bluuebunny/crossref_metadata_2025 huggingface dataset:
Investigating the attack angle of squeegees with different geometries
Authors: Krammer Oliver , Jakab László , Illes Balazs , Bušek David , Beshajová Pelikánová Ivana
Published: December 2017

Purpose

The attack angle of stencil printing squeegees with different geometries was analysed using finite element modelling.

Design/methodology/approach

A finite element model (FEM) was developed to determine the attack angle during the stencil printing. The material properties of the squeegee were included in the model according to the parameters of steel AISI 4340, and the model was validated by experimental measurements. Two geometric parameters were investigated; two different unloaded angles (45° and 60°) and four overhang sizes of the squeegee (6, 15, 20 and 25 mm).

Findings

It was found that the deflection of the blade is nearly homogenous along the length of the squeegee. This implies that the attack angle does not change significantly along the squeegee length. The results showed significant differences between the initial and the attack angle. For example, the angle of the squeegee with 15 mm overhang size and with 60° initial angle decreased by more than 5° for a specific squeegee force of 0.3 N/mm; resulting in an attack angle of 53.4°.

Originality/value

The attack angle during the printing is considerably lower than the initial angle as a result of the printing force. The papers, which were dealing with the numerical modelling of the stencil printing presumed that the squeegees were having their initial angle. This could have led to invalid numerical results. Therefore, we decided to investigate the attack angle during stencil printing for squeegees with different initial geometries to enhance the numerical modelling of stencil printing.
Transcriptome analysis of ultraviolet A‐induced photoaging cells with deep sequencing
Authors: Zheng Yue , Xu Qingfang , Chen Haiyan , Chen Qiaoping , Gong Zijian , Lai Wei
Published: December 2017

Gene expression changes associate with many biological processes. However, the relative consequences of the genetic alterations induced by ultraviolet (UV)‐A radiation on skin photoaging are still not clear. Here, we performed deep sequencing of the transcriptome and explored altered genes related to biological changes in repeated UV‐A‐irradiated human dermal fibroblasts (HDF) to better understand the skin photoaging mechanisms. The repeatedly UV‐A‐irradiated group (HDF were induced by 10 J/cm2 UV‐A twice daily for 7 days) and the control group (HDF without irradiation) were evaluated. Expression genes profile was measured and compared using high‐throughput sequencing on an Illumina HiSeq 2500 platform and DEGseq. Functional annotation and metabolic pathway analysis of genes with altered expression were preformed via National Center for Biotechnology Information, Uniprot, Gene Ontology and Kyoto Encyclopedia of Genes and Genomes databases. Genes related to skin photoaging were verified by quantitative reverse transcription polymerase chain reaction. Transcriptome comparison revealed that 607 genes exhibited significant changes (P < 0.05), of which 238 genes were upregulated and 369 downregulated in UV‐A‐irradiated HDF. Functional annotations showed that genes altered by UV‐A irradiation took part in a variety of biological process, cellular component synthesis, molecular function and metabolic pathway. Photoaging‐related genes encoding elastin, sprout, cathepsin K, cathepsin D, cathepsin B ribose‐phosphate diphosphokinase and phosphoglucomutase were identified to be changed. We obtained the comprehensive transcriptome and altered genes in repeated UV‐A‐irritated HDF and identified that the modulated genes were related to a wide panel of pathways and functions. Our results provide new insights into photoaging molecular mechanisms and suggest some novel targets for interfering in skin photoaging.
For an anthropology of the demoralized: state pay, mock‐labour, and unfreedom in a Serbian firm
Authors: Rajković Ivan
Published: December 2017

Recently, the leitmotif of much anthropological writing became that of the virtue of precarity: the belief that people continue to exercise their ethical imagination in the most trying circumstances. While refreshingly non‐deterministic, the Foucauldian approach to freedom that guides this vision neglects those situations in which people see their ability to be moral as irreparable, and structurally compromised. Such is the case of a Serbian firm selling spare car parts, where policies of financing unprofitable employment gradually involved workers in everyday, ritualized performances of productivity for the state – what I call mock‐labour. Unable either to meaningfully fulfil or to renounce the ethos of work, workers remain in an affective blend of nonchalance and failure, experiencing mock‐labour as both a source of material security and an abandonment of their creative capacities – a mocking of moral self. I call for a reconciliation of the anthropologies of ethics and precarity through the notion of demoralization, as a state in which the deficits of structural agency and the limits of reflective freedom overlap.
Effect of cactus pear (Opuntia ficus‐indica (L.) Miller) on the antioxidant capacity of donkey milk
Authors: Valentini Valeria , Allegra Alessio , Adduci Francesco , Labella Cristiana , Paolino Rosanna , Cosentino Carlo
Published: December 2017

