bluuebunny/crossref_metadata_2025 huggingface dataset:
Performance of 4 definitions of childhood elevated blood pressure in predicting subclinical cardiovascular outcomes in adulthood
Authors: Fan Hui , Hou Dongqing , Liu Junting , Yan Yinkun , Mi Jie
Published: January 2018

We aimed to compare the ability of the pediatric blood pressure (BP) standards issued by the US Fourth Report, the recently proposed US, Chinese, and international standards to predict adult hypertension and subclinical cardiovascular disease (CVD). 2296 children were randomly selected from Beijing at baseline. The follow‐up survey was conducted among 1177 adults. Subclinical adult CVD was assessed using the carotid‐femoral pulse wave velocity (cfPWV), carotid intima‐media thickness (CIMT), and left ventricular mass index (LVMI). The prevalence of pediatric elevated BP was significantly higher according to the Chinese standards vs the Fourth Report, the updated US standards, and the international standards (18.7% vs 14.2%, 17.5%, and 18.0%, respectively; all Ps < .001). Children identified as elevated BP using any of the 4 standards were more likely to have adult hypertension, high cfPWV, and high LVMI than children without elevated BP. However, only the Chinese and updated US standards can predict the increased risk of adult high CIMT. Our results indicated that the Chinese standards performed equally or better compared with 3 other standards in predicting adult hypertension and subclinical CVD.
Norcantharidin, a clinical used chemotherapeutic agent, acts as a powerful inhibitor by interfering with fibrinogen–integrin αIIbβ3 binding in human platelets
Authors: Hsia Chih‐Hsuan , Lu Wan‐Jung , Lin Kuan‐Hung , Chou Duen‐Suey , Geraldine Pitchairaj , Jayakuma Thanasekaran , Chang Nen‐Chung , Sheu Joen‐Rong
Published: January 2018

During platelet activation, fibrinogen binds to its specific platelet receptor, integrin αIIbβ3, thus completing the final common pathway for platelet aggregation. Norcantharidin (NCTD) is a promising anticancer agent in China from medicinal insect blister beetle. In this study, we provided the evidence to demonstrate NCTD (0.1–1.0 μM) possesses very powerful antiplatelet activity in human platelets; nevertheless, it had no effects on surface P‐selectin expression and only slight inhibition on ATP‐release reaction in activated platelets. Moreover, NCTD markedly hindered integrin αIIbβ3 activation by interfering with the binding of FITC‐labelled PAC‐1. It also markedly reduced the number of adherent platelets and the single platelet spreading area on immobilized fibrinogen as well as clot retraction. Additionally, NCTD attenuated phosphorylation of proteins such as integrin β3, Src and FAK in platelets spreading on immobilized fibrinogen. These results indicate that NCTD restricts integrin αIIbβ3‐mediated outside‐in signalling in human platelets. Besides, NCTD substantially prolonged the closure time in human whole blood and increased the occlusion time of thrombotic platelet plug formation and prolonged the bleeding time in mice. In conclusion, NCTD has dual activities, it can be a chemotherapeutic agent for cancer treatment, and the other side it possesses powerful antiplatelet activity for treating thromboembolic disorders.
Inducibly decreased MITF levels do not affect proliferation and phenotype switching but reduce differentiation of melanoma cells
Authors: Vlčková Kateřina , Vachtenheim Jiri , Réda Jiri , Horák Pavel , Ondrušová Lubica
Published: January 2018

Melanoma arises from neural crest‐derived melanocytes which reside mostly in the skin in an adult organism. Epithelial–mesenchymal transition (EMT) is a tumorigenic programme through which cells acquire mesenchymal, more pro‐oncogenic phenotype. The reversible phenotype switching is an event still not completely understood in melanoma. The EMT features and increased invasiveness are associated with lower levels of the pivotal lineage identity maintaining and melanoma‐specific transcription factor MITF (microphthalmia‐associated transcription factor), whereas increased proliferation is linked to higher MITF levels. However, the precise role of MITF in phenotype switching is still loosely characterized. To exclude the changes occurring upstream of MITF during MITF regulation in vivo, we employed a model whereby MITF expression was inducibly regulated by shRNA in melanoma cell lines. We found that the decrease in MITF caused only moderate attenuation of proliferation of the whole cell line population. Proliferation was decreased in five of 15 isolated clones, in three of them profoundly. Reduction in MITF levels alone did not generally produce EMT‐like characteristics. The stem cell marker levels also did not change appreciably, only a sharp increase in SOX2 accompanied MITF down‐regulation. Oppositely, the downstream differentiation markers and the MITF transcriptional targets melastatin and tyrosinase were profoundly decreased, as well as the downstream target livin. Surprisingly, after the MITF decline, invasiveness was not appreciably affected, independently of proliferation. The results suggest that low levels of MITF may still maintain relatively high proliferation and might reflect, rather than cause, the EMT‐like changes occurring in melanoma.
Fracture resistance of prepared premolars restored with bonded new lab composite and all‐ceramic inlay/onlay restorations: Laboratory study
Authors: Wafaie Ramy Ahmed , Ibrahim Ali Ashraf , Mahmoud Salah Hasab
Published: January 2018

Objectives

To assess the influence of new light curing lab composite, lithium‐disilicate glass‐ceramic and yttrium‐stabilized zirconia‐based ceramic on the fracture resistance of maxillary premolars with class II inlay and onlay preparations.

