bluuebunny/crossref_metadata_2025 huggingface dataset:
Economies of visibility as a moderator of feminism: ‘Never mind Brexit. Who won Legs‐it!’
Authors: Mavin Sharon , Elliott Carole , Stead Valerie , Williams Jannine
Published: October 2018

This article utilizes economies of visibility to interpret how two UK women political leaders’ bodies are constructed in the press, online and by audience responses across several media platforms via a multimodal analysis. We contribute politicizing economies of visibility, lying at the intersection of politics of visibility and economies of visibility, as a possible new modality of feminist politics. We suggest this offers a space where feminism can be progressed. Analysis illustrates how economies of visibility moderate feminism and tie women leaders in various ways to their bodies; commodities constantly scrutinized. The study surfaces how media insist upon femininity through appearance from women leaders, serving to moderate power and feminist potential. We consider complexities attached to public consumption of powerful women's constructions, set up in opposition, where sexism is visible and visceral. This simultaneously fortifies moderate feminism and provokes feminism. The insistence on femininity nevertheless disrupts, through an arousal of audible and commanding feminist voices, to reconnect with the political project of women's equality.
Identifying the processes of change and engagement from using a social network intervention for people with long‐term conditions. A qualitative study
Authors: Vassilev Ivaylo , Rogers Anne , Kennedy Anne , Oatley Chad , James Elizabeth
Published: October 2018

Background

Personal and community networks are recognized as influencing and shaping self‐management activities and practices. An acceptable intervention which facilitates self‐management by mobilizing network support and improves network engagement has a positive impact on health and quality of life. This study aims to identify the processes through which such changes and engagement take place.

Methods

The study was conducted in the south of England in 2016‐2017 and adopted a longitudinal case study of networks design. Purposive sample of respondents with long‐term conditions (n = 15) was recruited from local groups. Barriers and facilitators to implementation were explored in interviews with key stakeholders (5).

Results

Intervention engagement leads to a deepening of relationships within networks, adding new links and achieving personal objectives relevant for improving the health and well‐being of users and network members. Such changes are supported through two pathways: the mobilization of network capabilities and by acting as a nudge. The first is a gradual process where potentially relevant changes are further contemplated by forefronting immediate concerns and negotiating acceptable means for achieving change, prioritizing objective over subjective valuations of support provided by network members and rehearsing justifications for keeping the status quo or adopting change. The second pathway changes are enacted through the availability of a potential fit between individual, network and environmental conditions of readiness.

Conclusions

The two pathways of network mobilization identified in this study illuminate the individual, network and environmental level processes involved in moving from cognitive engagement with the intervention to adopting changes in existing practice.
Brokering International Education and (re)producing Class in Mumbai
Authors: Tuxen Nonie , Robertson Shanthi
Published: October 2018

This article discusses the role that education brokers play in the decision‐making processes of international students in Mumbai, India. Drawing on 80 interviews with students and education brokers, the analysis reveals how the services that brokers provide, and who accesses them, are shaped by the class status of prospective international students within the localized and granular hierarchies of Mumbai's upper‐middle‐class. Brokers are divided into agents and counsellors, who offer different service models and draw their clientele from two distinct segments of the upper‐middle‐class: “South Mumbai elites” and “suburban strivers”. Within these subtly differentiated landscapes of brokerage, advice from brokers can make certain students vulnerable, or hierarchise specific study destinations and trajectories. This article argues that attending to granular class differentiation within international education brokerage illuminates inequalities that exist within student cohorts from the same locality. It also outlines the policy implications of these inequalities in both sending and receiving countries.
Race, Wealth and the Masking of Opposition to Immigrants in the Netherlands
Authors: Creighton Mathew J. , Schmidt Peter , Zavala‐Rojas Diana
Published: October 2018

This work uses a list experiment to directly test for differences in attitudes towards poor, racially different and racially similar immigrants to the Netherlands in terms of (1) overt support and (2) covert support and (3) the difference between the two (i.e., social desirability bias). Results show that the expression of opposition to immigrants is significantly masked, suggesting that anonymous acts (e.g., voting) could capture greater opposition. Racially similar immigrants are subject to greater opposition relative to racially different or poorer immigrants, but only when anonymity is offered to respondents. The implication is that overt estimates (i.e., openly expressed) are misleading as levels of support appear consistent across immigrant groups. Going forward, we suggest the utility of the list experiment to better account for observable downward bias in estimates at least on the aggregate level or in contexts with clear normative pressure to appear tolerant.
A Nobel Prize‐worthy pursuit: cancer immunology and harnessing immunity to tumour neoantigens
Authors: Altmann Daniel M.
Published: October 2018

The field of cancer immunology stepped into the limelight this year when James P. Allison and Tasuku Honjo received the Nobel Prize in Physiology or Medicine for their discovery of cancer therapy by inhibition of negative immune regulation. Among many exciting advances contributing to the coming of age of tumour immunology as a viable clinical specialty has been the ability to progress from the initial elucidation of tumour antigens, such as the melanoma antigen, MAGE‐1, to high‐throughput sequencing facilitating identification of T cell epitopes from diverse tumour neoantigens. This has resulted from the convergence of expertise in tumour biology, next‐generation sequencing, T cell and structural immunology, and predictive algorithms. Among many examples, immunotherapy for ovarian cancer has been one of the beneficiaries of these advances, leading to a number of recent and ongoing clinical trials.
Neonatal abstinence syndrome in countries with no to low medical opioid consumption: a scoping review
Authors: Marcellus L.
Published: October 2018

Aim

To describe the current state of evidence on the care of neonates with neonatal abstinence syndrome in countries with low to virtually no medical opioid analgesic consumption.