The cladodes of Opuntia ficus‐indica (L.) Miller were fed to lactating donkeys as an alternative food, in order to evaluate effects on the chemical composition and antioxidant activity of their milk. Lactating donkeys were divided into two groups: standard feeding and alternative feeding. With regard to chemical composition, no differences were observed. Total antioxidant capacity was constant in the standard feeding group, while it increased in the alternative feeding group: the radical scavenging activity increased from 95.53% to 96.62% in the ABTS test and from 28.40% to 33.33% in the DPPH test. This indicated that alternative feeding affects the antioxidant capacity of milk.
Opportunities for training for nutritional professionals in nutritional genomics: What is out there?
Authors: Collins Jorja , Adamski Melissa M. , Twohig Cliona , Murgia Chiara
Published: December 2017

Aim

To identify and profile training courses available to dietitians and nutritionists in the area of nutritional genomics. Genetic technology is progressing quickly, leading to increased public interest and requests from the public for personalised nutrition advice based on genetic background. Tertiary courses often lack specific curriculum in nutritional genomics, preventing graduates from discussing confidently with their clients the relationships between genetics, nutrition and health. This has increased the demand for professional development in this field.

Methods

The search strategy was intended to replicate real‐life practice. Google and snowball searches were conducted using terms related to education and nutritional genomics. Results included online or face‐to‐face courses in any country providing content on nutritional genomics. One‐off courses and those courses no longer accessible were excluded. A descriptive analysis of characteristics of courses was undertaken, reporting on mode of delivery, cost, duration, content, qualification awarded, target audience and affiliations.

Results

In total, 37 courses varying in duration, content and cost were identified: 4 postgraduate university degrees, 5 university course units, 4 recurring face‐to‐face workshops, 15 online short courses, 8 pre‐recorded presentations and 1 service offering regular live webinars. Affiliations with food and pharmaceutical industry (e.g. genetic testing companies), professional organisations and research/education institutes were observed.

Conclusions

Training courses identified were predominantly delivered online, enabling nutrition professionals worldwide to upskill in nutritional genomics and personalised nutrition. Additional courses exist. Those seeking training should scrutinise and compare cost, duration, mode, content and affiliations of course providers to ensure learning needs are met.
Epidemiology of obscure gastrointestinal bleeding in China: A single‐center series and comprehensive analysis of literature
Authors: Zhang Yao , Wu Sui Yi , Du Yi Qi , Li Bing Han , Li Chen Fei , Li Ying , Li Zhao Shen , Bai Yu
Published: December 2017

OBJECTIVE

To determine the etiologies of obscure gastrointestinal bleeding (OGIB) in a Chinese population using a retrospective case series and a systematic analysis of the literatures on OGIB in Chinese patients.

METHODS

A large enteroscopy database in a tertiary endoscopic center was searched to identify patients with OGIB from 2010 to 2016. The patients’ characteristics and diagnostic findings were collected and analyzed. A comprehensive search of the literature was carried out to harvest all relevant studies published from 2004 to 2016.

RESULTS

In total, 708 patients were included in the case series. The most common causes of OGIB were inflammatory diseases (36.3%), non‐small bowel lesions (10.2%) and neoplasms (10.0%). A systematic analysis of the literatures included 39 studies providing relevant data for 3145 patients with a pooled detection rate of 84.2%. Inflammatory lesions (27.4%), neoplasms (18.5%), vascular lesions (16.1%) and diverticula or intestinal duplication (11.9%) were the most common causes of OGIB.

CONCLUSIONS

Inflammatory lesions, neoplasms, vascular lesions and diverticula or intestinal duplication are the most common in Chinese OGIB patients, while in pediatric patients diverticula or intestinal duplication, vascular lesions and Crohn's disease are prevalent. Furthermore, the etiologies of OGIB distribute differently across different areas in China.
Efficiency in wine grape production: comparing long‐established and newly developed regions of South Africa
Authors: Piesse Jenifer , Conradie Beatrice , Thirtle Colin , Vink Nick
Published: December 2017

Efficiency, partly based on technology, is central to international competitiveness. This article applies a stochastic frontier inefficiency model to a panel of 77 wine grape farms in South Africa between 2005 and 2015 and allows the comparison of efficiency levels for the old established wine regions with those of newer entrants. Thus, we investigate whether experience plus first choice of location matters more than the follower's advantage of newer technology.