Methods

Seventy sound maxillary premolars were divided randomly into seven main groups. The first group was left intact (control group). The remaining six groups were prepared with inlay and onlay cavities and restored with lab composite (SR Nexco), lithium‐disilicate glass‐ceramic (IPS e.max Press) and yttrium‐stabilized zirconia‐based ceramic (ICE Zirkon). The restorations were cemented with luting resin composite (Variolink N). All specimens were thermocycled 5000 cycles between 5°C ± 2°C and 55°C ± 2°C and were then cyclic loaded for 500 000 cycles. The specimens were subjected to a compressive load in a universal testing machine using a metal sphere until fracture occurred. The results were analyzed by 2‐way ANOVA and Tukey HSD post hoc tests. The level of significance was set at P < .05.

Results

There were no statistically significant differences among the means of control group and the groups restored with zirconia ceramic inlays and onlays (P > .05). However, statistically significant differences were found among the means of control group and the groups restored with lab composite inlays, lab composite onlays, pressable glass ceramic inlays and pressable glass ceramic onlays (P < .05).

Conclusions

The fracture resistance of prepared teeth for inlay and onlay restorations is inferior to the intact teeth when lab composite is used. Conversely, when a ceramic material being used, the prepared teeth for inlay and onlay restorations showed a comparable strength to the intact teeth especially zirconia ceramic.

Clinical Significance

Premolar teeth restored with zirconia ceramic inlays and onlays exhibited fracture resistance comparable to intact teeth.
Integrating Doulas Into First‐Trimester Abortion Care: Physician, Clinic Staff, and Doula Experiences
Authors: Chor Julie , Lyman Phoebe , Ruth Jean , Patel Ashlesha , Gilliam Melissa
Published: January 2018

Introduction

Balancing the need to provide individual support for patients and the need for an efficient clinic can be challenging in the abortion setting. This study explores physician, staff, and specially trained abortion doula perspectives on doula support, one approach to patient support.

Methods

We conducted separate focus groups with physicians, staff members, and doulas from a high‐volume, first‐trimester aspiration abortion clinic with a newly established volunteer abortion doula program. Focus groups explored 1) abortion doula training, 2) program implementation, 3) program benefits, and 4) opportunities for improvement. Interviews were transcribed and computer‐assisted content analysis was performed; salient findings are presented.

Results

Five physicians, 5 staff members, and 4 abortion doulas participated in separate focus group discussions. Doulas drew on both their prior personal skills and experiences in addition to their abortion doula training to provide women with support at the time of abortion. Having doulas in the clinic to assist with women's emotional needs allowed physicians and staff to focus on technical aspects of the procedure. In turn, both physicians and staff believed that introducing doulas resulted in more patient‐centered care. Although staff did not experience challenges to integrating doulas, physicians and doulas experienced initial challenges in incorporating doula support into the clinical flow. Staff and doulas reported exchanging skills and techniques that they subsequently used in their interactions with patients.

Discussion

Physicians, clinic staff, and doulas perceive abortion doula support as an approach to provide more patient‐centered care in a high‐volume aspiration abortion clinic.
From feudal colonization to agrarian capitalism in Mallorca: Peasant endurance under the rise and fall of large estates (1229–1900)
Authors: Tello Enric , Jover Gabriel , Murray Ivan , Fullana Onofre , Soto Ricard
Published: January 2018

The colonization of Mallorca gave rise to a late‐feudal agrarian society that evolved towards capitalism based on large estates owned by noblemen who hired large numbers of wage labourers from among smallholders living in agro‐towns, the dispossessed remnants of a formerly wealthier peasantry. These well‐off peasants originated from when the colonization frontier was open in the 13th and 14th centuries, but had been defeated when three peasant–plebeian revolts were crushed. Afterwards, Mallorca followed a latifundist transition towards agrarian capitalism similar to southern Italy or Spain, in sharp contrast with the middle‐peasant paths seen in Catalonia or Valencia. The land rent rose, while agricultural wages fell from 1659 to 1800. Peasant families could not survive, and had to supplement wages with the products of their own plots. This set a socio‐agroecological limit to growth in this agrarian class structure. The agrarian crisis at the end of the 19th century bankrupted the Mallorcan nobility. Bankers bought much of the land and sold it on as small allotments. This expanded the intensive cropping formerly limited to agro‐town belts, giving rise to a new “peasantization”. Despite their subordination, Mallorcan peasants had survived and created complex agroecological landscapes endowed with a rich biocultural heritage.
Do fertile women have an inferior treatment for high‐grade precancerous lesions?
Authors: Kim Miseon , Cho Hye‐yon , Lee Jaeil , Suh Dong Hoon , Kim Kidong , No Jae Hong , Kim Yong Beom
Published: January 2018

Aim

To investigate whether a concern for future pregnancy is reflected in the extent of large loop excision of the transformation zone (LLETZ) and to assess the clinical outcome.

Methods

We reviewed the medical records of 275 women who underwent LLETZ for precancerous lesions in cervix. We divided them into two groups according to pregnancy possibility in the future: nonpotential versus potential group. The potential group was arbitrarily defined as women who met one of the following: (i) regardless of marital status, younger than 41 years with less than two parities and (ii) regardless of parity, younger than 46 years and unmarried. After propensity score matching (1:1, 44 women in each group), we compared the extent of LLETZ with respect to short‐term recurrence.

