bluuebunny/crossref_metadata_2025 huggingface dataset:
The incidence and significance of periictal apnea in epileptic seizures
Authors: Lacuey Nuria , Zonjy Bilal , Hampson Johnson P. , Rani M. R. Sandhya , Zaremba Anita , Sainju Rup K. , Gehlbach Brian K. , Schuele Stephan , Friedman Daniel , Devinsky Orrin , Nei Maromi , Harper Ronald M. , Allen Luke , Diehl Beate , Millichap John J. , Bateman Lisa , Granner Mark A. , Dragon Deidre N. , Richerson George B. , Lhatoo Samden D.
Published: January 2018

Objective

The aim of this study was to investigate periictal central apnea as a seizure semiological feature, its localizing value, and possible relationship with sudden unexpected death in epilepsy (SUDEP) pathomechanisms.

Methods

We prospectively studied polygraphic physiological responses, including inductance plethysmography, peripheral capillary oxygen saturation (SpO2), electrocardiography, and video electroencephalography (VEEG) in 473 patients in a multicenter study of SUDEP. Seizures were classified according to the International League Against Epilepsy (ILAE) 2017 seizure classification based on the most prominent clinical signs during VEEG. The putative epileptogenic zone was defined based on clinical history, seizure semiology, neuroimaging, and EEG.

Results

Complete datasets were available in 126 patients in 312 seizures. Ictal central apnea (ICA) occurred exclusively in focal epilepsy (51/109 patients [47%] and 103/312 seizures [36.5%]) (P < .001). ICA was the only clinical manifestation in 16/103 (16.5%) seizures, and preceded EEG seizure onset by 8 ± 4.9 s, in 56/103 (54.3%) seizures. ICA ≥60 s was associated with severe hypoxemia (SpO2 <75%). Focal onset impaired awareness (FOIA) motor onset with automatisms and FOA nonmotor onset semiologies were associated with ICA presence (P < .001), ICA duration (P = .002), and moderate/severe hypoxemia (P = .04). Temporal lobe epilepsy was highly associated with ICA in comparison to extratemporal epilepsy (P = .001) and frontal lobe epilepsy (P = .001). Isolated postictal central apnea was not seen; in 3/103 seizures (3%), ICA persisted into the postictal period.

Significance

ICA is a frequent, self‐limiting semiological feature of focal epilepsy, often starting before surface EEG onset, and may be the only clinical manifestation of focal seizures. However, prolonged ICA (≥60 s) is associated with severe hypoxemia and may be a potential SUDEP biomarker. ICA is more frequently seen in temporal than extratemporal seizures, and in typical temporal seizure semiologies. ICA rarely persists after seizure end. ICA agnosia is typical, and thus it may remain unrecognized without polygraphic measurements that include breathing parameters.
Reversine inhibits MMP‐1 and MMP‐3 expressions by suppressing of ROS/MAPK/AP‐1 activation in UV‐stimulated human keratinocytes and dermal fibroblasts
Authors: Kim Jeong‐Mi , Kim Sun young , Noh Eun‐Mi , Song Hyun‐Kyung , Lee Guem‐San , Kwon Kang‐Beom , Lee Young‐Rae
Published: January 2018

UVB has been shown to stimulate the generation of reactive oxygen species (ROS), which subsequently results in the activation of various intracellular signalling pathways and transcription factors (AP‐1, NF‐κB). These transcription factors are regulated by MAPKs, which increase cytokine and MMP expression. We examined the preventive effects of reversine on MMP‐1 and MMP‐3 expressions in NHEKs and NHDFs exposed to UVB irradiation. Also, we confirmed that reversine decreased pro‐inflammatory cytokine expression in NHEKs. The mechanism underlying the MMP inhibitory effects of reversine occurred via the suppression of UVB‐induced ROS generation and MAPK/AP‐1 activation. Therefore, reversine is an effective therapeutic candidate for preventing skin photoageing.
Aging and hypertension decrease endothelial NO‐related dilating function and gamma‐glutamyl transferase activity but not S‐nitrosoglutathione‐induced aortic vasodilation
Authors: Perrin‐Sarrado Caroline , Dahboul Fatima , Leroy Pierre , Lartaud Isabelle
Published: January 2018

S‐nitrosoglutathione (GSNO), which is involved in the transport and the storage of NO, induces vasorelaxation. It requires gamma‐glutamyl transferase (GGT), an enzyme present on the endothelium, to transfer NO into the cell. We evaluated whether aging and hypertension, which induce NO‐related dilating dysfunction, are associated with decreased vascular GGT activity and modify the vasorelaxant effect of GSNO. Thoracic aortic rings isolated from male spontaneous hypertensive rats (SHR) and Wistar‐Kyoto rats (WKY) aged 20–22 (adult) or 57–60 weeks (mature) were preconstricted with phenylephrine, then submitted to concentration‐vasorelaxant response curves (maximal response: Emax; pD2) to GSNO and carbachol (the latter to measure NO‐related dilating function). GGT activity was measured using chromogenic substrate. Both aging and hypertension lowered Emax values for carbachol (Emax −8% in adult SHR, −42% in mature SHR vs. age‐matched WKY, page and phypertension < 0.05) demonstrating NO‐related dilating dysfunction. Aortic GGT activity also decreased with aging and hypertension (−22% in adult and −75%, reaching 3 nmol/min/g of tissue, in mature SHR vs. 12 in age‐matched WKY and 23 in adult WKY, page and phypertension < 0.05). The pD2 values of GSNO were similar in mature SHR and WKY but higher in adult SHR (pinteraction < 0.05). Aging in hypertensive rats decreased NO‐related vasorelaxant function and vascular GGT activity, but did not lower the vasorelaxant response to GSNO. This opens perspectives for GSNO‐based therapeutics restoring nitric oxide bioavailability and vascular protection in a context of endothelial dysfunction.
Preferential distribution of fish larvae in the California Current System: Time, space, and temperature
Authors: Bautista‐Romero J. Jesús , Funes‐Rodríguez Rene , Jiménez‐Rosenberg Sylvia P. A. , Lluch‐Cota Daniel B.
Published: January 2018