In all regions, a greater share of permanent labor and increased supervision raised efficiency, while more inorganic fertilizer and less irrigation has the opposite effect. Innovations in trellising had insignificant effects (except in the old regions) but not replacing old vines reduced efficiency. However, a higher proportion of red varietals also lowered efficiency in the old regions due to a fall in the price of red wine as these farmers continued to concentrate on quality reds. The new regions compensated for falling prices by increasing crop size with irrigation and fertilizer and extending the area planted, but with less concern for quality. This appears to be more successful in efficiency terms, but as international demand for quality wine increases it may be a poor long‐term strategy.
Dynamics of smallholder participation in horticultural export chains: evidence from Ecuador
Authors: Romero Granja Cristina , Wollni Meike
Published: December 2017

We study the dynamics of smallholder participation in export value chains focusing on the example of small‐scale broccoli producers in the highlands of Ecuador. Combining cross‐sectional data from a household survey with 11‐year longitudinal data on export market transactions, we explain the hazards of dropping out of a high‐value export chain. We apply a multispell cox duration model that allows us to consider multiple entries and exits from the supply chain. We also provide evidence on the welfare impacts associated with participation. The results suggest that small‐scale farmers’ exit from the export sector is accelerated by high transaction risks experienced in the past. While we find no particular evidence for the exclusion of small‐scale farmers from the export sector, we do find that poorer households and female‐headed households tend to drop out faster, especially as long as the sector is still prospering. Finally, when considering welfare effects, we do not find evidence that participation translates into tangible benefits for broccoli farmers. We discuss some measures that could help improve the long‐term sustainability of smallholder integration in high‐value chains.
Fast permutation tests and related methods, for association between rare variants and binary outcomes
Authors: Sondhi Arjun , Rice Kenneth Martin
Published: December 2017

In large‐scale genetic studies, a primary aim is to test for an association between genetic variants and a disease outcome. The variants of interest are often rare and appear with low frequency among subjects. In this situation, statistical tests based on standard asymptotic results do not adequately control the type I error rate, especially if the case : control ratio is unbalanced. In this article, we propose the use of permutation and approximate unconditional tests for testing association with rare variants. We use novel analytical calculations to efficiently approximate the true type I error rate under common study designs, and in numerical studies show that the proposed classes of tests significantly improve upon standard testing methods. We also illustrate our methods in data from a recent case–control study for genetic causes of a severe side effect of a common drug treatment.
Expression of miRNA‐146a, miRNA‐155, IL‐2, and TNF‐α in inflammatory response to Helicobacter pylori infection associated with cancer progression
Authors: Zabaglia Luanna Munhoz , Sallas Mayara Luciana , Santos Mônica Pezenatto Dos , Orcini Wilson Aparecido , Peruquetti Rita Luiza , Constantino Dulce Helena , Chen Elizabeth , Smith Marilia De Arruda Cardoso , Payão Spencer‐Luiz Marques , Rasmussen Lucas Trevizani
Published: December 2017

miRNAs appear to play an important role in controlling the expression of several genes, and they are a potential biomarker and prognostic tool in gastric diseases. We analyzed 53 controls, 86 patients with gastritis, and 19 patients with gastric cancer. Real‐time‐PCR was used to determine the expression levels of miRNA‐146a, miRNA‐155, IL‐2, and TNF‐α. The subsequent analysis of the target genes was performed using the bioinformatics approach. There was no difference in IL‐2 expression between the groups. However, there was a significant increase in TNF‐α expression in the gastritis group relative to the control and a significant decrease in the gastric cancer group relative to the control. There was also a statistically significant increase in miRNA‐146a and miRNA‐155 expression in the gastritis group relative to the control, but not in the gastric cancer group. Similar results were found when the presence of H. pylori was considered. The data revealed an increase in miRNA‐146a and miRNA‐155 expression but not enough to control the expression of TNF‐α. The presence of H. pylori was found to affect increases in TNF‐α and microRNA expression, and miRNA‐146a and miRNA‐155 alone were not able to eliminate bacteria or restore tissue homeostasis.
The relationship between DSM‐5 PTSD symptom clusters and alcohol misuse among military veterans
Authors: Walton Jessica L. , Raines Amanda M. , Cuccurullo Lisa‐Ann J. , Vidaurri Desirae N. , Villarosa‐Hurlocker Margo C. , Franklin C. L.
Published: December 2017

Background and Objectives

Prior research has revealed a strong relationship between Posttraumatic Stress Disorder (PTSD) and alcohol misuse. However, previous attempts to understand nuanced associations between PTSD symptom clusters and alcohol misuse within military veteran samples have produced mixed results. In an attempt to better understand the associations between PTSD and alcohol misuse, the current study examined the unique relationships between the newly classified Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM‐5) PTSD symptom clusters and alcohol misuse in an outpatient sample of military veterans seeking treatment for PTSD and Substance Use Disorders.

Methods

Veterans (N = 100) were administered a brief battery of self‐report questionnaires prior to receiving psychological services to aid in diagnostic assessment and treatment planning.

Results

Hierarchical regression analyses revealed that PTSD intrusions (cluster B), negative alterations in cognition and mood (cluster D), and arousal/reactivity (cluster E) symptoms were associated with alcohol misuse.

