bluuebunny/crossref_metadata_2025 huggingface dataset:
Multilevel Governance as a Global Governance Challenge: Assumptions, Methods, Shortcomings, and Future Directions
Authors: Rennstich Joachim K.
Published: September 2017

Multilevel governance (MLG) as a research approach has mostly been applied to explain governance issues surrounding the European Union or international organizations. As a general research framework in the area of international relations (IR) theory, however, MLG has widely been underutilized, despite the many advantages that the approach offers in the empirical investigation of an increasingly complex international or global system. There are key concepts, assumptions, and definitions of MLG that focus separately on levels and governance as key elements of the approach and its interdisciplinary lineage. Some contested IR concepts include sovereignty, the nation-state, the international system, anarchy, agency, and levels of analysis. These IR concepts benefit from the application of an MLG framework by enabling the use of an interdisciplinary and multimethodological, yet systematically comprehensive, approach—which allows for nuanced use of these concepts. Other areas that benefit from IR methodologies applied in MLG research are methodological toolkits with a special focus on the areas of global governance, security studies, and international political economy.
Economic Interdependence and Conflict
Authors: Chang Hyo Joon , Kastner Scott L.
Published: September 2017

Recent studies on commercial liberalism have paid more attention to microfoundations linking economic interdependence to peace. Using a bargaining model of war, these studies have specified and tested different causal mechanisms through which economic ties function as a constraint, a source of information, or a transformative agent. Recent scholarly efforts in theoretical development and some empirical testing of different causal processes suggest the need to consider scope conditions to see when an opportunity cost or a signaling mechanism is likely to be salient. Future research can be best benefited by focusing on how economic interdependence affects commitment problems and empirically assessing the relative explanatory power of different causal arguments.
The Latin American Puzzles for the Study of International Relations
Authors: Mares David R.
Published: September 2017

Puzzles for the scholar of international relations abound in Latin America, whether one focuses on unexpected outcomes or examines purported causal variables that, when properly specified, do not lead where theory expects. In fact, the Latin American experience is a great case to illustrate two problems in the empirical application of international relations theories: theoretical formulations tend to be poorly developed and articulated, and the empirical evaluations of those theories are not rigorously designed.

The empirical record of Latin American interstate violence is more present and varied than generally accepted by scholars and policy makers. The relationship between conflict and the region’s use of international fora to peacefully resolve some conflicts obscures this record. Puzzles also arise when explaining why the region has the empirical record it does since the causal logic underlying the variables is generally misspecified in studies of Latin American security relations. These analytic errors render most explanations offered in the literature drawing on Latin American cases incorrect. Indeed, the failed explanations themselves offer new puzzles for scholars of international relations. Scholars of international relations can, therefore, benefit from studying the actual empirical history of Latin American interstate relations with the correctly specified causal variables offered by the various theories of international relations.
Population Aging and International Conflict
Authors: Haas Mark L.
Published: September 2017

Most of the world has experienced a revolutionary and unprecedented development over the course of the last century and especially since the end of the Second World War: significant population aging. By any standard measure—median age, the number of 60- or 65-year-olds and over as a percentage of a population, or old-age dependency ratios (the ratio of seniors to working-age adults), most of the world is significantly older today than in the middle of the 20th century, and the trend is accelerating.

The world’s great powers have not been immune to this trend. To the contrary, many of these countries have been leading the way, aging faster and to a greater extent than most other countries. By 2050, the median age of China, France, Germany, Japan, Russia, the United Kingdom, and the United States will be at least 40. Germany and Japan are currently two of the oldest countries in the world, and China is likely aging faster than any other country in history.

How is the near worldwide phenomenon of population aging likely to affect international relations (IR)? Most scholars who have examined this issue have linked the potential effects created by aging to established IR theories. Most analyses that have developed around the issue of aging, in other words, have not created new theoretical approaches to the study of international politics. They have instead argued that aging is likely to affect key variables associated with existing IR theories, which will then tend to generate particular outcomes based on these theories’ predictions. The IR theories that studies of populating aging have most frequently tied into include ones from realist, diversionary war, and constructivist research programs. Many of the arguments that link the effects of aging to these theories reach opposite conclusions, with some predicting a much higher probability of international conflict due to aging, others the reverse. There are, however, very few empirical analyses that test these competing hypotheses, largely because aging is such a new phenomenon.
Leech Mechanosensation
Authors: Burrell Brian D.
Published: September 2017

The medicinal leech (Hirudo verbana) is an annelid (segmented worm) and one of the classic model systems in neuroscience. It has been used in research for over 50 years and was one of the first animals in which intracellular recordings of mechanosensory neurons were carried out. Remarkably, the leech has three main classes of mechanosensory neurons that exhibit many of the same properties found in vertebrates. The most sensitive of these neurons are the touch cells, which are rapidly adapting neurons that detect low-intensity mechanical stimuli. Next are the pressure cells, which are slow-adapting sensory neurons that respond to higher intensity, sustained mechanostimulation. Finally, there are nociceptive neurons, which have the highest threshold and respond to potentially damaging mechanostimuli, such as a pinch. As observed in mammals, the leech has separate mechanosensitive and polymodal nociceptors, the latter responding to mechanical, thermal, and chemical stimuli. The cell bodies for all three types of mechanosensitive neurons are found in the central nervous system where they are arranged as bilateral pairs. Each neuron extends processes to the skin where they form discrete receptive fields. In the touch and pressure cells, these receptive fields are arranged along the dorsal-ventral axis. For the mechano-only and polymodal nociceptive neurons, the peripheral receptive fields overlap with the mechano-only nociceptor, which also innervates the gut. The leech also has a type of mechanosensitive cell located in the periphery that responds to vibrations in the water and is used, in part, to detect potential prey nearby.