The preferential larval distributions of 22 fish species in the California Current System were identified in their temporal, spatial, and thermal domains using single parameter quotient analysis. This analysis allowed the characterization of their reproductive habitats based on ranges of preference, tolerance, and avoidance. In the temporal domain, the species’ preference intervals were wider than those previously reported, and all species showed preferences during two or more seasons of the year. In the spatial domain, the preferential distributions of the species were also wider, and some of them had different preferred zones from those described in previous works. Because one group of species was preferably distributed in coastal zones, and the other group was preferably distributed in oceanic zones, the biological production mechanisms sustaining these groups differ, namely, coastal upwelling and geostrophic fluxes of subarctic origin, respectively. In the thermal domain, the larval distribution preferences of 20 of 22 species have been determined for the first time, providing important information on their thermal tolerance window during the larval stage, a window that changes in width throughout each of the ontogenetic stages of fish. The distribution in each domain suggests association patterns between species, but additional studies are necessary to validate these patterns.
Staff preparedness for providing palliative and end‐of‐life care in long‐term care homes: Instrument development and validation
Authors: Chan Helen YL , Chun Gloria KM , Man CW , Leung Edward MF
Published: January 2018

Aim

Although much attention has been on integrating the palliative care approach into services of long‐term care homes for older people living with frailty and progressive diseases, little is known about the staff preparedness for these new initiatives. The present study aimed to develop and test the psychometric properties of an instrument for measuring care home staff preparedness in providing palliative and end‐of‐life care.

Methods

A 16‐item instrument, covering perceived knowledge, skill and psychological readiness, was developed. A total of 247 staff members of different ranks from four care homes participated in the study. Exploratory factor analysis using the principal component analysis extraction method with varimax rotation was carried out for initial validation. Known group comparison was carried out to examine its discriminant validity. Reliability of the instrument was assessed based on test–retest reliability of a subsample of 20 participants and the Cronbach's alpha of the items.

Results

Exploratory factor analysis showed that the instrument yielded a three‐factor solution, which cumulatively accounted for 68.5% of the total variance. Three subscales, namely, willingness, capability and resilience, showed high internal consistency and test–retest reliability. It also showed good discriminant validity between staff members of professional and non‐professional groups.

Conclusions

This is a brief, valid and reliable scale for measuring care home staff preparedness for providing palliative and end‐of‐life care. It can be used to identify their concerns and training needs in providing palliative and end‐of‐life care, and as an outcome measure to evaluate the effects of interventional studies for capacity building in this regard. Geriatr Gerontol Int 2018; 18: 745–749
Development and validation of a scoring system to predict progression to acute‐on‐chronic liver failure in patients with acute exacerbation of chronic hepatitis B
Authors: Ren Yi , Liu Lulu , Li Ying , Yang Fangwan , He Yihuai , Zhu Yanping , Hu Xinxin , Lin Shide
Published: January 2018

Aim

The aim of this study was to develop and validate a scoring system to predict the progression to acute‐on‐chronic liver failure (ACLF) in patients with acute exacerbation (AE) of chronic hepatitis B (CHB).

Methods

The baseline characteristics of 474 patients with AE of CHB were retrospectively reviewed; 280 and 194 patients were randomly assigned to the derivation and validation cohorts, respectively. Univariate risk factors associated with ACLF development were entered into a multivariate logistic regression. The score model was established, and its predictive value was evaluated by the receiver operating characteristic (ROC) curve and the area under the ROC curve (AUROC).

Results

Hepatitis B virus (HBV) DNA, international normalized ratio (INR) of prothrombin time, and patient age were identified as independent risk factors associated with progressing to ACLF. The prediction model was established as R = −13.323 + 0.553 × log HBV‐DNA (copies/mL) + 3.631× INR + 0.053 × age. The AUROCs of our prediction model were higher than those of the Model for End‐stage Liver Disease (MELD) and MELD‐sodium (Na) for both cohorts. At the cut‐off value of −2.43, our prediction model had higher sensitivity (87.5%), specificity (73.6%), positive predictive value (23.0%), positive likelihood ratio (3.30), and lower negative likelihood ratio (0.17) in the validation cohort than those of MELD and MELD‐Na.

