bluuebunny/crossref_metadata_2025 huggingface dataset:
Strategies to link rural areas to European and national transport networks
Authors: Sitányiová Dana , Masarovičová Soňa , Berselli Daniele , Nicolini Antonio
Published: September 2018

Transport capacity is very important indicator of country’s economic power reflecting its economic development. All means of transport must be efficient and able to transport goods and people as cheaply and quickly as possible. This requires constant upgrading of transport networks often with limited budget. This is a problem especially in rural areas, where population density is very low and there are difficulties in providing transport links between cities and rural communities. It is very expensive to upgrade transport network and also to ensure public transport services there. Individual car transport can diminish the problem, but some groups (the young, old or poor) will always require public transport service, moreover increasing car traffic put pressure especially on existing road transport. Public transport linking isolated rural regions to transport hubs towards the European and national transport networks play a crucial role in that regard. Paper presents some outputs of RUMOBIL project focusing on pilot actions testing a number of innovative applications during a period 2017-2018 how sparsely populated peripheral areas can be better linked to a primary, secondary or tertiary transport node by public transport.
Synthesis of High-Precision Hydraulic Control Systems of an Excavator
Authors: Galitskov Konstantin , Galitskov Stanislav , Dudanov Ivan
Published: September 2018

Practical implementation of the program controlling the movement of the excavator’s working tool (including the use of satellite navigation system) imposes stringent requirements on the dynamic and static accuracy of automatic control systems for the hydraulic excavator’s operating mechanisms, in conditions of non-stationary parameters of these mechanisms as control objects. The authors describe the effective solution of this problem by implementing structural synthesis of each servo hydraulic drive as a multi-loop system with one measured coordinate (MLSOMC). The EO-4121 excavator with four hydraulic drives (rotary platform, boom, arm and ladle) was used as an example to demonstrate that the implementation of three circuits in the multi-loop system with one measured coordinate in each of these drives with typical PID-controllers allows to ensure the robustness of the ACS for known uncertainties, as well as the required rates of control quality in static and dynamic modes.
Modeling of proportions and prediction of properties of macadam and sand mixes stabilized with mineral binders with the ant additive
Authors: Matua Vakhtang , Sizonets Sergey , Stroev Dmitry
Published: September 2018

Optimization of the proportion and the properties of stabilized macadam and sand mixes (MSM) with introduction of the ANT additive was carried out by means of the mathematical designing of the experiment. This method allows a rather full and comprehensive assessment of the effect of the components on the properties of stabilized macadam and sand mixes (MSM), obtaining of the mathematical model of the process in graphic form, and obtaining of the theoretical model of assessment and prediction of the physical-mechanical and performance properties of the materials under study.At the first stage of the research percentages of a mineral binder, water and an additive were selected and the effect of the variability factor of these components on the mix’s physical-mechanical properties was studied. The following factors were selected as variates: X1 standing for quantity of water, %; X2 standing for the content of sulfate-resistant portland cement grade 500, %; X3 standing for the content of the ANT ionic stabilizer being essentially a water-soluble active organo-mineral additive containing amphoteric surfactants and microelements, %. The experimental design and the levels of the factors’ variability were specified on the basis of the test results.The principal factor exerting influence on the strength property of stabilized macadam and sand mixes is application of the ANT X3 ionic stabilizer.
Effects of waterjet cutting waste addition on properties of building ceramics
Authors: Skanavi Natalia , Dovydenko Timofei
Published: September 2018

The purpose of the paper is to investigate the possibility of using wastes of waterjet metal cutting in the manufacture of building ceramics. A complex study of the composition and properties of the abrasive and hydroabrasive cutting wastes was carried out. The behavior of waste in the composition of the ceramic mass and the ceramic body was investigated. Positive results of the effect of addition of waste on the properties of ceramics were obtained on two types of polymineralic argillaceous raw materials: increase of strength at the optimum content of waste in the mixture, reduction of air and fire shrinkage in all compositions with waste content, possibility of varying the color of products, etc. The similarity of the chemical composition of argillaceous raw materials and wastes was established: oxides of iron, silicon and aluminum are predominant. Electron microscope research has demonstrated that the introduction of waste modifies the structure of the ceramic shard, but does not affect its uniformity. The obtained results allowed to draw conclusions about the possible use of wastes of waterjet metal cutting in the production of ceramics: as a fluxing agent – flux, component for volumetric staining, thinning agent.
Natural radioactivity of finish and masonry materials
Authors: Buzina Daria , Engovatov Igor , Dap Nguyen Dinh , Ovakimyan Artur
Published: September 2018

Research findings of natural radioactivity of materials widely used in industrial and civil construction, are presented. The research is carried out according complex techniques which include measurement and calculation of radiation parameters establishing natural radioactivity of materials – specific radioactivity of 226Ra, 232Th, 40K, summarised specific radioactivity, equivalent dose rate and radon flow density. Finish and masonry materials were used as principle objects of the research. The obtained findings allow to make a conclusion that all the studied materials are related to the first class and may be used unrestricted. Comparison with foreign data is provided. Correlation between radiation parameters is established. The data received may be deployed for comparative analysis of the Russian and European approaches to assessment of radiation safety to use the studied types of building materials.
Use of Pairwise Comparison Method in Road-and-Bridge Tenders
Authors: Bucholc Karol , Koczkodaj Waldemar W. , Trochymiak Wojciech
Published: September 2018