Results

After LLETZ, similar percentages of patients were finally diagnosed with ≥CIN3 (cervical intraepithelial neoplasia 3) in the two groups (27 [61.4%] vs 32 [72.7%], P = 0.257). Notably, the largest transverse diameter of LLETZ specimen was significantly larger in the nonpotential group (2.74 ± 1.06 vs 2.37 ± 0.62 cm, P = 0.047). There were more women with exocervical resection margin involvement in the potential group than in the nonpotential group (14 [31.8%] vs 6 [13.6%], P = 0.042). However, there was no significant difference in the incidence of short‐term recurrence ≥HSIL (high‐grade squamous intraepithelial lesion) within 24 months after LLETZ between the two groups (1 [2.3%] vs 1 [2.3%], P > 0.999).

Conclusion

Pregnancy possibility in the future may affect the extent of LLETZ, as assessed by the largest transverse diameter obtained. This finding may be associated with increased resection margin involvement in women with future pregnancy possibility.
Continuing education: online monitoring of haemodialysis dose
Authors: Vartia Aarne
Published: January 2018

Background

Kt/Vurea reflects the efficacy of haemodialysis scaled to patient size (urea distribution volume). The guidelines recommend monthly Kt/V measurements based on blood samples. Modern haemodialysis machines are equipped with accessories monitoring the dose online at every session without extra costs, blood samples and computers.

Objective

To describe the principles, devices, benefits and shortcomings of online monitoring of haemodialysis dose.

Design

A critical literature overview and discussion.

Results

UV absorbance methods measure Kt/V, ionic dialysance Kt (product of clearance and treatment time; cleared volume without scaling). Both are easy and useful methods, but comparison is difficult due to problems in scaling of the dialysis dose to the patient's size.

Conclusions

The best dose estimation method is the one which predicts the quality of life and survival most accurately. There is some evidence on the predictive value of ionic dialysance Kt, but more documentation is required on the UV method. Online monitoring is a useful tool in everyday quality assurance, but blood samples are still required for more accurate kinetic modelling.

Learning outcomes

After reading this article the reader should be able to:

Understand the elements of the Kt/V equation for dialysis dose.

Compare and contrast different methods of measurement of dialysis dose.

Reflect on the importance of adequate dialysis dose for patient survival and life quality.
Sleep‐disordered breathing in hypertensive disorders of pregnancy: a BMI‐matched study
Authors: Wilson Danielle L. , Walker Susan P. , Fung Alison M. , Pell Gabrielle , O'Donoghue Fergal J. , Barnes Maree , Howard Mark E.
Published: January 2018

Sleep‐disordered breathing is more common in hypertensive disorders during pregnancy; however, most studies have not adequately accounted for the potential confounding impact of obesity. This study evaluated the frequency of sleep‐disordered breathing in women with gestational hypertension and pre‐eclampsia compared with body mass index‐ and gestation‐matched normotensive pregnant women. Women diagnosed with gestational hypertension or pre‐eclampsia underwent polysomnography shortly after diagnosis. Normotensive controls body mass index‐matched within ±4 kg m−2 underwent polysomnography within ±4 weeks of gestational age of their matched case. The mean body mass index and gestational age at polysomnography were successfully matched for 40 women with gestational hypertension/pre‐eclampsia and 40 controls. The frequency of sleep‐disordered breathing in the cases was 52.5% compared with 37.5% in the control group (P = 0.18), and the respiratory disturbance index overall did not differ (P = 0.20). However, more severe sleep‐disordered breathing was more than twice as common in women with gestational hypertension or pre‐eclampsia (35% versus 15%, P = 0.039). While more than half of women with a hypertensive disorder of pregnancy meet the clinical criteria for sleep‐disordered breathing, it is also very common in normotensive women of similar body mass index. This underscores the importance of adjusting for obesity when exploring the relationship between sleep‐disordered breathing and hypertension in pregnancy. More severe degrees of sleep‐disordered breathing are significantly associated with gestational hypertension and pre‐eclampsia, and sleep‐disordered breathing may plausibly play a role in the pathophysiology of pregnancy hypertension in these women. This suggests that more severe sleep‐disordered breathing is a potential therapeutic target for reducing the prevalence or severity of hypertensive disorders in pregnancy.
Introduction to Special Issue: Null Effects and Publication Bias in Learning Disabilities Research
Authors: Therrien William J. , Cook Bryan G.
Published: January 2018

The importance of publishing studies with null findings to the scientific enterprise is garnering attention in social science at large and education in particular. In this article, we first define null findings and publication bias as they relate to group and single‐subject instructional intervention research. We then explore the prevalence of instructional intervention studies that report null findings in the learning disabilities literature. Overall, we found that few studies have been published in learning disability journals that reported all null results. However, a significant number of group studies reported mixed findings (i.e., at least one, but not all, outcome measures were not statistically significant). Next, we summarize the experimental studies that comprise this special issue on null findings. Last, we speculate regarding strategies that might be enacted to increase the publication of studies with null findings in the learning disabilities field.
Multiple lithic clasts in lunar breccia Northwest Africa 7948 and implication for the lithologic components of lunar crust
Authors: Zeng Xiaojia , Joy Katherine H. , Li Shijie , Pernet‐Fisher John F. , Li Xiongyao , Martin Dayl J. P. , Li Yang , Wang Shijie
Published: January 2018