Background

While access to opioids for medical use improves globally, misuse grows as a health concern. One unintended consequence has been an increase in the incidence of neonatal abstinence syndrome. Because most evidence is generated in countries with adequate opioid analgesic consumption, a picture of evidence in lower opioid‐consuming countries is not available.

Design

A scoping review methodology was employed and augmented with principles of international development literature review. Electronic database searches (PubMed and CINAHL) located 1106 articles. Google was employed to access an additional 17 non‐indexed articles. From the total of 1123 articles located, 27 articles from 15 countries were included.

Results

Minimal evidence was produced in low to virtually no medical opioid‐consuming countries. Sources were primarily review articles, descriptive, comparative or case reports. Seventy‐one per cent of the articles identified at least one specific clinical practice related to the care of infants with neonatal abstinence syndrome.

Conclusions

As opioid analgesic use increases globally, a subsequent increase in neonatal abstinence syndrome is likely. It will be beneficial for providers and policymakers to be proactive in considering implications for neonatal and maternal populations and collaborate with providers who have been gaining experience in this area. A number of these countries are heroin‐growing regions and already experiencing issues.

Implications for nursing practice and health policy

Policymakers may use these findings to support data collection and reporting, context and resource relevant guideline development, and advocacy for inclusion of the maternal‐infant population in global opioid research priority setting. International collaboration for establishing gender and culturally appropriate practices globally is critical.
Reduction of cellular stress is essential for Fibroblast growth factor 1 treatment for diabetic nephropathy
Authors: Wu Yanqing , Li Yiyang , Jiang Ting , Yuan Yuan , Li Rui , Xu Zeping , Zhong Xingfeng , Jia Gaili , Liu Yanlong , Xie Ling , Xu Ke , Zhang Hongyu , Li Xiaokun , Xiao Jian
Published: October 2018

Diabetic nephropathy (DN) is one of general and common complication of diabetes, which severely affects the physical and mental health of diabetic patients. Fibroblast growth factor 1 (FGF1), an effective control agent of blood glucose, plays an effective treatment role on diabetes‐induced renal injury. But the specific molecule mechanism underlying it is still unclear. Since induction of cellular stress is the main and common mechanism of diabetes‐induced complication, we hypothesized that reduction of cellular stress is also the molecular mechanism of FGF1 treatment for DN. Here, we have further confirmed that FGF1 significantly ameliorated the diabetes‐induced renal interstitial fibrosis and glomerular damage. The expression levels of collagen and α‐smooth muscle actin (α‐SMA) also dramatically induced in kidney from db/db mice, but these effects were blocked by FGF1 administration. Our mechanistic investigation had further revealed that diabetes significantly induced oxidative stress, nitrosative stress, and endoplasmic reticulum (ER) stress with upregulation of malondialdehyde (MDA), nitrotyrosine level, ER stress makers and downregulation of antioxidant capacity (AOC). FGF1 treatment significantly attenuated the effect of diabetes on cellular stress. We conclude that FGF1‐associated glucose decreases and subsequent reduction of cellular stress is the another potential molecule mechanism underlying FGF1 treatment for DN.
Sri Lankan clinical practice guidelines: A methodological quality assessment utilizing the AGREE II instrument
Authors: Talagala Ishanka Ayeshwari , Samarakoon Yasara , Senanayake Sameera , Abeysena Chrishantha
Published: October 2018

Rationale, aims, and objectives

Clinical practice guidelines (CPG) play a major role in patient care in Sri Lanka. This study evaluates the methodological quality of the Sri Lankan CPGs developed in 2007.

Methods

A total of 94 CPGs developed by several professional colleges in Sri Lanka in the year 2007 were evaluated by 2 independent reviewers using AGREE II instrument for their methodological quality. Item score being ≤3 points was defined as “poor quality”. Each domain score was calculated according to AGREE II. A guideline was labelled as “strongly recommended” if 4 or more domains scored above 60%, “recommended for use with certain modification” if only 3 domain scores were above 60% or if 4 or more domain scores were between 30% and 60%, and “not recommended” if 4 or more domains scored less than 30%.

Results

Most (22.3%) guidelines were developed by the College of Pathologists. Most of the guidelines (>55%) poorly reported on all the items, except for items 1, 2, and 22 of AGREE II. Median domain scores [range] and the proportion of the guidelines with domain score of <30% were as follows: domain on scope and purpose (33.3% [2.8%‐83.3%]; 42.6%), stakeholder involvement (14.9% [0.0%‐61.1%]; 81.9%), rigour of development (6.1% [0.0%‐49%]; 98.9%), clarity and presentation (30.5% [8.3%‐61.1%]; 46.8%), and applicability (8.3% [4.2%‐14.6%]; 100%). All CPGs scored 50% for “editorial independence”. Reviewers reported the overall quality was poor in 86 (91.5%). Based on the definitions used in the study, of 94 CPGs, 8 (8.5%) could be recommended to be used with modifications, while 86 (91.5%) could not be recommended for clinical practice.

