bluuebunny/crossref_metadata_2025 huggingface dataset:
Does the 2017 revision improve the ability of GOLD to predict risk of future moderate and severe exacerbation?
Authors: Erol Serhat , Sen Elif , Gizem Kilic Yagmur , Yousif Ahmed , Akkoca Yildiz Oznur , Acican Turan , Saryal Sevgi
Published: June 2018

Introduction

In 2017 update, GOLD separated spirometry from ABCD classification.

Objectives

The aim was to investigate the predictive reliability of GOLD 2017 grading system in terms of future moderate and severe exacerbations.

Methods

COPD patients were classified into A to D groups according to GOLD 2011 and 2017. Patients who were assigned to C/D groups according to GOLD 2011 were divided into subgroups C 1/D1, C2/D2, C3/D3 according to FEV1% of predicted and exacerbation history. C1/D1 patients defined as FEV1 < 50% predicted and without ≥2 exacerbations or hospitalization in the last year.

Results

A total of 225 patients were enrolled. Among them, 25.8% were in groups C1/D1 according to GOLD 2011. These patients shifted to A/B according to GOLD 2017. C1/D1 patients had a significantly higher risk of future moderate and severe exacerbation compared to A/B (P = 0.018). The risk of future moderate and severe exacerbation was significantly higher in patients with a FEV1 < 50% (P = 0.018).The risk of future moderate and severe exacerbation was higher in GOLD 2017 groups A and B compared to GOLD 2011 groups A and B.

Conclusion

Low FEV1 was an important risk factor for future exacerbations. Downstaging of C1/D1 patients caused heterogeneity in A/B with including patients with low and high risk of future exacerbation. This resulted in a low discriminative power of GOLD 2017 regarding the risk of future exacerbation in groups A and B. This may cause underestimation of disease severity and inadequate treatment especially in A/B patients with low FEV1.
Clinical and cytopathological factors affecting the cellularity of urinary cell blocks and the implication for diagnosis and follow‐up of urinary bladder urothelial carcinoma
Authors: Brisuda Antonín , Háček Jaromír , Čechová Marcela , Škapa Petr , Babjuk Marek
Published: June 2018

Objective

The methodology of cell blocks (CBs) has long been an integrated part of cytology. However, there are very few data on CBs derived from urine. Their main disadvantage is a lack of cellularity, which limits their broader clinical applicability. Factors affecting cellular adequacy in urine remain unclear. We assessed the impact of basic clinical and cytopathological factors on the adequacy of cellularity in urinary CBs.

Methods

Freshly voided urine was collected from 401 consecutive individuals. Of these, 167 patients were diagnosed with urothelial carcinoma. The remaining 234 patients had various benign urological conditions. Papanicolaou classes were determined and CBs produced. Cellular adequacy was assigned to each CB (acellular, hypocellular, moderate cellularity, high cellularity), and moderately and highly cellular CBs were considered as adequate. Several factors were analysed to find any correlation with the adequacy of the cellularity.

Results

In univariate analysis, seven factors significantly correlated with the adequacy of the CBs. In the multivariate model, positive sediment (OR = 3.7), female sex (OR = 2.7), positive urinary cytology (OR = 2.6) and positive leucocyturia (OR = 2.1) were independent predictors of adequate cellularity. Positive predictive value and negative predictive value of the model were 65.0% and 77.7%, respectively.

Conclusions

We determined four clinical and cytopathological factors which independently predict adequate cellularity in urinary CBs. Based on these results, several clinical situations have been proposed, in which the highest probability of adequate cellularity in urinary CBs can be achieved.
Willingness to use an in‐hospital supervised inhalation room among people who smoke crack cocaine in Vancouver, Canada
Authors: Cortina Sandra , Kennedy Mary Clare , Dong Huiru , Fairbairn Nadia , Hayashi Kanna , Milloy M‐J , Kerr Thomas
Published: June 2018

Introduction and Aims

People who use illicit drugs (PWUD) often engage in drug use during hospitalisation. Adverse outcomes may arise from efforts to conceal inpatient drug use, especially in hospital settings that rely on abstinence‐based policies. Harm reduction interventions, including supervised drug consumption services, have not been well studied in hospital settings. This study examines factors associated with willingness to use an in‐hospital supervised inhalation room (SIR) among people who smoke crack cocaine in Vancouver, Canada.

Design and Methods

Cross‐sectional data from two open prospective cohorts of PWUD involving people who smoke crack cocaine were collected between June 2013 and May 2014. Multivariable logistic regression analyses were used to identify factors associated with willingness to use an in‐hospital SIR.

Results

Among 539 participants, 320 (59.4%) reported willingness to use an in‐hospital SIR. Independent factors positively associated with willingness included: ever used drugs in hospital [adjusted odds ratio (AOR) = 1.89], and daily non‐injection crack use (AOR = 1.63). Difficulty accessing new crack pipes (AOR = 0.51) was negatively associated with willingness (all P < 0.05). The most commonly reported reasons for willingness were to: remain in hospital (50.6%), reduce drug‐related risks (25.6%) and reduce the stress of hospital discharge for using drugs (24.7%).