This study presents the petrography, mineralogy, and bulk composition of lunar regolith breccia meteorite Northwest Africa (NWA) 7948. We identify a range of lunar lithologies including basaltic clasts (very low‐titanium and low‐titanium basalts), feldspathic lithologies (ferroan anorthosite, magnesian‐suite rock, and alkali suite), granulites, impact melt breccias (including crystalline impact melt breccias, clast‐bearing impact melt breccias, and glassy melt breccias), as well as regolith components (volcanic glass and impact glass). A compositionally unusual metal‐rich clast was also identified, which may represent an impact melt lithology sourced from a unique Mg‐suite parent rock. NWA 7948 has a mingled bulk rock composition (Al2O3 = 21.6 wt% and FeO = 9.4 wt%) and relatively low concentrations of incompatible trace elements (e.g., Th = 1.07 ppm and Sm = 2.99 ppm) compared with Apollo regolith breccias. Comparing the bulk composition of the meteorite with remotely sensed geochemical data sets suggests that the sample was derived from a region of the lunar surface distal from the nearside Th‐rich Procellarum KREEP Terrane. Our investigations suggest that it may have been ejected from a nearside highlands‐mare boundary (e.g., around Mare Crisium or Orientale) or a cryptomare region (e.g., Schickard‐Schiller or Mare smythii) or a farside highlands‐mare boundary (e.g., Mare Australe, Apollo basin in the South Pole–Aitken basin). The distinctive mineralogical and geochemical features of NWA 7948 suggest that the meteorite may represent lunar material that has not been reported before, and indicate that the lunar highlands exhibit wide geological diversity.
3D Parametric Modeling of Complex Geological Structures for Geotechnical Engineering of Dam Foundation Based on T‐Splines
Authors: Zhang Yichi , Zhong Denghua , Wu Binping , Guan Tao , Yue Pan , Wu Han
Published: January 2018

We propose a novel geological modeling method based on T‐splines for computer‐aided design (CAD) and building information modeling (BIM) systems of geotechnical engineering and perform original research on special T‐splines modeling strategies and the algorithm aiming at depicting structural complexity to develop and introduce the T‐splines technology into engineering geological modeling. A methodology of parametric geological modeling with T‐splines is established, where a topology‐geometry modeling strategy is adopted, the inhomogeneity, arbitrary connectivity and discontinuity of geological structures are quantified and associated with T‐spline surface elements in the topology phase. A representative parametric algorithm called IBALR is presented in the context of dam foundation geological modeling to generate an inhomogeneous local refined T‐mesh with high genus topology which can fit a complex geological layer. The proposed method is flexible and effective in improving geological representation within geotechnical engineering.
Ecological characterization of a tick community across a landscape gradient exhibiting differential anthropogenic disturbance in the Atlantic Forest ecoregion in Argentina
Authors: Lamattina D. , Venzal J. M. , Costa S. A. , Arrabal J. P. , Flores S. , Berrozpe P. E. , González‐Acuña D. , Guglielmone A. A. , Nava S.
Published: January 2018

An ecological analysis of a tick (Ixodida: Ixodidae) community across a landscape gradient presenting differential anthropogenic disturbance in the Atlantic Forest ecoregion in Argentina was performed. Ticks were collected from vegetation and hosts between September 2014 and August 2016. A total of 12 697 free‐living ticks and 3347 specimens from hosts were collected, including 317 ticks infesting humans. The values obtained show considerable species diversity in the forest environment accompanied by low equitability. The similarity index derived from a comparison of forest and agricultural environments was higher than that calculated by comparing forest and urban environments. The data suggest that although a cycle of one generation per year is apparent in some species, more than one cohort may co‐exist within the populations of some of these species. Well‐marked patterns of the seasonal distribution of free‐living tick species emerged in environments with no anthropic modification. The results indicate that forest environments are more suitable habitats than agricultural and urban environments for many species of native tick, but are unsuitable for exotic species that have successfully established in environments that have been modified by man.
In ineffective esophageal motility, failed swallows are more functionally relevant than weak swallows
Authors: Jain A. , Baker J. R. , Chen J. W.
Published: January 2018

Background

Esophageal pressure topography (EPT) diagnosis of ineffective esophageal motility (IEM) can be non‐specific with unclear clinical significance.

Aims

To determine whether peristaltic vigor or lower esophageal sphincter (LES) integrity is associated with poor clearance and acid reflux in IEM.

Methods

Bolus clearance on high‐resolution impedance manometry (HRIM) and available reflux studies in patients with IEM were retrospectively reviewed. Bolus clearance was assessed using both line tracing and colored contour methods on HRIM. EPT parameters, bolus clearance, and acid reflux variables were explored.