The paper is a brief presentation of the pairwise comparison (PC) method, implemented with the use of the Concluder, a modern tool for PC analysis which is being developed by Professor Waldermar Koczkodaj and which is used for comparing tenders in the road-and-bridge construction industry. The paper discusses the tender criteria which are adopted for tenders in this industry. It addresses the issue of developing the relevant weights while using one of the functions of the expert system, i.e. the function which relies on the opinions of the experts familiar with a given matter, who however not always present the same views. Once the experts’ opinions have been collected, they can be “agreed” while using the PC method. Diversification of the criteria is particularly important from the point of view of improvement of the quality of the services offered by the road-and-bridge construction industry in Poland, since in to-date practice the price has been the only or the dominant criterion. The paper contains examples (in terms of numbers) of analysis of tender criteria where the price was not the only criterion, which is the starting point for further research.
Analysis of the interaction between risk factors for construction works on an example of the small experience of labourers
Authors: Kaczorek Krzysztof , Malara Jarosław
Published: September 2018

The successful course of any enterprise depends on materializing or non-risk factors. These factors affect not only the success or failure of the venture, but may also interact with each other. This paper describes the interactions between the factor "low experience of labourers" and six groups of other risk factors. The results of the analysis are presented in tabular form. The work was ended with conclusions and suggestions for further scientific and research work.
Low Pass-rate in postgraduate surgical examination in Nigeria and its contribution to the low surgeon workforce in the country; a review article
Authors: Ajah Jonathan L.
Published: September 2018

Surgical postgraduate examiners and examinees in Nigeria complain of the low pass rate at all levels of the postgraduate surgical training examinations to which several factors are contributing. For several years there has been being a persistently low surgeon workforce in the country despite having two surgeon producing institutions been for at least 37 years. A review of the probable causes was carried out to shed more light on the matter. At the time of writing there are 52 National Postgraduate Medical College of Nigeria (NPMCN) and 46 West African College of Surgeons (WACS) accredited post graduate surgery training programs in Nigeria compared with 99 in the United Kingdom (UK) and 1056 in the United States (US). Based on available data Nigeria has approximately 572 surgery residency training slots yearly compared with approximately 646 in the UK and 4225 in the US. Examination pass rate was less than 40% for primary WACS compared with 98% pass rate in USMLE (United States Medical Licensing Examination) 3, pass rate at part I was 28.8% for WACS compared with 37% at MRCS (Membership Royal College of Surgeons) part A and 57% for MRCS part B. For the exit examination or part II WACS pass rate was 31.5% (general surgery) while it was 64% for Fellowship Royal College of Surgeons (FRCS) cumulative and 70% in the American board of surgery (ABS). Surgeon per 100 000 population was 0.69 for Nigeria compared with 11.7 and 25.6 for the UK and US respectively. In the last 35 years WACS has produced 1638 surgeons (2.8 times more than NPMCN) in surgery and NPMCN has produced 572. The frequency of examination were twice per year for both WACS and NPMCN examinations, 3 times per year for the USMLE step 3, MRCS (A & B) and Fellowship Royal College of Surgeons (FRCS) general surgery. The American Board of Surgery (ABS) is once per year for Qualifying Examination (QE) and 5 times per year for Certifying Examination (CE).
Selbst-Etikett Burnout? – Das diagnostische Spektrum
dahinter
Authors: Rothermund Eva , Wietersheim Jörn von , Balint Elisabeth Maria
Published: September 2018

Burnout ist keine in den Klassifikationssystemen ICD-10 und DSM-5 definierte
Diagnose, in der Arbeits- und Organisationspsychologie jedoch etabliertes
ätiologisches Modell. Ärzte, Psychologen, Patienten, aber auch Vertreter des
Sozialversicherungssystems nutzen den relativ unspezifischen Symptomkomplex
häufig, der ätiologisch mit (Arbeitsplatz-)Anforderungen in Verbindung gebracht
wird. Deshalb erscheint es sinnvoll, das diagnostische Spektrum hinter der
Selbst-Etikettierung „Burnout“ zu beleuchten.
Schlechte Arbeitsbedingungen – Gefährdung der psychischen
Gesundheit
Authors: Schmidt Astrid
Published: September 2018

Ob Arbeit positiv oder negativ auf die psychische Gesundheit wirkt, hängt auch
davon ab, wie die Arbeit gestaltet ist, welche Ressourcen zur Verfügung
stehen und in welchem Maß Fehlbeanspruchungen vorhanden sind. Zentral dabei
ist, wie die Betroffenen selbst ihre Bedingungen einschätzen und beurteilen.
Mit dem DGB-Index „Gute Arbeit“ steht ein Instrument zur Verfügung, das die
Qualität der Arbeitsbedingungen aus Sicht der Betroffenen ermittelt.
Ausgebrannt – Wege aus dem Burnout
Authors: Tränkner Johanna
Published: September 2018