Discussion and Conclusions

A high proportion of people who smoke crack cocaine reported willingness to use an in‐hospital SIR, and those willing were more likely to report heavy drug use and previous in‐hospital use. These findings highlight the potential utility of SIRs to complement existing in‐hospital services for PWUD.
Vertikale Übertragung des Herpes‐simplex‐Virus: eine Aktualisierung
Authors: Bhatta Anil Kumar , Keyal Uma , Liu Yeqiang , Gellen Emese
Published: June 2018

Infektionen mit den Herpes‐simplex‐Viren (HSV)‐1 und ‐2 haben weltweit eine hohe Prävalenz. Eine HSV‐Infektion während der Schwangerschaft kann eine neonatale Herpes‐Infektion verursachen, die durch eine lebenslange Infektion mit Latenz‐ und Reaktivierungsperioden gekennzeichnet ist. Ein Säugling kann sich in utero (5 %), peripartal (85 %) oder postnatal (10 %) mit dem HS‐Virus infizieren. Herpes neonatorum ist eine seltene aber bedeutsame Infektion, die mit schwerer Morbidität und Mortalität assoziiert sein kann, insbesondere bei Dissemination oder Beteiligung des zentralen Nervensystems. Fortschritte bei Diagnose und Therapie haben zur Verringerung der Mortalität sowie, in geringerem Ausmaß, zu einem verbesserten neurologischen Outcome geführt. Dennoch sind weitere Verbesserungen wünschenswert. Dabei ist es entscheidend, Ärzte in die Lage zu versetzen, diejenigen Säuglinge, die einem erhöhten Risiko einer HSV‐Infektion ausgesetzt sind, zu erkennen und die Mutter‐Kind‐Übertragung effektiver zu verhindern. Ein lohnendes Ziel für die Zukunft ist die Entwicklung neuer antiviraler Wirkstoffe mit höherer Wirksamkeit.
Was ist Schuppenflechte? – Wahrnehmung und Bewertung der Psoriasis in der deutschen Bevölkerung
Authors: Sommer Rachel , Mrowietz Ulrich , Radtke Marc Alexander , Schäfer Ines , von Kiedrowski Ralph , Strömer Klaus , Enk Alexander , Maul Julia‐Tatjana , Reich Kristian , Zander Nicole , Augustin Matthias
Published: June 2018

Hintergrund

Die Versorgung der Psoriasis vulgaris nimmt in der Dermatologie einen wichtigen Stellenwert ein. Im Zuge der WHO‐Resolution 2014 und des WHO Global Reports 2016 hat die öffentliche Aufmerksamkeit für die Psoriasis zugenommen. Unklar ist, wie Psoriasis in der Allgemeinbevölkerung wahrgenommen wird. Ziel ist die Erfassung der Wahrnehmung und Bewertung von Psoriasis in der Bevölkerung.

Patienten und Methoden

Repräsentative Telefonumfrage mit 2001 Erwachsenen mittels eines standardisierten Fragebogens. Die Auswertungen erfolgten deskriptiv nach Region, Alter, Geschlecht und Bildungsstatus.

Ergebnisse

Die Begriffe Psoriasis bzw. Schuppenflechte waren 29 % bzw. 86 % der Befragten, bekannt. 93 % schätzten die Krankheit als sehr belastend für die Betroffenen ein, 59 % nahmen an, dass es wirksame Medikamente gegen Schuppenflechte gibt und 9 % hielten diese Erkrankung für ansteckend. 10 % würden nicht mit einer betroffenen Person im Haushalt leben wollen, 23 % nicht mit Betroffenen ins Schwimmbad gehen und 27 % nicht in einer Partnerschaft sein. 12 % gaben an, die WHO‐Resolution zur Psoriasis zu kennen, 6 % den Weltpsoriasistag und 3 % die Kampagne „Bitte berühren“.

Schlussfolgerungen

Wenngleich einer Mehrheit in der deutschen Bevölkerung die Schuppenflechte bekannt ist, bestehen deutliche Wissensdefizite und teilweise Vorurteile gegenüber dieser Erkrankung. Weitergehende Maßnahmen zur besseren Information und zur Minderung der Stigmatisierung sind notwendig.
Tumoren der Kopfhaut
Authors: Prodinger Christine Maria , Koller Josef , Laimer Martin
Published: June 2018

Kopfhauttumoren zeigen ein beeindruckend breites, heterogenes Entitätsspektrum und nicht selten relevante lokalisationsbezogene Eigenheiten im Vergleich zu ihren Pendants am restlichen Integument. Wiewohl großenteils benigner Natur, können erschwerte Einsehbarkeit und verzögerte Wahrnehmung, lokale anatomische Verhältnisse, verstärkte Exposition gegenüber (exogenen) Noxen, distinkte histomorphologische Muster wie auch das häufig vorgeschrittene Alter der Betroffenen die Behandlung zu einer diagnostischen und therapeutischen Herausforderung werden lassen. Letztes gilt umso mehr für die seltenen bösartigen Tumoren an der Kopfhaut mit häufig schlechter Prognose. Interdisziplinär akkordierte Behandlungsstrategien sind deshalb von besonderer kontextualer Relevanz. Vor diesem komplexen Hintergrund werden allgemeine Prinzipien und relevante Spezifika der wichtigsten Kopfhauttumoren dargestellt.
Identification and functional analysis of inflammation‐related miRNAs in skin wound repair
Authors: Mori Ryoichi , Tanaka Katsuya , Shimokawa Isao
Published: June 2018

