bluuebunny/crossref_metadata_2025 huggingface dataset:
Lung volume reduction surgery as salvage procedure after previous use of endobronchial valves
Authors: Caviezel Claudio , Guglielmetti Laura-Chiara , Ladan Mateja , Hansen Henrik Jessen , Perch Michael , Schneiter Didier , Weder Walter , Opitz Isabelle , Franzen Daniel
Published: October 2020

OBJECTIVES

Lung volume reduction (LVR) is an efficient and approved treatment for selected emphysema patients. There is some evidence that repeated LVR surgery (LVRS) might be beneficial, but there are no current data on LVRS after unsuccessful bronchoscopic LVR (BLVR) with endobronchial valves (EBVs). We hypothesize good outcome of LVRS after BLVR with valves.

METHODS

In this study, we retrospectively investigated all patients who underwent LVRS between 2015 and 2019 at 2 centres after previous unsuccessful EBV treatment. They were further divided into subgroups with patients who never achieved the intended improvement after BLVR (primary failure) and patients whose benefit was fading over time due to the natural development of emphysema (secondary failure). Patients with severe air leak after BLVR and immediate concomitant LVRS and fistula closure thereafter were analysed separately.

RESULTS

A total of 38 patients were included. Of these, 19 patients had primary failure, 15 secondary failure and 4 were treated as an emergency due to severe air leak. At 3 months after LVRS, forced expiratory volume in 1 s had improved significantly by 12.5% (P = 0.011) and there was no 90-day mortality. Considering subgroups, patients with primary failure after BLVR seem to profit more than those with secondary failure. Patients with severe air leak after BLVR did not profit from fistula closure with concomitant LVRS.

CONCLUSIONS

LVRS after previous BLVR with EBVs can provide significant clinical improvement with low morbidity, although results might not be as good as after primary LVRS.
“A catalyst for action”: Factors for implementing clinical risk prediction models of infection in home care settings
Authors: Dowding Dawn , Russell David , McDonald Margaret V , Trifilio Marygrace , Song Jiyoun , Brickner Carlin , Shang Jingjing
Published: October 2020

Objective

The study sought to outline how a clinical risk prediction model for identifying patients at risk of infection is perceived by home care nurses, and to inform how the output of the model could be integrated into a clinical workflow.

Materials and Methods

This was a qualitative study using semi-structured interviews with 50 home care nurses. Interviews explored nurses’ perceptions of clinical risk prediction models, their experiences using them in practice, and what elements are important for the implementation of a clinical risk prediction model focusing on infection. Interviews were audio-taped and transcribed, with data evaluated using thematic analysis.

Results

Two themes were derived from the data: (1) informing nursing practice, which outlined how a clinical risk prediction model could inform nurse clinical judgment and be used to modify their care plan interventions, and (2) operationalizing the score, which summarized how the clinical risk prediction model could be incorporated in home care settings.

Discussion

The findings indicate that home care nurses would find a clinical risk prediction model for infection useful, as long as it provided both context around the reasons why a patient was deemed to be at high risk and provided some guidance for action.

Conclusions

It is important to evaluate the potential feasibility and acceptability of a clinical risk prediction model, to inform the intervention design and implementation strategy. The results of this study can provide guidance for the development of the clinical risk prediction tool as an intervention for integration in home care settings.
Coercion at the ICC
Authors: Schack Marc
Published: October 2020

Throughout the history of international criminal justice, it has been the source of fierce debate whether institutions like the International Criminal Court (ICC) can prevent atrocity crimes from being committed by putting coercive judicial pressure on potential rule-breakers. Theories and insights drawn from the domestic literature on criminal justice have shaped much of this debate — based on the assumption that international criminal justice is essentially an internationalized version of domestic criminal justice (what I term the ‘domestic origin’ approach). The present article challenges this perspective by pointing out its shortcomings. It suggests that we should instead — or, at least, additionally — treat these international courts and tribunals as sui generis institutions imbedded in the world of international politics. From this perspective we can therefore draw on rationalist approaches to coercive power within the field of International Relations (IR) to analyse these institutions' coercive capacity. Unlike the domestic origin approach, this would allow researchers to draw on existing work on coercive power focusing on scenarios that play out in the kind of setting (major intra- or interstate conflicts) and involve the types of people (leaders of nations, armies and militias) which courts like the ICC were built to deal with.
Evaluating the Effects of Minimal Risk Natural Products for Control of the Tick, Ixodes scapularis (Acari: Ixodidae)
Authors: Dyer Megan C , Requintina Matthew D , Berger Kathryn A , Puggioni Gavino , Mather Thomas N
Published: October 2020