Discussion and Conclusions

The positive association between alcohol misuse and PTSD symptom severity is consistent with a broader body of literature demonstrating the co‐occurrence of these disorders, particularly in military samples.

Scientific Significance

Increased alcohol consumption may interfere with current front‐line treatments for PTSD, which encourages patients to experience a full range of emotions. As such, future research should explore the impact of substance use on the effectiveness of trauma focused treatments in the alleviation of DSM‐5 PTSD symptoms. (Am J Addict 2018;27:23–28)
Relation between electrical and mechanical dyssynchrony in patients with left bundle branch block: An electro‐ and vectorcardiographic study
Authors: De Pooter Jan , El Haddad Milad , Kamoen Victor , Kallupurackal Thomas Tibin , Stroobandt Roland , De Buyzere Marc , Timmermans Frank
Published: December 2017

Background

Current guidelines select patients for cardiac resynchronization therapy (CRT) mainly on electrocardiographic parameters like QRS duration and left bundle branch block (LBBB). However, among those LBBB patients, heterogeneity in mechanical dyssynchrony occurs and might be a reason for nonresponse to CRT. This study assesses the relation between electrocardiographic characteristics and presence of mechanical dyssynchrony among LBBB patients.

Methods

The study included patients with true LBBB (including mid‐QRS notching) on standard 12‐lead electrocardiograms. Left bundle branch block‐induced mechanical dyssynchrony was assessed by the presence of septal flash on two‐dimensional echocardiography. Previously reported electro‐ and vectorcardiographic dyssynchrony markers were analyzed: global QRS duration (QRSDLBBB), left ventricular activation time (QRSDLVAT), time to intrinsicoid deflection (QRSDID), and vectorcardiographic QRS areas in the 3D vector loop (QRSA3D).

Results

The study enrolled 545 LBBB patients. Septal flash (SF) is present in 52% of patients presenting with true LBBB. Patients with SF are more frequent female, have less ischemic heart disease and smaller left ventricular dimensions. In multivariate analysis longer QRSDLBBB, QRSDLVAT and larger QRSA3D were independently associated with SF. Of all parameters, QRSA3D has the best accuracy to predict SF, although overall accuracy remains moderate (59% sensitivity, 58% specificity). The predictive value of QRSA3D remained constant in both sexes, irrespective of ischemic heart disease, ejection fraction and even when categorizing for QRSDLBBB.

Conclusion

In LBBB patients, large QRS areas correlate better with mechanical dyssynchrony compared to wide QRSD intervals. However, the overall accuracy to predict mechanical dyssynchrony by electrocardiographic dyssynchrony markers, even when using complex vectorcardiographic parameters, remains low.
A prospective investigation of perceived stress, infertility‐related stress, and cortisol levels in women undergoing in vitro fertilization: influence on embryo quality and clinical pregnancy rate
Authors: Cesta Carolyn E. , Johansson Anna L.V. , Hreinsson Julius , Rodriguez‐Wallberg Kenny A. , Olofsson Jan I. , Holte Jan , Wramsby Håkan , Wramsby Margareta , Cnattingius Sven , Skalkidou Alkistis , Nyman Iliadou Anastasia
Published: December 2017

Introduction

Women undergoing fertility treatment experience high levels of stress. However, it remains uncertain if and how stress influences in vitro fertilization (IVF) cycle outcome. This study aimed to investigate whether self‐reported perceived and infertility‐related stress and cortisol levels were associated with IVF cycle outcomes.

Material and methods

A prospective cohort of 485 women receiving fertility treatment was recruited from September 2011 to December 2013 and followed until December 2014. Data were collected by online questionnaire prior to IVF start and from clinical charts. Salivary cortisol levels were measured. Associations between stress and cycle outcomes (clinical pregnancy and indicators of oocyte and embryo quality) were measured by logistic or linear regression, adjusted for age, body mass index, education, smoking, alcohol and caffeine consumption, shiftwork and night work.

Results

Ultrasound verified pregnancy rate was 26.6% overall per cycle started and 32.9% per embryo transfer. Stress measures were not associated with clinical pregnancy: when compared with the lowest categories, the adjusted odds ratio (OR) and 95% confidence interval (CI) for the highest categories of the perceived stress score was 1.04 (95% CI 0.58–1.87), infertility‐related stress score was OR = 1.18 (95% CI 0.56–2.47), morning and evening cortisol was OR = 1.18 (95% CI 0.60–2.29) and OR = 0.66 (95% CI 0.34–1.30), respectively.