Conclusion

The independent risk factors associated with progressing to ACLF in patients with AE of CHB are HBV‐DNA, INR, and age. Our risk prediction model is useful for predicting the development of ACLF.
Neglect of attention to reproductive health in women with HIV infection: contraceptive use and unintended pregnancies in the Swiss HIV Cohort Study
Authors: Aebi‐Popp K , Mercanti V , Voide C , Nemeth J , Cusini A , Jakopp B , Nicca D , Rasi M , Bruno A , Calmy A , Martinez de Tejada B ,   the Swiss HIV Cohort Study
Published: January 2018

Objectives

Women with HIV infection are mainly of reproductive age and need safe, effective and affordable contraception to avoid unintended pregnancies. The aim of this study was to evaluate contraceptive use and unintended pregnancies in this population in Switzerland.

Methods

A self‐report anonymous questionnaire on contraceptive methods, adherence to them, and unintended pregnancies was completed by women included in the Swiss HIV Cohort Study (SHCS) between November 2013 and June 2014. Sociodemographic characteristics and information related to combined antiretroviral therapy and HIV disease status were obtained from the SHCS database.

Results

Of 462 women included, 164 (35.5%) reported not using any contraception. Among these, 65 (39.6%) reported being sexually active, although 29 (44.6%) were not planning a pregnancy. Of 298 women using contraception, the following methods were reported: condoms, 219 (73.5%); oral hormonal contraception, 32 (10.7%); and intrauterine devices, 28 (9.4%). Among all women on contraception, 32 (10.7%) reported using more than one contraceptive method and 48 (16%) had an unintended pregnancy while on contraception (18, condoms; 16, oral contraception; four, other methods). Of these, 68.1% terminated the pregnancy and almost half (43.7%) continued using the same contraceptive method after the event.

Conclusions

Family planning needs in HIV‐positive women are not fully addressed because male condoms remained the predominant reported contraceptive method, with a high rate of unintended pregnancies. It is of utmost importance to provide effective contraception such as long‐acting reversible contraceptives for women living with HIV.
On Microaggressions: Cumulative Harm and Individual Responsibility
Authors: Friedlaender Christina
Published: January 2018

Microaggressions are a new moral category that refers to the subtle yet harmful forms of discriminatory behavior experienced by members of oppressed groups. Such behavior often results from implicit bias, leaving individual perpetrators unaware of the harm they have caused. Moreover, microaggressions are often dismissed on the grounds that they do not constitute a real or morally significant harm. My goal is therefore to explain why microaggressions are morally significant and argue that we are responsible for their harms. I offer a conceptual framework for microaggressions, exploring the central mechanisms used for identification and the empirical research concerning their harm. The cumulative harm of microaggressions presents a unique case for understanding disaggregation models for contributed harms, blame allocation, and individual responsibility within structural oppression. Our standard moral model for addressing cumulative harm is to hold all individual contributors blameworthy for their particular contributions. However, if we aim to hold people responsible for their unconscious microaggressions and address cumulative harm holistically, this model is inadequate. Drawing on Iris Marion Young's social connection model, I argue that we, as individual perpetrators of microaggressions, have a responsibility to respond to the cumulative harm to which we have individually contributed.
“I longed to cherish mirrored reflections”: Mirroring and Black Female Subjectivity in Carrie Mae Weems's Art against Shame
Authors: Shane Robert R.
Published: January 2018

Through staged photographs in which she herself is often the lead actor or through appropriation of historical photographs, contemporary African American artist Carrie Mae Weems deconstructs the shaming of the black female body in American visual culture and offers counter‐hegemonic images of black female beauty. The mirror has been foundational in Western theories of subjectivity and discussions of beauty. In the artworks I analyze in this article, Weems tactically employs the mirror to engage the topos of shame in order to reject it as a way of seeing the self and to offer a new way of lovingly seeing the self. I use the work of Kelly Oliver, Helen Block Lewis, and bell hooks to articulate the relationships among the mirror, shame, and black female subjectivity in Weems's work. Weems's subjects often reckon with what Oliver calls “social melancholy” as they experience shame while standing before the mirror. However, Weems also shows that by looking again—a critical strategy I explain using Oliver's model of “the loving eye”—her subjects can use the mirror as a corrective to the social shaming gaze and make it a stage for establishing black female subjectivity, a gaze of self‐love, and beauty.
Teaching & Learning Tips 4: Motivation and emotion in learning
Authors: Lemoine Elizabeth R. , Nassim Janelle S. , Rana Jasmine , Burgin Susan
Published: January 2018

Challenge: Trainees’ motivational and emotional states can influence their learning and career decisions, but historically these “affective” learning factors have received little attention in medical education. In this “Tips” piece, we outline strategies to positively influence trainees’ intrinsic motivation and emotion toward their training to ultimately enhance their overall learning experience.
Gender‐specific risk factors for androgenetic alopecia in the Korean general population: Associations with medical comorbidities and general health behaviors
Authors: Kim Bo‐Kyung , Choe Sung Jay , Chung Hee‐Chul , Oh Sung‐Soo , Lee Won‐Soo
Published: January 2018

Background

The relationships between androgenetic alopecia (AGA) and various factors related to metabolic syndrome have been demonstrated in previous studies. However, it remains unclear because of inconsistent results. We investigated the associations between AGA and various risk factors related to metabolic syndrome according to gender.

Methods

We conducted a population‐based cross‐sectional survey of 2028 Koreans (1050 men, 978 women). The basic and specific (BASP) classification was used for diagnosis of AGA. We collected information on risk factors though questionnaires and medical records.