Conclusions

The methodological quality of the CPGs was poor irrespective of the source of development. Major efforts are essential to update the CPGs according to the principles of evidence based medicine.
Establishment and characterization of a cell line from tilapia brain for detection of tilapia lake virus
Authors: Wang Yingying , Wang Qing , Zeng Weiwei , Yin Jiyuan , Li Yingying , Ren Yan , Shi Cunbin , Bergmann Sven M. , Zhu Xinping
Published: October 2018

Tilapia lake virus (TiLV) is an emerging disease threatening tilapia culture in many parts of the world. A cell line from the brain of tilapia, which was named TiB, was established, characterized and subcultured with more than 100 passages. The TiB cell line was optimally maintained at 27°C using medium 199 (M199) supplemented with 10% foetal bovine serum (FBS). Chromosome analysis revealed that 60% of TiB cells at passage 5 maintained the modal chromosome number 2n = 44, while at passage 60, there were 43% of TiB cells with the diploid chromosome number 2n = 50. A significant cytopathic effect was observed in TiB cells after infection with tilapia lake virus (TiLV‐2017A), and the viral replication in the cells was confirmed by transmission electron microscopy, immunofluorescence assays and viral titres, indicating the susceptibility of TiB cells to TiLV‐2017A. The viral titres of TiLV‐2017A in TiB cells reached 107.43 TCID50/ml within 10 days. The stable growth and susceptibility to fish viruses make TiB cells a useful tool for fish virus–host cell interaction and for immune response of fish.
Ethnic differences in body image perception in patients with type 2 diabetes
Authors: Toselli S. , Gualdi‐Russo E. , Campa F.
Published: October 2018

Background

The present study compared the prevalence of obesity, fat distribution, body image perception and lifestyle among diabetic African and Albanian immigrants living in Italy, as well as diabetic Italians, aiming to identify health risks and their possible causes.

Methods

The study sample consisted of 200 diabetic subjects living in Italy. A questionnaire regarding socio‐demographic and lifestyle information was administered to participants, and anthropometric measurements and body image perception were assessed. Proper perception of weight status and the degree of dissatisfaction in body image perception were valued.

Results

Italians showed a higher health risk, both with regard to anthropometric characteristics and lifestyle, whereas African immigrants showed a lower one. All of the male groups underestimated their weight and Albanians were the most dissatisfied. Women perceived their current body image as heavier than their desired body image, showing a dissatisfaction toward their weight. Subjects of both sexes belonging to the overweight and obese categories generally underestimated themselves; this was particularly true in obese Africans. People with a higher body mass index were more likely to be dissatisfied than those with a lower one. Body image dissatisfaction increased when people estimated themselves as being overweight. Among lifestyle habits, being an ex‐smoker increased body image dissatisfaction.

Conclusions

The underestimation of weight detected in the present study requires attention. Nevertheless, the high percentage of overweight/obese people, coupled with the higher frequency of people dissatisfied with their high weight, suggests an awareness of the problem that could be more effective for weight loss.
The pragmatics of kin address: A sociolinguistic universal and its semantic affordances
Authors: Fleming Luke , Slotta James
Published: October 2018

This paper focuses on an understudied sociolinguistic variable – the use of proper names as opposed to kin terms in address. We present findings from a survey of 80 speech communities that reveals a striking regularity in the way these two noun‐phrase types are used. Where kin terms alternate with names in address, kin terms are always used for senior kin and names for junior kin. The strong cross‐cultural uniformity of this alternation is not easily accounted for by reference to culture‐specific language ideologies, but neither is it explained by proposed universals of politeness. We argue that the referential and semantic properties of kin terms and names motivate culturally grounded, but convergent, conceptualizations of kin terms as honorific and names as anti‐honorific. Our study suggests that the relationship between linguistic forms and sociolinguistic functions may be language‐‘internally’ constrained in such a manner as to be subject to substantive comparative investigation.
Korean consumers’ acceptability of commercial food products and usage of the 9‐point hedonic scale
Authors: Yang Jiyun , Lee Jeehyun
Published: October 2018

In this study, 32 food samples evaluated previously with the 9‐point hedonic scale were examined to determine: (a) Korean consumers’ acceptability of commercial food products; (b) differences in liking score and its distribution among the samples; and (c) the use of the 9‐point hedonic scale by Korean consumers. The results show the existence of hedonic asymmetry and central tendency, but not much evidence of avoiding extreme categories. Cluster analysis was utilized to group food products based on consumers’ 9‐point hedonic scale distribution and four clusters were found to show positive asymmetry, negative asymmetry, central tendency, or consumers’ opinion showing no trend.