In the central nervous system, the touch, pressure, and nociceptive cells all form synaptic connections with a variety of motor neurons, interneurons, and even each other, using glutamate as the neurotransmitter. Synaptic transmission by these cells can be modulated by a variety of activity-dependent processes as well as the influence of neuromodulatory transmitters, such as serotonin. The output of these sensory neurons can also be modulated by conduction block, a process in which action potentials fail to propagate to all the synaptic release sites, decreasing synaptic output. Activity in these sensory neurons leads to the initiation of a number of different motor behaviors involved in locomotion, such as swimming and crawling, as well as behaviors designed to recoil from aversive/noxious stimuli, such as local bending and shortening. In the case of local bending, the leech is able to bend in the appropriate direction away from the offending stimuli. It does so through a combination of which mechanosensory cell receptive fields have been activated and the relative activation of multiple sensory cells decoded by a layer of downstream interneurons.
Cortical Processing of Odorants
Authors: Cohen Yaniv , Courtiol Emmanuelle , Sullivan Regina M. , Wilson Donald A.
Published: September 2017

Odorants, inhaled through the nose or exhaled from the mouth through the nose, bind to receptors on olfactory sensory neurons. Olfactory sensory neurons project in a highly stereotyped fashion into the forebrain to a structure called the olfactory bulb, where odorant-specific spatial patterns of neural activity are evoked. These patterns appear to reflect the molecular features of the inhaled stimulus. The olfactory bulb, in turn, projects to the olfactory cortex, which is composed of multiple sub-units including the anterior olfactory nucleus, the olfactory tubercle, the cortical nucleus of the amygdala, the anterior and posterior piriform cortex, and the lateral entorhinal cortex. Due to differences in olfactory bulb inputs, local circuitry and other factors, each of these cortical sub-regions appears to contribute to different aspects of the overall odor percept. For example, there appears to be some spatial organization of olfactory bulb inputs to the cortical nucleus of the amygdala, and this region may be involved in the expression of innate odor hedonic preferences. In contrast, the olfactory bulb projection to the piriform cortex is highly distributed and not spatially organized, allowing the piriform to function as a combinatorial, associative array, producing the emergence of experience-dependent odor-objects (e.g., strawberry) from the molecular features extracted in the periphery. Thus, the full perceptual experience of an odor requires involvement of a large, highly dynamic cortical network.
Women, Militarized Domesticity, and Transnationality in the U.S. Occupation of Okinawa
Authors: Koikari Mire
Published: September 2017

After World War II, Okinawa was placed under U.S. military rule and administratively separated from mainland Japan. This occupation lasted from 1945 to 1972, and in these decades Okinawa became the “Keystone of the Pacific,” a leading strategic site in U.S. military expansionism in Asia and the Pacific. U.S. rule during this Cold War period was characterized by violence and coercion, resulting in an especially staggering scale of sexual violence against Okinawan women by U.S. military personnel. At the same time, the occupation also facilitated numerous cultural encounters between the occupiers and the occupied, leading to a flourishing cross-cultural grassroots exchange. A movement to establish American-style domestic science (i.e., home economics) in the occupied territory became a particularly important feature of this exchange, one that mobilized an assortment of women—home economists, military wives, club women, university students, homemakers—from the United States, Okinawa, and mainland Japan. The postwar domestic science movement turned Okinawa into a vibrant theater of Cold War cultural performance where women of diverse backgrounds collaborated to promote modern homemaking and build friendship across racial and national divides. As these women took their commitment to domesticity and multiculturalism into the larger terrain of the Pacific, they articulated the complex intertwining that occurred among women, domesticity, the military, and empire.
Roe v. Wade
Authors: Ziegler Mary
Published: September 2017

Decided by the Supreme Court in 1973, Roe v. Wade legalized abortion across the United States. The 7-2 decision came at the end of a decades-long struggle to reform—and later repeal—abortion laws. Although all of the justices understood that Roe addressed a profoundly important question, none of them imagined that it would later become a flashpoint of American politics or shape those politics for decades to come.