Results

AGA was significantly associated with age, family history of AGA, hypertension, diabetes mellitus, and waist circumference in both genders. Female subjects with AGA were more likely to have cerebrovascular disease, dyslipidemia, and obesity; however, these associations were not observed in the male subjects. When multiple regression analysis was applied, there was a significant relationship between hypertension and AGA in male subjects. However, there was no statistically significant association in female subjects.

Conclusion

The different results according to gender might arise from different mechanisms of AGA. There was a significant relationship between hypertension and AGA in male subjects. Evaluation of blood pressure in male patients with AGA might facilitate interventions for hypertension.
Wolbachia‐induced transcription factor GATA4 suppresses ovary‐specific genes blastoderm‐specific protein 25D and imaginal disc growth factor
Authors: Osei‐Amo S. , Hussein M. , Asad S. , Hugo L. , Asgari S.
Published: January 2018

The endosymbiotic bacterium Wolbachia infects a wide array of insect hosts and has been implicated in a range of biological modifications as a consequence of its infection. Previously, it was shown that the transcription factor GATA4 was significantly induced in Wolbachia wMelPop‐CLA strain infected Aedes aegypti whole mosquitoes and cells. Here, we provide evidence that this induction also occurs in mosquito ovaries where the ovary‐specific genes blastoderm‐specific protein 25D (Bsg25D) and imaginal disc growth factor (Disc) are suppressed by Wolbachia. We further demonstrate that transcriptional depletion of GATA4 results in upregulation of both genes and conversely its overexpression leads to downregulation of the genes, suggesting that Wolbachia‐induced GATA4 plays a suppressive regulatory role with regards to Bsg25D and Disc expression in mosquito ovaries. When the Disc gene was silenced in mosquitoes, we did not observe any difference in the number of mature ovarian follicles developed between treatment groups. However, we did find a significant delay in the hatching of eggs that had been laid by Disc knockdown mosquitoes.
Adaptive immune education by gut microbiota antigens
Authors: Zhao Qing , Elson Charles O.
Published: January 2018

Host–microbiota mutualism has been established during long‐term co‐evolution. A diverse and rich gut microbiota plays an essential role in the development and maturation of the host immune system. Education of the adaptive immune compartment by gut microbiota antigens is important in establishing immune balance. In particular, a critical time frame immediately after birth provides a ‘window of opportunity’ for the development of lymphoid structures, differentiation and maturation of T and B cells and, most importantly, establishment of immune tolerance to gut commensals. Depending on the colonization niche, antigen type and metabolic property of different gut microbes, CD4 T‐cell responses vary greatly, which results in differentiation into distinct subsets. As a consequence, certain bacteria elicit effector‐like immune responses by promoting the production of pro‐inflammatory cytokines such as interferon‐γ and interleukin‐17A, whereas other bacteria favour the generation of regulatory CD4 T cells and provide help with gut homeostasis. The microbiota have profound effects on B cells also. Gut microbial exposure leads to a continuous diversification of B‐cell repertoire and the production of T‐dependent and ‐independent antibodies, especially IgA. These combined effects of the gut microbes provide an elegant educational process to the adaptive immune network. Contrariwise, failure of this process results in a reduced homeostasis with the gut microbiota, and an increased susceptibility to various immune disorders, both inside and outside the gut. With more definitive microbial–immune relations waiting to be discovered, modulation of the host gut microbiota has a promising future for disease intervention.
Physiological responses to water stress and yield of winter wheat cultivars differing in drought tolerance
Authors: Thapa S. , Reddy S. K. , Fuentealba M. P. , Xue Q. , Rudd J. C. , Jessup K. E. , Devkota R. N. , Liu S.
Published: January 2018

Moderate to severe drought (water stress) at the reproductive stage is common in the U.S. Southern High Plains (SHP), where wheat is grown as a major winter crop. The objective of this study was to better understand the physiological basis of drought tolerance in elite wheat cultivars. A 2‐yr glasshouse study was conducted using three cultivars (TAM 111, TAM 112 and TAM 304) and two water treatments (wet: adequate water and dry: water‐limited). Overall, TAM 111 and TAM 112 used more water for cumulative evapotranspiration (ET) and had more tillers and greater root mass and shoot mass compared to TAM 304. In the dry treatment, TAM 112 had 67% and 81% more grain yield than TAM 111 and TAM 304, respectively. Water use efficiency for grain (WUEg) and water use efficiency for biomass (WUEbm) were also greater in TAM 112 compared to the other cultivars in the dry treatment. The flag leaves in TAM 112 at mid‐grain filling stage (about 15 days after flowering) had lower stomatal conductance (Gs), intercellular CO2 concentration (Ci), transpiration rate (Tr) and net photosynthetic rate (Pn), but higher photosynthetic water use efficiency (PWUE) than TAM 111 and TAM 304 under water stress. This study demonstrated a distinct role of gas exchange parameters in response to drought, and TAM 112 was more efficient than TAM 111 and TAM 304 in evolving physiological mechanisms to adapt to water stress.
Generation of hydrogen under visible light irradiation with enhanced photocatalytic activity of Bi2WO6/Cu1.8Se for organic pollutants under Vis‐NIR light reign
Authors: Qiao Li‐Na , Wang Huan‐Chun , Luo Yi‐Dong , Xu Hao‐Min , Ding Jun‐Ping , Lan Shun , Shen Yang , Lin Yuan‐Hua , Nan Ce‐Wen
Published: January 2018

