bluuebunny/crossref_metadata_2025 huggingface dataset:
Measurement invariance and validity of the Athlete Engagement Questionnaire
Authors: De Francisco Cristina , Arce Constantino , Graña Mar , Sánchez-Romero Elisa I
Published: July 2018

Engagement is a psychological construct that was originally defined in an organizational context to refer to the emotional, cognitive and physical components that drive people to get actively involved in their occupational duties. In sports science, the Athlete Engagement Questionnaire conceptualizes engagement as a multidimensional construct comprising four factors: confidence, vigor, dedication and enthusiasm. The purpose of this study was to analyze the measurement model invariance of the Athlete Engagement Questionnaire across different competitive levels and to provide evidence of construct validity in relation to burnout. To this end, we recruited 1157 athletes of both sexes, aged between 12 and 35 years, to complete the Athlete Engagement Questionnaire and Athlete Burnout Questionnaire. The results provided evidence of Athlete Engagement Questionnaire measurement model invariance and its validity with respect to burnout.
Examining the relationships among the coaching climate, life skills development and well-being in sport
Authors: Cronin Lorcan D , Allen Justine
Published: July 2018

Using Benson and Saito’s framework for positive youth development, we investigated the relationships between the coaching climate, young people’s perceived life skills development within sport, and their psychological well-being. British youth sport participants ( N = 326, Mage = 13.81, range = 11–18 years) completed a survey assessing the coaching climate, participants’ perceived life skills development (teamwork, goal setting, time management, emotional skills, interpersonal communication, social skills, leadership, and problem solving and decision making) and psychological well-being (self-esteem, positive affect, and satisfaction with life). In all analyses, the coaching climate was positively related to young peoples’ perceived development of life skills within sport and their psychological well-being. Total life skills development (a summative score of all eight life skills scores) was positively related to all three psychological well-being indicators – providing support for the “pile-up” effect – and partially mediated the relationships between the coaching climate and participants’ psychological well-being. Interpretation of the results indicated that coaches should foster the development of multiple life skills in youth sport participants, as they are associated with participants’ psychological well-being. One way this can be achieved is through autonomy-supportive coaching behaviours.
Hearing the Contradictions: Aesthetic Experience, Music and Digitization
Authors: Hanrahan Nancy Weiss
Published: July 2018

If, as Susan Buck-Morss (2003) suggests, aesthetic experience is an occasion for “making critical judgments about not only cultural forms but social forms of our being-in-the-world,” or if it is linked, in David Hesmondhalgh’s (2013) account, to the possibilities of collective flourishing, potential changes in the nature of that experience merit critical attention. This article reflects on the ways in which these social or ethical dimensions of the aesthetic experience of music are affected by digitization. It moves from a discussion of aesthetic experience as a form of encounter that refers to a common world, to consideration of recent work in music sociology that engages themes that emerge from that discussion: aesthetic judgment, and the question of difference and commonality. With illustrations from focus group interviews, I suggest that the quantization associated with digital environments is altering the cultural form of aesthetic judgment, just as personalization is changing the meaning of “difference” in this context. The essay is intended as a disclosive critique that takes as its primary object not the world observable through thick description or hermeneutic interpretation of actual cultural practice, but a world evoked through critical reflection on its actual and potential constellations of meaning.
Culture, Heritage, Art: Navigating Authenticities in Contemporary Hungarian Folk Singing
Authors: Nagy-Sándor Zsuzsa , Berkers Pauwke
Published: July 2018

In Hungary, the decline of traditional peasant culture and its heritage has prompted urban revivals, leading to the acceptance of traditional Hungarian folk singing as a performing arts genre. Drawing from a series of in-depth interviews, this study shows how contemporary Hungarian folk singers navigate (define, learn, police) different forms of authenticity within the field of folk music. While we find that objectified authenticity – heritagized classification systems – is the dominant form of symbolic capital, the broader symbolic economy of authenticity is complicated by competing definitions of folk singing as, variously, culture, heritage, and art. Third-person authenticity is more highly regarded, but it is more difficult for contemporary urban folk singers to achieve because they were not socialized in peasant communities. Therefore, they use objectified authenticity such as ‘original recordings’ as a proxy for learning about living folk culture. Although objectified authenticity constrains the agency of artistic expression, it affords discriminatory creativity (choosing one’s own repertoire) and rationalized creativity (adapting traditional material to external values and contexts).
Dancing with the DNA damage response: next-generation anti-cancer therapeutic strategies
Authors: Minchom Anna , Aversa Caterina , Lopez Juanita
Published: July 2018

Maintenance of genomic stability is a critical determinant of cell survival and relies on the coordinated action of the DNA damage response (DDR), which orchestrates a network of cellular processes, including DNA replication, DNA repair and cell-cycle progression. In cancer, the critical balance between the loss of genomic stability in malignant cells and the DDR provides exciting therapeutic opportunities. Drugs targeting DDR pathways taking advantage of clinical synthetic lethality have already shown therapeutic benefit – for example, the PARP inhibitor olaparib has shown benefit in BRCA-mutant ovarian and breast cancer. Olaparib has also shown benefit in metastatic prostate cancer in DDR-defective patients, expanding the potential biomarker of response beyond BRCA. Other agents and combinations aiming to block the DDR while pushing damaged DNA through the cell cycle, including PARP, ATR, ATM, CHK and DNA-PK inhibitors, are in development. Emerging work is also uncovering how the DDR interacts intimately with the host immune response, including by activating the innate immune response, further suggesting that clinical applications together with immunotherapy may be beneficial. Here, we review recent considerations related to the DDR from a clinical standpoint, providing a framework to address future directions and clinical opportunities.
Salvage surgery for local recurrence after stereotactic body radiotherapy for early stage non-small cell lung cancer: a systematic review
Authors: Dickhoff Chris , Rodriguez Schaap Pedro M. , Otten Rene H. J. , Heymans Martijn W. , Heineman David J. , Dahele Max
Published: July 2018