Holding that the right to privacy covered a woman’s choice to terminate her pregnancy, Roe and its companion case, Doe v. Bolton, struck down many of the abortion regulations on the books. The lead-up to and aftermath of Roe tell a story not only of a single Supreme Court decision but also of the historical shifts that the decision shaped and reflected: the emergence of a movement for women’s liberation, the rise of grassroots conservatism, political party realignment, controversy about the welfare state, changes to the family structure, and the politicization of science. It is a messy and complicated story that evolved parallel to different ideas about the decision itself. In later decades, Roe arguably became the best-known opinion issued by the Supreme Court, a symbol of an ever-changing set of beliefs about family, health care, and the role of the judiciary in American democracy.
Guerrilla Movements and Armed Struggle in Cold War Mexico
Authors: Aviña Alexander
Published: September 2017

After decades of revolutionary upheaval and political violence that began early in the 20th century, Mexico had seemingly achieved stability and a relative level of social peace by the 1940s. The peasant revolution of 1910—beginning with its armed, insurrectionary phase (1910–1920) to the subsequent decades (1920–1940) that involved making “The Revolution” manifest in the everyday lives of Mexicans who (to borrow historian Jeffrey Pilcher’s metaphor) chose à la carte from the revolutionary menu—produced a durable political order characterized by an active level of popular participation and legitimacy. The peace was durable, yet potentially fragile since postrevolutionary rulers, contained within the confines of the Partido Revolucionario Institucional (PRI) and its previous incarnations, could not take the peasant masses for granted. Revolution had taught these masses something about their power, both its limitations and potential, to shape the content and form of the Mexican state.

After 1940, as the PRI gradually exhibited its preference for political authoritarianism and an economic project that rapidly industrialized and urbanized the country while pauperizing the countryside, a series of disparate popular protest movements continually emerged. Usually peaceful and basing their alternative modernizing visions on the 1917 Constitution and the radical policies of President Lázaro Cárdenas during the 1930s, these movements—peasant, organized labor, and student movements—often faced repression and violence at the hands of state agents and/or local-regional caciques when demanding political democracy and economic justice. The spectacular massacre of protestors in public spaces and the selective assassination of dissident movement leaders represent two of the tactics employed by the PRI to quell popular resistance in the post–1940 era. Yet, such instances of state violence also stimulated political and tactical radicalization as some protestors organized revolutionary expressions of armed struggle and guerrilla warfare. From 1940 to 1982, more than three dozen armed organizations emerged in almost every region, in both urban and rural settings, displaying a wide variety of revolutionary ideologies and practices. Beginning with Rubén Jaramillo’s 1943 armed resistance in Morelos and ending with the formal dissolution of the urban Liga Comunista 23 de Septiembre in 1982, these armed struggles generally shared the goal of overthrowing the PRI regime, seizing state power, and articulating a socialist vision for a post-PRI Mexico.
Interventions for Students with Autism and Asperger’s Syndrome
Authors: Ballan Michelle S. , Burke Freyer Molly , Powledge Lauren
Published: September 2017

Evidence-based interventions for students with autism spectrum disorder (ASD) are explored, and trends and changes in the diagnosis of ASD in the United States are examined. Evidence-based interventions in various settings and modalities are discussed, with detailed descriptions of several effective evidence-based interventions including joint attention training, video modeling, story-based interventions, and activity schedules. The integral role of social workers in the lives of children with ASD in multiple settings, particularly the classroom, is emphasized. Social work must be vigilant to keep pace with the ever-changing field of autism, with its frequent improvements in understanding, diagnosis, and treatment.
Interventions for Physically and Sexually Abused Children
Authors: Faller Kathleen Coulborn
Published: September 2017

Social workers play a vital role in helping physically and sexually abused children. In order to play this role, they need knowledge about the nature of the problem: (1) legal definitions of physical and sexual abuse, (2) its incidence and prevalence, and (3) its signs and symptoms. Social workers have three major roles to play: (1) identifying and reporting child abuse to agencies mandated to intervene; (2) investigating and assessing children and families involved in child abuse; and (3) providing evidence-based interventions, both case management and treatment, to physically and sexually abused children.
Radiation-pressure-driven sub-Keplerian rotation of the disc around the AGB star L2Pup
Authors: Haworth Thomas J. , Booth Richard A. , Homan Ward , Decin Leen , Clarke Cathie J. , Mohanty Subhanjoy
Published: September 2017

We study the sub-Keplerian rotation and dust content of the circumstellar material around the asymptotic giant branch (AGB) star L2 Puppis. We find that the thermal pressure gradient alone cannot explain the observed rotation profile. We find that there is a family of possible dust populations for which radiation pressure can drive the observed sub-Keplerian rotation. This set of solutions is further constrained by the spectral energy distribution (SED) of the system, and we find that a dust-to-gas mass ratio of ∼10−3 and a maximum grain size that decreases radially outwards can satisfy both the rotation curve and SED. These dust populations are dynamically tightly coupled to the gas azimuthally. However, grains larger than ∼ 0.5 μm are driven outwards radially by radiation pressure at velocities ∼5 km s−1, which implies a dust replenishment rate of ∼3 × 10−9 M⊙ yr−1. This replenishment rate is consistent with observational estimates to within uncertainties. Coupling between the radial motion of the dust and gas is weak and hence the gas does not share in this rapid outward motion. Overall, we conclude that radiation pressure is a capable and necessary mechanism to explain the observed rotation profile of L2 Pup, and offers other additional constraints on the dust properties.
The growing problem of pediatric obesity
Authors: Panday Stephanie L.
Published: September 2017