To make better use of solar light, a new Bi2WO6/Cu1.8Se photocatalyst active to visible and near‐infrared light has been synthesized by a facile hydrothermal method. The composites were characterized by X‐ray diffractometry (XRD), scanning electron microscopy (SEM), UV‐vis diffuse reflectance spectroscopy (DRS), and photoluminescene (PL). The photocatalytic activities of Bi2WO6/Cu1.8Se are evaluated by degrading Congo red solution and hydrogen generation from water. It was found that the molar percentage of Cu1.8Se had great effects on the morphology and photocatalytic property of the Bi2WO6/Cu1.8Se heterojunctions, and the composite with suitable molar amount of Cu1.8Se exhibits much enhanced photocatalytic activity for Congo red degradation under visible and near‐infrared light irradiation and for hydrogen generation under visible light compared to Bi2WO6. The significant improvement photocatalytic activity of the composite could be attributed to its good light absorption, suitable band gap structure, and effective separation of photogenerated electron‐hole pairs of Bi2WO6/Cu1.8Se heterojunction. This work presents an efficient multifunction photocatalyst owning the activity both for water splitting under visible light and for organic contaminants decomposition under visible‐near‐infrared light.
“LEARN”ing what is important to children and young people with intellectual disabilities when they are in hospital
Authors: Oulton K. , Sell D. , Gibson F.
Published: January 2018

Background

The need to review health service provision for children and young people (CYP) with disabilities and their families in the United Kingdom has been expressed in multiple reports: the most consistent message being that services need to be tailored to meet their individual needs. Our aim was to understand the hospital‐related needs and experiences of CYP with intellectual disabilities.

Method

An ethnographic study of a neurosciences ward and outpatient department was conducted within a paediatric tertiary hospital setting.

Results

Five themes, developed using the acronym LEARN, explained what is important to CYP with intellectual disabilities in hospital: (i) little things make the biggest difference, (ii) eliminate unnecessary waiting, (iii) avoid boredom, (iv) routine and home comforts are key and (v) never assume.

Conclusions

It is imperative that the present authors continue to challenge the idea that it is acceptable to exclude CYP with intellectual disabilities from research because of their inability to participate.
Read, write, touch: Co‐construction and multiliteracies in a third‐grade digital writing exercise
Authors: Cordero Kristina , Nussbaum Miguel , Ibaseta Valentina , Otaíza María José , Chiuminatto Pablo
Published: January 2018

Many researchers and educators believe that reading and writing instruction needs to change in order to reflect the multimodal, technological, interactive nature of communication today. To date, few studies have examined how touchscreen devices may influence primary school students' reading and writing practices. Guided by Vygotsky's notion of co‐construction and aspects of the New London Group's multiliteracies framework, we built an original multimodal tablet tool and examined how 51 third graders in Costa Rica used it to co‐construct and design meaning in a reading‐to‐writing activity. The first aim of this study, therefore, is to understand how multimodality and technology can work together to support young people's reading and writing. Secondly, we asked how a specific interactive, touchscreen feature might positively contribute to third graders' writing samples. The key findings were that the tool used in this study encouraged a broad range of writing practices, that the touch feature supported co‐construction, and that the careful integration of touchscreen features can engage and motivate students in reading and writing activities.
Efficacy and safety of sacubitril/valsartan in patients with essential hypertension uncontrolled by olmesartan: A randomized, double‐blind, 8‐week study
Authors: Cheung Deanna G. , Aizenberg Diego , Gorbunov Vladimir , Hafeez Kudsia , Chen Chien‐Wei , Zhang Jack
Published: January 2018

A majority of patients with hypertension fail to achieve blood pressure (BP) control despite treatment with commonly prescribed drugs. This randomized, double‐blind phase III trial assessed the superiority of sacubitril/valsartan 200 mg (97/103 mg) to continued olmesartan 20 mg in reducing ambulatory systolic BP after 8‐week treatment in patients with mild to moderate essential hypertension uncontrolled with olmesartan 20 mg alone. A total of 376 patients were randomized to receive either sacubitril/valsartan (n = 188) or olmesartan (n = 188). Superior reductions in 24‐hour mean ambulatory systolic BP were observed in the sacubitril/valsartan group vs the olmesartan group (−4.3 mm Hg vs −1.1 mm Hg, P < .001). Reductions in 24‐hour mean ambulatory diastolic BP and pulse pressure and office systolic BP and diastolic BP were significantly greater with sacubitril/valsartan vs olmesartan (P < .014). A greater proportion of patients achieved BP control with sacubitril/valsartan vs olmesartan. The overall incidence of adverse events was comparable between the groups. Compared with continued olmesartan, sacubitril/valsartan was more effective and generally safe in patients with hypertension uncontrolled with olmesartan 20 mg.
Britain at the Centre of European Co‐operation (1948–2016)
Authors: Warlouzet Laurent
Published: January 2018

This article will revisit the vision of a Britain based on two supposedly eternal features: the promotion of free‐trade values and a reticence towards European integration. By examining the history of Britain's relationship with the organization of the European continent, it will demonstrate that since the creation of the first European institution in 1948, London has constantly exerted considerable influence on the organization of the European continent. In this regard, Brexit is just another step in a proactive British policy of influencing European co‐operation. Most instances of isolationism were self‐induced, not the result of any sinister Franco‐German plot. In addition, this article will also demonstrate that the UK government has not consistently put forth a free‐trade European policy. UK economic policy has traditionally been based on multiple legacies, including some protectionist tendencies.
The low FODMAP diet in the management of irritable bowel syndrome: an evidence‐based review of FODMAP restriction, reintroduction and personalisation in clinical practice
Authors: Whelan K. , Martin L. D. , Staudacher H. M. , Lomer M. C. E.
Published: January 2018