Inflammation at a wound site is essential for preventing infection. However, misregulated inflammation leads to pathologies of the healing process, including chronic non‐healing wounds and scarring. MicroRNAs (miRNAs) are key regulators of the inflammatory response and tissue repair, acting by translational processing of target mRNAs. In the final step of miRNA processing, Argonaute 2 (Ago2)‐bound mature miRNA complexes bind to target mRNAs and inhibit their translation. A variety of wound healing‐related miRNAs have been identified and their misregulation likely contributes to wound pathologies, including scarring and chronic healing. Recently, we have developed an Ago2‐bound mature miRNA purification system that uses Ago2 antibody to analyze the expression of miRNAs from wound tissues by microarray and next generation sequencing. We have identified several wound inflammation‐related miRNAs via Ago2‐target immunoprecipitation assays and next generation sequencing of wound tissues from wild‐type and PU.1 knockout mice, which exhibit no inflammatory response because of a lack of immune cell lineages. We demonstrated that miR‐142, an identified inflammation‐related miRNA, is essential role for neutrophilic chemotaxis via inhibition of small GTPase translation; its misregulation leads to susceptibility to infection against Staphylococcus aureus at skin wound sites. In this review, we summarize recent advances of miRNA studies in skin wound healing, introduce our miRNA purification system using an immunoprecipitation assay method, and discuss the function of miR‐142 in skin wound healing.
Attention to faces in social context in children with neurofibromatosis type 1
Authors: Lewis Amelia K , Porter Melanie A , Williams Tracey A , Bzishvili Samantha , North Kathryn N , Payne Jonathan M
Published: June 2018

Aim

To examine visual attention to faces within social scenes in children with neurofibromatosis type 1 (NF1) and typically developing peers.

Method

Using eye‐tracking technology we investigated the time taken to fixate on a face and the percentage of time spent attending to faces relative to the rest of the screen within social scenes in 24 children with NF1 (17 females, seven males; mean age 10y 4mo [SD 1y 9mo]). Results were compared with those of 24 age‐matched typically developing controls (11 females, 13 males; mean age 10y 3mo [SD 2y]).

Results

There was no significant between‐group differences in time taken to initially fixate on a face (p=0.617); however, children with NF1 spent less time attending to faces within scenes than controls (p=0.048). Decreased attention to faces was associated with elevated autism traits in children with NF1.

Interpretation

Children with NF1 spend less time attending to faces than typically developing children when presented in social scenes. Our findings contribute to a growing body of literature suggesting that abnormal face processing is a key aspect of the social‐cognitive phenotype of NF1 and appears to be related to autism spectrum disorder traits. Clinicians should consider the impact of reduced attention to faces when designing and implementing treatment programmes for social dysfunction in this population.

What this paper adds

Children with neurofibromatosis type 1 (NF1) demonstrated atypical gaze behaviour when attending to faces.

NF1 gaze behaviour was characterized by normal initial fixation on faces but shorter face dwell time.

Decreased attention to faces was associated with elevated autism traits in the sample with NF1.
Does reason for referral to an ultra‐high risk clinic predict transition to psychosis?
Authors: Rice Simon , Polari Andrea , Thompson Andrew , Hartmann Jessica , McGorry Patrick , Nelson Barnaby
Published: June 2018

Aim

To examine reasons for referral to a specialist ultra‐high risk (UHR) for psychosis clinic and whether these reasons are associated with risk for subsequent transition to psychosis.

Methods

Data for 127 patients referred to the Personal Assessment and Crisis Evaluation clinic were collected by medical record audit. Time to transition to psychosis was calculated from date of referral to time at which the young person was judged by their treating team to be experiencing onset of first episode psychosis.

Results

Patients were primarily referred due to attenuated psychotic symptoms and depression (40.2%). There was an association with transition, with those in the attenuated psychotic‐symptom‐only category being more likely to transition.

Conclusion

As well as attenuated psychotic symptoms, depression and anxiety were also important reasons for referral indicating that there is a broad clinical phenotype of young people presenting to UHR clinics. Clinical reason for referral may index level of risk for subsequent transition to psychosis.
Making Risk Management Strategic: Integrating Enterprise Risk Management with Strategic Planning
Authors: Sax Johanna , Andersen Torben Juul
Published: June 2018

Enterprise risk management (ERM) is an established management practice and is increasing in prominence as more firms spend substantial resources implementing ERM frameworks, partially induced by regulatory requirements. Yet, there is a lack of knowledge as to whether such frameworks add value and, if so, how the performance enhancing dynamic works. Drawing on survey data from 260 of the largest firms in Denmark, this study analyzes these empirical questions and finds that ERM is associated with higher profitability and lower financial leverage, and that strategic planning enforces these favorable outcomes. The study develops a new multidimensional measure of adherence to ERM practices where earlier studies typically have relied on dichotomous proxies. We discuss the implications of these findings for ERM practice and strategic management in general.
Abseiling From The Shard: The Cognitive Foundations Of Capability Development In Temporary Organizations
Authors: Ford Chris J. , Friesl Martin
Published: June 2018

This paper focuses on capability development in temporary organizations. Prior research in such organizations problematizes but does not explicitly address the cognitive foundations of capability development, particularly with regard to actors’ interpretation of organizational purpose, resources and capabilities. Drawing on the recent advances in research on the micro‐foundations of capability development, we present an in‐depth, longitudinal study of the run up to a large‐scale fundraising event. We propose a process model of capability development in temporary organizations that delineates how managerial cognition affects the accumulation of resources as well as the eventual assembly of organization level capabilities. This process model complements existing research on capability development in temporary organizations and provides new insights into the evolution of temporary organizations over time.
A suitable boy? Gendered roles and hierarchies in family business succession
Authors: Byrne Janice , Fattoum Salma , Thébaud Sarah
Published: June 2018