Key Results

Eighty‐eight patients with IEM were included. Bolus clearance occurred in 71% of all swallows, and 55.7% of patients had complete bolus transit (CBT, bolus clearance in ≥80% of swallows). Bolus clearance was impaired in swallows with distal contractile integral (DCI) <100 mmHg•cm•s compared to DCI 100‐450 (0.43 vs 0.79, P < .0001). A cutoff at DCI 100 mmHg•cm•s was associated with clearance with an accuracy of 76% compared to 49% at DCI 450 (P = .0001 for both). A median DCI <100 was associated with a higher Eckardt score (9 vs 3, P = .03), and on reflux testing available in 47 patients, with abnormal acid exposure time (P = .002). Peristaltic reserve (PR) defined as (DCI of multiple rapid swallow/median DCI of wet swallows), integrated relaxation pressure, and resting lower esophageal sphincter pressure were not associated with clearance or acid exposure.

Conclusions & Inferences

Failed peristalsis, as defined by DCI <100 mmHg•cm•s, is associated with impaired bolus clearance and more severe dysphagia in IEM, and likely abnormal acid exposure.
Rituximab in myasthenia gravis: a “to be or not to be” inhibitor of T cell function
Authors: Marino Mariapaola , Bartoccioni Emanuela , Alboini Paolo Emilio , Evoli Amelia
Published: January 2018

In recent years, rituximab (RTX), a monoclonal antibody that binds the B lymphocyte membrane protein CD20, has been increasingly used for the treatment of autoimmune diseases, with the rationale of destroying pathogenic B lymphocytes and decreasing autoantibody formation. Surprisingly, RTX has also proven effective in predominantly T cell–mediated diseases, raising the question whether additional mechanisms may play roles in determining the therapeutic response. Here, we review the current literature on the effects of RTX in autoimmune diseases, with special emphasis on myasthenia gravis (MG). To elicit a complete and effective immune response, B and T lymphocytes cooperate in a loop in which they affect each other. Disruption of this cross talk has profound effects on the immune system. RTX is likely to affect the whole spectrum of B cell function, including antigen presentation, cytokine production, and T cell stimulation. In addition, as a small subset of T lymphocytes expresses CD20, its direct targeting by RTX may contribute to the therapeutic effect. Owing to its distinctive immune characteristics, MG proved to be a useful model to investigate the multifaceted implications of B cell depletion.
Evaluation of QT dispersion and Tp‐e interval in children with subclinical hypothyroidism
Authors: Akın Alper , Unal Edip , Yıldırım Ruken , Ture Mehmet , Balık Hasan , Haspolat Yusuf Kenan
Published: January 2018

Background

Studies on adults have shown increased dispersion of QT and corrected QT (QTc), peak‐to‐end interval of the T wave (Tp‐e), Tp‐e/QT ratio, and Tp‐e/QTc ratio in subclinical hypothyroidism (SH), but there have been no pediatric studies.

Materials and methods

A total of 40 SH patients were compared with 40 healthy children in respect to serum thyroid‐stimulating hormone (TSH), serum‐free level of triiodothyronine, and free level of thyroxine (fT4). SH diagnosis was accepted as TSH above the laboratory accepted upper limit (>4.2 mU/L) and normal fT4 values. The patient and control group data were compared by calculating the QT interval, QTc, QT dispersion (QTd), QTc dispersion (QTcd), Tp‐e, Tp‐e/QT ratio, and Tp‐e/QTc ratio on 12‐lead surface electrocardiogram.

Results

The mean age was 7.91 ± 3.6 years in the SH group and 8.8 ± 2.4 years in the control group. In the SH group, the minimum QT (QTmin) was determined to be statistically significantly lower (P < 0.001) and maximum QT (QTmax), QTd, QTcd, Tp‐e, Tp‐e/QT ratio, and Tp‐e/QTc ratio were statistically significantly higher (P = 0.028, P < 0.001, P = 0.003, P < 0.001, P = 0.001, P < 0.001, respectively). A positive correlation was determined between TSH and QTmax (r: +0.331, P = 0.037).

Conclusions

The current study is the first to have shown significantly increased QTd, QTcd, Tp‐e, Tp‐e/QT ratio, and Tp‐e/QTc ratio in children diagnosed with SH. A positive correlation was determined between TSH and maximum QT values, Tp‐e, Tp‐e/QT ratio, and Tp‐e/QTc ratio. These results suggest the need to further assess the long‐term risks of prolonged QT dispersion in the setting of subclinical hypothyroidism.
Safety and efficacy of epicutaneous immunotherapy for food allergy
Authors: Wang Julie , Sampson Hugh A.
Published: January 2018

Food allergy is increasingly common in children, affecting about 4%‐8%. The mainstays of management remain allergen avoidance and emergency preparedness to treat allergic reactions with emergency medications. Unfortunately, these approaches are unsatisfactory for many patients and their families as the restrictions, constant vigilance, and unpredictable severity of allergic reactions negatively impact quality of life. In recent decades, there has been significant interest in developing treatments for food allergy that lead to desensitization to increase thresholds for triggering allergic reactions and decrease the risk of reacting to allergen‐contaminated food products. Epicutaneous immunotherapy (EPIT) is a novel therapy that is currently under investigation, delivering allergen via repeated applications to the skin and targeting antigen‐presenting cells in the superficial skin layers. Murine models have demonstrated that allergen uptake is an active process by skin dendritic cells with subsequent migration to draining lymph nodes. Allergen exposure to the non‐vascularized epidermis limits systemic absorption, contributing to the high‐safety profile. Results from murine experiments showed that EPIT has comparable efficacy as subcutaneous immunotherapy in terms of challenge outcomes, airway hyper‐responsiveness, and immunologic parameters. Several clinical trials of EPIT have recently been completed or are ongoing. Results support the high safety and tolerability of this approach. Efficacy data suggest that the change in threshold eliciting dose following 1 year of therapy is less than that seen compared to high‐dose (2‐4 g peanut protein) oral immunotherapy, but more prolonged treatment with EPIT appears to lead to increasing desensitization. Additional data from larger‐scale studies should provide a more robust assessment of safety and efficacy of EPIT.
Mothers' informational needs when deciding to have their newborn infant vaccinated with BCG. A Mixed‐methods design
Authors: Pihl Gitte Thybo , Ammentorp Jette , Johannessen Helle , Kjærgaard Jesper , Nissen Thomas Nørrelykke , Birk Nina Marie , Stensballe Lone Graff , Thøstesen Lisbeth Marianne , Kofoed Poul‐Erik
Published: January 2018