Dietary restriction of fermentable oligosaccharides, disaccharides, monosaccharides and polyols (FODMAPs) is effective in the management of functional gastrointestinal symptoms that occur in irritable bowel syndrome (IBS). Numerous reviews have been published regarding the evidence for their restriction in the low FODMAP diet; however, few reviews discuss the implementation of the low FODMAP diet in practice. The aim of this review is to provide practical guidance on patient assessment and the implementation and monitoring of the low FODMAP diet. Broadly speaking, the low FODMAP diet consists of three stages: FODMAP restriction; FODMAP reintroduction; and FODMAP personalisation. These stages can be covered in at least two dietetic appointments. The first appointment focuses on confirmation of diagnosis, comprehensive symptom and dietary assessment, detailed description of FODMAPs and their association with symptom induction, followed by counselling regarding FODMAP restriction. Dietary counselling should be tailored to individual needs and appropriate resources provided. At the second appointment, symptoms and diet are re‐assessed and, if restriction has successfully reduced IBS symptoms, education is provided on FODMAP reintroduction to identify foods triggering symptoms. Following this, the patient can follow FODMAP personalisation for which a less restrictive diet is consumed that excludes their personal FODMAP triggers and enables a more diverse dietary intake. This review provides evidence and practice guidance to assist in delivering high‐quality clinical service in relation to the low FODMAP diet.
Urban Metabolism of Bangalore City: A Water Mass Balance Analysis
Authors: Paul Reba , Kenway Steven , McIntosh Brian , Mukheibir Pierre
Published: January 2018

Cities are increasingly depending on energy‐intensive water sources, such as distant rivers and the ocean, to meet their water demand. However, such expensive sources could be avoided using alternative local sources of water such as wastewater, rainwater, and stormwater. Many cities do not have robust accounts of those localized water resources, as estimating those resources requires comprehensive accounting in complex urban water systems. In this article, we investigate whether an urban metabolism evaluation framework built on the urban water mass balance can help analyze these resources, especially in a rapidly growing developing city. We first refined the water mass balance equation developed by Kenway and his colleagues in 2011 for a developing country context with the inclusion of some significant components such as system loss. Then, we applied the refined equation for the first time to Bangalore city in India, a developing country, for the year 2013–2014 as a real case example, which is a rare water mass balance analysis of its kind. The refined equation helped analyze Bangalore's urban water system. The total available wastewater, stormwater, and rainwater were 656 gigaliters (GL). The gap between water demand and supply could be met if 54% of this recycled potential were harnessed. Wastewater had enough potential (362 GL) to replace the whole centralized water supply from the Cauvery. A scenario analysis showed that the gap between water demand and supply in 2021 can be met if 60% of total recycled potential is utilized. This approach can be used to help other cities identify the potential of alternative water sources and support integrated water planning and monitoring water metabolic performance.
Using Difference Scores to Inform Therapy Practice: Differences in Perceptions of Attachment Behaviors between Partners in a Clinical Sample
Authors: Novak Joshua R. , Sandberg Jonathan G. , Busby Dean M.
Published: January 2018

Using clinically relevant research methodology, this study focuses on differences (cross‐partner difference scores) in perceptions of attachment behaviors (emotional accessibility, responsiveness, and engagement) between partners in couples therapy. In general, findings suggest that higher levels of self‐enhancement attachment behaviors (participant perceives self as demonstrating more attachment behaviors than the partner's ratings of the participant) are associated with lower relationship satisfaction and greater relationship instability. The association between attachment behavior difference scores and measures of relationship health is mediated through partner perceived positive communication. These results suggest that differences in perceptions between partners’ level of attachment behaviors are an important clinical construct for therapy. As such, clinical recommendations for addressing self‐enhancing attachment behaviors, and the mediating role of positive communication, are discussed with recommendations for researchers.
A multimodal microcharacterisation of trace‐element zonation and crystallographic orientation in natural cassiterite by combining cathodoluminescence, EBSD, EPMA and contribution of confocal Raman‐in‐SEM imaging
Authors: WILLE G. , LEROUGE C. , SCHMIDT U.
Published: January 2018

In cassiterite, tin is associated with metals (titanium, niobium, tantalum, indium, tungsten, iron, manganese, mercury). Knowledge of mineral chemistry and trace‐element distribution is essential for: the understanding of ore formation, the exploration phase, the feasibility of ore treatment, and disposal/treatment of tailings after the exploitation phase. However, the availability of analytical methods make these characterisations difficult.