Knockdown and residual activity of 10 minimal risk natural products (MRNPs), one experimental formulation of nootkatone, and two bifenthrin labels were evaluated against host-seeking nymphal Ixodes scapularis Say using a novel micro-plot product screening system placed in a landscape setting similar to a wooded residential property. The MRNPs evaluated included Tick Stop, EcoPCO EC-X, Met52 EC, CedarCide PCO Choice, EcoEXEMPT IC2, EcoSMART Organic Insecticide, Essentria IC3, privately labeled products 1 and 2 (based on EcoEXEMPT IC2 and sold as a professional pest control application), and Tick Killz. Just the nootkatone and 4 of these 10 products tested (EcoPCO EC-X, Met52 EC, EcoEXEMPT IC2, and Essentria IC3) had statistically significant (P < 0.05) knockdown effects (killed ticks while active in the arenas) when compared to water-only controls, but only 2 of these, EcoPCO EC-X and nootkatone, displayed significant residual tick-killing activity after weathering naturally in the landscape for 2 wk prior to tick application/testing. Moreover, botanical oil-based products with the same active ingredients provided inconsistent results when tested multiple times across study years.
Reciprocal Links Between Physical Health and Coping Among Adolescents With Cystic Fibrosis
Authors: D’Angelo Christina M , Mrug Sylvie , Grossoehme Daniel , Leon Kevin , Thomas Lacrecia , Troxler Bradley
Published: October 2020

Objective

Adolescents with cystic fibrosis (CF) often face a unique set of difficulties and challenges as they transition to adulthood and autonomy while also managing a progressive illness with a heavy treatment burden. Coping styles have been related to changes in physical health among youth with chronic illness more generally, but the directionality of these links has not been fully elucidated. Therefore, the objective of this study was to evaluate bidirectional links between coping styles and physical health indicators among adolescents with CF over time.

Methods

Adolescents (N = 79, 54% female) recruited from inpatient and outpatient CF clinics at two sites completed questionnaires assessing secular and religious/spiritual coping styles at two time points (18 months apart, on average). Health indicators including pulmonary functioning, nutritional status, and days hospitalized were obtained from medical records.

Results

More frequent hospitalizations predicted lower levels of adaptive secular coping over time. However, poorer pulmonary functioning predicted higher levels of positive religious/spiritual coping. The number of days hospitalized was related to adaptive secular coping and negative religious/spiritual coping.

Conclusions

Among youth with CF, physical health functioning is more consistent in predicting coping strategies than the reverse. Poorer pulmonary functioning appears to enhance adaptive coping over time, suggesting resilience of adolescents with CF, while more frequent hospitalizations may inhibit the use of adaptive coping strategies. Findings support the use of interventions aimed at promoting healthy coping among hospitalized adolescents with CF.
Who
Can Make Treaties? The European Union
Authors: Cremona Marise
Published: October 2020

This chapter examines the EU’s robust and complex treaty-making. The first section deals with the EU’s treaty-making capacity from the perspective of EU law, and then of international treaty practice. It examines the ways in which international treaty-making practice has accommodated EU participation in bilateral and in multilateral agreements. The second section discusses the legal effects of treaties concluded by the EU, first as regards the EU legal order, including their enforcement and interpretation by the Court of Justice of the European Union and the legal effects of mixed agreements. A discussion of the impact of EU treaty-making on the powers of the Member States follows: through the doctrines of exclusivity and pre-emption, the impact of EU law on treaties concluded by the Member States, and finally EU treaty-making from the perspective of international responsibility.
Reacting against Treaty Breaches
Authors: Simma Bruno , Tams Christian J
Published: October 2020

This chapter considers whether international law provides means and methods to respond to alleged treaty breaches. It does so in four steps. First, it provides an overview of the international regime governing reactions against treaty breaches. The next two sections analyse the two most relevant generally available means of response under the law of treaties and the law of State responsibility, respectively. The final section offers some concluding observations. In addressing questions of treaty breaches and responses, the chapter focuses on rules of international law regulating inter-State behaviour. Notwithstanding this restriction, it seems clear that treaty breaches can be committed by and against different (non-State) subjects of international law, notably by and against international organizations. While these raise some special problems, they are in principle subject to the rules developed to govern inter-State relations.
Initial Decisions on Treaty-Making
Authors: Hollis Duncan B
Published: October 2020

This chapter offers a new set of sample clauses, building off the Treaty Maker’s Handbook framework with several modifications. First, based on current practice, it includes samples of clauses not found in Blix and Emerson’s earlier work (e.g. participation clauses for regional integration organizations, NGO participation clauses, clauses signalling an intent to conclude a political commitment). Second, this new treatment reorganizes the treatment of other topics Blix and Emerson did consider; for example, in lieu of simply reproducing Preambles, clauses that implicate a treaty’s object and purpose are presented instead. The current set of sample clauses focuses on illustrating variations and precedents in treaties themselves.
Detention in Armed Conflict
Authors: Pejic Jelena
Published: October 2020