Objective

To explore the informational needs of mothers with different levels of education in order to improve counselling about vaccination.

Methods

In the setting of a large vaccination trial, mothers' assessments and yield of written information in combination with telephone consultations were evaluated in a survey. Furthermore, searching strategies for additional information were investigated. Mothers' perspectives on informational needs were explored in focus group discussions.

Results

Out of 2025 mothers, 95% felt well‐informed. Of the 4% not feeling well‐informed, there were significantly more mothers with basic schooling and nontheoretical education. There was no correlation between searching for additional information and feeling well‐informed. The telephone consultation was found to be very supportive for the decision.

Conclusion

The written information was digestible over time. The telephone consultation ensured the mothers' understanding by tailoring and deriving meaning from the information to her special needs. Moreover, it helped the mothers gain an overview of risks and benefits and inspired confidence. These findings indicate that the telephone consultation improved health literacy.

Practice implications

Individual counselling about vaccines is required in addition to information about side effects and accurate instructions on how to react upon them.
Value choices in a mixed economy of care: How politics shapes the implementation of complex social policies
Authors: Nevile Ann , Kay Adrian , Carey Gemma
Published: January 2018

While social and public policy studies recognize the diversity of actors and processes occurring in the implementation of policy and the organization of public service delivery, analysis of the role of value pluralism in implementation remains underdeveloped. This article contributes to a more nuanced understanding of the relationship between value pluralism and organizational responses to value conflict by exploring the effect of politics on the value choices of senior public servants involved in the design and implementation of Australia's National Disability Insurance Scheme. Our analysis shows that politics may play an essential role in facilitating implementation of a complex social policy that contains a number of incommensurable values because successful politics allows these incommensurable values to co‐exist and adaption to take place, thereby avoiding organizational dysfunction.
Women's Yarning Circles: A gender‐specific bail program in one Southeast Queensland Indigenous sentencing court, Australia
Authors: Radke Amelia
Published: January 2018

In response to the over‐representation of Australian Indigenous women in the criminal justice system, culturally relevant and gender‐specific bail programs operate in several Queensland Indigenous sentencing courts or Murri Courts. Queensland Murri Courts are a specialist criminal law practice, which includes Elders and respected persons of Community Justice Groups in the sentencing process of Indigenous peoples. This paper explores the role of one gender‐specific bail program, Women's Yarning or Talking Circles, in one Southeast Queensland Murri Court. Women's Yarning Circles aspire to create an Indigenous‐centred space outside of court proceedings where defendants and Community Justice Group members of the same gender can build a rapport. Gender‐specific bail programs aim to recognise the intricacies of an Indigenous woman's intersectional identity and the diverse needs of each defendant that comes before the Murri Court.
Papain‐treated panels are a simple method for the identification of alloantibodies in multiple myeloma patients treated with anti‐CD38‐based therapies
Authors: Carreño‐Tarragona G. , Cedena T. , Montejano L. , Alonso R. , Miras F. , Valeri A. , Rivero A. , Lahuerta J. J. , Martinez‐Lopez J.
Published: January 2018

Objectives

To report our 2 years of experience navigating the interference of anti‐CD38 monoclonal antibodies (MAs) in 33 patients and describe papain‐treated panels as a complementary method to dithiothreitol (DTT).

Background

Novel anti‐CD38 MAs are now approved or undergoing clinical trials to evaluate their activity in patients with multiple myeloma. A concern with the use of these drugs is that they interfere with blood bank tests in a group of patients who often require blood transfusions.

Methods

Clinical data and whole blood samples were collected from patients receiving daratumumab or isatuximab. Routine blood bank serological tests were performed.

Results

A total of 9·1% of patients presented with alloantibodies prior to treatment. All patients exhibited nonspecific reactivity in indirect antiglobulin tests, and 26% had positive direct antiglobulin tests after beginning treatment. This interference disappeared in all patients after discontinuing treatment. Papain panels avoided this reactivity and allowed us to identify alloantibodies. Phenotyped blood units were transfused, and no patient suffered any transfusion‐related complications.