Introduction:

Stereotactic body (or ablative) radiotherapy (SBRT/SABR) is now a guideline-recommended treatment for medically inoperable patients with peripherally-located, stage I non-small cell lung cancer (NSCLC), and for medically operable patients who decline surgery. The 5-year local failure rate after SBRT is about 10% and in highly selected patients, surgery has been used as a salvage therapy. We performed a systematic review to address the feasibility, safety, and outcome of salvage surgery for locally recurrent early stage NSCLC after SBRT.

Methods:

A systematic literature search was performed according to Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. PubMed, Embase and Cochrane databases were searched and two authors independently assessed the articles. A total of seven eligible articles were identified.

Results:

All seven articles were retrospective case series, representing a total of 47 patients. Surgery was completed in all patients. Where reported in sufficient detail, morbidity (four studies) was between 29 and 50% (series of two patients) and 90-day mortality (six studies) was between 0% (four studies) and 11% ( n = 1, disease progression). Median ( n = 5)/mean ( n = 1) reported or calculated follow ups were 7–54.5/17.3 months. Median overall survival was reported in three studies and ranged between 13.6–82.7 months. Crude survival in three others was 2–35 months.

Conclusion:

Limited, low-level evidence prevents firm conclusions, but based on the existing data, salvage surgery after local recurrence of NSCLC following SBRT appears technically feasible, with acceptable morbidity and mortality in appropriately selected and counselled patients who are fit enough and who accept the risks (level of evidence 4, strength of recommendation C).
The convergence of business models and long-term financing in the energy transition
Authors: Dutra Joisa , Barbalho Antonio
Published: July 2018

In this article, we examine the convergence of business models and long-term financing to close the infrastructure gap in the context of the energy transition, revisiting challenges, and issues faced by policy makers and investors in mobilizing capital in a disrupted environment. Contextual analysis framework is developed to capture information from interviews with key stakeholders. We single out business models that emerged in the energy industry requiring different types of return and financing needs. The convergence among the type of the business models and the financing requirements determines the return allocation. Additionally, we identify key regulatory challenges that should be addressed along the way to promote investments and innovation in the context of the energy transition.
Establishing Methods to Determine Clinically Relevant Bolus and Basal Rate Delivery Accuracy of Insulin Pumps
Authors: Kamecke Ulrike , Waldenmaier Delia , Haug Cornelia , Ziegler Ralph , Freckmann Guido
Published: July 2018

Background:

Adequate testing of delivery accuracy of insulin pumps is under discussion. Especially for patch pumps, test settings are challenging. In addition, evaluation and presentation of accuracy results in a way that is reasonable and useful for clinicians, not only for technicians, is important.

Methods:

Test setups based on IEC 60601-2-24 were used and, in addition, different setups for patch pumps were compared to identify an adequate alternative for pumps without external infusion set. These setups are applicable for both bolus and basal rate accuracy testing. In addition, evaluation procedures considering clinical relevance were compiled.

Results:

A setup for patch pumps that provides reliable results could be realized. Evaluation of basal rate accuracy data should also consider the actual clinical use of insulin pumps and thus, deviating from IEC 60601-2-24, compose the whole measurement period without excluding the first 24 hours. In addition to the presentation using trumpet curves, accuracy of 1-hour windows should be evaluated and displayed.

Conclusions:

This article proposes an approach on how to test, evaluate, and present bolus and basal rate accuracy of insulin pumps from a clinical perspective.
Extra-articular Medial Impression Fracture of the Talus: A Previously Undescribed Injury
Authors: Wijers Olivier , Looijen Rosa C. , Halm Jens A. , Schepers Tim
Published: July 2018

Background: Peripheral fractures of the talus are uncommon. Almost all the literature regarding talar fractures consists of central intra-articular fractures, whereas studies about peripheral talar fractures are lacking. The aim of this study is to increase awareness in diagnosing an unusual peripheral extra-articular medial impression fracture of the talus. Methods: This study includes a retrospective case series of patients with an extra-articular medial impression fracture of the talus. Patient characteristics, trauma mechanism, diagnostics, fracture characteristics, and treatment were reported. Results: Eight consecutive patients with an extra-articular medial impression fracture of the talus were identified. In 80%, the trauma mechanism was a supination or inversion injury of the ankle and foot. An X-ray was obtained in all patients; in 7 (88%) patients, a computed tomography scan was done, and an additional magnetic resonance imaging was done in 3 (38%) patients. In 4 patients (50%), the correct diagnosis was missed at first presentation. The delay between injury and diagnosis was 0 to 180 days (of 36 days on average). Conclusion: This is the first case series to describe patients with a peripheral extra-articular medial impression fracture of the talus. Good clinical examination and judicious use of diagnostic imaging are a necessity to find the talar impression fractures in a timely manner, and treatment can be started immediately.