Given the importance of family business to economies and societies, the persistence of gender inequality in succession requires further exploration. While gender theorizing has penetrated mainstream management theorizing, its application in family business literature remains underdeveloped: extant research conceptualizes gender as an objective property of individuals, synonymous with biological sex. In this paper, we adopt a social constructionist approach and study four cases of family business succession, revealing significant insights into how gender structures successor selection. We show how gender dynamics are more complicated than a binary view focused on gender category would imply. Specifically, we identify how family members, through discourses and interactions, socially construct the successor role, and how this gendered construction of the role frames a hierarchy of potential successors. This hierarchy is based on the combination of gender category and the extent to which an individual's traits and characteristics are perceived to align with that role.
Detection of convulsive seizures using surface electromyography
Authors: Beniczky Sándor , Conradsen Isa , Wolf Peter
Published: June 2018

Bilateral (generalized) tonic–clonic seizures (TCS) increase the risk of sudden unexpected death in epilepsy (SUDEP), especially when patients are unattended. In sleep, TCS often remain unnoticed, which can result in suboptimal treatment decisions. There is a need for automated detection of these major epileptic seizures, using wearable devices. Quantitative surface electromyography (EMG) changes are specific for TCS and characterized by a dynamic evolution of low‐ and high‐frequency signal components. Algorithms targeting increase in high‐frequency EMG signals constitute biomarkers of TCS; they can be used both for seizure detection and for differentiating TCS from convulsive nonepileptic seizures. Two large‐scale, blinded, prospective studies demonstrated the accuracy of wearable EMG devices for detecting TCS with high sensitivity (76%‐100%). The rate of false alarms (0.7‐2.5/24 h) needs further improvement. This article summarizes the pathophysiology of muscle activation during convulsive seizures and reviews the published evidence on the accuracy of EMG‐based seizure detection.
Seizure detection using scalp‐EEG
Authors: Baumgartner Christoph , Koren Johannes P.
Published: June 2018

Scalp electroencephalography (EEG)–based seizure‐detection algorithms applied in a clinical setting should detect a broad range of different seizures with high sensitivity and selectivity and should be easy to use with identical parameter settings for all patients. Available algorithms provide sensitivities between 75% and 90%. EEG seizure patterns with short duration, low amplitude, circumscribed focal activity, high frequency, and unusual morphology as well as EEG seizure patterns obscured by artifacts are generally difficult to detect. Therefore, detection algorithms generally perform worse on seizures of extratemporal origin as compared to those of temporal lobe origin. Specificity (false‐positive alarms) varies between 0.1 and 5 per hour. Low false‐positive alarm rates are of critical importance for acceptance of algorithms in a clinical setting. Reasons for false‐positive alarms include physiological and pathological interictal EEG activities as well as various artifacts. To achieve a stable, reproducible performance (especially concerning specificity), algorithms need to be tested and validated on a large amount of EEG data comprising a complete temporal assessment of all interictal EEG. Patient‐specific algorithms can further improve sensitivity and specificity but need parameter adjustments and training for individual patients. Seizure alarm systems need to provide on‐line calculation with short detection delays in the order of few seconds. Scalp‐EEG–based seizure detection systems can be helpful in an everyday clinical setting in the epilepsy monitoring unit, but at the current stage cannot replace continuous supervision of patients and complete visual review of the acquired data by specially trained personnel. In an outpatient setting, application of scalp‐EEG–based seizure‐detection systems is limited because patients won't tolerate wearing widespread EEG electrode arrays for long periods in everyday life. Recently developed subcutaneous EEG electrodes may offer a solution in this respect.
Heart rate variability in epilepsy: A potential biomarker of sudden unexpected death in epilepsy risk
Authors: Myers Kenneth A. , Bello‐Espinosa Luis E. , Symonds Joseph D. , Zuberi Sameer M. , Clegg Robin , Sadleir Lynette G. , Buchhalter Jeffrey , Scheffer Ingrid E.
Published: June 2018

Objective

Sudden unexpected death in epilepsy (SUDEP) is a tragic and devastating event for which the underlying pathophysiology remains poorly understood; this study investigated whether abnormalities in heart rate variability (HRV) are linked to SUDEP in patients with epilepsy due to mutations in sodium channel (SCN) genes.

Methods

We retrospectively evaluated HRV in epilepsy patients using electroencephalographic studies to study the potential contribution of autonomic dysregulation to SUDEP risk. We extracted HRV data, in wakefulness and sleep, from 80 patients with drug‐resistant epilepsy, including 40 patients with mutations in SCN genes and 40 control patients with non‐SCN drug‐resistant epilepsy. From the SCN group, 10 patients had died of SUDEP. We compared HRV between SUDEP and non‐SUDEP groups, specifically studying awake HRV and sleep:awake HRV ratios.

Results

The SUDEP patients had the most severe autonomic dysregulation, showing lower awake HRV and either extremely high or extremely low ratios of sleep‐to‐awake HRV in a subgroup analysis. A secondary analysis comparing the SCN and non‐SCN groups indicated that autonomic dysfunction was slightly worse in the SCN epilepsy group.