This chapter highlights deprivation of liberty or detention, which is a regular occurrence in armed conflict. Along with the conduct of hostilities, it is one of the ways in which a belligerent attempts to weaken and ultimately defeat an adversary. Detention is regulated by a large number of provisions of international humanitarian law (IHL), the underlying and overarching purpose of which is to ensure the humane treatment of persons deprived of liberty. Apart from the relevant IHL treaty provisions, rules on various aspects of detention in armed conflict are also found in customary IHL, domestic law, and human rights law. The chapter then addresses some issues which concern the topic of detention: treatment and conditions of detention, procedural safeguards in internment, fair trial rights, and the transfer of detainees.
The effects of rotation on the lithium depletion of G- and K-dwarfs in Messier 35
Authors: Jeffries R D , Jackson R J , Sun Qinghui , Deliyannis Constantine P
Published: October 2020

New fibre spectroscopy and radial velocities from the WIYN telescope are used to measure photospheric lithium in 242 high-probability, zero-age main-sequence F- to K-type members of the rich cluster M35. Combining these with published rotation periods, the connection between lithium depletion and rotation is studied in unprecedented detail. At Teff < 5500 K there is a strong relationship between faster rotation and less Li depletion, although with a dispersion larger than measurement uncertainties. Components of photometrically identified binary systems follow the same relationship. A correlation is also established between faster rotation rate (or smaller Rossby number), decreased Li depletion and larger stellar radius at a given Teff. These results support models where star-spots and interior magnetic fields lead to inflated radii and reduced Li depletion during the pre-main-sequence (PMS) phase for the fastest rotators. However, the data are also consistent with the idea that all stars suffered lower levels of Li depletion than predicted by standard PMS models, perhaps because of deficiencies in those models or because saturated levels of magnetic activity suppress Li depletion equally in PMS stars of similar Teff regardless of rotation rate, and that slower rotators subsequently experience more mixing and post-PMS Li depletion.
Magnetic field evolution time-scales in superconducting neutron stars
Authors: Gusakov M E , Kantor E M , Ofengeim D D
Published: October 2020

The self-consistent approach to the magnetic field evolution in neutron star (NS) cores, developed recently, is generalized to the case of superfluid and superconducting NSs. Applying this approach to the cold matter of NS cores composed of neutrons, protons, electrons, and muons, we find that, similarly to the case of normal matter, an arbitrary configuration of the magnetic field may result in generation of macroscopic particle velocities, strongly exceeding their diffusive (relative) velocities. This effect substantially accelerates evolution of the magnetic field in the stellar core. An hierarchy of time-scales of such evolution at different stages of NS life is proposed and discussed. It is argued that the magnetic field in the core cannot be considered as frozen or vanishing and that its temporal evolution should affect the observational properties of NSs.
2′-O-Methylation can increase the abundance and lifetime of alternative RNA conformational states
Authors: Abou Assi Hala , Rangadurai Atul K , Shi Honglue , Liu Bei , Clay Mary C , Erharter Kevin , Kreutz Christoph , Holley Christopher L , Al-Hashimi Hashim M
Published: October 2020

2′-O-Methyl (Nm) is a highly abundant post-transcriptional RNA modification that plays important biological roles through mechanisms that are not entirely understood. There is evidence that Nm can alter the biological activities of RNAs by biasing the ribose sugar pucker equilibrium toward the C3′-endo conformation formed in canonical duplexes. However, little is known about how Nm might more broadly alter the dynamic ensembles of flexible RNAs containing bulges and internal loops. Here, using NMR and the HIV-1 transactivation response (TAR) element as a model system, we show that Nm preferentially stabilizes alternative secondary structures in which the Nm-modified nucleotides are paired, increasing both the abundance and lifetime of low-populated short-lived excited states by up to 10-fold. The extent of stabilization increased with number of Nm modifications and was also dependent on Mg2+. Through phi-value analysis, the Nm modification also provided rare insights into the structure of the transition state for conformational exchange. Our results suggest that Nm could alter the biological activities of Nm-modified RNAs by modulating their secondary structural ensembles as well as establish the utility of Nm as a tool for the discovery and characterization of RNA excited state conformations.
Separable functions of Tof1/Timeless in intra-S-checkpoint signalling, replisome stability and DNA topological stress
Authors: Westhorpe Rose , Keszthelyi Andrea , Minchell Nicola E , Jones David , Baxter Jonathan
Published: October 2020

The highly conserved Tof1/Timeless proteins minimise replication stress and promote normal DNA replication. They are required to mediate the DNA replication checkpoint (DRC), the stable pausing of forks at protein fork blocks, the coupling of DNA helicase and polymerase functions during replication stress (RS) and the preferential resolution of DNA topological stress ahead of the fork. Here we demonstrate that the roles of the Saccharomyces cerevisiae Timeless protein Tof1 in DRC signalling and resolution of DNA topological stress require distinct N and C terminal regions of the protein, whereas the other functions of Tof1 are closely linked to the stable interaction between Tof1 and its constitutive binding partner Csm3/Tipin. By separating the role of Tof1 in DRC from fork stabilisation and coupling, we show that Tof1 has distinct activities in checkpoint activation and replisome stability to ensure the viable completion of DNA replication following replication stress.
Gramene 2021: harnessing the power of comparative genomics and pathways for plant research
Authors: Tello-Ruiz Marcela K , Naithani Sushma , Gupta Parul , Olson Andrew , Wei Sharon , Preece Justin , Jiao Yinping , Wang Bo , Chougule Kapeel , Garg Priyanka , Elser Justin , Kumari Sunita , Kumar Vivek , Contreras-Moreira Bruno , Naamati Guy , George Nancy , Cook Justin , Bolser Daniel , D’Eustachio Peter , Stein Lincoln D , Gupta Amit , Xu Weijia , Regala Jennifer , Papatheodorou Irene , Kersey Paul J , Flicek Paul , Taylor Crispin , Jaiswal Pankaj , Ware Doreen
Published: October 2020