The number of children and adolescents who are overweight or obese is increasing, both in the United States and worldwide. Here's how to provide guidance for patients and families.
Sharing clinical notes with patients
Authors: Fant Catherine T. , Adelman Deborah S.
Published: September 2017

Patient portals are access points to patient information, meeting Centers for Medicare and Medicaid Services incentives. Providing patients with access to clinical notes has garnered positive feedback with few concerns. This article addresses the latest literature on patient access to clinical notes and offers suggestions for NPs in their use.
The Role of Cognitive Content and Cognitive Processes in Chronic Pain
Authors: Jensen Mark P. , Thorn Beverly E. , Carmody James , Keefe Francis J. , Burns John W.
Published: September 2017

Objectives:

Pain-related cognitive content (what people think about pain) and cognitive processes (how people think about pain; what they do with their pain-related thoughts) and their interaction are hypothesized to play distinct roles in patient function. However, questions have been raised regarding whether it is possible or practical to assess cognitive content and cognitive process as distinct domains. The aim of this study was to determine the extent to which measures that seem to assess mostly pain-related cognitive content, cognitive processes, and content and process, are relatively independent from each other and contribute unique variance to the prediction of patient function.

Materials and Methods:

Individuals with chronic low back pain (N=165) participating in an ongoing RCT were administered measures of cognitions, pain, and function (depressive symptoms and pain interference) pretreatment.

Results:

Analyses provided support for the hypothesis that cognitive content and cognitive process, while related, can be assessed as distinct components. However, the measure assessing a cognitive process—mindfulness—evidenced relatively weak associations with function, especially compared with the stronger and more consistent findings for the measures of content (catastrophizing and self-efficacy).

Discussion:

The results provide preliminary evidence for the possibility that mindfulness could have both benefits and costs. Research to evaluate this possibility is warranted.
Exploration of Quantitative Sensory Testing in Latent Trigger Points and Referred Pain Areas
Authors: Ambite-Quesada Silvia , Arias-Buría José L. , Courtney Carol A. , Arendt-Nielsen Lars , Fernández-de-las-Peñas César
Published: September 2017

Objective:

The objective of this study was to investigate somatosensory nerve fiber function by applying different quantitative sensory testing including thermal, mechanical, and vibration thresholds over latent trigger points (TrP) and in its associated referred pain area.

Methods:

A total of 20 patients with unilateral latent TrPs in the extensor carpi radialis brevis were included. Warmth detection threshold (WDT), cold detection threshold (CDT) and heat/cold pain thresholds (HPT, CPT), mechanical detection (MDT) and pain (MPT) thresholds, vibration threshold (VT), and pressure pain thresholds (PPT) were blinded assessed over the TrP, in the referred pain area, and in the respective contralateral mirror areas. A multilevel mixed-model ANOVA with site (TrP, referred pain area) and side (real or contralateral) as within-patient factors and sex as between-patients factor was conducted.

Results:

No significant differences for thermal detection (WDT, CDT) or thermal pain thresholds (HPT, CPT) were found (all, Ps>0.141). The assessments over the TrP area showed lower PPT and MDT compared with the mirror contralateral TrP area (P<0.05). MDT were higher (P=0.001) but PPT (P<0.001) and MPT (P=0.032) were lower over the TrP area and contralateral mirror point compared with their respectively referred pain areas. Finally, VT was higher over the TrP area than in the referred pain area and over both mirror contralateral points.

Discussion:

Assessing sensory changes over latent myofascial TrPs reveal mechanical hyperesthesia, pressure pain hyperalgesia, and vibration hypoesthesia compared with a contralateral mirror area.
Hamstring Reconstruction for Chronic Achilles Pathology
Authors: Karnovsky Sydney C. , Drakos Mark C.
Published: September 2017

There are many accepted treatment options for chronic tears of the Achilles tendon. In cases involving a tendon gap of over 5 cm after debridement and removal of unhealthy tissue, a primary tendon reconstruction is recommended, as there is not enough healthy tissue to perform a direct repair. Various tendons have been used, including the peroneal tendons, the Flexor Hallucis Longus (FHL), as well as allografts including use of the Achilles, FHL, flexor digitorum longus, and semitendinosus tendons. We propose the use of a hamstring autograft, using both gracilis and semitendinosus. In addition, if the patient is young and active and hoping to return to sports, we recommended augmenting the Achilles reconstruction by transferring an FHL tendon to help restore full strength.
The impact of stress on social behavior in adult zebrafish (Danio rerio)
Authors: Saszik Shannon M. , Smith Conor M.
Published: September 2017