Significance

These findings suggest that autonomic dysfunction is associated with SUDEP risk in patients with epilepsy due to sodium channel mutations. The relationship of HRV to SUDEP merits further study; HRV may eventually have potential as a biomarker of SUDEP risk, which would allow for more informed counseling of patients and families, and also serve as a useful outcome measure for research aimed at developing therapies and interventions to reduce SUDEP risk.
Modelling a smart environment for nonintrusive analysis of attention in the workplace
Authors: Durães Dalila , Carneiro Davide , Bajo Javier , Novais Paulo
Published: June 2018

Nowadays, the world is getting increasingly competitive and the quality and the amount of the work presented are one of the decisive factors when choosing an employee. It is no longer necessary to only perform but, to achieve a product with quality, on time, at the lowest possible cost and with the minimum resources. For this reason, the employee must have a high score of attention when performing a task, and the factors that influence attention negatively must be reduced. This is true in many different domains, from the workplace to the classroom. In this paper, we present a nonintrusive smart environment for monitoring people's attention when working in teams. The presented system provides real time information about each individual and information about the team. It can be very useful for team managers to identify potentially distracting events or individuals because when the attention of an individual is not at its best when performing the proposed task, her/his performance will be negatively affected, with consequences for the individual and for the organization.
Crack tip plastic zone evolution during an overload cycle and the contribution of plasticity‐induced shielding to crack growth rate changes
Authors: Vasco‐Olmo J.M. , Díaz F.A. , James M.N. , Yang B.
Published: June 2018

This work explores the contribution to crack growth rate acceleration and deceleration that arises from plasticity‐induced shielding during an overload cycle. The CJP model of crack tip displacements and stress fields was proposed to better capture the influences on the applied elastic stress field of the plastic enclave that is generated around a growing fatigue crack. The model does this through a set of elastic stresses applied at a notional elastic‐plastic boundary, and it has been shown to accurately model plastic zone shape and size, whilst its ability to predict the effective range of stress intensity factor during a fatigue cycle has been independently verified. In this paper, the CJP model is used to follow plastic zone size and shape through an overload fatigue cycle and to assess the extent that plasticity‐induced shielding accounts for the observed crack growth changes. The changes in effective stress intensity factor range during the overload demonstrate that the observed growth rate changes during overload cycles can only be partially rationalised through plasticity‐induced shielding (closure).
Fatigue life prediction of notched specimen for ultrahigh‐strength steel TM210A
Authors: Yin G.Q. , Ji X.H. , Kang X. , Zhao G.P.
Published: June 2018

The effective stress model of the fatigue life prediction for notched components based on smooth specimens is presented. The model used surface area elements in the high‐stress region surrounding the root of a notch. The weakest link theory incorporating the stress field intensity model was used in this approach. The effects of stress gradient and component size were considered. A constant amplitude rotating bending fatigue experiment was performed at room temperature at stress ratio R = −1 for smooth and notched specimens of the ultrahigh‐strength steel TM210A. The proposed prediction method was checked against the experimental results of the TM210A notched specimens. Prediction results of 50% survival rate were all within a factor of 2 scatter band of the experimental results.
The effect of Helicobacter pylori eradication on functional dyspepsia in Turkish children
Authors: Ünlüsoy Aksu Aysel , Yılmaz Güldal , Eğritaş Gürkan Ödül , Sarı Sinan , Dalgıç Buket
Published: June 2018

Background

The aim of this study was to evaluate the effect of Helicobacter pylori (H. pylori) eradication on dyspepsia symptom scores in children with functional dyspepsia (FD).

Materials and Methods

One hundred and fifty functional dyspeptic children (ages 8‐18 years, mean: 13.3 ± 2.84 years; 30% male) were enrolled to this prospective study. Upper gastrointestinal endoscopy was performed on all patients, and the samples from the gastric antrum and corpus were obtained for the existence of H. pylori. 13Carbon‐urea breath test was performed to evaluate the eradication therapy's efficacy. The symptoms were assessed at first visit and at the 8th week and 16th week.

Results

Forty‐nine (33%) children were in the H. pylori‐positive group, and 101 (67%) children were in the H. pylori‐negative group. Dyspepsia symptom scores improved at 8th week in both groups (P < .05). Helicobacter pylori was eradicated in 30 patients (61%), while in the H. pylori‐eradicated group, all dyspepsia symptoms' scores decreased, and in the H. pylori‐uneradicated group, only three symptoms' scores decreased. Symptom scores were lower in H. pylori‐eradicated group than H. pylori‐uneradicated group.

Conclusions

Although the tests used for the diagnosis of H. pylori in functional dyspeptic patients increased the cost of health care, the dyspepsia symptom scores decreased with the eradication therapy in a high prevalence community. The findings may differ in low prevalence communities where the diagnostic tests for H. pylori infection are not recommended in children in the absence of alarm signs or symptoms.
Epistemic lenses and virtues, beyond evidence‐based medicine
Authors: Murphy Mark E.
Published: June 2018

This editorial is based on the keynote by Dr Mark Murphy, Department of General Practice, Royal College of Surgeons, Ireland, at the Health Libraries Group conference, Keele University on 13–15 June 2018. https://bit.ly/2rubsIR#HLG2018
Refugee Hospitality in Lebanon and Turkey. On Making ‘The Other’
Authors: Carpi Estella , Pınar Şenoğuz H.
Published: June 2018