Practical applications

Many consumer testing methods are used to evaluate consumer acceptability of food products and the 9‐point hedonic scale is the most frequently used scale. Many studies refer to the limitations of 9‐point hedonic scale and this problem can appear to be more severe in the case of Asian consumers. Because of the lack of consumer studies about scale usage, it is important to study how consumers use the 9‐point hedonic scale. This research is beneficial because we analyzed how Korean consumers use the 9‐point hedonic scale. Through this study, some previously reported tendencies, such as hedonic asymmetry and central tendency, were confirmed but the limitations regarding avoidance of extreme categories and negative responses by Asian consumers were not found for urban Korean consumers using the 9‐point hedonic scale. In the future, comparison with other groups in Korea and a cross‐cultural consumer study about scale usage to compare Korean consumers and those from other Asian countries would be helpful.
Ontogenetic analysis of siliceous cell wall formation in Triparma laevis f. inornata (Parmales, Stramenopiles)
Authors: Yamada Kazumasa , Katsura Hirotaka , Noël Mary‐Hélène , Ichinomiya Mutsuo , Kuwata Akira , Sato Shinya , Yoshikawa Shinya
Published: October 2018

Triparma laevis f. inornata is a unicellular alga belonging to the Bolidophyceae, which is most closely related to diatoms. Like diatoms, T. laevis f. inornata has a siliceous cell wall. The cell wall of T. laevis f. inornata consists of four round plates (three shields and one ventral plate) and one dorsal and three girdle plates. But, unlike diatoms, T. laevis f. inornata cells can grow when concentrations of silica are depleted. We took advantage of this ability, using TEM to study the ontogeny of the siliceous plate, pattern center formation, and development. Two types of pattern centers (annulus and sternum) were observed in the early and middle stage of plate formation. During their formation, the annuli were initially crescent‐shaped but eventually their ends fused to make a ring. Only outward silica deposition of the branching ribs occurred on the growing annulus until it became a ring, resulting in an unfilled circle inside the annulus. The pattern center of the shield plate was always an annulus, but in ventral plates both annulus and sternum were observed. The annuli and sterna in T. laevis f. inornata round plates were very similar to the annuli and sterna in diatom valves. These results suggested that the round plates of Parmales are homologous to diatom valves. This information on the plate ontogeny of T. laevis f. inornata provides new insights into the evolution of the siliceous cell wall in the Parmales and diatoms.
Extent of portal vein tumour thrombosis in patients with hepatocellular carcinoma: The more, the worse?
Authors: Mähringer‐Kunz Aline , Steinle Verena , Düber Christoph , Weinmann Arndt , Koch Sandra , Schmidtmann Irene , Schotten Sebastian , Hinrichs Jan B. , Graafen Dirk , Pinto dos Santos Daniel , Galle Peter R. , Kloeckner Roman
Published: October 2018

Background & Aims

Portal vein tumour thrombosis (PVTT) has a significant impact on the prognosis of patients with hepatocellular carcinoma (HCC). The degree of PVTT varies from sub‐/segmental invasion to complete occlusion of the main trunk. Aim of this study was to evaluate whether the degree of PVTT correlates with prognosis.

Methods

A total of 1317 patients with HCC treated at our tertiary referral centre between January 2005 and December 2016 were included. PVTT was diagnosed by contrast‐enhanced computed tomography or magnetic resonance imaging. The extent of PVTT was documented according to the Liver Cancer Study Group of Japan classification: Vp0 = no PVTT, Vp1 = segmental portal vein invasion, Vp2 = right anterior/posterior portal vein, Vp3 = right/left portal vein and Vp4 = main trunk. Median overall survival (OS) was calculated for each group.

Results

Portal vein tumour thrombosis was present in 484 (36.8%) patients. Median OS without PVTT was 35.7 months, significantly longer than in patients with PVTT (7.2 months, P < 0.001). The patients with PVTT were subclassified as follows: 103 Vp1, 87 Vp2, 143 Vp3 and 151 Vp4. The corresponding median OS yielded 14.6, 9.4, 5.8 and 4.8 months for Vp1‐Vp4, respectively (P < 0.001).

Conclusions

Portal vein tumour thrombosis in patients with HCC is associated with a dismal prognosis. The results indicate an association between the extent of PVTT and OS. However, the extent of PVTT is not that decisive, as even minor PVTT leads to a very poor prognosis. Therefore, meticulous evaluation of cross‐sectional imaging is crucial for the clinical management of patients with HCC.
Artificial destratification for reducing reservoir water evaporation: Is it effective?
Authors: Helfer Fernanda , Andutta Fernando P. , Louzada José A. , Zhang Hong , Lemckert Charles
Published: October 2018

The objective of the present study was to assess the effectiveness of artificial destratification by air‐bubble plumes in reducing evaporation from reservoirs. The model DYRESM was used to model the evaporation rates and thermodynamic behaviour of a temperate reservoir in Australia under a number of combinations of destratification designs and operating conditions, comprising various numbers of ports and air‐flow rates per port. The operating conditions involved continuous operation and various intermittent operating strategies. Three reservoir depths were considered, characterizing “shallow,” “medium” and “deep” reservoirs, respectively. The present study results indicated that, assuming thermal stratification develops in a reservoir (the case for the “medium” and “deep” reservoirs), artificial destratification is able to reduce surface temperatures and evaporation rates. As a result of the larger volume of cold water at the lake bottom, deeper reservoirs can derive greater benefit from the use of these systems. Being raised to the water surface by the air injected through the destratification system, the cold water from the bottom will help reduce surface temperatures. Conversely, because of their typical homothermous regime, shallow lakes are unlikely to benefit from these systems, since these reservoirs lack an abundant cold water source at the bottom. Even so, however, the reductions in evaporation from deep reservoirs are only modest, with the maximum reduction being only 2.9% for a deep lake (16.5 m) using an energy‐intensive destratification system. Based on the present study, it was concluded that using destratification systems for reducing reservoir evaporation was not warranted because of the modest water savings achieved.
Distinct microglia profile in Creutzfeldt–Jakob disease and Alzheimer's disease is independent of disease kinetics
Authors: Krbot Katarina , Hermann Peter , Skorić Magdalena Krbot , Zerr Inga , Sepulveda‐Falla Diego , Goebel Stefan , Matschke Jakob , Krasemann Susanne , Glatzel Markus
Published: October 2018