In den letzten Jahren stand wohl kaum ein seelisches Handicap so sehr im
Zentrum der Aufmerksamkeit wie das Burnout-Syndrom. Der Begriff „Burnout”
gehört heute zum alltäglichen Sprachgebrauch. Wer daher im Internet nach
Informationen sucht – der ist zunächst einer Flut wenig qualifizierter
Internetseiten ausgeliefert, die meist kommerzieller Natur sind. Im
Nachfolgenden sollen einige Links bereitgestellt werden, die einen Anspruch
auf Seriosität haben.
Weiterbildung in der Anästhesie nach Novellierung der Musterweiterbildungsordnung
Authors: Quandt Christina , Koppert Wolfgang
Published: September 2018

Schlichtungsstellen für Arzthaftpflichtfragen bieten Patienten, Ärzten und Versicherern eine Möglichkeit, Arzthaftungsstreitigkeiten außergerichtlich zu klären. In der Rubrik „Fälle der Schlichtungsstelle“ stellen wir abgeschlossene Fälle aus der Schlichtungsstelle für Arzthaftpflichtfragen der norddeutschen Ärztekammern vor.
Multimodale Behandlung von Burnout
Authors: Söllner Wolfgang , Hertle Christine
Published: September 2018

Burnout ist ein durch mangelhaft verarbeiteten arbeitsbezogenen Distress
hervorgerufenes Erschöpfungssyndrom. Die Behandlung kann institutions- oder
personbezogen erfolgen. Letztere sollte je nach Schweregrad in einem gestuften
Therapieprogramm stattfinden – für schwere Fälle haben sich multimodale
Behandlungspakete bewährt. Der Beitrag skizziert deren Inhalte und diskutiert
psychodynamische Aspekte und die Wirksamkeit solcher Behandlungen.
Copper-Catalyzed Synthesis of Substituted 4-Acylpyrazole Derivatives through a Cascade Transformation from N-Propargylic Sulfonylhydrazones and Diaryliodonium Salts
Authors: Chen Yi-Hui , Li Ren-Hao , Fan Xin-Yang , Hu Zi-Lin , Liu Zhi-Kai , Yang Ying , Tang Hai-Tao , Chen Li , Zhan Zhuang-Ping
Published: September 2018

A concise strategy for the synthesis of substituted 4-acylpyrazole derivatives from N-propargylic sulfonylhydrazones and diaryliodonium salts has been developed. The pyrazole derivatives are formed through a five-step cascade sequence that includes intramolecular cyclization, hydroxylation, elimination, copper-catalyzed aerobic oxidation, and intramolecular rearrangement.
Antibody-Associated Autoimmune Encephalitis and Epilepsies in Children
Authors: Govil Tuhina , Williams Mitchel
Published: September 2018

Autoimmune causes of epilepsy have become an increasingly recognized etiology, especially in treatment refractory cases. Over the past two decades, there has been an explosion of new biomarkers that have led to the identification of new syndromes. As the underlying pathophysiology is immune driven, their management and treatment are directed at the modulation of this abnormal immune response against self-antigens. These antibody-specific syndromes show variation between adult and pediatric populations. We focus this review article on those identified autoimmune encephalopathies and epilepsies and clinical differences between them as well as age-related variations that have been reported.
Electroencephalography Findings in Autoimmune and Neuroinflammation-Related Epilepsies
Authors: Kim Jeong-A , Albert Dara , Weber Amanda
Published: September 2018

Autoimmune epilepsy occurs in association with localized central nervous system or systemic immune-mediated inflammation. Traditional anticonvulsant medications are frequently ineffective, and alternative approaches including immunomodulatory agents may be required. Identification of patients with autoimmune epilepsy may be challenging due to the variability of presentation and normal or nonspecific diagnostic results. Electroencephalography (EEG) features tend to include patterns of encephalopathy, generalized or focal interictal epileptiform abnormalities, or status epilepticus. Occasionally, specific EEG features may lend insight into the diagnosis. In this review article, we discuss EEG features of several suspected or proven immune-mediated pediatric epilepsies, including Rasmussen's encephalitis, idiopathic hemiconvulsion-hemiplegia syndrome, febrile infection-related epilepsy syndrome, epilepsies associated with autoantibodies to neuronal surface or intracellular antigens, and other systemic autoimmune diseases.
Glutton: a tool for generating structural ensembles of partly disordered proteins from chemical shifts
Authors: He Yi , Nagpal Suhani , Sadqi Mourad , de Alba Eva , Muñoz Victor
Published: September 2018

Motivation

Many proteins are partially disordered in physiological conditions and only fold, fully or partially, upon binding. Their structural analysis is challenging because the accessible information, typically chemical shifts (CS) from nuclear magnetic resonance experiments, are averages over broad ensembles of conformations. We aim to develop a database for the analysis of such data in terms of conformational distributions of the protein backbone rather than of individual high-resolution structures.

Results

Glutton is the largest available database linking CS and protein 3D structures (5270 entries organized in three levels) and is searchable via a python script. It generates statistical distributions of ϕ−ψ dihedral angles based on CS or vice versa. Such ϕ−ψ distributions are used to calculate structural ensembles of partially disordered proteins from their CS. For folded proteins, such ensembles are excellent starting points for further refinement with additional experimental restraints (structure determination) or computational methods (structure prediction).

Availability and implementation

Glutton is freely available at https://github.com/YeeHo/Glutton.