This paper examines the hospitality provided to Syrian refugees during the refugee crisis spanning from 2011 to 2016 in the border areas of Gaziantep (southeastern Turkey) and the Akkar region (northern Lebanon). Hospitality, apart from a cultural value and societal response to the protracted refugee influx, is a discursive strategy of socio‐spatial control used by humanitarian agencies, local and national authorities. This paper, first, argues against hospitality as an assessment to ethically compare host countries (i.e. more welcoming versus less welcoming states). Second, drawing on Walters’ notion of “humanitarian border”, it shows how the governmental, humanitarian, and everyday workings of hospitality exercise an assertive politics of sovereignty over the social encounter between locals and refugees. We examine the state‐centered hospitality in the Turkish case and a humanitarian‐promoted hospitality in the Lebanese case. We also show how the hospitality discourse shapes the spaces that refugees, citizens, and earlier migrants partake in.
How do mental health services respond when child abuse or neglect become known? A literature review
Authors: Read John , Harper David , Tucker Ian , Kennedy Angela
Published: June 2018

Child abuse and neglect are strongly associated with many subsequent mental health problems. This review summarizes the research on how adult mental health services respond when child abuse or neglect become known. MEDLINE, PsycINFO, and Scopus were searched for studies with rates of responding in various ways to child abuse and neglect by mental health professionals. Thirteen studies were identified: seven case note reviews, three surveys of staff, and three sets of interviews with service users. Rates of inclusion of abuse or neglect in treatment plans ranged from 12% to 44%. Rates of referral to abuse‐related therapy ranged from 8% to 23%. Rates were lower for neglect than for abuse and were also lower for men and people with a diagnosis of psychosis. Two per cent or less of all cases were referred to legal authorities. The studies varied in focus and methodology, but all indicated inadequate clinical practice. The rates of abused or neglected people referred for therapy are actually lower than indicated by this review because most users of adult mental health services are not asked about abuse or neglect in the first place. The barriers to good practice, and the need for trauma‐informed services, are discussed.
Change of sensing vector in the subcutaneous ICD during follow‐up and after device replacement
Authors: Bettin Markus , Rath Benjamin , Ellermann Christian , Leitz Patrick , Bögeholz Nils , Reinke Florian , Köbe Julia , Eckardt Lars , Frommeyer Gerrit
Published: June 2018

Background

The subcutaneous implantable cardioverter defibrillator (S‐ICD) has been established as a valuable alternative to transvenous ICD for prevention of sudden cardiac death. The system automatically chooses the optimal sensing vector. However, during follow‐up and especially after device replacement we observed a change of the suggested sensing vector in automatic setup. Therefore, we analyzed frequency and reasons of vector change and its impact on inappropriate shocks (IAS).

Material and methods

Between June 2010 and December 2017, a total of 216 patients with S‐ICD® were included in this analysis. In all patients sensing vectors at the time of implantation, during follow‐up, and after device replacement were investigated. Median follow‐up time was 27.3 ± 25.3 months.

Results

A change of the initial vector was seen in 77 patients (35.7%). The most frequent reason for vector change was the postoperative setup in supine and erect position in 54 patients (70.1%). In 12 patients (15.5%), the vector was manually changed due to inappropriate sensing and/or therapies. Routine setup during follow‐up led to automatic vector change in 10 cases (13.0%). In only 1 patient the vector was manually changed due to oversensing in an exercise treadmill test. In 27 patients, the device was replaced due to battery depletion and in 6 of these patients the sensing vector was changed by the automatic setup. Vector change did not have an impact for inappropriate therapies in the follow‐up; only 1 patient received an IAS due to an inadvertent vector change after device replacement.

Conclusion

In the present study, a significant number of S‐ICD® patients had a manual or automatic vector change during follow‐up and after device replacement. The study underlines the importance of a thoroughly performed screening and at least two valuable sensing vectors preimplant. Further studies are needed to evaluate the necessity of a routine automatic setup during follow‐up.
Alcohol‐mediated miR‐34a modulates hepatocyte growth and apoptosis
Authors: Iwagami Yoshifumi , Zou Jing , Zhang Hongyu , Cao Kevin , Ji Chengcheng , Kim Miran , Huang Chiung‐Kuei
Published: June 2018

MicroRNAs (miRs) have been recently shown to be heavily involved in the development of alcoholic liver disease (ALD) and suggested as a potential therapeutic target in ALD. The miR‐34a was consistently reported to be significantly elevated in several ALD rodent models, but it remains unclear how miR‐34a modulates the cellular behaviours of hepatocytes in ALD development and progression. This study aims to characterize alcohol‐induced miR‐34a impact on hepatocytes growth and apoptosis. The miRNA array was performed to assess changes in miRNA after chronic alcohol feeding. Liver and blood samples were used to examine ALD progression. The miR‐34a was overexpressed in human hepatocytes to evaluate its impact on cell growth and apoptosis. Real‐time quantitative PCR and Western blot were used to determine the growth and apoptosis molecular signalling pathways associated with miR‐34a. Alcohol feeding significantly promoted fatty liver progression, serum ALT levels, apoptosis and miR‐34a expression in rat liver. Overexpression of miR‐34a in human hepatocytes suppressed cell growth signallings, including c‐Met, cyclin D1 and cyclin‐dependent kinase 6 (CDK6). The miR‐34a might also inhibit the expression of sirtuin 1 (Sirt1) and its target, B‐cell lymphoma 2. Interestingly, the expression of miR‐34a reverses the suppressive effects of ethanol on cell growth. But, miR‐34a promotes hepatocyte senescence and apoptosis. Although the miR‐34a‐mediated down‐regulation of cell growth‐associated genes may contribute to cell growth retardation, other miR‐34a targets, such as Sirt1, may reverse this phenotype. Future studies will be needed to clarify the role of miR‐34a in ALD progression.
Phenotypic selection on growth rhythm in whitebark pine under climatic conditions warmer than seed origins
Authors: Warwell Marcus V. , Shaw Ruth G.
Published: June 2018