Stress has adverse effects on social behavior that is mediated by dopamine circuits in the midbrain. The purpose of this research is to examine the effect of chronic stress and dopamine signals on social behavior in zebrafish (Danio rerio). Chronic stress was induced chemically with low dosage of ethanol (0.25% for 5 days), and psychosocially with isolation (3–5 days) or overcrowding (5 days). Dopamine activity was decreased by 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP) exposure. Social behavior was observed by introducing one treated zebrafish to a group of four control zebrafish and measuring the nearest neighbor distance (NND). Swimming ability was analyzed by measuring total swim distance and average velocity. Analysis of swim ability showed that treatment had no adverse effect upon locomotor functioning. However, stress and MPTP affected social behavior similarly. In all stress conditions, there was a significant increase in NND (7.4±3.9–9.1±4.4 cm). MPTP also caused an increase in NND (8.9±2.7 cm), but MPTP/isolation treatment did not amplify the effect (8.9±5.5 cm). One possible explanation is that chronic stress causes a change in dopamine activity and decreases social behavior, providing insight into the function of dopamine in social behavior.
Fatigue Following Traumatic Brain Injury in Children and Adolescents: A Longitudinal Follow-Up 6 to 12 Months After Injury
Authors: Crichton Alison , Anderson Vicki , Oakley Ed , Greenham Mardee , Hearps Stephen , Delzoppo Carmel , Beauchamp Miriam H. , Hutchison James S. , Guerguerian Anne-Marie , Boutis Kathy , Babl Franz E.
Published: September 2017

Background:

Longitudinal fatigue data in children suffering from traumatic brain injury (TBI) are lacking.

Objectives:

To examine the effects of time postinjury (6-12 months) and injury severity on fatigue after childhood TBI. Secondarily, we compared fatigue 12 months postinjury against published control data.

Setting:

Three tertiary children's hospitals across Australia (n = 1) and Canada (n = 2).

Participants:

Parents (n = 109) of children (mean [M] = 9.9 years at injury; range, 1.0-16.9 years) admitted to one of 3 participating hospitals with mild (n = 69) or moderate/severe (n = 37) TBI.

Design:

Longitudinal prospective study.

Measures:

Primary: Pediatric Quality of Life Multidimensional Fatigue Scale (total, general, sleep/rest, and cognitive), rated by parents 6 and 12 months postinjury. Secondary: Pediatric Injury Functional Outcome Scale (fatigue and sleep items, rated on recruitment and 6 and 12 months postinjury). Demographic and children data were collected at recruitment.

Results:

Mixed-models analysis demonstrated nonsignificant effects of time (6 vs 12 months postinjury) on multidimensional fatigue scores. Cognitive fatigue worsened over time. Moderate/severe TBI was associated with worse fatigue 12 months postinjury (general, P = .03; cognitive, P = .02). Across all severities, fatigue 12 months postinjury was significantly worse compared with control data (total fatigue, P < .001; all domains, all Ps < .025).

Conclusion:

Fatigue remains significant at 12 months since injury, particularly for those with moderate/severe TBI.
Using Functional Magnetic Resonance Imaging to Detect Chronic Fatigue in Patients With Previous Traumatic Brain Injury: Changes Linked to Altered Striato-Thalamic-Cortical Functioning
Authors: Berginström Nils , Nordström Peter , Ekman Urban , Eriksson Johan , Andersson Micael , Nyberg Lars , Nordström Anna
Published: September 2017

Objective:

To investigate whether functional magnetic resonance imaging (fMRI) can be used to detect fatigue after traumatic brain injury (TBI).

Setting:

Neurorehabilitation clinic.

Participants:

Patients with TBI (n = 57) and self-experienced fatigue more than 1 year postinjury, and age- and gender-matched healthy controls (n = 27).

Main Measures:

Self-assessment scales of fatigue, a neuropsychological test battery, and fMRI scanning during performance of a fatiguing 27-minute attention task.

Results:

During testing within the fMRI scanner, patients showed a higher increase in self-reported fatigue than controls from before to after completing the task (P < .001). The patients also showed lower activity in several regions, including bilateral caudate, thalamus, and anterior insula (all P < .05). Furthermore, the patients failed to display decreased activation over time in regions of interest: the bilateral caudate and anterior thalamus (all P < .01). Left caudate activity correctly identified 91% of patients and 81% of controls, resulting in a positive predictive value of 91%.

Conclusion:

The results suggest that chronic fatigue after TBI is associated with altered striato-thalamic-cortical functioning. It would be of interest to study whether fMRI can be used to support the diagnosis of chronic fatigue in future studies.
Depression and Depressive Symptoms in Pediatric Traumatic Brain Injury: A Scoping Review
Authors: Laliberté Durish Christianne , Pereverseff Rosemary S. , Yeates Keith O.
Published: September 2017

Objective:

This scoping review aimed to summarize the existing knowledge base regarding depression and depressive symptoms in pediatric traumatic brain injury (TBI) and to identify gaps in the literature in an effort to guide future research.

Methods:

MEDLINE Ovid and PsycINFO Ovid databases were each searched by the authors using search terms intended to identify any original research study that examined depressive symptoms in children (ie, aged 0-18 years) with TBI.