Activated microglia represent a common pathological feature of neurodegenerative diseases. Sporadic Creutzfeldt–Jakob disease (sCJD) patients show more pronounced microglial activation than Alzheimer's disease (AD) patients. Whether these differences are due to differences in disease kinetics or represent disease‐specific changes is unknown. We investigated microglial phenotypes in brains of rapidly progressive AD (rpAD) and sCJD patients matched for clinical presentation, including disease duration. We immunostained the frontal cortex, basal ganglia and cerebellum in 16 patients with rpAD and sCJD using antibodies against markers of microglia and recruited monocytes (ionized calcium‐binding adaptor molecule 1, human leukocyte antigen DPQR, Cluster of Differentiation 68), an antibody unique to brain‐resident microglia (transmembrane protein 119 (TMEM119)), in addition to antibodies against a marker of astrocytes (glial fibrillary acidic protein), amyloid‐β (Aβ) and pathological prion protein. rpAD patients showed a distinct microglial phenotype with a high abundance of TMEM119‐positive microglia in all investigated regions. Presence of Aβ deposits seen in a sCJD patient with concomitant deposition of Aβ led to increase of TMEM119‐positive microglia. Our data suggest that in rpAD, activation of brain‐resident microglia significantly contributes to microgliosis, whereas in sCJD the TMEM119 signature of resident microglial cells is barely detectable. This is irrespective of disease duration and may indicate disease‐specific microglial reaction.
Unaltered phenology but increased production of ectomycorrhizal roots of Pinus elliottii under 4 years of nitrogen addition
Authors: Kou Liang , Li Shenggong , Wang Huimin , Fu Xiaoli , Dai Xiaoqin
Published: October 2018

Timing (phenology) and amount (production) are two integral facets of root growth, and their shifts have profound influences on below‐ground resource acquisition. However, the environmental control and the effects of nitrogen (N) deposition on the production and phenology of ectomycorrhizal (ECM) roots remain unclear.

Using a 4 yr minirhizotron experiment, we explored the control of the production and three phenophases (initiation, peak, and cessation of growth) of ECM roots in two soil layers and investigated their dynamic responses to N addition in a seasonally dry subtropical Pinus elliottii forest.

We found a stronger control of water availability on the production and a stronger control of temperature on the phenology of ECM roots under ambient conditions. Temperature was correlated positively with initiation and negatively with cessation, especially in the shallow layer. N addition did not affect the phenology of ECM roots but increased their production by modifying N and phosphorus (P) stoichiometry in the soil and foliage.

Our findings suggest a greater sensitivity of production than phenology of ECM roots to N addition. The increased production of ECM roots under N addition could be driven by N‐induced P limitation or some combination of below‐ground resources (P, N, water).
The readability, suitability, and content features of eczema action plans in the United States
Authors: Stringer Thomas , Yin H. Shonna , Gittler Julia , Curtiss Paul , Schneider Amanda , Oza Vikash S.
Published: October 2018

Background/Objectives

Little is known about the reading grade level (readability), appropriateness of design (suitability), and content variability of written eczema action plans (EAPs), which can impact the effectiveness of these patient education tools. Here, we assess the readability, suitability, and content of EAPs currently used by pediatric dermatologists in the United States.

Methods

This was a cross‐sectional study of EAPs submitted by members of the Society for Pediatric Dermatology (n = 26). Readability, suitability, and content of sampled plans were systematically assessed.

Results

Mean (SD) reading grade level was 9.0 (2.1); one in five was written at the recommended level of 6th grade or lower. While the majority of EAPs were found to be adequately suitable, one in five was unsuitable and only two superior. Documents scored most poorly in layout/design and learning stimulation. Plans scored best in the categories of content and literacy demand. EAPs focused on similar content themes, though specific recommendations and descriptors of atopic dermatitis (AD) disease states varied considerably.