Gramene (http://www.gramene.org), a knowledgebase founded on comparative functional analyses of genomic and pathway data for model plants and major crops, supports agricultural researchers worldwide. The resource is committed to open access and reproducible science based on the FAIR data principles. Since the last NAR update, we made nine releases; doubled the genome portal's content; expanded curated genes, pathways and expression sets; and implemented the Domain Informational Vocabulary Extraction (DIVE) algorithm for extracting gene function information from publications. The current release, #63 (October 2020), hosts 93 reference genomes—over 3.9 million genes in 122 947 families with orthologous and paralogous classifications. Plant Reactome portrays pathway networks using a combination of manual biocuration in rice (320 reference pathways) and orthology-based projections to 106 species. The Reactome platform facilitates comparison between reference and projected pathways, gene expression analyses and overlays of gene–gene interactions. Gramene integrates ontology-based protein structure–function annotation; information on genetic, epigenetic, expression, and phenotypic diversity; and gene functional annotations extracted from plant-focused journals using DIVE. We train plant researchers in biocuration of genes and pathways; host curated maize gene structures as tracks in the maize genome browser; and integrate curated rice genes and pathways in the Plant Reactome.
Loosely Relational Constitutional Rights
Authors: Kohavi Tom
Published: October 2020

This article attends to claims that the expansionist trend in modern constitutional practices resulted in the recognition of many norms that are not real rights: that fail to guide and constrain duty-bearers and empower and protect right-holders because they are too abstract and can be limited too regularly. It claims that many constitutional rights are, indeed, ‘loosely relational’: the correlation between them and duties is flexible and affected by considerations external to the direct relations between the right-holder and the duty-bearer. However, it adds that the assumption that rights must be ‘strictly relational’ for them to exhibit the robust normativity that gives rights their force and value is incorrect. This is important because loosely relational constitutional rights confer this robust normativity on consequentialist standards for the evaluation of legal norms and activities: a fundamental role constitutional rights play in modern liberal legal systems, reflecting a collective commitment to the realisation of social justice.
Concentrated Ownership, State-Owned Enterprises and Corporate Governance
Authors: Lim Ernest W K
Published: October 2020

Concentrated ownership companies are increasing worldwide, a significant percentage of which are state-owned enterprises (SOEs), whose controller is the government. Government owners are the world’s second largest type of shareholder. Despite extensive literature on SOEs, there is little analysis of how corporate governance can be undermined by the state as the controller of SOEs or how it can be deployed by the government to serve its own ends. This article critically examines how the conflict of interest between the government as the controller of SOEs on the one hand and the minority shareholders and stakeholders on the other, as well as the conflict of interest between the government as the controller on the one hand and the government as the regulator on the other, can affect three corporate governance regimes, namely, sustainability (environmental, social and governance) reporting; directors’ duty to act in the best interests of the company; and stewardship code.
Fluorescein Sodium-Guided Neuroendoscopic Resection of Deep-Seated Malignant Brain Tumors: Preliminary Results of 18 Patients
Authors: Kutlay Murat , Durmaz Ozan , Ozer İlker , Kırık Alpaslan , Yasar Soner , Kural Cahit , Temiz Çağlar , Tehli Özkan , Ezgu Mehmet Can , Daneyemez Mehmet , Izci Yusuf
Published: October 2020

BACKGROUND

Deep-seated intracranial lesions are challenging to resect completely and safely. Fluorescence-guided surgery (FGS) promotes the resection of malignant brain tumors (MBTs). Classically, FGS is performed using microscope equipped with a special filter. Fluorescence-guided neuroendoscopic resection of deep-seated brain tumors has not been reported yet.

OBJECTIVE

To evaluate the feasibility, safety, and effectiveness of the fluorescence-guided neuroendoscopic surgery in deep-seated MBTs.

METHODS

A total of 18 patients with high-grade glioma (HGG) and metastatic tumor (MT) underwent fluorescein sodium (FS)-guided neuroendoscopic surgery. Tumor removal was carried out using bimanual microsurgical techniques under endoscopic view. The degree of fluorescence staining was classified as “helpful” and “unhelpful” based on surgical observation. Extent of resection was determined using magnetic resonance imaging (MRI). Karnofsky Performance Status (KPS) score was used for evaluation of general physical performances of patients.