Conclusions

Perceived stress, infertility‐related stress, and cortisol levels were not associated with IVF cycle outcomes. These findings are potentially reassuring to women undergoing fertility treatment with concerns about the influence of stress on their treatment outcome.
Novel concepts in sleep regulation
Authors: Wigren H.‐K. , Porkka‐Heiskanen T.
Published: December 2017

Knowledge regarding the cellular mechanisms of sleep regulation is accumulating rapidly. In addition to neurones, also non‐neuronal brain cells (astrocytes and microglia) are emerging as potential players. New techniques, particularly optogenetics and designed receptors activated by artificial ligands (DREADD), have provided also sleep research with important additional tools to study the effect of either silencing or activating specific neuronal groups/neuronal networks by opening or shutting ion channels on cells. The advantages of these strategies are the possibility to genetically target specific cell populations and the possibility to either activate or inhibit them with inducing light signal into the brain. Studies probing circuits of NREM and REM sleep regulation, as well as their role in memory consolidation, have been conducted recently. In addition, fundamentally new thoughts and potential mechanisms have been introduced to the field. The role of non‐neuronal tissues in the regulation of many brain functions has become evident. These non‐neuronal cells, particularly astrocytes, integrate large number of neurones, and it has been suggested that one of their functions is to integrate the (neural) activity in larger brain areas—a feature that is one of the prominent features of also the state of sleep.
Safety and efficacy of sofosbuvir‐based treatment of acute hepatitis C in end‐stage renal disease patients undergoing haemodialysis
Authors: He Y. L. , Yang S. J. , Hu C. H. , Dong J. , Gao H. , Yan T. T. , Liu J. F. , Yang Y. , Ren D. F. , Zhu L. , Zhao Y. R. , Chen T. Y.
Published: December 2017

Background

Hepatitis C virus (HCV) infection in patients undergoing haemodialysis is prevalent and aggressive. The treatment of chronic hepatitis C has been revolutionised by the advent of direct‐acting antivirals (DAAs). However, the safety, efficacy, and tolerance of DAAs in the treatment of acute HCV infection in patients with end‐stage renal disease who are on haemodialysis are unknown.

Aim

To evaluate the safety and efficacy of sofosbuvir plus daclatasvir in this specific, difficult‐to‐treat population.

Methods

We conducted a prospective and observational study of end‐stage renal disease patients who were undergoing haemodialysis and were acutely infected with HCV. Patients received a half dose of sofosbuvir (200 mg) and a full dose of daclatasvir (60 mg) daily. The primary endpoint was the proportion of patients with sustained virological responses (SVRs); the other primary outcomes were safety and tolerability.

Results

Thirty‐three patients were enrolled in the study. The median HCV RNA viral load at baseline was 6.8 log10IU/mL. Twenty‐four patients were infected with HCV genotype 2a, seven patients with 1b, and two patients with 2a+1b. All patients achieved a SVR at 12 weeks after the end of treatment. The treatment was well tolerated, and there were no drug‐related serious adverse events.

Conclusion

A half dose of sofosbuvir (200 mg once daily) plus a full dose of daclatasvir (60 mg once daily) were suitable for the treatment of acute HCV‐infected patients who were undergoing end‐stage renal disease and were on haemodialysis.
Postoperative outcomes in vedolizumab‐treated Crohn's disease patients undergoing major abdominal operations
Authors: Lightner A. L. , McKenna N. P. , Tse C. S. , Raffals L. E. , Loftus E. V. , Mathis K. L.
Published: December 2017

Background

Up to 80% of patients with Crohn's disease require an abdominal operation in their lifetime. As the use of vedolizumab is increasing for the treatment of Crohn's disease, it is important to understand its potential association with post‐operative complications.

Aim

We sought to compare 30‐day postoperative infectious complication rate among vedolizumab‐treated Crohn's disease patients vs those who had received TNFα inhibitors or no biologic therapy.

Methods

A retrospective review of all Crohn's disease patients who received vedolizumab within 12 weeks of a major abdominal or pelvic operation was performed. Two control cohorts consisted of Crohn's disease patients treated with TNFα inhibitors or no biologic therapy.

Results

One hundred Crohn's disease patients received vedolizumab within 12 weeks of an abdominal operation. Vedolizumab‐treated patients underwent an equivalent rate of laparoscopic surgery (P = .25), had fewer anastomoses performed (P = .0002), and had equally frequent diversion in the setting of anastomoses (P = .47). Thirty‐two vedolizumab‐treated patients experienced postoperative infectious complications (32%), 26 of which were surgical site infections (26%). The vedolizumab‐treated group experienced no difference in nonsurgical site infections (6% vs 5% anti‐TNFα and 2% nonbiologic; P = .34), but significantly higher rates of surgical site infections (26% vs 8% and 11%; P < .001). On univariate and multivariate analysis, exposure to vedolizumab remained a significant predictor of postoperative surgical site infection (P < .001 and P = .002).

