–7.7; p < 0.001); better alignment of the needle to the transducer, 3.1 (1.3–8.7; p = 0.009); and better visibility of the needle tip 3.0 (1.4–7.3; p = 0.005). In conclusion, use of the tracker needle improved the sciatic block performance of novices on the soft embalmed cadaver.
Clinical state of the paediatric acute scrotum in south‐eastern Victoria
Authors: Tan Tanny Sharman P. , Wijekoon Naveen , Pacilli Maurizio , Nataraja Ramesh M.
Published: September 2019

Background

Acute scrotal pain is a common paediatric surgical presentation. Delays in treatment can result in testicular loss from torsion. It is unclear where delays occur. We aimed to investigate presentations with an acute scrotum to identify any potential areas of delay.

Methods

We conducted a prospective study (April 2017–November 2018) of paediatric patients (<18 years) presenting with acute scrotal pain. Data collected included: patient demographics, history/examination findings, mode of presentation, clinical timeline details and outcomes.

Results

A total of 107 acute scrotum presentations were identified: 58 (54.2%) testicular appendage torsion, 23 (21.5%) testicular torsion, 6 (5.6%) epididymo‐orchidits and 20 (18.7%) other diagnoses. Median age at presentation was 11 years (4 months–16 years). Fifty‐seven (53.3%) underwent emergency surgery, of whom 23 (40.4%) had testicular torsion, with 2 requiring orchidectomy. Median time from onset of symptoms to seeking medical opinion was 5.5 (0–135) h. Once assessed by a medical professional, the route to paediatric surgical review via general practitioner (GP) and local emergency department (ED) to paediatric ED was 4.84 (1.67–24.5) h; via GP to paediatric ED was 2.58 (0.75–25.5) h; via local ED to paediatric ED was 2.25 (1–7.75) h; and directly to paediatric ED was 0.45 (0–1.42) h.

Conclusion

Delays in assessment and treatment of acute scrotal pain occur from the time parents are aware of symptoms to seeking medical opinion. Education to increase awareness may reduce time delays. GPs should refer patients directly to a paediatric ED. Local EDs should manage paediatric cases as per the local surgeons' skill base.
Long‐term repeatability of optical coherence tomography angiography parameters in healthy eyes
Authors: Lee Min‐Woo , Nam Ki‐Yup , Lim Hyung‐Bin , Koo Hyung‐Moon , Shin Yong‐Il , Kim Jung‐Yeul
Published: September 2019

Purpose

To determine the long‐term repeatability of optical coherence tomography angiography (OCTA) parameters in normal eyes.

Methods

We prospectively enrolled 104 normal eyes. Participants were divided into three groups based on differences in the signal strength (SS) of OCTA scans obtained at two visits at least 6 months apart: group 1, SS difference = 2; group 2, 1; group 3, 0. We measured a foveal centred scan area of 3 × 3 mm pattern. All measurements were performed twice at 5‐min intervals at the initial visit. The second measurements were performed at least 6 months later.

Results

In short‐term vessel density (VD) repeatability, the coefficient of variation (CV) ranged from 3.89% to 8.10% and the intraclass correlation coefficient (ICC) ranged from 0.785 to 0.941. In terms of long‐term repeatability, the CV was 5.39–12.62% and the ICC was 0.598–0.867. In group 1, the ICCs of the inner and full VDs were 0.194 and 0.221, respectively. In groups 2 and 3, the ICCs of the inner and full VDs were 0.611 and 0.603, and 0.763 and 0.765, respectively. The central VDs of all groups had high CV besides high ICC.

Conclusions

Optical coherence tomography angiography parameters showed good short‐term and reasonable long‐term repeatability in normal individuals. The differences in SSs between measurements affected such repeatability, so physicians should query the reliability of OCTA parameters when the differences in SS are 2 or more even when the SS is high.
Bone and joint complications and reduced mobility are associated with pain in children with cerebral palsy
Authors: Schmidt Steven M. , Hägglund Gunnar , Alriksson‐Schmidt Ann I.
Published: September 2019

Aim

To investigate the relationships between pain in the lower extremities and back, and spasticity, bone/joint complications and mobility.

Methods

Retrospective population‐based registry study. Participants (N = 3256) with cerebral palsy (CP), 2.5‐16 years of age, participating in the Swedish Cerebral Palsy Follow‐up Program were included.Spasticitywas measured using scissoring and the Modified Ashworth Scale.Bone/joint complicationsconsisted of hip displacement, range of motion, windswept posture and scoliosis.Mobilitywas measured using the Functional Mobility Scale (5‐, 50‐ and 500‐metres), wheelchair use (outdoors) and the ability to stand/get up from sitting/use stairs, respectively.Painwas measured as presence of pain in hips, knees, feet and back. Data were analysed using structural equation modelling.

Results

Bone/joint complications had the strongest direct pathway with pain in the lower extremities (standardised regression coefficient = 0.48), followed by reduced mobility (standardised regression coefficient = −0.24). The pathways between spasticity and pain, and age and pain were not significant. The R2of the model was 0.15.

Conclusion

Bone/joint complications and reduced mobility were associated with pain in the lower extremities when controlling for sex. Considering theR2of the model, other factors not included in the model are also associated with pain in the lower extremities in children with CP.
Positive mother‐child interactions and parenting styles were associated with lower screen time in early childhood
Authors: Detnakarintra Khanittha , Trairatvorakul Pon , Pruksananonda Chandhita , Chonchaiya Weerasak
Published: September 2019

Aim

This study examined long‐term associations between mother‐child interactions and parenting styles and electronic screen time.

Methods

We studied 280 healthy children (53.2% girls) enrolled at a mean age of 36 ± 0.4 months from February 2015 to September 2016. The study included retrospective data on 267 children who had been recruited from medical facilities in Thailand at 6 months of age. Mother‐child interaction, parenting styles and screen time were assessed at various ages and path analyses were performed to elucidate the directionality and relationships between the variables.

Results

Increased mother‐child interaction at 18 months of age was positively associated with less screen time at 2 and 3 years of age. Likewise, nurturing authoritative parenting at 3 years of age was directly related to lower media exposure at 4 years. The total screen time at younger ages had positive direct relationships with relaxed permissive and strict authoritarian parenting styles, but negative direct relationships with nurturing authoritative parenting in subsequent years.

Conclusion

Early mother‐child interaction and nurturing authoritative parenting were associated with subsequent decreased screen time, while media exposure at the age of two was related to relaxed permissive and strict authoritarian parenting at 3 years of age.