RESULTS

A total of 11 patients had HGG, and 7 had MT. No technical difficulty was encountered regarding the use of endoscopic technique. “Helpful” fluorescence staining was observed in 16 patients and fluorescent tissue was completely removed. Postoperative MRI confirmed gross total resection (88.9%). In 2 patients, FS enhancement was not helpful enough for tumor demarcation and postoperative MRI revealed near total resection (11.1%). No complication, adverse events, or side effects were encountered regarding the use of FS. KPS score of patients was improved at 3-mo follow-up.

CONCLUSION

FS-guided endoscopic resection is a feasible technique for deep-seated MBTs. It is safe, effective, and allows for a high rate of resection. Future prospective randomized studies are needed to confirm these preliminary data.
Fiber Microdissection Technique for Demonstrating the Deep Cerebellar Nuclei and Cerebellar Peduncles
Authors: Pruthi Nupur , Kadri Paulo A S , Türe Uğur
Published: October 2020

BACKGROUND

The cerebellum is one of the most primitive and complex parts of the human brain. The fiber microdissection technique can be extremely useful for neurosurgeons to understand the topographical organization of the cerebellum's important contents, such as the deep cerebellar nuclei and the cerebellar peduncles, and their relationship with the brain stem.

OBJECTIVE

To dissect the deep cerebellar nuclei and the cerebellar peduncles using the fiber microdissection technique.

METHODS

Under the operating microscope, 5 previously frozen, formalin-fixed human cerebellums and brain stems were dissected from the superior surface, and 5 were dissected from the inferior surface. Each stage of the process is described. The primary dissection tools were handmade, thin, wooden spatulas with tips of various sizes, toothpicks, and a fine regulated suction.

RESULTS

In 15 simplified dissection steps (6 for the superior surface and 9 for the inferior surface), the deep cerebellar nuclei (dentate, interpositus, and fastigial) and the cerebellar peduncles (inferior, middle, and superior) are delineated. Their anatomical relationships with each other and other neighboring structures are demonstrated.

CONCLUSION

The anatomy of the deep cerebellar nuclei and the cerebellar peduncles are clearly defined and understood through the use of the fiber microdissection technique. These stepwise dissections will guide the neurosurgeon in acquiring a topographical understanding of these complex and deep structures of the cerebellum. This knowledge, along with radiological information, can help in planning the most appropriate surgical strategy for various lesions of the cerebellum.
Must We Love Epistemic Goods?
Authors: Crerar Charlie
Published: October 2020

It is widely held that for an agent to have any intellectual character virtues, they must be fundamentally motivated by a love of epistemic goods. In this paper, I challenge this ‘strong motivational requirement’ on virtue. First, I call into question three key reasons offered in its defence: that a love of epistemic goods is needed to explain the scope, the performance quality, or the value of virtue. Secondly, I highlight several costs and restrictions that we incur from its acceptance. In so doing, I show that my titular question is more than just a question about the nature of virtuous motivation or the structure of intellectual virtue. Ultimately, it is a question about the very function of virtue epistemology itself.
Prevalence and correlates of skin self-examination behaviors among melanoma survivors: a systematic review
Authors: Bhurosy Trishnee , Heckman Carolyn J , Riley Mary
Published: October 2020

Melanoma is the most common cause of skin cancer deaths, and individuals who have had melanoma have an increased risk of developing new melanomas. Doing regular self-examinations of skin enables one to detect thinner melanomas earlier when the disease is more treatable. The aim of this systematic review is to characterize and evaluate the existing literature on the prevalence and correlates of skin self-examination (SSE) behaviors among adult melanoma survivors in the USA and Canada. A computerized literature search was performed using PubMed, Google Scholar, and ScienceDirect. The inclusion criteria for the studies were: (a) reported results for adult melanoma survivors in the USA or Canada, (b) papers described empirical research, (c) assessed SSE and related behaviors, and (d) papers were published in a peer-reviewed journal in the past 20 years. Key phrases such as “skin self-examination/SSE in melanoma survivors in the United States” and “correlates of skin self-examination/SSE” were used. Based on the inclusion criteria, 30 studies were included in the systematic review. SSE prevalence varied depending on how SSE was defined. Demographics and factors (gender, education level, patient characteristics, partner assistance, and physician support) associated with SSE were identified. Findings of this review show evidence for the need to have a consistent way to assess SSE and suggest different types of correlates on which to focus in order to promote SSE and reduce the risk of melanoma recurrence in survivors. This systematic review and its protocol have been registered in the international database of prospectively registered systematic reviews in health and social care (PROSPERO; ID: 148878)
A systematic review of physical activity, sedentary behavior, and substance use in adolescents and emerging adults
Authors: West Ashley B , Bittel Kelsey M , Russell Michael A , Evans M Blair , Mama Scherezade K , Conroy David E
Published: October 2020