Results:

A total of 14 published studies were included in the review. The studies included examined the prevalence of depression, risk factors associated with depression, and depression as a predictor of other TBI-related outcomes.

Conclusion:

Existing research suggests that depressive symptoms are more common in a TBI population than in a healthy or orthopedically injured population. Injury-related factors such as lesions in the brain and the presence of pain, as well as noninjury factors such as older age at injury and low socioeconomic status, may be predictive of depressive symptoms. Depression is likely a secondary outcome of pediatric TBI rather than a direct result of the injury itself. Overall, a relative dearth of research exists on this topic; thus, the review concludes by proposing future research directions.
Personality Traits in Panic Disorder Patients With and Without Comorbidities
Authors: Zugliani Morena M. , Martin-Santos Rocio , Nardi Antonio Egidio , Freire Rafael Christophe
Published: September 2017

Panic disorder (PD) is often correlated with high neuroticism and low extraversion. This study aims to ascertain whether PD patients differ from healthy controls in regard to personality traits and determine if these traits are correlated with comorbid disorders, anxiety, and depression symptoms. Personality traits of 69 PD patients and 42 controls were compared using the Maudsley Personality Inventory. In PD patients, comorbidities, anxiety, and depression symptoms were also evaluated. PD patients showed higher neuroticism and lower extraversion compared with healthy controls. Patients without comorbidities presented similar results to controls, whereas those with comorbidities presented higher neuroticism and lower extraversion scores. PD per se may be unrelated to deviant personality traits, although comorbidities with major depressive disorder and agoraphobia are probably associated with high neuroticism and low extraversion. These traits show a strong correlation with the accumulation and severity of these disorders.
High Levels of Morbidity and Mortality Among Pediatric Hematopoietic Cell Transplant Recipients With Severe Sepsis: Insights From the Sepsis PRevalence, OUtcomes, and Therapies International Point Prevalence Study*
Authors: Lindell Robert B. , Gertz Shira J. , Rowan Courtney M. , McArthur Jennifer , Beske Florian , Plunkett Adrian , Weiss Scott L. , Thomas Neal J. , Nadkarni Vinay M. , Fitzgerald Julie C.
Published: September 2017

Objectives:

Pediatric severe sepsis is a major cause of morbidity and mortality worldwide, and hematopoietic cell transplant patients represent a high-risk population. We assessed the epidemiology of severe sepsis in hematopoietic cell transplant patients, describing patient outcomes compared with children with no history of hematopoietic cell transplant.

Design:

Secondary analysis of the Sepsis PRevalence, OUtcomes, and Therapies point prevalence study, comparing demographics, sepsis etiology, illness severity, organ dysfunction, and sepsis-related treatments in patients with and without hematopoietic cell transplant. The primary outcome was hospital mortality. Multivariable logistic regression models were used to determine adjusted differences in mortality.

Setting:

International; 128 PICUs in 26 countries.

Patients:

Pediatric patients with severe sepsis prospectively identified over a 1-year period.

Interventions:

None.

Measurements and Main Results:

In patients with severe sepsis, 37/567 (6.5%) had a history of hematopoietic cell transplant. Compared with patients without hematopoietic cell transplant, hematopoietic cell transplant patients had significantly higher hospital mortality (68% vs 23%; p < 0.001). Hematopoietic cell transplant patients were more likely to have hospital acquired sepsis and had more preexisting renal and hepatic dysfunction than non–hematopoietic cell transplant patients with severe sepsis. History of hematopoietic cell transplant, renal replacement therapy, admission from inpatient floor, and number of organ dysfunctions at severe sepsis recognition were independently associated with hospital mortality in multivariable analysis; hematopoietic cell transplant conferred the highest odds of mortality (odds ratio, 4.00; 95% CI, 1.78–8.98). In secondary analysis of hematopoietic cell transplant patients compared with other immunocompromised patients with severe sepsis, history of hematopoietic cell transplant remained independently associated with hospital mortality (odds ratio, 3.03; 95% CI, 1.11–8.27).

Conclusions:

In an international study of pediatric severe sepsis, history of hematopoietic cell transplant is associated with a four-fold increased odds of hospital mortality after adjustment for potential measured confounders. Hematopoietic cell transplant patients more often originated from within the hospital compared to children with severe sepsis without hematopoietic cell transplant, possibly providing an earlier opportunity for sepsis recognition and intervention in this high-risk population.
Do All Clavicle Fractures in Children Need To Be Managed by Orthopedic Surgeons?
Authors: Adamich John , Howard Andrew , Camp Mark
Published: September 2017

Objectives

Although many uncomplicated pediatric fractures do not require routine long-term follow-up with an orthopedic surgeon, practitioners with limited experience dealing with pediatric fractures will often defer to a strategy of frequent clinical and radiographic follow-up. Development of an evidence-based clinical care pathway can help unnecessary radiation exposure to this patient population and reduce costs to patient families and the health care system.

Methods

A retrospective analysis including patients who presented to the Hospital for Sick Children (SickKids) for management of clavicle fractures was performed.