Conclusion

Anti‐CD38 MAs produce nonspecific interference in blood bank tests. This interference can be overcome by various methods, including DTT or papain treatment as proposed here. These methods have limitations that can be resolved using phenotyped blood units.
Singaporean students’ language repertoires and attitudes revisited
Authors: Leimgruber Jakob R. E. , Siemund Peter , Terassa Laura
Published: January 2018

Singapore has received a large amount of scholarly interest with regards to the structural and sociolinguistic properties of its local variety of English. In contrast, there is comparatively less empirical data on individual linguistic repertoires and usage patterns. Building on previous research into the linguistic and sociological background of young Singaporean adults, our study examines 450 students recruited from three distinct educational institutions: a university, polytechnics, and vocational training schools. A detailed language background questionnaire reveals the degree of multilingualism, patterns of language use, as well as language attitudes towards different languages. We find important differences between the three student cohorts examined here and are able to relate them to their social and ethnic backgrounds.
A quantitative genetic examination of non‐target‐site resistance applied to Avena species
Authors: Darmency H , Uludag A
Published: January 2018

Quantitative genetics tools can be used to assess whether using herbicides at low doses drive selection on standing genetic variation in populations leading to non‐target‐site resistance (NTSR). These tools are particularly important for estimating the number of genes involved and the potential speed of evolution. A short cut to answering questions about the evolution of NTSR may be to measure heritability. The heritability index (H) provides a measure of the potential to develop NTSR and can be simply calculated from classical dose–response experiments. This measure and the associated experimental designs are discussed with two applied examples on Avena spp. (A. fatua and A. sterilis). In these examples, H values ranged from 0.24 to 0.73, which means that selection for NTSR is highly probable in cases with high H value. We suggest that structuring plants into genetic groups (e.g. families or populations) can contribute to our understanding of the evolutionary potential of populations and plant species to evolve resistance, without increasing experimental cost and time.
Hypertonicity‐induced cation channels in HepG2 cells: architecture and role in proliferation vs. apoptosis
Authors: Koos Björn , Christmann Jens , Plettenberg Sandra , Käding Domenic , Becker Julia , Keteku Melody , Klein Christian , Imtiaz Sarah , Janning Petra , Bastiaens Philippe I. H. , Wehner Frank
Published: January 2018

Key points

Na+ conducting hypertonicity‐induced cation channels (HICCs) are key players in the volume restoration of osmotically shrunken cells and, under isotonic conditions, considered as mediators of proliferation – thereby opposing apoptosis.

In an siRNA screen of ion channels and transporters in HepG2 cells, with the regulatory volume increase (RVI) as read‐out, δENaC, TRPM2 and TRPM5 were identified as HICCs.

Subsequently, all permutations of these channels were tested in RVI and patch‐clamp recordings and, at first sight, HICCs were found to operate in an independent mode. However, there was synergy in the siRNA perturbations of HICC currents.

Accordingly, proximity ligation assays showed that δENaC was located in proximity to TRPM2 and TRPM5 suggesting a physical interaction.

Furthermore, δENaC, TRPM2 and TRPM5 were identified as mediators of HepG2 proliferation – their silencing enhanced apoptosis. Our study defines the architecture of HICCs in human hepatocytes as well as their molecular functions.

Hypertonicity‐induced cation channels (HICCs) are a substantial element in the regulatory volume increase (RVI) of osmotically shrunken cells. Under isotonic conditions, they are key effectors in the volume gain preceding proliferation; HICC repression, in turn, significantly increases apoptosis rates. Despite these fundamental roles of HICCs in cell physiology, very little is known concerning the actual molecular architecture of these channels. Here, an siRNA screening of putative ion channels and transporters was performed, in HepG2 cells, with the velocity of RVI as the read‐out; in this first run, δENaC, TRPM2 and TRPM5 could be identified as HICCs. In the second run, all permutations of these channels were tested in RVI and patch‐clamp recordings, with special emphasis on the non‐additivity and additivity of siRNAs – which would indicate molecular interactions or independent ways of channel functioning. At first sight, the HICCs in HepG2 cells appeared to operate rather independently. However, a proximity ligation assay revealed that δENaC was located in proximity to both TRPM2 and TRPM5. Furthermore, a clear synergy of HICC current knock‐downs (KDs) was observed. δENaC, TRPM2 and TRPM5 were defined as mediators of HepG2 cell proliferation and their silencing increased the rates of apoptosis. This study provides a molecular characterization of the HICCs in human hepatocytes and of their role in RVI, cell proliferation and apoptosis.
Combustion Process Analysis and Diagnostic Using Optical Flame Scanners in Front-Fired Pulverized Coal Boiler
Authors: Nabagło Daniel , Kurek Teresa , Wojdan Konrad
Published: January 2018

The paper presents a novel concept and method of coal combustion process analysis using flame scanners supervision system. The combustion process analysis and diagnostic has a crucial influence on boiler effectiveness, especially in high variance of load demand, which is nowadays a top challenge for coal-fired power plants. The first indicator of combustion inefficiency is flame stability, which can be observed as variation of flame intensity. Nowadays, there are no validated measuring methods dedicated for industrial usage, which are able to give complete information about flame condition. For this reason, the research activity was launched and focused on usage of commercial flame scanners for fast combustion analysis based on on-line flame parameters measuring. The analysis of combustion process was performed for 650 t/h live steam power boiler, which is supplied by five coal mill units. Each coal mill supplies four pulverized coal burners pulverized fuel ((PF) burners). The boiler start-up installation consists of 12 heavy oil burners placed in PF burners equipped with individual supervisory system based on Paragon 105f-1 flame scanners, which gave the possibility to observe and analyze the PF burner flame and oil burner flame individually. The research included numerous tests in which the combustion conditions inside the combustion chamber were changed. During stable load of selected mills, the primary air flow, secondary air dampers, air–coal mixture temperature, and balance were changed. The results of the changes were observed by flame scanners and the available optical parameters of the flame were analyzed: power spectral density, average amplitude (AA) of flame fluctuation, and flame temperature.
A Continuum Model for Fiber-Reinforced Soft Robot Actuators
Authors: Sedal Audrey , Bruder Daniel , Bishop-Moser Joshua , Vasudevan Ram , Kota Sridhar
Published: January 2018