The transition from adolescence into emerging adulthood is marked by changes in both physical activity and substance use. This systematic review characterized associations between movement behaviors (physical activity, sedentary behavior) and frequently used substances (alcohol, cannabis) among adolescents and emerging adults to inform lifestyle interventions that target multiple behavior change outcomes. This systematic review was guided by PRISMA. Electronic databases of PubMed, PsycINFO, and Web of Science were searched from inception through June 25, 2019. The search was designed to identify empirical studies reporting an association between physical activity or sedentary behavior and alcohol or cannabis, with search criteria determining eligibility based on several sampling characteristics (e.g., participants under 25 years of age). After identifying and screening 5,610 studies, data were extracted from 97 studies. Physical activity was positively associated with alcohol use among emerging adults, but the literature was mixed among adolescents. Sedentary behavior was positively associated with alcohol and cannabis use among adolescents, but evidence was limited among emerging adults. Self-report measures were used in all but one study to assess these behaviors. Physical activity is linked to greater alcohol use among emerging adults. Whereas existing studies demonstrate that sedentary behavior might serve as a risk marker for alcohol and cannabis use among adolescents, additional primary research is needed to explore these associations in emerging adults. Future work should also use device-based measures to account for timing of and contextual features surrounding activity and substance use in these populations.
Guidelines for caregivers and healthcare professionals on speaking to children about overweight and obesity: a systematic review of the gray literature
Authors: Lampe Elizabeth W , Abber Sophie R , Forman Evan M , Manasse Stephanie M
Published: October 2020

Caregivers and healthcare professionals (HPs) are increasingly concerned about childhood obesity. A critical consideration of caregivers and HPs is discussing weight status without provoking disordered eating. Given the complexity of these interacting concerns, major health advocacy groups have independently published guidelines for having conversations with children about overweight/obesity. The current investigation represented the first-ever systematic review of these guidelines to analyze their content, consistency, actionability, or scientific support. To conduct a systematic review, the authors performed a web-based search using the terms parent/HP, guidelines, child, and overweight/obesity that identified 59 guidelines on childhood obesity broadly, of which 13 provided explicit direction on how the caregiver or HP should approach a conversation about overweight with a child. Within these 13 guidelines, nine topic domains were identified: attitude modeling (covered by 31% of guidelines), behavior modeling (61%), dietary recommendations (54%), physical activity (46%), body acceptance and self-esteem (69%), conversation advice (92%), contact with HP (46%), talking about “weight” versus “overall health” (54%) and external factors (e.g., bullying, media) (54%). Although guidelines presented similar content, several inconsistencies in recommendations emerged. Notably, only three of the 13 guidelines referenced any scholarly sources and only a small minority of advice was actionable by caregivers or HPs. It is evident that guidelines for caregivers and HPs on speaking to children about obesity offer inconsistent advice, minimally based on empirical evidence. Future guidelines should aim to unify their messages for caregivers and HP and be better supported by empirical data.
A systematic review of intensive outpatient care programs for high-need, high-cost patients
Authors: Delaney Rebecca K , Sisco-Taylor Brittany , Fagerlin Angela , Weir Peter , Ozanne Elissa M
Published: October 2020

Five percent of the patient population accounts for 50% of U.S. healthcare expenditures. High-need, high-cost patients are medically complex for numerous reasons, often including behavioral health needs. Intensive outpatient care programs (IOCPs) are emerging, innovative clinics which provide patient-centered care leveraging multidisciplinary teams. The overarching goals of IOCPs are to reduce emergency department visits and hospitalizations (and related costs), and improve care continuity and patient outcomes. The purpose of this review was to examine the effectiveness of IOCPs on multiple outcomes to inform clinical care. A systematic search of the literature was conducted to identify articles. Six studies were included that varied in rigor of research design, analysis, and measurement of outcomes. Most studies reported results on healthcare utilization (n = 4) and costs (n = 3), with fewer reporting results on patient-reported and health-related outcomes (n = 2). Overall, there were decreasing trends in emergency department visits and hospitalizations. However, results on healthcare utilization varied based on time of follow-up, with shorter follow-up times yielding more significant results. Two of the three studies that evaluated costs found significant reductions associated with IOCPs, and the third was cost-neutral. Two studies reported improvements in patient-reported outcomes (e.g., satisfaction, depression, and anxiety). Overall, these programs reported positive impacts on healthcare utilization and costs; however, few studies evaluated patient characteristics and behaviors (e.g., engagement in care) which may serve as key mechanisms of program effectiveness. Future research should examine patient characteristics, behaviors, and clinic engagement metrics to inform clinical practice.
A systematic review of interventions using health behavioral theories to improve medication adherence among patients with hypertension
Authors: Nili Mona , Mohamed Rowida , Kelly Kimberly M
Published: October 2020