Levels of Evidence: Level V
Spinal neuraxial anaesthesia for Caesarean section in a parturient with Type I Arnold–Chiari malformation and syringomyelia
Authors: Teo Mavis Miqi
Published: July 2018

Type 1 Arnold–Chiari Malformation is associated with prolapse of the cerebellar tonsils into or below the level of the foramen magnum and is usually diagnosed in adults. There are no current guidelines for the management of patients with a residual Type I Arnold–Chiari Malformation, planned for a Caesarean section under spinal neuraxial anaesthesia. The paucity of literature on this topic presents as a management dilemma. We report a case of a term parturient with Type 1 Arnold–Chiari Malformation, following surgical decompression four years earlier, with a residual syringomyelia who underwent an elective Caesarean section under spinal neuraxial anaesthesia. This case highlights that multidisciplinary management and an early anaesthetic consult is of paramount importance in the outcome of the patient, and that spinal neuraxial anaesthesia can be considered as a safe anaesthetic option.
Sociopolitical efficacy as a mediator of pedagogical experience and sociopolitical involvement
Authors: Harrell-Levy Marinda K
Published: July 2018

Discourse on youth development has only begun to explore how Black youth experience courses intended to result in their sociopolitical development. The present study examined the link between pedagogical experience in a culturally relevant class and sociopolitical involvement and tested the mediating role of sociopolitical efficacy. Cross-sectional data were collected from 278 Black, former students of a mandatory high school course, called Social Justice. Pedagogical experience, sociopolitical efficacy and sociopolitical involvement were all measured as latent variables. As anticipated, structural equation modeling showed that pedagogical experience is associated with sociopolitical involvement, and that sociopolitical efficacy mediates this relationship. Ultimately, the current study shows the merit of giving Black youth the opportunity to learn how to respond to social and personal unjustness, and the paramountcy of improving youth’s perception of their ability to make a difference in their communities. Findings highlight the role of sociopolitical efficacy and support the idea that student experience has implications for whether culturally relevant teachers meet their intended goals. In the case of the present study, many years after the course, there is a relationship between their perceptions of their course experiences and their intention to engage productively in their communities.
Development and validation of a prognostic model for survival in patients treated with venoarterial extracorporeal membrane oxygenation: the PREDICT VA-ECMO score
Authors: Wengenmayer Tobias , Duerschmied Daniel , Graf Erika , Chiabudini Marco , Benk Christoph , Mühlschlegel Sven , Philipp Alois , Lubnow Matthias , Bode Christoph , Staudacher Dawid Leander
Published: July 2018

Aims:

Several scoring systems have been introduced for prognostication after initiating venoarterial extracorporeal membrane oxygenation (VA-ECMO) therapy. However, static scores offer limited guidance once VA-ECMO is implanted, although continued allocation of healthcare resources is critical. Patients requiring continued VA-ECMO support are extremely unstable, with minimal heart function and multi-organ failure in most cases. The aim of the present study was to develop and validate a dynamic prognostic model for patients treated with VA-ECMO.

Methods and results:

A derivation cohort included 205 all-comers undergoing VA-ECMO implantation at a tertiary referral hospital (51% received VA-ECMO during resuscitation and 43% had severe shock). Two prediction models based on point-of-care biomarkers were developed using penalised logistic regression in an elastic net approach. A validation cohort was recruited from an independent tertiary referral hospital. Comparators for the prediction of hospital survival were the SAVE score (area under the receiver operation characteristic curve (AUC) of 0.686), the SAPS score (AUC 0.679), the APACHE score (AUC 0.662) and the SOFA score (AUC 0.732) in 6-hour survivors. The 6-hour PREDICT VA-ECMO score (based on lactate, pH and standard bicarbonate concentration) outperformed the comparator scores with an AUC of 0.823. The 12-hour PREDICT VA-ECMO integrated lactate, pH and standard bicarbonate concentration at 1 hour, 6 hours and 12 hours after ECMO insertion allowed even better prognostication (AUC 0.839). Performance of the scores in the external validation cohort was good (AUCs 0.718 for the 6-hour score and 0.735 for the 12-hour score, respectively).

Conclusion:

In patients requiring VA-ECMO therapy, a dynamic score using three point-of-care biomarkers predicts hospital mortality with high reliability. Furthermore, the PREDICT scores are the first scores for extracorporeal cardiopulmonary resuscitation patients.
Objectification, Sexualization, and Misrepresentation: Social Media and the College Experience
Authors: Davis Stefanie E
Published: July 2018

Social media use can have major impacts on one’s construction of identity, sexuality, and gender. However, some social media sites exhibit problematic and prejudiced themes through their photo and video posts. This paper examines two Instagram sites specifically targeting traditionally college-aged individuals. These sites have tens of thousands of followers, post frequently, and solely focus on highlighting the college experience. Through a textual analysis of these two sites, problematic themes emerged, including objectification of female college students, submissiveness of female college students, and emphasis on a young white college experience. These themes are detailed and explored, followed by a discussion on their potential impacts on broader societal structures and ideas for education on gendered prejudices in the media.
Evaluation of Montelukast for the Treatment of Children With Japanese Cedar Pollinosis Using an Artificial Exposure Chamber (OHIO Chamber)
Authors: Hashiguchi Kazuhiro , Okubo Kimihiro , Inoue Yoichi , Numaguchi Hirotaka , Tanaka Kumi , Oshima Nobuyuki , Mehta Anish , Nishida Chisato , Saito Itori , Philip George
Published: July 2018

Background

This study evaluated the efficacy of montelukast in reducing seasonal allergic rhinitis symptoms in Japanese children with Japanese cedar (JC) pollinosis induced in an artificial exposure chamber (OHIO Chamber).