Supplementary information

Supplementary data are available at Bioinformatics online.
Which individual, social and environmental influences shape key phases in the amphetamine type stimulant use trajectory? A systematic narrative review and thematic synthesis of the qualitative literature
Authors: O'Donnell Amy , Addison Michelle , Spencer Liam , Zurhold Heike , Rosenkranz Moritz , McGovern Ruth , Gilvarry Eilish , Martens Marcus‐Sebastian , Verthein Uwe , Kaner Eileen
Published: September 2018

Background and aims

There is limited evidence on what shapes amphetamine‐type stimulant (ATS) use trajectories. This systematic narrative review and qualitative synthesis aimed to identify individual, social and environmental influences shaping key phases in the ATS use trajectory: initiation, continuation, increase/relapse and decrease/abstinence.

Methods

MEDLINE, PsycINFO, EMBASE, and PROQUEST (social science premium collection) were searched from 2000 to 2018. Studies of any qualitative design were eligible for inclusion. Extracted data were analysed according to four key phases within drug pathways, and then cross‐analysed for individual, social and environmental influences.

Results

Forty‐four papers based on 39 unique studies were included, reporting the views of 1879 ATS users. Participants were aged 14–58 years, from varied socio‐economic and demographic groups, and located in North America, Europe, Australasia and South East Asia. Reasons for initiation included: to boost performance at work and in sexual relationships, promote a sense of social ‘belonging’ and help manage stress. Similar reasons motivated continued use, combined with the challenge of managing withdrawal effects in long‐term users. Increased tolerance and/or experiencing a critical life event contributed to an increase in use. Reasons for decrease focused on: increased awareness of the negative health impacts of long‐term use, disconnecting from social networks or relationships and financial instability.

Conclusions

Amphetamine‐type stimulant users are a highly diverse population, and their drug use careers are shaped by a complex dynamic of individual, social and environmental factors. Tailored, joined‐up interventions are needed to address users’ overlapping economic, health and social care needs in order to support long‐term abstinence.
The role of nutrition in inflammatory pilosebaceous disorders: Implication of the skin‐gut axis
Authors: Maarouf Melody , Platto Jody F , Shi Vivian Y
Published: September 2018

Nutrition plays a critical role in the manifestation and management of inflammatory pilosebaceous disorders. There is rich potential for insight into the impact of dietary effects on the pathophysiology of inflammatory pilosebaceous disorders including acne vulgaris, hidradenitis suppurativa, rosacea, and the closely related seborrhoeic dermatitis. Acne vulgaris and hidradenitis suppurativa are thought to have similar diet‐modulating pathogenic pathways. Western diet influences Acne vulgaris and hidradenitis suppurativa by increasing insulin and modulating FOX01/mTOR, resulting in over‐expression of cytokeratins, hyperproliferation of keratinocytes, and hypercornification of the follicular wall. Key receptors in rosacea are alternatively activated by UV radiation, hot beverages, spicy foods, vanilla, cinnamon, caffeine, alcohol, cold temperatures, and niacin‐ and formalin‐containing foods, to increase oedema and flushing, resulting in erythema, telangiectasia, and warmth, characteristic features of the condition. Seborrhoeic dermatitis, while not a follicular disorder, is closely related, and can be modulated by dietary influences, such as biotin and probiotics. This overview summarizes the role that nutrition plays on these disorders, and identifies dietary modifications as potential adjunctive therapies.
The Integrity of Elections in Asia: Policy Lessons from Expert Evaluations
Authors: Grömping Max
Published: September 2018

There is an evolving debate about how to strengthen elections in Asia, amidst widespread concerns about electoral malpractice in the region. While contests in some countries match or surpass international standards of electoral integrity, there are deep‐seated problems of violence and conflict, corruption and clientelism, or vote rigging and fraud in others. This review of policy practice draws on the Perceptions of Electoral Integrity expert survey (PEI Release 6.0) to map the state of electoral integrity in Asia and to draw lessons for public policy. The empirics rely on the assessment of 535 experts who evaluated 47 elections in 27 countries in South, Southeast, Northeast, and Central Asia between July 2012 and December 2017. The review identifies three cross‐cutting challenges for electoral integrity in Asia. Policymakers and other stakeholders should (i) curb incumbent advantage enshrined in electoral laws regulating candidate registration and voting district boundaries; (ii) introduce regulation of political finance in order to reduce the influence of money in elections; and (iii) increase the transparency of the electoral process by encouraging nonpartisan domestic election monitoring and advocacy.
Scaling beta‐lactam antimicrobial pharmacokinetics from early life to old age
Authors: Lonsdale Dagan O. , Baker Emma H. , Kipper Karin , Barker Charlotte , Philips Barbara , Rhodes Andrew , Sharland Mike , Standing Joseph F.
Published: September 2018

Aims

Beta‐lactam dose optimization in critical care is a current priority. We aimed to review the pharmacokinetics (PK) of three commonly used beta‐lactams (amoxicillin ± clavulanate, piperacillin–tazobactam and meropenem) to compare PK parameters reported in critically and noncritically ill neonates, children and adults, and to investigate whether allometric and maturation scaling principles could be applied to describe changes in PK parameters through life.