Medication adherence is a major problem in the treatment of hypertension. Approximately half of the patients who use antihypertensive medications are not adherent. Several interventions have endeavored to improve medication adherence among patients with hypertension, and some have used health behavioral models/theories. However, the quality and effectiveness of using health behavioral models/theories in improving medication adherence among patients with hypertension remain unknown. The main aim of this systematic review was to describe study characteristics and types of health behavioral models/theories used in interventions for improving medication adherence among adults with hypertension. PubMed, Scopus, Ovid MEDLINE, CINAHL, and PsycINFO databases were searched for randomized clinical trial interventions using any health behavioral models/theories published in English from 1979 to 2019. Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, two independent reviewers searched, screened abstracts and articles, extracted data, and assessed the risk of bias and the use of the model/theory using the Theory Coding Scheme. A total of 11 articles were included in this systematic review. Two studies reported significant improvement in medication adherence. The Self-Regulation Model and Social Cognitive Theory were the most common types of models/theories. Nine studies used a single model/theory, and four studies measured the constructs of a model/theory. Risk of bias was good (n = 4) and fair (n = 5) in interventions. Using health behavioral models/theories may be an efficient way for health care professionals to improve adherence to medications among patients with hypertension. More interventions with rigorous designs are needed that appropriately utilize health behavioral models/theories for improving medication adherence among adults with hypertension.
A systematic review examining the relationship between food insecurity and early childhood physiological health outcomes
Authors: Simonovich Shannon Deirdre , Pineros-Leano Maria , Ali Asma , Awosika Olanrewaju , Herman Anne , Withington Margaret H C , Loiacono Bernardo , Cory Molly , Estrada Monica , Soto Danya , Buscemi Joanna
Published: October 2020

Food insecurity, or limited access to nutritious foods, is a significant public health concern especially among vulnerable populations including infants and young children in low-income households. While literature to date has thoroughly examined the psychological and behavioral impacts of food insecurity on children, no known study to date has specifically synthesized the literature exploring the relationship between food insecurity and physiological health outcomes during early childhood. The purpose of this study was to review the literature on physiological health outcomes associated with food insecurity during early childhood among children aged 0–5 years in developed countries. Our literature search sources included PubMed, PsycInfo, CINAHL, and Embase databases. A total of 657 articles published up to September 2019 were reviewed for eligibility by two coders, with a third reviewer in cases of disagreement. Eighty-three articles remained after screening by abstract, with a final 27 studies ultimately included in the final synthesis. This review is registered with PROSPERO and adhered to PRISMA guidelines. In total, 20 articles (74%) noted significant relationships between food insecurity and physiological health outcomes in young children. Findings included an association with overweight or obesity (n = 9), anemia (n = 3), poor child health (n = 3), low birth weight (n = 3), chronic illness (n = 1), special health care needs (n = 1), and increased cortisol (n = 1), in young children who experience food insecurity. Identifying relationships between food insecurity and health outcomes during early childhood has the potential to inform future prevention interventions to reduce health disparities in these vulnerable populations.
A systematic review and meta-analysis of physical activity interventions among colorectal cancer survivors
Authors: Mbous Yves Paul , Patel Jayeshkumar , Kelly Kimberly M
Published: October 2020

With the growing number of colorectal cancer survivors (CRCS), theory-based, high-quality physical activity (PA) interventions are needed to promote quality and quantity of life. This systematic review and meta-analysis synthesized theory-based PA interventions among CRCS. Using PubMed, PsyINFO, CINAHL, MEDLINE, SportDiscus, and Cochrane databases, studies including CRCS participants, a PA outcome, a behavioral theory/model or behavior change techniques (BCTs), and randomized research design were identified. Two reviewers coded BCT, intervention reproducibility (Template for Intervention Description and Replication–TIDier), risk of bias, and quality of evidence. From an initial screen of 1,328 articles, 10 RCTs met our inclusion criteria. The Transtheoretical Model (n = 3), Social Cognitive Theory (n = 3), and Theory of Planned Behavior (n = 2) were the most used theories. “Goal setting (behavior)” (n = 10), “goal setting (outcome)” (n = 10), “action planning” (n = 9), and “problem solving” (n = 9) were the most commonly used BCTs. Intervention modalities were primarily print material based (n = 4) and telephone counseling (n = 4). Findings demonstrated that theory-based PA interventions are successful at increasing PA among CRCS as meta-analysis evidenced a small effect size of 0.26. TDier items 3, 9, and 12 hindered intervention replicability. Lack of blinding and bias in the measurement of outcomes by assessors resulted in serious bias. In-depth theoretical applications are needed for PA interventions that minimize bias and improve outcomes measurement. Intervention adherence and fidelity, as well as theoretical construct measurement pre- and post-intervention, will enhance the behavioral research enterprise. PROSPERO registration: CRD42019142816.
A systematic review of the implementation of obesity prevention interventions in early childcare and education settings using the RE-AIM framework
Authors: Sanchez-Flack Jennifer C , Herman Annie , Buscemi Joanna , Kong Angela , Bains Alexis , Fitzgibbon Marian L
Published: October 2020