Methods

Pediatric patients aged 10 to 15 years sensitive to JC pollen entered a randomized, double-blind, single-site, crossover study. After confirmation of an allergic response to a JC pollen exposure for 3 hours in the OHIO Chamber during the screening period, subjects received either montelukast 5 mg chewable tablets or placebo for a 7-day treatment period, followed by a 3-hour pollen exposure in the chamber. After a 7-day washout period, subjects crossed over to the other treatment. Subjects were instructed to self-assess their nasal symptoms using 5-point scale for every 30 minutes. The primary end point was the change from baseline (just before entering the exposure chamber for each exposure) in total nasal symptom score (TNSS; the sum of nasal congestion, nasal discharge, and sneezing scores) over 3 hours of pollen exposure. Adverse events (AEs) were evaluated throughout the study.

Results

A total of 220 subjects (median age, 12 years) received treatment. For TNSS, the between-group difference in the change (95% confidence interval) was −0.01 (−0.11 to 0.10); the change between placebo and montelukast 5 mg was not significant. TNSS in the screening and treatment periods after receiving placebo for 7 days was 1.58 and 1.31, respectively, suggesting a placebo response. On account of high placebo response, a post hoc analysis was conducted. The analysis in a subgroup of subjects who did not show placebo response demonstrated a difference in the efficacy between montelukast and placebo (nominal P < .037). The most common AE was positive urine protein (4.6% with montelukast vs 7.8% with placebo).

Conclusions

Although montelukast was well tolerated, this study did not demonstrate a treatment difference between active drug and placebo in Japanese children exposed to JC pollen in the OHIO Chamber. Trial Registry: ClinicalTrials.gov, NCT01852812
Integrating Unbanked Rural Populations through Frugal Innovation: A Case of Gramateller in India
Authors: Raju Prageetha G.
Published: July 2018

Vortex Engineering Private Limited is based at Chennai in Tamil Nadu state in southern part of India. This company came into news with its breakthrough innovation in manufacturing, selling, installing and servicing the world’s lowest power-consuming automated teller machines (ATMs), named, the GramatellerTM targeted at the semi-urban and rural segments of India.

With a mission to help banks reach out gainfully to every nook and corner of the country, Vortex, after seven years of diligent research, has designed highly reliable, eco-friendly, easy to use and rugged ATM, which can save power up to 90 per cent and can be operated using solar power. The ATM hitherto was an unviable proposition in rural areas to any bank but GramatellerTM broke the stereotype with its low power-consuming ATM, which not only provided financial access to remote areas but also increased deposits in banks.

The case presents a coherent depiction about the business, and growth of Gramateller, an innovation that is unique by virtue of its frugality, disruptivity and game-changing characteristics vis-à-vis its role in integrating isolated geographies. The facts are compiled from published sources.
Patient and Provider’s Experience and Perspective in Addressing Barriers to Medication Adherence Among Noncommunicable Disease Patients in Rural Puducherry, South India—A Qualitative Study
Authors: Krishnamoorthy Yuvaraj , Giriyappa Dinesh Kumar , Eliyas Salin K , Priyan Shanthosh , Saya Ganesh Kumar , Lakshminarayanan Subitha
Published: July 2018

Background:

Trend in morbidity and mortality due to noncommunicable diseases (NCDs) is rising because of poor control status. Medication nonadherence is one of the most common and modifiable causes of inadequate control status.

Objectives:

To examine the barriers in drug adherence among NCD patients in rural Puducherry.

Methods:

This qualitative study includes in-depth and key informant interview conducted among 6 NCD patients and 4 health-care providers. Interviews were audio-recorded, and transcript was prepared in verbatim format. Thematic content analysis was done to derive the categories and themes.

Results:

Major barriers for nonadherence to medications found were stress, substance abuse, forgetfulness, lack of family support, and high case load of health facilities. Corrective measures suggested to address the barriers were to provide health education to patients and family members, awareness campaigns in community, and health education sessions at the clinic.