Conclusions

The health literacy burden of EAPs in the United States could be lowered by improving their readability, incorporating graphics, stimulating reader engagement, and developing standards for how AD flares are defined.
Pediatric dermatology workforce in the United States
Authors: Prindaville Brea , Horii Kimberly A. , Siegfried Elaine C. , Brandling‐Bennett Heather
Published: October 2018

Studies have suggested there is a shortage of pediatric dermatologists in the United States, but the workforce has not been well defined. The Society for Pediatric Dermatology (SPD) Workforce Committee sought to characterize the US pediatric dermatology workforce with a nine‐question survey, sent to all 484 US SPD members in December 2016. The response rate was 30%. Most pediatric dermatologists were practicing in major metropolitan markets, seeing an average of 80 patients a week with an average 6‐week wait time. These findings indicate that geographic maldistribution and long wait times for new patient appointments remain substantial hurdles for adequate access to subspecialty pediatric dermatology care.
Infantile hemangiomas with minimal or arrested growth: A retrospective case series
Authors: Martin Jose M. , Sanchez Sara , González Víctor , Cordero Pilar , Ramon Dolores
Published: October 2018

Background/objectives

Infantile hemangiomas (IH) with minimal or arrested growth (MAG) constitute a distinctive subset of IH based on their clinical characteristics and natural history. They are often confused with capillary malformations.

Methods

A retrospective observational study has been carried out in which clinical and perinatal characteristics have been evaluated in all IH‐MAG evaluated in our Dermatology Department in a 5‐year period (January 2013‐December 2017).

Results

A total of 14 IH‐MAG affecting 13 patients were identified (10 girls and 3 boys). All were born full term, with a mean birth weight of 3448 g for girls vs 3540 g for boys, corresponding to the 72nd percentile for both sexes. The IH‐MAG was noticed at birth in 75% of cases. It had a segmental distribution in 6 cases and focal in 8. The most common clinical features was the presence of an erythematous or reticulated background and superficial red bright papules. Lesions were located preferentially in the lower body. Doppler ultrasound showed no significant vascular abnormalities in any case. Five IH‐MAG developed ulcerations and three required treatment with propranolol. Progressive involution was observed in all cases.

Conclusions

In spite of being a true IH, the absence of a relationship with prematurity, the high birth weight of the newborns, the predominance on the extremities, the higher percentage of segmental lesions, and their reduced ability to proliferate suggest possible etiopathogenic differences compared with conventional IH.
Retrospective analysis of simple and stage II renal cysts: Pediatric nephrology point of view
Authors: Eroglu Fehime Kara , Kargın Çakıcı Evrim , Can Gökçe , Güngör Tülin , Yazılıtaş Fatma , Kurt‐Sukur Eda Didem , Celikkaya Evra , Üner Çiğdem , Çakmakçı Emin , Bülbül Mehmet
Published: October 2018

Background

Increased ultrasonography (US) use has been correlated with an increased incidence of pediatric renal cysts. For simple and stage II cysts, the malignancy risk is low in adulthood, no follow up is recommended; but there is no consensus on childhood management. Given that pediatric renal cysts may be manifestations of hereditary cystic diseases, a different approach and follow up should be taken for these patients. Herein we present the clinical characteristics and follow‐up data of pediatric patients with simple and stage II renal cysts.

Methods

This cross‐sectional study involved 57 children (mean age, 12.44 ± 3.65 years) with simple (n = 35) and stage II cysts (n = 22) who were diagnosed and followed at the present institution for ≥2 years.

Results

The median follow‐up period was 2.84 years for simple and 3.10 years for stage II cysts. None of the patients developed complications. No change in cyst diameter was detected in 65.7% of simple or in 45.5% of stage II cysts, whereas 13 simple cysts (37.1%) and eight stage II cysts (36.4%) increased in diameter. The diameter change per year was significantly higher in the stage II cysts than in the simple cysts (P = 0.017). Overall, 13 patients (22%) had an estimated glomerular filtration rate <90 mL/min/1.73 m2, and two patients had hypertension.

Conclusion

Although the malignancy risk of simple and stage II kidney cysts is low for this age group, potential complications such as renal dysfunction, hypertension and hereditary cystic disease should be closely monitored.
Attitudinal and Phenomenological Theories of Pleasure
Authors: Lin Eden
Published: October 2018

On phenomenological theories of pleasure, what makes an experience a pleasure is the way it feels. On attitudinal theories, what makes an experience a pleasure is its relationship to the favorable attitudes of the subject who is having it. I advance the debate between these theories in two ways. First, I argue that the main objection to phenomenological theories, the heterogeneity problem, is not compelling. While others have argued for this before, I identify an especially serious version of this problem that resists existing solutions, and I explain why even this version of the problem does not undermine phenomenological theories. Second, I argue that a grand reconciliation can be effected between the two types of theory: it can be true both that pleasures are pleasures in virtue of the way they feel and that they are pleasures in virtue of how they are related to their subjects' favorable attitudes, so long as the attitudes that are constitutively related to pleasures are ones that feel a certain way. Hybrid views of this sort have significant advantages over pure attitudinal or phenomenological views.
Examining interpregnancy intervals and maternal and perinatal health outcomes using U.S. vital records: Important considerations for analysis and interpretation
Authors: Thoma Marie E. , De Silva Dane A. , MacDorman Marian F.
Published: October 2018

Background

Numerous studies use birth certificate data to examine the association between interpregnancy interval (IPI) and maternal and perinatal health outcomes. Substantive changes from the latest birth certificate revision have implications for examining this relationship.

Methods

We provide an overview of the National Vital Statistics System and recent changes to the national birth certificate data file, which have implications for assessing IPI and perinatal health outcomes. We describe the calculation of IPI using birth certificate information and related measurement issues. Missing IPI values by maternal age, race and education using 2016 birth certificate data were also compared. Finally, we review and summarise data quality studies of select covariate and outcome variables (sociodemographic, maternal health and health behaviours, and infant health) conducted after the most recent 2003 birth certificate revision.