Conclusions

Twenty‐six per cent of Crohn's disease patients who received vedolizumab within 12 weeks prior to a major abdominal operation experienced a 30‐day postoperative surgical site infection, significantly higher than that of patients receiving TNFα inhibitors or no biologic therapy. Vedolizumab within 12 weeks of surgery remained a predictor of 30‐day postoperative surgical site infection on multivariable analysis. While vedolizumab‐treated Crohn's disease patients may be a sicker cohort of patients, it is important to consider these findings with regard to preoperative counselling, operative timing and primary closure of wounds.
The gap in social care provision for older people in China
Authors: Zhu Huoyun , Walker Alan
Published: December 2017

Because of its unprecedented sociodemographic changes, particularly rapid population aging, China faces huge challenges in social care. Using data from the 2012 Chinese Longitudinal Healthy Longevity Survey (n = 9,765), this article examines the need for social care, as well as the major sources of provision. The findings indicate that the majority of older people face some restriction in their daily living activities. From their perspective, however, the most urgent social protection services are related to health care and legal aid rather than services supporting daily living. Although Chinese Government policy since the 1990s has been a strategy of social welfare socialization, the role of government, both as provider and funder, is limited and focuses only on the most deprived and on urban areas. The result is a massive “care gap” between the need for social care and its supply. The primary responsibility for care provision is borne by the family. The direction of social policy in the future should focus on shared care between the family and the state, giving priority to expanding the coverage of social care services, especially in rural areas.
Barriers and facilitators to birth without epidural in a tertiary obstetric referral center: Perspectives of health care professionals and patients
Authors: Knox Alyssa , Rouleau Geneviève , Semenic Sonia , Khongkham Malisa , Ciofani Luisa
Published: December 2017

Background

Epidural rates are high in tertiary obstetric referral centers, even though many patients in tertiary settings might not want or need epidural analgesia. Epidural rates are influenced by factors including labor support and routine medical intervention. This study aimed to identify barriers and facilitators to birth without epidural in a Canadian tertiary center, from the perspectives of doctors, nurses, and patients.

Methods

In this qualitative exploratory study, individual, semi‐structured interviews were conducted in 2016 with 5 doctors, 5 nurses, and 4 patients who intended to birth without epidural. Interviews were audio‐recorded, transcribed, and analyzed using inductive qualitative thematic analysis.

Results

Several contextual factors in the tertiary center facilitated or were barriers to birth without epidural. The following themes emerged: (1) differing perceptions of pain, (2) being ready for things to go wrong, (3) labor support is more labor intensive, and (4) having insufficient resources for birth without epidural.

Conclusions

Reconciling patient birth goals with staff focus on patient safety is challenging in the tertiary context. Discrepancies between health care professional and patient attitudes about childbirth pain may influence decision‐making about epidural use. Maintaining labor support skills is challenging for health care professionals who have limited exposure to birth without epidural. There is a need to allocate dedicated resources to better support birth without epidural. Specifically, support could be improved through the implementation of guidelines for assessment and management of labor pain, provision of a variety of pain management options, and labor support training for health care professionals.
What are the risk factors associated with hospital birth among women planning to give birth in a birth center in Washington State?
Authors: Stephenson‐Famy Alyssa , Masarie Kaitlin S. , Lewis Ali , Schiff Melissa A.
Published: December 2017

Background

Few studies have evaluated risk factors associated with hospital birth among women planning to give birth in a birth center in the United States. This study describes the obstetrical risk factors for hospital birth among women intending to deliver in a birth center in Washington State.

Methods

We performed a retrospective cohort study of Washington State birth certificate data for women with singleton, term pregnancies planning to give birth at a birth center from 2004 to 2011. We assessed risk factors for hospital birth including demographic, obstetrical, and medical characteristics. We used multivariable logistic regression to estimate the odds ratio (OR) and 95% confidence interval (CI) of the association between risk factors and hospital birth.

Results

Among the 7118 women planning to give birth at a birth center during the study period, 7% (N = 501) had a hospital birth, and 93% delivered at a birth center (N = 6617). The strongest risk factors for hospital transfer included nulliparity (OR 7.2 [95% CI 5.3‐9.8]), maternal age >40 years (OR 3.7 [95% CI 2.1‐6.7]), inadequate prenatal care (OR 3.7 [95% CI 2.7‐5.0]), body mass index ≥30 (OR 2.1 [95% CI 1.6‐3.0]), government health insurance (OR 9.3 [95% CI 5.0‐17.1]), and hypertension (10.1 [95% CI 5.7‐18.1]). Among nulliparous women, all of these demographic and obstetrical factors remained strongly associated with hospital birth.