Growth rhythm that is well synchronized with seasonal changes in local climatic conditions is understood to enhance fitness; however, rapid ongoing climate change threatens to disrupt this synchrony. To evaluate phenotypic selection on growth rhythm under expected warmer and drier future climate, seedlings from 49 populations of whitebark pine (Pinus albicaulis Engelm.) were grown and measured over more than 10 years in two common garden field experiments on sites that approximate the projected future climate of the seed origins. Selection on growth rhythm was assessed by relating individual plant fitness to timing and rate of shoot elongation. Differential survival clearly evidenced selection on growth rhythm. We detected directional and stabilizing selection that varied in magnitude between experimental sites and among years. The observed phenotypic selection supports the interpretation of clinal variation among populations within tree species as reflecting adaptive variation in response to past natural selection mediated by climate. To the extent that growth rhythm is heritable, results of the present study suggest evolution of whitebark pine toward a more distinct timing of shoot elongation and generally more rapid elongation in the immediate next generation under ongoing climate change in environments similar to the study sites.
Prolonged (>100 Ma) ultrahigh temperature metamorphism in the Napier Complex, East Antarctica: A petrochronological investigation of Earth's hottest crust
Authors: Clark Chris , Taylor Richard J. M. , Kylander‐Clark Andrew R. C. , Hacker Bradley R.
Published: June 2018

The Napier Complex in East Antarctica preserves a record of ultrahigh temperature (UHT) metamorphism during the late Archean to early Palaeoproterozoic. While there is little argument that the UHT metamorphic event began at c. 2,580 Ma, the duration over which the rocks resided at UHT has been the subject of intense debate, with estimates for the end of metamorphism ranging from 2,545 to 2,440 Ma—a discrepancy of some 105 Ma. To resolve the time‐scale of UHT metamorphism, a zircon and garnet petrochronological (U–Pb, REE and Ti) data set from a suite of rocks from the Tula Mountains region of the Napier Complex was analysed. Individual concordant populations define zircon U–Pb ages for (a) reset zircon cores of 2,502–2,439 Ma; (b) zircon rims of 2,491–2,454 Ma; and (c) neocrystallized sector‐zoned zircon from 2,492 to 2,443 Ma. Ti‐in‐zircon thermometry places a minimum estimate of 830°C for zircon crystallization, with the majority of concordant populations yielding temperatures >900°C. Zircon–garnet partitioning (DYb vs. DYb/Gd) arrays reveal that the bulk of metamorphic zircon defines an equilibrium relationship with the garnet that forms part of the peak assemblage. Combined with existing geochronological constraints, the new petrochronological data demonstrate that the Napier Complex remained at UHT from c. 2,585 Ma until at least 2,450 Ma, a residence time of 135 Ma. In the absence of evidence for contemporaneous emplacement of large volumes of igneous rocks, a number of factors likely combined to drive and maintain these extreme temperatures. We propose that the P–T conditions experienced by the Napier Complex were achieved through a combination of orogenic plateau formation, preconditioning of the crust by a high‐T magmatic and UHT metamorphic event at c. 2,850 Ma, inefficient removal of heat‐producing elements during partial melting and slow exhumation. This style of long duration, regional, extreme metamorphism is becoming more commonly identified in the rock record as larger and more robust data sets are collected (e.g. the Eastern Ghats of India and the Gondwanan East African Orogen) and is commonly associated with the amalgamation phases of supercontinents/cratons.
Maternal Confidence for Physiologic Childbirth: A Concept Analysis
Authors: Neerland Carrie E.
Published: June 2018

Introduction

Confidence is a term often used in research literature and consumer media in relation to birth, but maternal confidence has not been clearly defined, especially as it relates to physiologic labor and birth. The aim of this concept analysis was to define maternal confidence in the context of physiologic labor and childbirth.

Methods

Rodgers’ evolutionary method was used to identify attributes, antecedents, and consequences of maternal confidence for physiologic birth. Databases searched included Ovid MEDLINE, CINAHL, PsycINFO, and Sociological Abstracts from the years 1995 to 2015. A total of 505 articles were retrieved, using the search terms pregnancy, obstetric care, prenatal care, and self‐efficacy and the keyword confidence. Articles were identified for in‐depth review and inclusion based on whether the term confidence was used or assessed in relationship to labor and/or birth. In addition, a hand search of the reference lists of the selected articles was performed. Twenty‐four articles were reviewed in this concept analysis.

Results

We define maternal confidence for physiologic birth as a woman's belief that physiologic birth can be achieved, based on her view of birth as a normal process and her belief in her body's innate ability to birth, which is supported by social support, knowledge, and information founded on a trusted relationship with a maternity care provider in an environment where the woman feels safe.