Results

Three hundred forty patients (227 males, 113 females) with an average age of 8.1 years (range, 0.1–17.8) were included in the study. The mean number of clinic visits including initial consultation in the emergency department was 2.1 (1.3). The mean number of radiology department appointments was 1.8 (1.3), where patients received a mean number of 4.2 (3.0) radiographs. Complications were minimal: 2 refractures in our series and no known cases of nonunion. All patients achieved clinical and radiographic union and returned to sport after fracture healing.

Conclusions

Our series suggests that the decision to treat operatively is made at the initial assessment. If no surgical indications were present at the initial assessment by the primary care physician, then routine clinical or radiographic follow-up is unnecessary. Our pediatric clavicle fracture pathway will reduce patient radiation exposure and reduce costs incurred by the health care system and patients' families without jeopardizing patient outcomes.
DNA Methylation–Targeted Drugs
Authors: Da Costa Elodie M. , McInnes Gabrielle , Beaudry Annie , Raynal Noël J.-M.
Published: September 2017

Targeting DNA hypermethylation, using nucleoside analogs, is an efficient approach to reprogram cancer cell epigenome leading to reduced proliferation, increased differentiation, recognition by the immune system, and ultimately cancer cell death. DNA methyltransferase inhibitors have been approved for the treatment of myelodysplastic syndromes, chronic myelomonocytic leukemia, and acute myelogenous leukemia. To improve clinical efficacy and overcome mechanisms of drug resistance, a second generation of DNA methyltransferase inhibitors has been designed and is currently in clinical trials. Although efficient in monotherapy against hematologic malignancies, the potential of DNA methyltransferase inhibitors to synergize with small molecules targeting chromatin or immunotherapy will provide additional opportunities for their future clinical application against leukemia and solid tumors.
Hidden Costs of Hospitalization After Firearm Injury
Authors: Rattan Rishi , Parreco Joshua , Namias Nicholas , Pust Gerd D. , Yeh D. Dante , Zakrison Tanya L.
Published: September 2017

Objective:

To compare the risk factors and costs associated with readmission after firearm injury nationally, including different hospitals.

Background:

No national studies capture readmission to different hospitals after firearm injury.

Methods:

The 2013 to 2014 Nationwide Readmissions Database was queried for patients admitted after firearm injury. Logistic regression identified risk factors for 30-day same and different hospital readmission. Cost was calculated. Survey weights were used for national estimates.

Results:

There were 45,462 patients admitted for firearm injury during the study period. The readmission rate was 7.6%, and among those, 16.8% were readmitted to a different hospital. Admission cost was $1.45 billion and 1-year readmission cost was $131 million. Sixty-four per cent of those injured by firearms were publicly insured or uninsured. Readmission predictors included: length of stay >7 days [odds ratio (OR) 1.43, P < 0.01], Injury Severity Score >15 (OR 1.41, P < 0.01), and requiring an operation (OR 1.40, P < 0.01). Private insurance was a predictor against readmission (OR 0.81, P < 0.01). Predictors of readmission to a different hospital were unique and included: initial admission to a for-profit hospital (OR 1.52, P < 0.01) and median household income ≥$64,000 (OR 1.48, P < 0.01).

Conclusions:

A significant proportion of the national burden of firearm readmissions is missed by not tracking different hospital readmission and its unique set of risk factors. Firearm injury-related hospitalization costs $791 million yearly, with the largest fraction paid by the public. This has implications for policy, benchmarking, quality, and resource allocation.
Mitotic systemic genomic instability in yeast
Authors: Sampaio Nadia M. V. , Rodrigues-Prause Aline , Ajith V. P. , Gurol Theodore M. , Chapman Mary J. , Malc Ewa P. , Chakraborty Parijat , Duarte Fabiana M. , Aguirre Guadalupe M. , Tizei Pedro A. , Pereira Gonçalo A. G. , Mieczkowski Piotr A. , Nishant Koodali T. , Argueso Juan Lucas
Published: September 2017

Conventional models of genome evolution generally include the assumption that mutations accumulate gradually and independently over time. We characterized the occurrence of sudden spikes in the accumulation of genome-wide loss-of-heterozygosity (LOH) inSaccharomyces cerevisiae, suggesting the existence of a mitotic systemic genomic instability process (mitSGI). We characterized the emergence of a rough colony morphology phenotype resulting from an LOH event spanning a specific locus (ACE2/ace2-A7). Surprisingly, half of the clones analyzed also carried unselected secondary LOH tracts elsewhere in their genomes. The number of secondary LOH tracts detected was 20-fold higher than expected assuming independence between mutational events. Secondary LOH tracts were not detected in control clones without a primary selected LOH event. We then measured the rates of single and double LOH at different chromosome pairs and found that coincident LOH accumulated at rates 30-100 fold higher than expected if the two underlying single LOH events occurred independently. These results were consistent between two different strain backgrounds, and in mutant strains incapable of entering meiosis. Our results indicate that a subset of mitotic cells within a population experience systemic genomic instability episodes, resulting in multiple chromosomal rearrangements over one or few generations. They are reminiscent of early reports from the classic yeast genetics literature, as well as recent studies in humans, both in the cancer and genomic disorder contexts, all of which challenge the idea of gradual accumulation of structural genomic variation. Our experimental approach provides a model to further dissect the fundamental mechanisms responsible for mitSGI.