Conclusion:

Psychological factors such as stress, social isolation, and negligence are major barriers for drug adherence. Health education session at community and health system is needed to improve the adherence.
Anti-RNA polymerase III antibodies in patients with suspected and definite systemic sclerosis: Why and how to screen
Authors: Lazzaroni Maria-Grazia , Airò Paolo
Published: July 2018

Anti-RNA Polymerase III antibodies are the most frequent anti-nuclear antibodies in systemic sclerosis, after anti-centromere and anti-Topoisomerase I. Considering their specificity for systemic sclerosis, they have been included in 2013 American College of Rheumatology/European League Against Rheumatism classification criteria for systemic sclerosis. They were first identified in 1993 using an immunoprecipitation method; the subsequent diffusion of commercial assays, based on the enzyme-linked immunosorbent assay or multiplex line immunoblot techniques, has allowed an increasing number of systemic sclerosis patients to be tested for this autoantibody; nevertheless, the diffusion of this test in systemic sclerosis patients is probably still sub-optimal. Anti-RNA Polymerase III antibodies have been associated with important clinical manifestations: rapid and diffuse cutaneous involvement, joint contractures, scleroderma renal crisis, gastric antral vascular ectasia and malignancies synchronous to systemic sclerosis onset. Moreover, other possible clinical associations, including pulmonary hypertension, still need confirmation. Since the correct approach for screening for anti- RNA Polymerase III antibodies in patients with suspected or definite systemic sclerosis is still debated, possible strategies are proposed here. Moreover, issues that are still controversial are discussed, including the interpretation of multiple simultaneous positivity for anti-RNA Polymerase III antibodies and other autoantibodies in line immunoassay, and the possible relevance of anti-RNA Polymerase III antibodies titre.
The role of ADAMTS13 testing in the diagnosis and management of thrombotic microangiopathies and thrombosis
Authors: Masias Camila , Cataland Spero R.
Published: July 2018

ADAMTS13 (a disintegrin and metalloproteinase with thrombospondin type 1 motif, 13) is a metalloprotease responsible for cleavage of ultra-large von Willebrand factor (VWF) multimers. Severely deficient activity of the protease can trigger an acute episode of thrombotic thrombocytopenic purpura (TTP). Our understanding of the pathophysiology of TTP has allowed us to grasp the important role of ADAMTS13 in other thrombotic microangiopathies (TMAs) and thrombotic disorders, such as ischemic stroke and coronary artery disease. Through its action on VWF, ADAMTS13 can have prothrombotic and proinflammatory properties, not only when its activity is severely deficient, but also when it is only moderately low. Here, we will discuss the biology of ADAMTS13 and the different assays developed to evaluate its function in the context of TTP, in the acute setting and during follow-up. We will also discuss the latest evidence regarding the role of ADAMTS13 in other TMAs, stroke, and cardiovascular disease. This information will be useful for clinicians not only when evaluating patients who present with microangiopathic hemolytic anemia and thrombocytopenia, but also when making clinical decisions regarding the follow-up of patients with TTP.
Post-migration follow-up programme for migrants at increased risk of developing tuberculosis: a cohort study
Authors: Kaushik Nishta , Lowbridge Chris , Scandurra Gabriella , Dobler Claudia C.
Published: July 2018

Following pre-migration screening for tuberculosis (TB), migrants who are deemed to be at a high risk of developing TB must attend post-entry follow-up in Australia. We aimed to evaluate the effectiveness of post-migration TB follow-up in the state of New South Wales to diagnose TB in these high-risk migrants.

In this retrospective cohort study, we assessed the risk of TB in migrants who arrived in New South Wales between 2000 and 2015 and were referred for post-migration follow-up. Clinical notes were examined for a nested cohort to determine whether TB was diagnosedviathe follow-up programme orviapassive case finding.

Of the 32 550 migrants referred for follow-up, 428 (1.3%) developed TB. The incidence of TB was 436 per 100 000 person-years (95% CI 384–491 per 100 000 person-years) in the first 2 years after arrival and 128 per 100 000 person-years (95% CI 116–140 per 100 000 person-years) over the mean study observation period of 10.3 years. An estimated 63% of cases were diagnosedviafollow-up. TB notifications occurred 0.55 years earlier since time of arrival in Australia in migrants who attended follow-up than in those who did not.

Post-migration follow-up detected 63% of TB cases in high-risk migrants and potentially prevented delay of TB diagnosis.
Comparison of different analysis algorithms to calculate multiple-breath washout outcomes
Authors: Anagnostopoulou Pinelopi , Kranz Nadja , Wolfensberger Jeremias , Guidi Marisa , Nyilas Sylvia , Koerner-Rettberg Cordula , Yammine Sophie , Singer Florian , Latzin Philipp
Published: July 2018

Lung clearance index (LCI) is the main outcome of the multiple-breath washout (MBW) test. Current recommendations for LCI acquisition are based on low-grade evidence. The aim of this study was to challenge those recommendations using alternative methods for LCI analysis.

Nitrogen MBW measurements from school-aged children, 20 healthy controls, 20 with cystic fibrosis (CF) and 17 with primary ciliary dyskinesia (PCD), were analysed using 1) current algorithms (standard), 2) three alternative algorithms to detect with higher precision the end of MBW testing and 3) two alternative algorithms to determine exhaled tracer gas concentrations. LCI values, intra-test repeatability, and ability to discriminate between health and lung disease were compared between these methods.

The analysis methods strongly influenced LCI (mean±sdoverall differences (%) between standard and alternative analysis methods: −4.9±5.7%; range: −66–19%), but did not improve intra-test variability. Discrimination between health and disease was comparable as areas under the receiver operator curves were not greater than that from standard analysis.