Previous systematic reviews have examined the efficacy of obesity prevention interventions within early childcare/education settings. Often lacking in these reviews is reporting on external validity, which continues to be underemphasized compared to internal validity. More attention to external validity would help better translate evidence-based interventions to real-world settings. This systematic review aimed to determine the availability of data on both internal and external validity across dimensions of the Reach, Efficacy/Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) framework in studies reporting on obesity prevention interventions in early childcare/education settings. Inclusion criteria included: randomized controlled trials, early childcare/education setting, targeted children 2–6 years old, addressed both diet and physical activity, collected measures of weight status and diet and/or physical activity, and published within the last 10 years. Searches were conducted in ERIC, PsychInfo, and PubMed; 23 studies met inclusion criteria. A validated RE-AIM abstraction tool was used to code studies. Most commonly reported dimensions were Reach (62.3%), Implementation (53.5%), and Efficacy/Effectiveness (48.7%). Adoption (21.7%) and Maintenance (11.6%) were less often reported. All studies reported on primary outcomes, but few reported on RE-AIM indicators of characteristics of participation and adoption, quality of life, methods used to identify staff, staff inclusion/exclusion criteria and adoption rates, implementation fidelity, measures of cost to start-up and deliver the intervention, and indicators of maintenance. This systematic review underscores the need for more focus on external validity to inform replication, dissemination, and implementation so that evidence-based early childcare/education obesity interventions can be generalized to real-world settings.
Responses of native and invasive woody seedlings to combined competition and drought are species-specific
Authors: Bueno Andrea , Pritsch Karin , Simon Judy
Published: October 2020

Woody species invasions are a major threat to native communities with intensified consequences during increased periods of summer drought as predicted for the future. Competition for growth-limiting nitrogen (N) between native and invasive tree species might represent a key mechanism underlying the invasion process, because soil water availability and N acquisition of plants are closely linked. To study whether the traits of invasive species provide an advantage over natives in Central Europe in the competition for N under drought, we conducted a greenhouse experiment. We analyzed the responses of three native (i.e., Fagus sylvatica L., Quercus robur L. and Pinus sylvestris L.) and two invasive woody species (i.e., Prunus serotina Ehrh. and Robinia pseudoacacia L.) to competition in terms of their organic and inorganic N acquisition, as well as allocation of N to N pools in the leaves and fine roots. In our study, competition resulted in reduced growth and changes in internal N pools in both native and invasive species mediated by the physiological characteristics of the target species, the competitor, as well as soil water supply. Nitrogen acquisition, however, was not affected by competition indicating that changes in growth and N pools were rather linked to the remobilization of stored N. Drought led to reduced N acquisition, growth and total soluble protein-N levels, while total soluble amino acid-N levels increased, most likely as osmoprotectants as an adaptation to the reduced water supply. Generally, the consequences of drought were enhanced with competition across all species. Comparing the invasive competitors, P. serotina was a greater threat to the native species than R. pseudoacacia. Furthermore, deciduous and coniferous native species affected the invasives differently, with the species-specific responses being mediated by soil water supply.
Flexible Fibreoptic Bronchoscopy and Bronchoalveolar Lavage for Confirmation of Pulmonary Hydatid Disease in Children: A Case Series
Authors: Kumar Ketan , Mathew Joseph L , Vaidya Pankaj C , Bal Amanjit , Gupta Nalini , Singhal Kamal K , Saxena Akshay Kumar , Singh Meenu
Published: October 2020

Hydatid disease of the lungs is common in endemic regions. It can be suspected clinically by non-specific respiratory symptoms in children living in endemic regions, especially when they are close to sheep or dogs. Chest imaging X-ray or computed tomography may show characteristic cysts in some cases, but typical findings are absent in many children. Hydatid serology may contribute to the diagnosis, but does not have sufficient sensitivity for pulmonary cysts. Thus, there is no confirmatory diagnostic test, other than surgical excision and histopathologic examination. Hence, there is a need for more reliable diagnostic tests. We present a series of children, both with and without suspected pulmonary hydatid, wherein flexible fibreoptic bronchoscopy (FFOB) performed under conscious sedation, revealed hydatid membranes in the airways. Bronchoalveolar lavage (BAL) analysis revealed hydatid in most of them. Thus the diagnosis could be confirmed even before surgical excision of cysts was performed. We propose that FFOB with BAL could be useful to confirm the diagnosis of pulmonary hydatid in children. This will be particularly helpful in children without characteristic radiological or serological findings. To the best of our knowledge, this is a completely novel approach to the condition with potential to alter the diagnostic paradigm

Lay summary

Hydatid disease of the lungs is commonly encountered in endemic regions. However, there is no confirmatory diagnostic test for pulmonary hydatid cyst, other than surgical excision and histopathologic examination. Imaging including chest X-ray and computed tomography may not be typical, especially in complicated cysts and hydatid serology does not have a satisfactory sensitivity for diagnosing lung cysts. Thus, there is a need for more reliable diagnostic tests. We present a series of children, both with and without suspected pulmonary hydatid, wherein flexible fibreoptic bronchoscopy (FFOB) under conscious sedation, revealed hydatid membranes in the airways. Bronchoalveolar lavage (BAL) analysis confirmed hydatid in most of them. We propose FFOB with BAL as a useful diagnostic modality to confirm pulmonary hydatid in children, prior to surgical excision. To the best of our knowledge, this is a completely novel approach to the condition with potential to alter the diagnostic paradigm.