Methods

A systematic review of PK studies of the three drugs was undertaken using MEDLINE and EMBASE. PK parameters and summary statistics were extracted and scaled using allometric principles to 70 kg individual for comparison. Pooled data were used to model clearance maturation and decline using a sigmoidal (Hill) function.

Results

A total of 130 papers were identified. Age ranged from 29 weeks to 82 years and weight from 0.9–200 kg. PK parameters from critically ill populations were reported with wider confidence intervals than those in healthy volunteers, indicating greater PK variability in critical illness. The standard allometric size and sigmoidal maturation model adequately described increasing clearance in neonates, and a sigmoidal model was also used to describe decline in older age. Adult weight‐adjusted clearance was achieved at approximately 2 years postmenstrual age. Changes in volume of distribution were well described by the standard allometric model, although amoxicillin data suggested a relatively higher volume of distribution in neonates.

Conclusions

Critical illness is associated with greater PK variability than in healthy volunteers. The maturation models presented will be useful for optimizing beta‐lactam dosing, although a prospective, age‐inclusive study is warranted for external validation.
A dense mapping study of six European AITD susceptibility regions in a large Chinese Han Cohort of Graves’ disease
Authors: Liu Wei , Zhang Qian‐Yue , Yuan Fei‐Fei , Wang Hai‐Ning , Zhang Le‐Le , Ma Yu‐Ru , Ye Xiao‐Ping , Zhang Man‐Man , Song Zhi‐Yi , Li Sheng‐Xian , Du Wen‐Hua , Liang Jun , Zhang Xiao‐Mei , Gao Guan‐Qi , Zhao Shuang‐Xia , Chen Feng‐ling , Song Huai‐Dong ,   The China Consortium for the Genetics of Autoimmune Thyroid Disease
Published: September 2018

Objective

We aimed to investigate the six susceptibility loci of GD identified from European population in Chinese Han population and further to estimate the genetic heterogeneity of them in stratification of our GD patients.

Design

Dense mapping studies based on GWAS.

Patients

A total of 1536 GD patients and 1516 controls in GWAS stage and 1994 GD patients and 2085 controls and 5033 GD patients and 5389 controls in two replication stages.

Measurements

Based on our previous GWAS data, independently GD‐associated SNPs in each region were identified by TagSNP analysis and logistic regression analysis. The association of these SNPs was investigated in 1994 GD patients and 2085 controls, and then, the significantly associated SNPs (P < 0.05) were further genotyped in a second cohort including 5033 GD patients and 5389 controls.

Results

After the first replication stage, four SNPs from three regions with Pfirst < 0.05 were further selected and genotyped in another independent cohort. The association of two SNPs with GD was confirmed in combined Chinese cohorts: rs12575636 at 11q21 (Pcombined = 7.55 × 10−11, OR = 1.27) and rs1881145 in TRIB2 at 2p25.1 (Pcombined = 5.59 × 10−8, OR = 1.14). Further study disclosed no significant difference for these SNPs between GD subsets. However, eQTL data revealed that SESN3 could be a potential susceptibility gene of GD in 11q21 region.

Conclusions

Out of the six susceptibility loci of GD identified from European population, two risk loci were confirmed in a large Chinese Han population. There is variability in GD genetic susceptibility in different ethnic groups. SESN3 is a potential susceptible gene of GD in 11q21.
An analysis of Ofsted inspection reports for children's social care services in England
Authors: Hood Rick , Nilsson David , Habibi Ruth
Published: September 2018

The Office for Standards in Education, Children's Services and Skills (Ofsted) is responsible for inspecting services that care for children and young people in England and Wales. This paper presents findings from an independent study of Ofsted inspections into children's social care in England, covering reports under three inspection frameworks during the period 2009 to 2016. The research aimed to identify the main themes of recommendations made in Ofsted reports and to explore similarities and differences between frameworks and between local authorities. The methodological approach was document analysis. A stratified sample of 60 reports was prepared on the basis of inspection framework and local authority characteristics such as local deprivation, Ofsted rating, and urban/rural category. A thematic analysis was conducted of the recommendations in each report, with emerging themes subjected to an iterative process of coding and categorization. The findings identified nine categories of themes, the most common of which were performance management, casework, oversight of practice, and multiagency working. Overall, the recommendations were strongly oriented towards process issues and compliance with standards. Recommendations were found to differ somewhat between inspection frameworks but remained largely consistent between local authorities with different characteristics. The paper concludes by examining the implications of findings for the current regulatory framework in children's social care.
Allergies and autoimmune disorders in children after heart transplantation
Authors: Avdimiretz Nicholas , Seitz Stefanie , Kim Tiffany , Murdoch Faye , Urschel Simon
Published: September 2018