Conclusions

This information may be useful for counseling women who plan a birth center birth about the risk of hospital birth.
Assessing the relationship between physician availability and viral load suppression in British Columbia
Authors: Amram Ofer , Wang Lu , Sereda Paul , Shoveller Jean A. , Barrios Rolando , Montaner Julio S.G. , Lima Viviane D.
Published: December 2017

Key Messages

Individuals residing in areas where there are substantially fewer physicians available to provide HIV treatment have a higher chance of not achieving viral suppression.

Individuals residing in rural areas have poorer health outcomes when compared to those residing in urban areas.

Discrepancies in HIV treatment outcomes exist despite the fact that HIV treatment costs are borne directly by government.
The rise of economics in competition policy: A Canadian perspective
Authors: Boyer Marcel , Ross Thomas W. , Winter Ralph A.
Published: December 2017

Competition policy in Canada and elsewhere has changed remarkably over the last 50 years—in large measure due to advances in economics. In this article, we trace the impact of developments in industrial organization on the three central areas of competition policy: cartels, single firm conduct and mergers. We focus on Canadian competition policy but draw comparisons with developments in the United States and Europe.
ALLO: A tool to discriminate and prioritize allosteric pockets
Authors: Akbar Rahmad , Helms Volkhard
Published: December 2017

Allosteric proteins make up a substantial proportion of human drug targets. Thus, rational design of small molecule binders that target these proteins requires the identification of putative allosteric pockets and an understanding of their potential activity. Here, we characterized allosteric pockets using a set of physicochemical descriptors and compared them to pockets that are found on the surface of a protein. Further, we trained predictive models capable of discriminating allosteric pockets from orthosteric pockets and models capable of prioritizing allosteric pockets in a set of pockets found on a given protein. Such models might be useful for identifying novel allosteric sites and in turn, potentially new allosteric drug targets. Datasets along with a Python program encapsulating the predictive models are available at http://github.com/fibonaccirabbits/allo.
Interaction of antivirals with a heptameric bundle model of the p7 protein of hepatitis C virus
Authors: Dahl Sophie L. , Kalita Monoj Mon , Fischer Wolfgang B.
Published: December 2017

A series of ligands are known experimentally to affect the infectivity cycle of the hepatitis C virus. The target protein for the ligands is proposed to be p7, a 63 amino acid polytopic channel‐forming protein, with possibly two transmembrane domains. Protein p7 is found to assemble into functional oligomers of various sizes, depending on the genotype (GT). Nine ligands are docked to various sites of a computationally derived heptameric bundle of p7 of GT1a. The energy of interaction, here binding energy, is calculated using three different docking programs (Autodock, MOE, LeadIT). Three protein regions are defined to which the ligands are placed, the loop region and the site with the termini as well as the mid‐region which is supposed to track poses inside the putative pore. A common feature is that the loop sites and poses either within the pore or at the intermonomer space of the bundle are preferred for all ligands with proposed binding energies smaller than −10 kJ/mol. BIT225, benzamine, amantadine, and NN‐DNJ show good overall scoring.
A model of well‐being for children with neurodevelopmental disorders: Parental perceptions of functioning, services, and support
Authors: Ritzema A. M. , Lach L. M. , Nicholas D. , Sladeczek I. E.
Published: December 2017

Background

Both child function and supports and services have been found to impact the well‐being of parents of children with neurodevelopmental disorders (NDD). The relationship between function and services and the well‐being of children with NDD is less well‐understood and is important to clarify in order to effect program and service change.

Methods

The current project assessed whether child function as well as the adequacy of formal supports and services provided to children and their families were predictive of child well‐being. Well‐being was assessed using a measure of quality of life developed for use with children with NDD. Data from 234 parents were analysed using structural equation modelling.

Results

Each predictor was found to load significantly on the overall outcome variable of well‐being. Parent concerns about child function were significantly related to child well‐being; parents who reported more concerns about their children's functioning reported lower levels of child well‐being. Unmet needs for formal supports and services were also significantly related to child well‐being; parents who reported that more of their children's and family's service needs were unmet reported lower child well‐being. An indirect relationship was also found between child function and child well‐being. When parents reported that their formal support needs were adequately met, their children's functional difficulties had a lower impact on parent perceptions of their children's overall well‐being.

Conclusions

Taken together, the results of the current study enrich our understanding of well‐being for children with NDD. Discussion focuses on the service implications for children with NDD and their families.
How practical experiences, educational routes and multidisciplinary teams influence genetic counselors' clinical practice in Europe
Authors: Pestoff R. , Moldovan R. , Cordier C. , Serra‐Juhé C. , Paneque M. , Ingvoldstad C. M.
Published: December 2017