Discussion

This concept analysis advances the concept of maternal confidence for physiologic birth and provides new insight into how women's confidence for physiologic birth might be enhanced during the prenatal period. Further investigation of confidence for physiologic birth across different cultures is needed to identify cultural differences in constructions of the concept.
Caspase 1 activity influences juvenile Batten disease (CLN3) pathogenesis
Authors: Burkovetskaya Maria , Bosch Megan E. , Karpuk Nikolay , Fallet Rachel , Kielian Tammy
Published: June 2018

Juvenile Neuronal Ceroid Lipofuscinosis (JNCL) is an autosomal recessive lysosomal storage disease caused by loss‐of‐function mutations in CLN3. Symptoms appear between 5 and 10 years of age, beginning with blindness and seizures, followed by progressive cognitive and motor decline, and premature death. Glial activation and impaired neuronal activity are early signs of pathology in the Cln3Δex7/8 mouse model of JNCL, whereas neuron death occurs much later in the disease process. We previously reported that Cln3Δex7/8 microglia are primed toward a pro‐inflammatory phenotype typified by exaggerated caspase 1 inflammasome activation and here we extend those findings to demonstrate heightened caspase activity in the Cln3Δex7/8 mouse brain. Based on the ability of caspase 1 to cleave a large number of substrates that have been implicated in JNCL pathology, we examined the functional implications of caspase 1 inflammasome activity by crossing Cln3Δex7/8 and caspase 1‐deficient mice to create Cln3Δex7/8/Casp‐1−/− animals. Caspase 1 deletion influenced motor behavior deficits and astrocyte activation in the context of CLN3 mutation, since both were significantly reversed in Cln3Δex7/8/Casp‐1−/− mice, with phenotypes approaching that of wild‐type animals. We also report a progressive age‐dependent reduction in whisker length in Cln3Δex7/8 mice that was partially caspase 1‐dependent. However, not all CLN3 phenotypes were reversed following caspase 1 deletion, since no significant differences in lysosomal accumulation or microglial activation were observed between Cln3Δex7/8 and Cln3Δex7/8/Casp‐1−/− mice. Although the molecular targets of aberrant caspase 1 activity in the context of CLN3 mutation remain to be identified, our studies suggest that caspase 1 may represent a potential therapeutic target to mitigate some attributes of CLN3 disease.

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This article is part of the Special Issue “Lysosomal Storage Disorders”.
The Relationship of Frailty and Hospitalization Among Older People: Evidence From a Meta‐Analysis
Authors: Chang Shu‐Fang , Lin Hsiang‐Chun , Cheng Chih‐Ling
Published: June 2018

Objectives

This research explored the relationship between the stages of frailty and risk for hospitalization in older adults and evaluated the risk for hospitalization among the elderly in relation to various frailty assessment indexes.

Methods

A systematic literature review and meta‐analysis were carried out. A total of 32,998 older people, 8,666 of whom were hospitalized, were included in this study. Two of the researchers independently collected and reviewed the literature. The key search terms used were “frailty” or “frail,” “hospitalization,” and “older people” or “older” or “geriatric” or “senior.” Data were recorded from January 2001 to July 2016. The Preferred Reporting Items for Systematic Reviews and Meta‐Analyses (PRISMA) guidelines were adopted for quality assessment. A systematic search was carried out using Embase and Scopus to analyze the collected literature.

Findings

A meta‐analysis was conducted on eight studies that discussed the relationship between frailty and hospitalization risk in older adults 65 years of age or older. The results showed that frail older people exhibited the highest risk for hospitalization, following by prefrail and robust older people. Next, different frailty assessment indicators were used to predict the risk for hospitalization among older people. All of these indexes also showed that older persons with frailty had the highest risk for hospitalization, followed by prefrail older people.

Conclusions

Frailty is a vital issue in geriatric care and is a crucial factor in the hospitalization of older people. Frail older people were at the highest risk for hospitalization, following by prefrail and robust older people. Assessing frailty as early as possible can reduce the hospitalization risk among older people.

Clinical Relevance

Professional nursing staff should use frailty indicators in a timely fashion to assess the status of frailty in older people and should effectively develop frailty prevention strategies to decrease the risk for hospitalization and to enhance quality of life for older adults.
Maternal characteristics and behavioural/emotional problems in preschoolers: how they relate to sleep rhythmic movements at sleep onset
Authors: Laganière Christine , Gaudreau Hélène , Pokhvisneva Irina , Atkinson Leslie , Meaney Michael , Pennestri Marie‐Hélène
Published: June 2018

Sleep rhythmic movements have been speculated to be a form of self‐soothing. While this sleep‐related movement has been associated with lower socioeconomic status, psychopathologies and maternal characteristics, prospective studies with sizeable sample and objective measurements are lacking. The objectives were: (a) to identify maternal characteristics predicting sleep rhythmic movements in children; and (b) to document behavioural/emotional problems in preschoolers with sleep rhythmic movements. Participants were mother–child dyads (N = 529) from the Adversity: Maternal Adversity, Vulnerability and Neurodevelopment cohort. Questionnaires evaluating socioeconomic status (prenatal), maternal depressive symptoms (prenatal, 48 months), sleep rhythmic movements (12, 18, 24, 36, 48 months), maternal anxiety trait (24 months) and children's behavioural/emotional problems (48 months) were used. Maternal sensitivity (accuracy and appropriateness of mother's responses to her baby's needs) was assessed objectively with a filmed mother–infant interaction (6 months). Generalized estimating equation was used to investigate associations between sleep rhythmic movements and maternal characteristics (depression, anxiety and sensitivity). Linear regressions were used to assess associations between sleep rhythmic movements and behavioural/emotional problems in children. Lower maternal sensitivity, higher maternal depressive symptoms and lower socioeconomic status predicted sleep rhythmic movements in children (p < 0.05). To our knowledge, this is the first study showing that sleep rhythmic movements are associated with lower maternal sensitivity, measured objectively. This study also builds on previous reports, by documenting an association between sleep rhythmic movements and behavioural/emotional problems even in preschoolers. The presence of psychosocial factors in sleep rhythmic movements aetiology should be considered in treatment.