SIGNIFICANCE STATEMENT

Point mutations and alterations in chromosome structure are generally thought to accumulate gradually and independently over many generations. Here, we combined complementary genetic approaches in budding yeast to track the appearance of chromosomal changes resulting in loss-of-heterozygosity (LOH). Contrary to expectations, our results provided evidence for the occurrence of non-independent accumulation of multiple LOH events over one or a few cell generations. These results are analogous to recent reports of bursts of chromosomal instability in humans. Our experimental approach provides a framework to further dissect the fundamental mechanisms underlying systemic chromosomal instability processes, including in the human cancer and genomic disorder contexts.
Insights into Origin and Evolution of α-proteobacterial Gene Transfer Agents
Authors: Shakya Migun , Soucy Shannon M. , Zhaxybayeva Olga
Published: September 2017

Several bacterial and archaeal lineages produce nanostructures that morphologically resemble small tailed viruses, but, unlike most viruses, contain apparently random pieces of the host genome. Since these elements can deliver the packaged DNA to other cells, they were dubbed Gene Transfer Agents (GTAs). Because many genes involved in GTA production have viral homologs, it has been hypothesized that the GTA ancestor was a virus. Whether GTAs represent an atypical virus, a defective virus, or a virus co-opted by the prokaryotes for some function, remains to be elucidated. To evaluate these possibilities, we examined the distribution and evolutionary histories of genes that encode a GTA in the α-proteobacteriumRhodobacter capsulatus(RcGTA). We report that although homologs of many individual RcGTA genes are abundant across bacteria and their viruses, RcGTA-like genomes are mainly found in one subclade of α-proteobacteria. When compared to the viral homologs, genes of the RcGTA-like genomes evolve significantly slower, and do not have higher %A+T nucleotides than their host chromosomes. Moreover, they appear to reside in stable regions of the bacterial chromosomes that are generally conserved across taxonomic orders. These findings argue against RcGTA being an atypical or a defective virus. Our phylogenetic analyses suggest that RcGTA ancestor likely originated in the lineage that gave rise to contemporary α-proteobacterial ordersRhizobiales, Rhodobacterales, Caulobacterales, Parvularculales, and Sphingomonadales,and since that time the RcGTA-like element has co-evolved with its host chromosomes. Such evolutionary history is compatible with maintenance of these elements by bacteria due to some selective advantage. As for many other prokaryotic traits, horizontal gene transfer played a substantial role in the evolution of RcGTA-like elements, not only in shaping its genome components within the orders, but also in occasional dissemination of RcGTA-like regions across the orders and even to different bacterial phyla.
Simulating the Idling Behavior of Escherichia Coli
Authors: Weidner Herbert
Published: September 2017

Until now, it is not known how the motors of E. coli reverse the direction of rotation, mostly simultaneously. If the C-ring is bistable and if the number of bound CheY-P depends on the direction of rotation, there is a strong variation in the concentration of CheY-P in the cytoplasm. Then, the synchronous changeover can be explained without further additional assumptions.
Indexing sensory plasticity: Evidence for distinct Predictive Coding and Hebbian Learning mechanisms in the cerebral cortex
Authors: Spriggs M. J. , Sumner R. L. , McMillan R. L. , Moran R. J. , Kirk I. J. , Muthukumaraswamy S. D.
Published: September 2017

Highlights

ERP and DCM study of two sensory plasticity paradigms: roving MMN and visual LTP

First demonstration of multiple learning mechanisms under different task demands

Evidence for both Predictive Coding and Hebbian learning mechanisms

The BDNF Val66Met polymorphism modulates ERPs for both paradigms

However, the polymorphism only modulates MMN network connectivity

The Roving Mismatch Negativity (MMN), and Visual LTP paradigms are widely used as independent measures of sensory plasticity. However, the paradigms are built upon fundamentally different (and seemingly opposing) models of perceptual learning; namely, Predictive Coding (MMN) and Hebbian plasticity (LTP). The aims of the current study were to 1) compare the generative mechanisms of the MMN and visual LTP, therefore assessing whether Predictive Coding and Hebbian mechanisms co-occur in the brain, and 2) assess whether the paradigms identify similar group differences in plasticity. Forty participants were split into two groups based on theBDNFVal66Met polymorphism and were presented with both paradigms. Consistent with Predictive Coding and Hebbian predictions, Dynamic Causal Modelling revealed that the generation of the MMN modulates forward and backward connections in the underlying network, while visual LTP only modulates forward connections. Genetic differences were identified in the ERPs for both paradigms, but were only apparent in backward connections of the MMN network. These results suggest that both Predictive Coding and Hebbian mechanisms are utilized by the brain under different task demands. Additionally, both tasks provide unique insight into plasticity mechanisms, which has important implications for future studies of aberrant plasticity in clinical populations.