This study supports current recommendations for LCI calculation in children. Alternative methods influence LCI estimates and hamper comparability between MBW setups. Alternative algorithms, whenever used, should be carefully reported.
Lateral Hypothalamic Area Neurotensin Neurons Are Required for Control of Orexin Neurons and Energy Balance
Authors: Brown Juliette , Sagante Andrew , Mayer Thomas , Wright Anna , Bugescu Raluca , Fuller Patrick M , Leinninger Gina
Published: July 2018

The lateral hypothalamic area (LHA) is essential for motivated ingestive and locomotor behaviors that impact body weight, yet it remains unclear how the neurochemically defined subpopulations of LHA neurons contribute to energy balance. In particular, the role of the large population of LHA neurotensin (Nts) neurons has remained ambiguous due to the lack of methods to easily visualize and modulate these neurons. Because LHA Nts neurons are activated by leptin and other anorectic cues and they modulate dopamine or local LHA orexin neurons implicated in energy balance, they may have important, unappreciated roles for coordinating behaviors necessary for proper body weight. In this study, we genetically ablated or chemogenetically inhibited LHA Nts neurons in adult mice to determine their necessity for control of motivated behaviors and body weight. Genetic ablation of LHA Nts neurons resulted in profoundly increased adiposity compared with mice with intact LHA Nts neurons, as well as diminished locomotor activity, energy expenditure, and water intake. Complete loss of LHA Nts neurons also led to downregulation of orexin, revealing important cross-talk between the LHA Nts and orexin populations in maintenance of behavior and body weight. In contrast, chemogenetic inhibition of intact LHA Nts neurons did not disrupt orexin expression, but it suppressed locomotor activity and the adaptive response to leptin. Taken together, these data reveal the necessity of LHA Nts neurons and their activation for controlling energy balance, and that LHA Nts neurons influence behavior and body weight via orexin-dependent and orexin-independent mechanisms.
A Systematic Review Evaluating Neuraxial Morphine and Diamorphine-Associated Respiratory Depression After Cesarean Delivery
Authors: Sharawi Nadir , Carvalho Brendan , Habib Ashraf S. , Blake Lindsay , Mhyre Jill M. , Sultan Pervez
Published: July 2018

The prevalence of neuraxial opioid–induced clinically significant respiratory depression (CSRD) after cesarean delivery is unknown. We sought to review reported cases of author-reported respiratory depression (ARD) to calculate CSRD prevalence. A 6-database literature search was performed to identify ARD secondary to neuraxial morphine or diamorphine, in parturients undergoing cesarean delivery. “Highest” (definite and probable/possible) and “lowest” (definite) prevalences of CSRD were calculated. Secondary outcomes included: (1) prevalence of CSRD associated with contemporary doses of neuraxial opioid, (2) prevalence of ARD as defined by each study’s own criteria, (3) case reports of ARD, and (4) reports of ARD reported by the Anesthesia Closed Claims Project database between 1990 and 2016. We identified 78 articles with 18,455 parturients receiving neuraxial morphine or diamorphine for cesarean delivery. The highest and lowest prevalences of CSRD with all doses of neuraxial opioids were 8.67 per 10,000 (95% CI, 4.20–15.16) and 5.96 per 10,000 (95% CI, 2.23–11.28), respectively. The highest and lowest prevalences of CSRD with the use of clinically relevant doses of neuraxial morphine ranged between 1.63 per 10,000 (95% CI, 0.62–8.77) and 1.08 per 10,000 (95% CI, 0.24–7.22), respectively. The prevalence of ARD as defined by each individual paper was 61 per 10,000 (95% CI, 51–74). One published case report of ARD met our inclusion criteria, and there were no cases of ARD from the Closed Claims database analysis. These results indicate that the prevalence of CSRD due to neuraxial morphine or diamorphine in the obstetric population is low.
Frequency of Operative Anesthesia Care After Traumatic Injury
Authors: Sunshine Jacob E. , Humbert Andrew T. , Booth Benjamin , Bowman Steven M. , Bulger Eileen M. , Sharar Sam R.
Published: July 2018

BACKGROUND:

Virtually all anesthesiologists care for patients who sustain traumatic injuries; however, the frequency with which operative anesthesia care is provided to this specific patient population is unclear. We sought to better understand the degree to which anesthesia providers participate in operative trauma care and how this differs by trauma center designation (levels I–V), using data from a comprehensive, regional database—the Washington State Trauma Registry (WSTR). We also sought to specifically assess operative anesthesia care frequency vis a vis the American College of Surgeons guidelines for continuous anesthesiology coverage for Level II trauma center accreditation.

METHODS:

We conducted a retrospective analysis measuring the frequency of operative anesthesia care among patients enrolled in the WSTR. Univariate comparisons were made between trauma patients who had surgery during their admission and those who did not (medical management only). In addition, clinical factors associated with surgical intervention were measured. We also measured the average times from hospital admission to surgery and compared these times across trauma centers, grouped level I, II, and III–V.

RESULTS:

From 2004 to 2014, there were approximately 176,000 encounters meeting WSTR inclusion criteria. Approximately 60% of these trauma encounters included exposure to operative anesthesia during the admission. Among all surgical procedures during the trauma admission, approximately 33% occurred within a level I trauma center, 23% occurred within a level II trauma center, and 44% occurred in a trauma center with a III, IV, or V designation. The predominant procedure category during a trauma admission was orthopedic. The presence of hypotension on admission (P < .01), increasing injury severity score (P < .01) and higher emergency department Glasgow Coma Score (P < .01) were all associated with surgical intervention during the trauma hospitalization, after adjustment for potential confounders. In level I trauma centers, for general surgical procedures, the median time to surgery was 2.5 hours; in level II trauma centers, the median time was 1.7 hours.