Fiber-reinforced elastomeric enclosures (FREEs) generate sophisticated motions, when pressurized, including axial rotation, extension, and compression, and serve as fundamental building blocks for soft robots in a variety of applications. However, most modeling techniques employed by researchers do not capture the key characteristics of FREEs to enable development of robust design and control schemes. Accurate and computationally efficient models that capture the nonlinearity of fibers and elastomeric components are needed. This paper presents a continuum model that captures the nonlinearities of the fiber and elastomer components as well as nonlinear relationship between applied pressure, deformation, and output forces and torque. One of the key attributes of this model is that it captures the behavior of FREEs in a computationally tractable manner with a minimum burden on experimental parameter determination. Without losing generality of the model, we validate it for a FREE with one fiber family, which is the simplest system exhibiting a combination of elongation and twist when pressurized. Experimental data in multiple kinematic configurations show agreement between our model prediction and the moments that the actuators generate. The model can be used to not only determine operational parameters but also to solve inverse problems, i.e., in design synthesis.
Mechanics Design of Stretchable Near Field Communication Antenna With Serpentine Wires
Authors: Xie Zhaoqian , Ji Bowen , Huo Qingze
Published: January 2018

Recent advances in materials, mechanics, and electronics manufacturing are establishing the foundations for health/wellness monitoring technologies that have “skin-like” properties, with options in long-term integration with the epidermis. However, most examples of such emerging classes of devices require batteries and/or hard-wired connections to enable operation. The note reported here introduces a foundational mechanics design strategy of stretchable near field communication (NFC) antenna with serpentine microstructures to achieve wireless, battery-free transmission of power and/or data, where the planar layout, polyimide (PI) layer thickness of the serpentine wire, and composite substrate are designed to achieve larger elastic stretchability.
Technical Overview of Osseointegrated Transfemoral Prostheses: Orthopedic Surgery and Implant Design Centered
Authors: Maryniak Andrii , Laschowski Brock , Andrysek Jan
Published: January 2018

Bone-anchored prostheses represent a promising solution to numerous medical complications associated with conventional socket-suspended prostheses. The following technical overview was constructed for engineers and orthopedic surgeons interested in osseointegrated implants for transfemoral prosthesis-residuum interfacing. Existing osseointegrated implants comprise different biomaterial compositions (i.e., titanium alloy versus cobalt-chromium-molybdenum alloy) and mechanical designs (i.e., screw-fixated versus press-fixated devices). Perioperative systems of osseointegration surgery include preoperative assessments (i.e., alongside inclusion and exclusion criteria), intraoperative procedures, and postoperative rehabilitation (i.e., static loading and dynamic gait rehabilitation). The intraoperative procedures involve transecting and reorganizing the residual musculature, embedding the implant into the femoral intramedullary cavity, and coupling the osseointegrated implant to an external prosthesis. Postoperative clinical evaluations have demonstrated significant biomechanical, psychological, and physiological improvements in patients using bone-anchored prostheses compared to conventional socket-suspended prostheses. Nevertheless, bacterial infections surrounding the skin-implant bio-interface, often resulting from Staphylococcus aureus or other coagulase-negative staphylococci, remain a relatively frequent medical complication, which can culminate in periprosthetic osteomyelitis and/or implant extraction. The technical overview concludes with discussing the recent Food and Drug Administration humanitarian use device designations, financial analyses between bone-anchored prostheses and socket-suspended prostheses, and applications of vibrotactile osseoperception for augmenting walking and balance feedback control.
Effects of Superplastic Forming on Modification of Surface Properties of Ti Alloys for Biomedical Applications
Authors: Palumbo G. , Sorgente D. , Vedani M. , Mostaed E. , Hamidi M. , Gastaldi D. , Villa T.
Published: January 2018

In the present work, both the surface chemical contamination and the mechanical alteration of Ti–6Al–4V (Ti64) and Ti–6Al–4V extra low interstitial (Ti64ELI) titanium alloys subjected to superplastic forming (SPF) for the manufacturing of highly customized biomedical prostheses have been investigated. As case study, a cranial implant was considered. The design of the manufacturing process was assisted by a numerical model calibrated on free inflation experimental tests. Glow discharge optical emission spectrometry (GDOES) analyses, nanoindentation tests, and metallographic analyses allowed to relate the mechanical alteration to the oxygen enrichment due to the environmental exposition during processing. While similar diffusion kinetics were found, different oxidation rates were measured in the two investigated alloys. The hardness variation was strictly related to the oxygen content. In order to verify the material biocompatibility, cytotoxicity tests were conducted on the most oxidized part. Results highlighted that the oxygen enrichment due to the manufacturing process did not significantly affect the cells viability.