Results

Substantive changes to data collection, dissemination and quality have occurred since the 2003 revision. These changes impact IPI measurement, trends and associations with perinatal health outcomes. Missing values of IPI were highest for older ages, lower education and non‐Hispanic black women. Minimal differences were found when comparing IPI using different gestational age measures. Recent data quality studies pointed to substantial variation in data quality by item and across states.

Conclusion

Future studies examining the association of IPI with maternal and perinatal data using vital records should consider these aspects of the data in their research plan, sensitivity analyses and interpretation of findings.
Two new Pseudanabaena (Cyanobacteria, Synechococcales) species from Japan, Pseudanabaenacinerea and Pseudanabaena yagii, which produce 2‐methylisoborneol
Authors: Tuji Akihiro , Niiyama Yuko
Published: October 2018

Two new Pseudanabaena species, Pseudanabaena cinerea and Pseudanabaena yagii, were described. Both species are members of taxa that produce 2‐methylisoborneol and have a musty odor. P. cinerea was found at the Serikawa reservoir and in Lake Ogawara in Japan. P. cinerea is morphologically similar to P. subfoetida Niiyama et Tuji, but its cell color is different. The cell color of the former is greenish‐gray to gray, and that of the latter is bright blue‐green. P. yagii was described using an old strain, NIVA‐CYA 111, which was isolated from Lake Biwa in 1982. P. yagii can be distinguished from other 2‐MIB‐producing taxa by its thinner cell width and by the absence of small granules in its cells. The putative secondary structures of the internal transcribed spacer (ITS) regions of the ribosomal RNA operon were predicted for 2‐MIB‐producing Pseudanabaena species including the two new taxa. Both new taxa are also distinguished by their molecular phylogenies using 16S rRNA and rbcL, and by the secondary structures of the ITS regions of the rRNA operon.
Fearing Food: The Influence of Risk Perceptions on Public Preferences for Uniform and Centralized Risk Regulation
Authors: Maestas Cherie , Chattopadhyay Jacqueline , Leland Suzanne , Piatak Jaclyn
Published: October 2018

Public opinion features prominently in policy research because it sets bounds on the definition of policy problems and acceptable policy solutions. We contend that public opinion is also important for setting bounds on the level of government at which policy hazards are regulated by shaping preferences for uniformity of regulation and, relatedly, preferences for centralization. We offer a theoretical argument for why risk creates pressures for uniform standards and examine the extent to which preferences for uniformity and centralization are the product of fairly stable individual‐level predispositions (e.g. partisanship and ideology) versus more fluid attitudes like perceptions of risk, which vary in response to crises, new information, and issue framing. We test our argument using survey data in the policy domain of food safety and find that individuals who anticipate greater risk from food‐borne illness prefer more uniform food safety regulation, which translates into preferences for federal‐level policymaking. Our results imply that contextual circumstances and strategic communications that influence risk perceptions can create not only generalized public demand for more regulatory policy but specific demand for uniform, centralized regulation.
Predictive factors and prognostic effect of telomere shortening in pulmonary fibrosis
Authors: Planas‐Cerezales Lurdes , Arias‐Salgado Elena G. , Buendia‐Roldán Ivette , Montes‐Worboys Ana , López Cristina Esquinas , Vicens‐Zygmunt Vanesa , Hernaiz Patricio Luburich , Sanuy Roger Llatjós , Leiro‐Fernandez Virginia , Vilarnau Eva Balcells , Llinás Ernest Sala , Sargatal Jordi Dorca , Abellón Rosario Perona , Selman Moisés , Molina‐Molina Maria
Published: October 2018

Background and objective

The abnormal shortening of telomeres is a mechanism linking ageing to idiopathic pulmonary fibrosis (IPF) that could be useful in the clinical setting. The objective of this study was to identify the IPF patients with higher risk for telomere shortening and to investigate the outcome implications.

Methods

Consecutive Spanish patients were included at diagnosis and followed up for 3 years. DNA blood samples from a Mexican cohort were used to validate the results found in Spanish sporadic IPF. Prior to treatment, telomere length was measured through quantitative polymerase chain reaction (qPCR) and Southern blot. Outcome was assessed according to mortality or need for lung transplantation. A multivariate regression logistic model was used for statistical analysis.

Results

Family aggregation, age of <60 years and the presence of non‐specific immunological or haematological abnormalities were associated with a higher probability of telomere shortening. Overall, 66.6% of patients younger than 60 years with telomere shortening died or required lung transplantation, independent of functional impairment at diagnosis. By contrast, in patients older than 60 years with telomere shortening, the negative impact of telomere shortening in outcome was not significant.

Conclusion

Our data indicate that young sporadic IPF patients (<60 years) with some non‐specific immunological or haematological abnormalities had higher risk of telomere shortening, and furthermore, they presented a poorer prognosis.
When technology enters the home – a systematic and integrative review examining the influence of technology on the meaning of home
Authors: Lindahl Berit , Kirk Sue
Published: October 2018

Aim

To analyse and synthesise the research that has investigated the experience of home in relation to home mechanical ventilation (HMV).