CONCLUSIONS:

This study highlights the frequent role anesthesiologists play in caring for patients who sustain traumatic injuries, in trauma centers levels I–V. In level II trauma centers, in-house anesthesiology coverage might have benefit for those patients requiring surgery within 1 hour, whereas the former American College of Surgeons requirement of 30-minute response time for out-of-hospital anesthesiology coverage is likely sufficient to provide satisfactory care to patients requiring surgery within 3 hours. Whether the increased cost of such in-house anesthesiology coverage at level II trauma centers is justified by its clinical benefit remains an unanswered question.
“I Am Just aTiçitl”: Decolonizing Central Mexican Nahua Female Healers, 1535–1635
Authors: Polanco Edward Anthony
Published: July 2018

Since the sixteenth century, Central Mexican tiçiyotl (Nahua healing knowledge) has been portrayed as a male-dominated system akin to Western medicine. This has made Nahua women invisible in broader discussions of tiçiyotl. Though the historiography acknowledges that women were titiçih (healing ritual specialists), the scholarship has primarily focused on their role in midwifery. This article first uses early modern Spanish dictionaries to underscore discrepancies in the vocabulary used to describe indigenous healers. Then, using evidence from two sixteenth-century proceedings against Nahua women in Central Mexico (in conjunction with other primary sources), this article demonstrates that female titiçih were not analogous to Spanish midwives. Sixteenth- and seventeenth-century female titiçih—like their ancestors—were practitioners of tiçiyotl who gazed into water, hurled corn kernels, applied salubrious materials, and communicated with deities through entheogenic substances to keep their communities whole. Moreover, this article argues that scholarship must decolonize tiçiyotl in order to explore and understand its complexities. This can only be achieved by moving away from Western terms and frameworks that do not adequately describe Nahua ideologies.
SNRP-27, the C. elegans homolog of the tri-snRNP 27K protein, has a role in 5′ splice site positioning in the spliceosome
Authors: Zahler Alan M. , Rogel Lucero E. , Glover Marissa L. , Yitiz Samira , Ragle J. Matthew , Katzman Sol
Published: July 2018

The tri-snRNP 27K protein is a component of the human U4/U6-U5 tri-snRNP and contains an N-terminal phosphorylated RS domain. In a forward genetic screen in C. elegans, we previously identified a dominant mutation, M141T, in the highly-conserved C-terminal region of this protein. The mutant allele promotes changes in cryptic 5′ splice site choice. To better understand the function of this poorly characterized splicing factor, we performed high-throughput mRNA sequencing analysis on worms containing this dominant mutation. Comparison of alternative splice site usage between the mutant and wild-type strains led to the identification of 26 native genes whose splicing changes in the presence of the snrp-27 mutation. The changes in splicing are specific to alternative 5′ splice sites. Analysis of new alleles suggests that snrp-27 is an essential gene for worm viability. We performed a novel directed-mutation experiment in which we used the CRISPR-cas9 system to randomly generate mutations specifically at M141 of SNRP-27. We identified eight amino acid substitutions at this position that are viable, and three that are homozygous lethal. All viable substitutions at M141 led to varying degrees of changes in alternative 5′ splicing of native targets. We hypothesize a role for this SR-related factor in maintaining the position of the 5′ splice site as U1snRNA trades interactions at the 5′ end of the intron with U6snRNA and PRP8 as the catalytic site is assembled.
Improving the energy efficiency of industrial enterprises on the basis of the formation of energy management system
Authors: Федоськина Людмила , Fedoskina Lyudmila , Абрамов Евгений , Abramov Eugene
Published: July 2018

The monograph examines the trends and prospects of energy efficiency management of industrial enterprises, taking into account international and domestic experience. Theoretical and methodological provisions in the field of energy efficiency management are considered and practical approaches to the formation of energy management systems based on the requirements of international and national standards ISO 50001 taking into account the Russian practice of energy saving and energy efficiency management are proposed. For researchers dealing with energy efficiency management of enterprises
IMAGEM CORPORAL NO CÁRCERE: PERCEPÇÕES DE MULHERES PRIVADAS DE LIBERDADE
Authors: Canário Carlos de Andrade Ana Luísa , Dias Inocêncio Barbosa Ana Paula , Bagni Ursula Viana
Published: July 2018