We present a multitechnical approach to chemical and structural data that includes scanning electron microscopy (SEM)‐based imaging and microanalysis techniques such as: secondary and backscattered electrons, cathodoluminescence (CL), electron probe microanalyser (EPMA), electron backscattered diffraction (EBSD) and confocal Raman‐imaging integrated in a SEM (RISE). The presented results show the complementarity of the used analytical techniques. SEM, CL, EBSD, EPMA provide information from the interaction of an electron beam with minerals, leading to atomistic information about their composition, whereas RISE, Raman spectroscopy and imaging completes the studies with information about molecular vibrations, which are sensitive to structural modifications of the minerals. The correlation of Raman bands with the presence/absence of Nb, Ta, Fe (heterovalent substitution) and Ti (homovalent substitution) is established at a submicrometric scale. Combination of the different techniques makes it possible to establish a direct link between chemical and crystallographic data of cassiterite.
Morphometric and morphologic parameters of the heart in healthy Alouatta guariba clamitans (Cabrera, 1940)
Authors: Charlier Murilo Gomes de Soutello , Filippi Maurício Gianfrancesco , Girotto Carolina Hagy , Ribeiro Vanessa Lanes , Teixeira Carlos Roberto , Lourenço Maria Lúcia Gomes , Vulcano Luiz Carlos
Published: January 2018

Background

This study aimed at assessing the heart function of one neotropical primate (Alouatta guariba clamitans) kept in captivity using radiography, electrocardiogram (ECG) and Doppler echocardiography.

Methods

Ten adult healthy howler monkeys (A. g. clamitans) were evaluated under general anaesthesia. Vertebral Heart Scores (VHS) were obtained from radiographic studies. Ejection fraction, shortening fraction of left ventricle, left atrial/aortic root ratio, ascending aortic diameter, peak velocity of pulmonary, mitral, tricuspid and aortic blood flow and other values were measured by Doppler echocardiography. Heart rate, mean electrical axis of QRS complex, P, Q, R, S, T amplitude, P, PR interval, QRS, QT interval duration and ST segment unbalancing were measured by ECG.

Results and conclusions

Exam techniques were akin the ones used in humans. Doppler echocardiographic, radiographic, electrocardiographic and clinical parameters for howler monkey were described and correlated. The results have shown profiles of cardiovascular function and structure of A. g. clamitans.
Loss of STI1‐mediated neuronal survival and differentiation in disease‐associated mutations of prion protein
Authors: Landemberger Michele Christine , de Oliveira Gabriela Pintar , Machado Cleiton Fagundes , Gollob Kenneth John , Martins Vilma Regina
Published: January 2018

Cellular prion protein (PrPC) is widely expressed and displays a variety of well‐described functions in the central nervous system (CNS). Mutations of the PRNP gene are known to promote genetic human spongiform encephalopathies, but the components of gain‐ or loss‐of‐function mutations to PrPC remain a matter for debate. Among the proteins described to interact with PrPC is Stress‐inducible protein 1 (STI1), a co‐chaperonin that is secreted from astrocytes and triggers neuroprotection and neuritogenesis through its interaction with PrPC. In this work, we evaluated the impact of different PrPC pathogenic point mutations on signaling pathways induced by the STI1‐PrPC interaction. We found that some of the pathogenic mutations evaluated herein induce partial or total disruption of neuritogenesis and neuroprotection mediated by mitogen‐activated protein kinase (MAPK)/extracellular signal‐regulated kinases 1 and 2 (ERK1/2) and protein kinase A (PKA) signaling triggered by STI1‐PrPC engagement. A pathogenic mutant PrPC that lacked both neuroprotection and neuritogenesis activities fail to promote negative dominance upon wild‐type PrPC. Also, a STI1‐α7‐nicotinic acetylcholine receptor‐dependent cellular signaling was present in a PrPC mutant that maintained both neuroprotection and neuritogenesis activities similar to what has been previously observed by wild‐type PrPC. These results point to a loss‐of‐function mechanism underlying the pathogenicity of PrPC mutations.

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Alterations in mGlu5 receptor expression and function in the striatum in a rat depression model
Authors: Mao Li‐Min , Wang John Q.
Published: January 2018

Major depressive disorder is a common form of mental illness. Many brain regions are implicated in the pathophysiology and symptomatology of depression. Among key brain areas is the striatum that controls reward and mood and is involved in the development of core depression‐like behavior in animal models of depression. While molecular mechanisms in this region underlying depression‐related behavior are poorly understood, the glutamatergic input to the striatum is believed to play a role. In this study, we investigated changes in metabotropic glutamate (mGlu) receptor expression and signaling in the striatum of adult rats in response to prolonged (10–12 weeks) social isolation, a pre‐validated animal paradigm modeling depression in adulthood. We found that mGlu5 receptor protein levels in the striatum were increased in rats that showed typical depression‐ and anxiety‐like behavior after chronic social isolation. This increase in mGlu5 receptor expression was seen in both subdivisions of the striatum, the nucleus accumbens and caudate putamen. At subcellular and subsynaptic levels, mGlu5 receptor expression was elevated in surface membranes at synaptic sites. In striatal neurons, the mGlu5‐associated phosphoinositide signaling pathway was augmented in its efficacy after prolonged social isolation. These data indicate that the mGlu5 receptor is a sensitive substrate of depression. Adulthood social isolation leads to the up‐regulation of mGlu5 receptor expression and function in striatal neurons.

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Effect of Sleep Duration, Diet, and Physical Activity on Obesity and Overweight Elementary School Students in Shanghai
Authors: Zhang Jing , Zhang YunTing , Jiang YanRui , Sun WanQi , Zhu Qi , Ip Patrick , Zhang DongLan , Liu ShiJian , Chen Chang , Chen Jie , Zhang Lei , Zhang Hao , Tang MingYu , Dong WenFang , Wu YuFeng , Yin Yong , Jiang Fan
Published: January 2018

BACKGROUND

This was a cross‐sectional survey to investigate the relationship of age, parent education, sleep duration, physical activity, and dietary habits with overweight or obesity in school‐age children in Shanghai.