Method

Systematic integrative review. Four electronic databases (CINAHL, PubMed, Scopus and ISI Web of Knowledge) were searched between January 2010 and April 2017 as well as reference lists of included studies. Quantitative and qualitative studies meeting the inclusion criteria were critically appraised. Study findings were inductively analysed and synthesised using the integrative approach.

Results

Twenty‐one studies were included in the review. Two main themes emerged: home and at‐homeness and altered interpersonal relationships. The literature suggests that the technology alters the meaning of home through its structural and conceptual reconfiguration. Paradoxically, the space is experienced as both a home and a workplace which creates tensions and ambiguities for HMV users/families and care workers. HMV users and their families attempt to recreate a sense of home and identity while gaining control over space and decision‐making. Nevertheless, the home is seen as the preferred place to live and close bonds can develop between the different actors.

Conclusions

The literature suggests that the transformation of the meaning of home by the presence of technology and workers poses challenges that are often under‐recognised. Healthcare professionals and personal care assistants need preparation for the complexities of working in the home setting in addition to clinical aspects of caregiving. Home adaptations need to be carefully planned and include design principles that retain ‘at‐homeness’ while enabling the creation of a safe workplace.
Recovery, symptoms, and well‐being one to five years after lung transplantation – A multi‐centre study
Authors: Lundmark Martina , Lennerling Annette , Almgren Matilda , Forsberg Anna
Published: October 2018

Background

In recent years, survival after lung transplantation has remained largely unchanged despite improvements in short‐and intermediate‐term survival, indicating the need to identify factors associated with recovery and long‐term survival. Very little is known about how lung recipients recover after lung transplantation and whether such factors are related to symptom distress and well‐being. This constitutes the rationale of the study.

Aim

The aim was to explore symptom prevalence and distress as well as the degree of self‐reported perceived recovery and well‐being 1–5 years after adult lung transplantation.

Method

This multicentre, cross‐sectional nationwide study includes 117 lung recipients due for follow‐up at 1 year (n = 35), 2 years (n = 28), 3 years (n = 23), 4 years (n = 20) and 5 years (n = 11). Three different self‐assessment instruments were utilised; The Postoperative Recovery Profile, the Organ Transplant Symptom and Well‐Being Instrument, and the Psychological General Well‐Being Instrument. Ethical approval of the study was obtained.

Results

Few (5.7%) lung recipients were recovered 1–5 years after lung transplantation and 27.6% were not recovered at all. No relationship was identified between present lung function and self‐reported recovery or well‐being. There was a strong relationship between recovery and well‐being. It is possible to be partly recovered and experience good health. The most prevalent symptoms were tremor 66%, breathlessness 62%, and decreased libido 60%, while the symptoms perceived as most distressing were embarrassment about appearance, decreased libido, and poor appetite.

Limitations

The cross‐sectional design prevents identification of any causal relationships. Patient loss due to transplant mortality and inclusion difficulties resulted in a fairly small sample.

Conclusion

Our findings suggest the need for changes in follow‐up care such as systematic measurement of the degree of self‐reported recovery and symptoms. This entails self‐management support tailored to the recipients' symptom‐management and health‐management requirements.
Role of regulatory T cells in CD47/donor‐specific transfusion‐induced immune tolerance in skin‐heart transplantation mice
Authors: Hu Yu , Zhou Honglan , Gao Baoshan , Wang Gang , Wang Yuantao
Published: October 2018

Objectives

To explore the role of regulatory T (Treg) cells in the establishment of immune tolerance induced by donor‐specific transfusion (DST) in mice with skin‐heart transplantation.

Methods

C57BL/6 mice received DST of splenocytes from CD47+/+ or CD47−/− H‐2bm1 mice or no DST 7 days before skin‐heart transplantation from major histocompatibility complex class I‐mismatched H‐2bm1 donors. The number and proportion of Treg cells in graft and lymphoid organs were measured by flow cytometry (FACS) and immunohistochemistry (IHC). The inhibitory function of Treg cells and anti‐donor T‐cell responses were assessed by mixed lymphocyte reaction.

Results

We observed that mean survival time (MST) of skin or heart graft was significantly longer in C57BL/6 mice which received DST from CD47+/+ H‐2bm1 mice than from CD47−/− H‐2bm1 mice. By FACS, we found that the number of Treg cells in spleen was increased significantly in mice which received CD47−/− DST compared to mice which received CD47+/+ DST. However, the percentages of Treg cells in total splenocytes and lymph node cells were significantly higher in mice that received CD47+/+ DST than mice which received CD47−/− DST. Immunohistochemistry showed an increased heart grafts infiltration of Treg cells in the recipients with CD47−/− DST, but not CD47+/+ DST. Supporting this, we found that donor T‐cell proliferation was significantly suppressed in mice which received CD47+/+ DST compared to mice which received CD47−/− DST. There was no difference of inhibitory function of Treg cells between these two groups.

Conclusion

Our results indicated that CD47 expression on DST cells plays an important role in the induction of immune tolerance in mice with skin‐heart transplantation. Increased percentage of Treg cells may contribute to immune tolerance induced by CD47+/+ DST.