Objetivo: avaliar a percepção da imagem corporal em mulheres privadas de liberdade em regime fechado em relação ao corpo atual, corpo antes do encarceramento e corpo ideal. Metodologia: Estudo transversal, desenvolvido com 149 reclusas em regime fechado em Natal, Rio Grande do Norte, Brasil. A imagem corporal foi avaliada a partir de uma escala de figuras de silhuetas validada para brasileiros, contendo 15 figuras e seus respectivos valores de índice de massa corporal. Cada participante apontou qual figura refletia seu corpo atual (no momento da entrevista), seu corpo antes da reclusão e o corpo que gostaria de ter. As análises referentes ao conceito de corpo ideal e à percepção de mudança no corpo após a reclusão foram realizadas por meio do teste qui-quadrado, considerando-se o p-valor <0,05 para significância estatística. Resultados e discussão: Metade das reclusas percebeu-se como obesa (50,3%) ou sobrepeso (26,8%). Em relação ao corpo desejado, 83,8% almejam estar acima do peso, e 40% das mulheres obesas desejam manter o tamanho do corpo ou ainda aumentá-lo. Desse modo, evidenciou-se que a imagem corporal e do referencial de corpo ideal no ambiente do cárcere é muito complexa, indo para além de um corpo belo e esguio tradicionalmente desejado pela maior parte das mulheres. Conclusão: A elevada proporção de mulheres privadas de liberdade com excesso de peso e que anseia por corpos ainda mais robustos aponta para a necessidade de intensificação nas ações de saúde, aprofundamento das investigações no âmbito das Ciências Sociais e Humanas, bem como da qualificação dos profissionais de saúde para atuação nesses espaços.DOI: 10.12957/demetra.2018.33309
INTERFACES ENTRE A GORDOFOBIA E A FORMAÇÃO ACADÊMICA EM NUTRIÇÃO: UM DEBATE NECESSÁRIO
Authors: Silva Barbara Leone , Cantisani Jacobina Rivas
Published: July 2018

Este estudo propõe refletir sobre como a formação em Nutrição é passível de reproduzir gordofobia, e os riscos impostos às pessoas gordas por essa opressão. A gordofobia, enquanto discriminação dos indivíduos gordos, consequente da estigmatização, traduz-se em desigualdades nos mais diversos ambientes, repercutindo nos níveis biológico, psicológico, social e econômico. A hierarquização das populações consideradas mais ou menos saudáveis, baseada na lógica médico-estatística polarizada entre normal e patológico, sustenta a predominância da fisiologia no estudo das ciências da saúde, consolidando práticas de intervenção e controle sobre os desviantes, como medidas de prevenção. A formação teórica, enquanto definidora da prática, apresenta dilemas criando uma tendência de atuação patologizante, direcionando os Cursos de Nutrição a priorizarem interesses econômicos em detrimento das demandas sociais. Essa patologização contribui para a manutenção do modelo de saúde que corrobora a busca incessante pelo tipo corpóreo ideal, favorecendo a mercantilização das práticas em saúde. O debate conceitual e teórico mostra-se essencial para a discussão da abordagem prática, uma vez que a crença na obesidade enquanto reflexo das qualidades morais dos indivíduos tem importantes consequências sociais. De forma agravante, ao reproduzir a estigmatização das pessoas gordas, os profissionais as afastam do acesso aos serviços de saúde. Para desenvolver práticas humanizadas, promotoras de saúde e que reconheçam o indivíduo em sua historicidade e sociabilização, é preciso desenvolver outras concepções de saúde, já que a abordagem clínico-biomédica se mostra insuficiente para atuar de maneira satisfatória diante desta complexidade.DOI: 10.12957/demetra.2018.33311
DEBATE – Rastros e Restos que Interessam: Na pista de uma humanidade encarnada
Authors: Rios Clarice
Published: July 2018

Discussão crítica sobre os textos que compõem este Dossiê.
A Marcha das Vadias e Seu Feminismo: Práticas, experiências e conflitos de uma geração de jovens feministas
Authors: Vargas Janaína , Brites Jurema
Published: July 2018

O artigo apresenta uma reflexão acerca das relações geracionais de jovens engajadas na luta feminista. A partir de uma pesquisa etnográfica realizada junto ao Coletivo Marcha das Vadias de Santa Maria, no Rio Grande do Sul, desenvolvemos uma discussão a respeito da articulação dos novos movimentos sociais em sua interface com as dinâmicas de uma prática feminista marcada pela atuação em espaços da internet. As disputas entre diferentes práticas políticas dessas jovens são descritas como parte da  configuração de um feminismo contemporâneo, marcado por disputas simbólicas que articulam novas formas de ação política, manifestadas por fragmentação, fluidez, efemeridade e primazia das pautas imateriais.Palavras-chave: Marcha das Vadias. Feminismo. Juventude.
Expression of Luminal Progenitor Marker CD117 in the Human Breast Gland
Authors: Kim Jiyoung , Villadsen René
Published: July 2018

CD117 is a putative marker of luminal progenitor cells in the human breast. However, so far mapping the expression pattern of CD117 within the normal gland has not been reported. Here, we examined the anatomical distribution of CD117-expressing cells in lobular and ductal structures by immunohistochemistry. The presence of CD117-positive luminal cells could be divided into three distinct patterns: (1) contiguous, with coherent positive cells and rare negative cells interspaced; (2) patched, with a roughly equal frequency of positive and negative cells distributed focally; or (3) scattered, with few or no positive cells in the structure. Generally, a patched or scattered expression pattern was more frequent in lobules compared with ducts. Furthermore, an age-correlated increase in heterogeneity was observed. When comparing women below and above 21 years of age this heterogeneity was evident for both lobules and ducts. Although CD117-expression was generally segregated from luminal-lineage transcription factor GATA3-positive cells, some did co-express both markers. Finally, co-staining with Ki-67 revealed that a prominent part of cycling cells belonged to the CD117-positive population. Together these data demonstrate the presence of a CD117-expressing progenitor compartment with the capacity to replenish the luminal lineage of the breast gland.