Pediatric heart transplantation requires lifelong immune suppression and may require thymectomy, both of which alter T‐cell repertoires. We hypothesized that atopic and autoimmune diseases are more common in pediatric heart transplant patients than the general population, and that transplantation in early childhood increases the risk of development or worsening of atopic or autoimmune disease. A cross‐sectional single‐center study including 21 heart transplant patients aged ≤18 years was conducted. Data collected included age at transplant, induction, thymectomy, and development and severity of atopic or autoimmune disease. A majority (67%) reported having any atopic disease post‐transplant, all of whom reported onset or worsening post‐transplantation. Thymectomized patients were significantly more likely to have asthma (P = 0.018) and report asthma worsening post‐transplant (P = 0.045). Patients with worsening of asthma post‐transplant were transplanted at a significantly younger age (P = 0.040). ABO incompatible and ABO compatible recipients presented similarly. Anemia was common (38%) but not always clearly of autoimmune origin. Atopic diseases are common in children following heart transplantation: Compared to the general population, there is a higher prevalence of eczema (43% vs 11%) and asthma (33% vs 9%). Both thymectomy and younger age at transplant are associated with atopic disorders, possibly due to altered T‐cell repertoires.
Trajectories of obesity by spousal diabetes status in the English Longitudinal Study of Ageing
Authors: Silverman‐Retana O. , Hulman A. , Simmons R. K. , Nielsen J. , Witte D. R.
Published: September 2018

Aims

To examine whether the development of obesity with age was different for individuals with and without a spouse with diabetes.

Methods

We analysed data from the English Longitudinal Study of Ageing [n= 7123, median (interquartile range) age 59 (53–67) years, 51% men], which included four clinical examination waves between 1998 and 2012. The main exposure was having a spouse with diabetes. Outcomes of interest were BMI and waist circumference. We fitted quadratic age‐related trajectories using mixed‐effect models stratified by sex and adjusted for education, smoking and the corresponding interaction terms between age and spousal diabetes status.

Results

The baseline spousal diabetes prevalence was 4.4%. Men with a wife with diabetes experienced a steeper increase in BMI (1.6 kg/m2) between ages 50 to 65 years than men with a wife without diabetes (0.9 kg/m2). Women with a husband with diabetes had a similarly shaped BMI trajectory to women with a husband without diabetes, but their average BMI levels were higher between ages 55 and 65 years. Waist circumference trajectories showed a similar shape by spousal diabetes status for men and women, although individuals with a spouse with diabetes had higher waist circumference values throughout follow‐up.

Conclusions

We found a positive association between spousal diabetes status and obesity development, which differed by sex among middle‐aged individuals. Evidence from couple‐based interventions is needed to test whether the latter could improve the current individual‐focused public health strategies for obesity prevention.
‘It's an important part, but I am not quite sure that it is working’: educators’ perspectives on the implementation of goal‐setting within the ‘DAFNE’ diabetes structured education programme
Authors: Fredrix M. , Byrne M. , Dinneen S. , McSharry J.
Published: September 2018

Aim

To explore educators’ perspectives on the implementation of goal‐setting and action‐planning strategies within a structured diabetes self‐management education programme.

Methods

Ten semi‐structured interviews were conducted with diabetes self‐management education providers delivering the ‘Dose Adjustment for Normal Eating’ (DAFNE) programme to people with Type 1 diabetes throughout Ireland. A pre‐designed topic guide, focused on exploring educators’ experiences of delivery and application and views on usefulness of goal‐setting strategies, was used in all interviews. The interviews were recorded, transcribed and analysed using thematic analysis.

Results

Five main themes were identified: ‘people need a plan’, discussing perspectives on goal‐setting's value; ‘the power of the group’, highlighting the impact a group format has on goal‐setting practices; ‘diversity and individuality’, discussing differences in DAFNE participants’ and educators’ engagement with goal‐setting; ‘goal‐setting's fit’, exploring perspectives on how well goal‐setting fits within diabetes self‐management education and follow‐up care; and ‘feelings of inadequate psychological knowledge’, addressing challenges experienced in the delivery of goal‐setting components.

Conclusion

While educators saw benefits in the implementation of goal‐setting and planning strategies within diabetes self‐management education, concerns about how well goal‐setting currently fits within diabetes self‐management education and follow‐up care were evident. Additionally, many educators experienced the delivery of goal‐setting and action‐planning strategies as challenging and would value additional training opportunities.
Antidepressant effects of direct‐acting antivirals against hepatitis C virus—Results from a pilot study
Authors: Hahn Daphne , Stokes Caroline S. , Kaiser Ralf , Meyer Markus R. , Lammert Frank , Gruenhage Frank
Published: September 2018

Background and Aims

The new direct‐acting antiviral agents (DAA) have revolutionized the treatment of patients with chronic hepatitis C virus (HCV) infection. This study investigates to which extent DAA affect fatigue and mood and, if so, whether this results from changes to tryptophan (TRP) metabolism, as reflected by two critical biosynthetic pathways, serotonin (SRT) generation from TRP and TRP degradation through kynurenines (KYN) via indoleamine 2,3‐dioxygenase (IDO).

Methods

This study assessed 24 patients with chronic HCV infection, before (T1), during (T2: at 4 weeks) and 12 weeks post‐treatment with DAA (T3) with respect to viral load, fatigue and depressive symptoms (BDI‐II questionnaire), physical activity (actigraph) and plasma serotonin‐tryptophan metabolites (LC/MS). The KYN:TRP ratio reflected IDO activity.