METHODS

The survey gathered information from 13,001 children in grades 1 through 5 (age 6 to 10 years) among 26 elementary schools in 7 districts. Activity level was evaluated using the International Children's Leisure Activities Study Survey Questionnaire (CLASS‐C). The definitions of normal, overweight, and obese were adjusted for each age.

RESULTS

Logistic regression analysis indicated that age, being male, having ≤10 hours of sleep on non‐school days, eating ≥1 vegetable/day, or drinking ≥1 sugar‐sweetened drink/day increased the risk for a child being overweight or obese compared with having >10 hours of sleep or ≤3 vegetables or ≤3 sugar‐sweetened drinks/month (p ≤ .008). Having >2 hours of outdoor activities on non‐school days reduced the risk of being overweight or obese compared with ≤2 hours of outdoor activities on non‐school days (p < .001).

CONCLUSIONS

We found that age, sex, sleep, and some dietary habits impacted weight, and suggests that specific cultural and economic factors may impact risk of a child being overweight or obese.
Early Adolescents' Emotional Well‐Being in the Classroom: The Role of Personal and Contextual Assets
Authors: Oberle Eva
Published: January 2018

BACKGROUND

The objective was to predict early adolescents' emotional well‐being from personal and contextual assets in the classroom. Emotional well‐being is a key indicator of health. Aligned with the positive youth development (PYD) framework, a supportive classroom environment and positive relationships with teachers and peers were contextual assets in the present study; positive self‐concept was a personal asset.

METHODS

The sample was 406 grade 4 to 7 public elementary school students from diverse backgrounds (mean = 11.27 years; SD = 0.89; 50% female). Data were self‐, teacher‐, and peer‐reported. Structural equation modeling (SEM) analyses were used to evaluate model fit and identify significant pathways.

RESULTS

SEM indicated a good model fit. Overall, 68% of variability in early adolescents' emotional well‐being was explained. Positive self‐concept directly predicted emotional well‐being. Supportive classroom environment predicted emotional well‐being directly and indirectly through increases in positive social relationships and self‐concept. Positive social relationships predicted well‐being only indirectly through positive self‐concept.

CONCLUSIONS

Contextual and personal assets are central for early adolescents' emotional well‐being. The interrelation among assets needs to be considered when understanding, and ultimately promoting students' emotional well‐being. The present findings extend previous research and inform school‐based intervention and prevention programming and teacher professional development.
Who Eats School Breakfast? Parent Perceptions of School Breakfast in a State With Very Low Participation
Authors: Spruance Lori A. , Harrison Caleb , Brady Patrick , Woolford Marti , LeBlanc Heidi
Published: January 2018

BACKGROUND

Having breakfast is correlated with health and academic benefits; yet, many children do not consume breakfast, and participation in the federal School Breakfast Program remains low. The purpose of this study was to examine parent perceptions of school breakfast and identify relationships between those who consume breakfast at school and those who do not.

METHODS

A random sample of 100 schools, representing 29 school districts, across the state of Utah was selected to participate in the survey. Administrators were asked to distribute an online survey link to the parents of their school. Parents answered questions about their oldest kindergarten through 12th grade child. Qualitative and quantitative analyses were performed.

RESULTS

A total of 488 parents completed the survey. In a multilevel model, child grade level, participation in free and reduced‐price lunch, and perceive benefits to school breakfast were significantly related to eating breakfast at school. Some major themes from the qualitative analysis included no need for school breakfast, perception of regional values, and logistical issues.

CONCLUSIONS

Parent perception of school meals is related to participation. This study identifies several areas of perception that could be address through parent education to increase school breakfast participation.
Increase in motility and invasiveness of MCF7 cancer cells induced by nicotine is abolished by melatonin through inhibition of ERK phosphorylation
Authors: Proietti Sara , Catizone Angela , Masiello Maria Grazia , Dinicola Simona , Fabrizi Gianmarco , Minini Mirko , Ricci Giulia , Verna Roberto , Reiter Russel J. , Cucina Alessandra , Bizzarri Mariano
Published: January 2018

Through activation of the ERK pathway, nicotine, in both normal MCF‐10A and low‐malignant breast cancer cells (MCF7), promotes increased motility and invasiveness. Melatonin antagonizes both these effects by inhibiting almost completely ERK phosphorylation. As melatonin has no effect on nonstimulated cells, it is likely that melatonin can counteract ERK activation only downstream of nicotine‐induced activation. This finding suggests that melatonin hampers ERK phosphorylation presumably by targeting a still unknown intermediate factor that connects nicotine stimulation to ERK phosphorylation. Furthermore, downstream of ERK activation, melatonin significantly reduces fascin and calpain activation while restoring normal vinculin levels. Melatonin also counteracts nicotine effects by reshaping the overall cytoskeleton architecture and abolishing invasive membrane protrusion. In addition, melatonin decreases nicotine‐dependent ROCK1/ROCK2 activation, thus further inhibiting cell contractility and motility. Melatonin actions are most likely attributable to ERK inhibition, although melatonin could display other ERK‐independent effects, namely through a direct modulation of additional molecular and structural factors, including coronin, cofilin, and cytoskeleton components.