Results

All participants achieved sustained virological response (SVR12) with DAA treatment (79% sofosbuvir‐based). Fatigue (scores at T1:0.83 ± 0.70, T2:0.48 ± 0.70, T3:0.30 ± 0.50; P = 0.023) and depressive symptoms (scores at T1:9.8 ± 10.2, T2:6.0 ± 7.3, T3:5.0 ± 7.6; P = 0.005) improved significantly on therapy, whereas no changes were noted in five untreated controls. TRP plasma concentrations markedly decreased (T1:306 ± 179 mg/L, T2:283 ± 84 mg/L), whereas 5‐HTP levels increased (T1:0.08 ± 0.01 mg/L, T2:0.10 ± 0.06 mg/L). KYN concentrations (T1:2.4 ± 2.0 mg/L, T2:3.7 ± 1.4 mg/L, P = 0.003) increased significantly during treatment, as did IDO activity (T1:0.008 ± 0.006 mg/L, T2:0.014 ± 0.004 mg/L; P < 0.001).

Conclusions

In this study, DAA exert positive and persistent effects on both fatigue and mood in patients with chronic HCV infection. These extrahepatic benefits are, at least in part, related to the modulation of TRP metabolism. The robust elevation of KYN concentrations challenges the current paradigm of low KYN levels as prerequisite for mental health.
Analysis of key genes and signaling pathways involved in Helicobacter pylori‐associated gastric cancer based on The Cancer Genome Atlas database and RNA sequencing data
Authors: Hu Yi , He Cong , Liu Jian‐Ping , Li Nian‐Shuang , Peng Chao , Yang‐Ou Yao‐Bin , Yang Xiao‐Yu , Lu Nong‐Hua , Zhu Yin
Published: September 2018

Background

Helicobacter pylori (H. pylori) infection is associated with the development of gastric cancer, although the mechanism is unclear. Herein, this study aimed to clarify the key genes and signaling pathways involved in H. pylori pathogenesis based on The Cancer Genome Atlas (TCGA) database and RNA sequencing analysis.

Materials and Methods

Forty‐nine gastric cancer samples (16 with H. pylori and 33 without H. pylori) and 35 cancer‐adjacent normal samples from TCGA database were analyzed by bioinformatics. The differentially expressed genes between H. pylori‐positive and H. pylori‐negative patients were verified in 18 gastric cancer (GC) samples (9 with H. pylori and 9 without H. pylori), which were analyzed using RNA sequencing. Survival analysis was carried out to explore associations between the differentially expressed genes and prognosis. Bioinformatics analysis was performed to determine the signaling pathways associated with H. pylori.

Results

The baseline level of clinical features from TCGA database and RNA sequencing showed no differences between the H. pylori‐positive and H. pylori‐negative GC groups (P > 0.05). TP53 was shown to be upregulated in the H. pylori‐positive group in both TCGA database and RNA sequencing data, which also showed higher expression in the GC tissues than in adjacent normal tissues (P < 0.05). CCDC151, CHRNB2, GMPR2, HDGFRP2, and VSTM2L were shown to be downregulated in the H. pylori‐positive group by both TCGA database and RNA sequencing, which also showed lower expression in the GC tissues than in adjacent normal tissues (P < 0.05). GC patients with low expression levels of HDGFRP2 had a poor prognosis (P < 0.05). Thirty‐three signaling pathways and 10 biological processes were found to be positively associated with H. pylori infection (P < 0.05, FDR < 0.05).

Conclusions

These results indicate that some genes (TP53, CCDC151, CHRNB2, GMPR2, HDGFRP2, VSTM2L) and previously unidentified signaling pathways (eg, the Hippo signaling pathway) might play an important role in H. pylori‐associated GC.
Rufous‐capped Warblers Basileuterus rufifrons show seasonal, temporal and annual variation in song use
Authors: Demko Alana D. , Mennill Daniel J.
Published: September 2018

In the majority of songbird species, males have repertoires of multiple song types used for mate attraction and territory defence. The wood‐warblers (family Parulidae) are a diverse family of songbirds in which males of many migratory species use different song types or patterns of song delivery (known as ‘singing modes’) depending on context. The vocal behaviour of most tropical resident warblers remains undescribed, although these species differ ecologically and behaviourally from migratory species, and may therefore differ in their vocal behaviour. We test whether male Rufous‐capped Warblers Basileuterus rufifrons use distinct singing modes by examining song structure and context‐dependent variation in their songs. We recorded multiple song bouts from 50 male Warblers in a Costa Rican population over 3 years to describe seasonal, diel and annual variation in song structure and vocal behaviour. We found that Rufous‐capped Warbler songs are complex, with many syllable types shared both within and between males’ repertoires. Males varied their song output depending on context: they sang long songs at a high rate at dawn and during the breeding season, and shortened songs in the presence of a vocalizing female mate. Unlike many migratory species, Rufous‐capped Warblers do not appear to have different singing modes; they did not change the song variants used or the pattern of song delivery according to time of day, season or female vocal activity. Our research provides the first detailed vocal analysis of any Basileuterus warbler species, and enhances our understanding of the evolution of repertoire specialization in tropical resident songbirds.
A histomorphometric classification system for normal and inflamed mouse duodenum—Quali‐quantitative approach
Authors: Pereira e Silva Airton , Soares João R. A. , Mattos Erika Bertozzi de Aquino , Josetti Claudia , Guimarães Isabelle M. , Campos Sylvia M. N. , Teixeira Gerlinde A. P. B.
Published: September 2018

Gut‐associated intestinal lymphoid tissue, the largest secondary lymphoid organ in the human body, constantly samples antigens from the gut lumen, presenting as a default response the activation of TCD4+FOXP3+ regulatory T cells that secrete a profile of anti‐inflammatory cytokines maintaining gut homeostasis denominated from an immunological perspective as mucosal tolerance. However, when antigens are sampled in an inflammatory setting, the immune response may either be protective, in the case of harmful pathogens, or cause further inflammatory reactions as in food allergy, inflammatory bowel diseases, coeliac disease or food protein‐induced enterocolitis syndrome. Therefore, there is a need for accurate and consistent experimental models. However, a drawback in comparing these models is the lack of a classification system similar to that which is already used for humans. Thus, the aim of this work was to propose a classification system of the small intestinal histomorphology in experimental mice. To do this we used a mouse antigen‐specific gut inflammation model developed by our research group. Duodenum sections stained with haematoxylin‐eosin and Alcian blue were scanned using the APERIO scanning system and analysed with the ImageScope® software. The evaluated parameters were villus area, villus height and width, enterocyte count, mononuclear intra‐epithelial leucocyte and goblet cell counts, and architectural and cellular ratios. Food‐sensitized animals challenged with a diet containing the corresponding food allergen presented, as for humans, time‐dependent shortened and widened villi accompanied by leucocyte infiltrate and loss of goblet cells. With these data, we were able to establish a classification system for experimental intestinal inflammation in mice thus permitting better comparisons among and between experiments than has been possible previously.
Effects of financial education on sound personal finance in Korea: Conceptualization of mediation effects of financial literacy across income classes
Authors: Son Jiyeon , Park Jooyung
Published: September 2018

This study analyzed the role of financial literacy as a mediator between financial education and sound personal finance to assess how financial education affects the soundness of personal finance. In particular, this study conducted three sets of mediation analyses using data from the 2014 Consumer Empowerment Index survey of the Korea Consumer Agency to verify whether the mediating relationship is valid across different income classes of the Korean population. The results suggest that financial literacy works as a mediator between financial education and sound personal finance in the high‐income class and the middle‐income classes. Therefore, policymakers should consider the limitations of financial education and financial literacy when addressing low‐income consumers.
The physical health of young people experiencing first‐episode psychosis: Mental health consumers’ experiences
Authors: Chee Gin‐Liang , Wynaden Dianne , Heslop Karen
Published: September 2018

Young people experiencing first‐episode psychosis taking antipsychotic medications often develop comorbidities such as obesity and cardiometabolic abnormalities at an earlier age than young people in the general population. Therefore, it is important to explore the healthcare needs and experiences of this group of consumers. This paper reports research conducted to obtain an informed understanding of young people's health literacy, physical healthcare needs, and interest and knowledge about their physical health. Grounded theory methodology was used to guide the research. Semistructured interviews were conducted with 24 young consumers aged between 18 and 35 years who were case managed by one metropolitan community mental health service. The results describe the journey of young people from the time of diagnosis, to when they developed an awareness of the need to improve their physical health and the impact of physical health issues on their overall health and well‐being. Six categories emerged from the data: (i) initial responses when diagnosed with first‐episode psychosis; (ii) focus of care on treating first‐episode psychosis; (iii) lack of education on antipsychotic medications; (iv) adverse effects from taking antipsychotic medication; (v) increased awareness of the need for good physical health; and 6) importance of social support in the community. The findings highlight the importance for health professionals improving young people's health literacy and addressing physical health and well‐being as part of first‐episode psychosis programmes. Young people require improved health education on the importance of maintaining healthy lifestyle in relation to their overall health and well‐being.
The challenges of prenatal care for Bangladeshi women: a qualitative study
Authors: Akter M.K. , Yimyam S. , Chareonsanti J. , Tiansawad S.
Published: September 2018

Background

Maternal and infant morbidity and mortality are major issues in developing countries, but the literature reveals there are limited studies on the sociocultural issues affecting adequate prenatal care in Bangladesh.

Aim

To explore the sociocultural influences underlying perceived barriers to prenatal care among pregnant women in an urban area of Bangladesh.

Methods

A descriptive qualitative research was conducted with 20 women and 20 of their significant others in three purposively sampled hospitals using individual in‐depth interview between November 2016 and March 2017. Content analysis was used for analysis.

Findings

Six themes emerged as follows: women's lack of opportunity to make decision; pregnancy as a normal life event; insufficient money for prenatal care; heavy family workload without family support; no permission to go to hospital without a guardian; and inconvenient transportation.

Discussion

Good prenatal care is vital for maternal and infant health, but our participants were challenged by a number of key issues as follows: they lacked empowerment to make their own pregnancy decisions, they were impoverished financially, struggled to get to their prenatal appointments by local transport and they lacked family understanding and support for necessary prenatal care.

Conclusion and policy implications

Based on the findings, it is recommended that promoting prenatal care adequacy among pregnant women in Bangladesh needs socioculturally sensitive health education programmes which target are not only pregnant women, but also their significant others who are authorized persons in the family. It should be established remote PNC services. Empowerment of women is vital in the country and free antenatal education programmes are needed through a variety of media. Findings provide information for nursing and health policymakers to develop policies to improve adequacy of prenatal care among pregnant women.