The main objective of our study was to explore whether, and to what extent, genetic counselors’ characteristics impact on their tasks in practice. Specifically, we explored the complementariness between genetic counselors and medical geneticists and therefore looked at the most relevant tasks of genetic counselors, according to genetic counselors themselves and according to the medical geneticists they work with. A total of 104 genetic counselors and 29 medical geneticists from 15 countries completed a purposefully designed questionnaire. Results showed that most genetic counselors in Europe perform similar tasks, irrespective of their backgrounds. When looking at the factors influencing genetic counselors’ roles data showed that the type of tasks performed by genetic counselors is associated with the years of experience in the field, not with their background or education. Of particular interest was the consensus between genetic counselors and medical geneticists regarding the genetic counselor's role. Not surprisingly, tasks with more psychosocial implications were seen as genetic counselors’ eligibility while tasks with more medical implications were seen as medical geneticists’ attribution. Our study shows that most genetic counselors work in tune with international recommendations and seem to be supportive of multidisciplinary teams. Corroborating our data with previous research, we discuss potential implications for practice and training in genetic counseling.
Bidirectional Rendering of Vector Light Transport
Authors: Jarabo Adrian , Arellano Victor
Published: December 2017

On the foundations of many rendering algorithms it is the symmetry between the path traversed by light and its adjoint path starting from the camera. However, several effects, including polarization or fluorescence, break that symmetry, and are defined only on the direction of light propagation. This reduces the applicability of bidirectional methods that exploit this symmetry for simulating effectively light transport. In this work, we focus on how to include these non‐symmetric effects within a bidirectional rendering algorithm. We generalize the path integral to support the constraints imposed by non‐symmetric light transport. Based on this theoretical framework, we propose modifications on two bidirectional methods, namely bidirectional path tracing and photon mapping, extending them to support polarization and fluorescence, in both steady and transient state.
Role of capsule endoscopy in alarm features and non‐responsive celiac disease: A European multicenter study
Authors: Perez‐Cuadrado‐Robles Enrique , Lujan‐Sanchis Marisol , Elli Luca , Juanmartinena‐Fernandez Jose‐Francisco , Garcıa‐Lledo Javier , Ruano‐Dıaz Lucıa , Egea‐Valenzuela Juan , Jimenez‐Garcıa Victoria‐Alejandra , Arguelles‐Arias Federico , Juan‐Acosta Mileidis San , Carretero‐Ribon Cristina , Alonso‐Lazaro Noelia , Rosa Bruno , Sanchez‐Ceballos Francisco , Lopez‐Higueras Antonio , Fernandez‐Urien‐Sainz Ignacio , Branchi Federica , Valle‐Muñoz Julio , Borque‐Barrera Pilar , Gonzalez‐Vazquez Santiago , Pons‐Beltran Vicente , Xavier Sofıa , Gonzalez‐Suarez Begona , Herrerıas‐Gutierrez Juan‐Manuel , Perez‐Cuadrado‐Martınez Enrique , Sempere‐Garcıa‐Arguelles Javier ,   Enteroscopy and Capsule Endoscopy Spanish Society Group of the Spanish Society of Digestive Endoscopy (SEED)
Published: December 2017

Background and Aim

The role of capsule endoscopy (CE) in established celiac disease (CD) remains unclear. Our objective was to analyze the usefulness of CE in the suspicion of complicated CD.

Methods

This was a retrospective multicenter study. One hundred and eighty‐nine celiac patients (mean age: 46.6 ± 16.6, 30.2% males) who underwent CE for alarm symptoms (n = 86, 45.5%) or non‐responsive CD (n = 103, 54.5%) were included. Diagnostic yield (DY), therapeutic impact and safety were analyzed.

Results

Capsule endoscopy was completed in 95.2% of patients (small bowel transit time: 270.5 ± 100.2 min). Global DY was 67.2%, detecting atrophic mucosa (n = 92, 48.7%), ulcerative jejunoileitis (n = 21, 11.1%), intestinal lymphoma (n = 7, 3.7%) and other enteropathies (n = 7, 3.7%, six Crohn's disease cases and one neuroendocrine tumor).

The DY of CE was significantly higher in patients presenting with non‐responsive disease compared to patients with alarm symptoms (73.8% vs 59.3%, P = 0.035). The new findings of the CE modified management in 59.3% of the cases. There were no major complications.

Conclusion

Capsule endoscopy may be a moderately helpful and safe diagnostic tool in the suspicion of complicated CD, modifying the clinical course of these patients.
Children retain implicitly learned phonological sequences better than adults: a longitudinal study
Authors: Smalle Eleonore H.M. , Page Mike P.A. , Duyck Wouter , Edwards Martin , Szmalec Arnaud
Published: December 2017

Whereas adults often rely on explicit memory, children appear to excel in implicit memory, which plays an important role in the acquisition of various cognitive skills, such as those involved in language. The current study aimed to test the assertion of an age‐dependent shift in implicit versus explicit learning within a theoretical framework that explains the link between implicit sequence memory and word‐form acquisition, using the Hebb repetition paradigm. We conducted a one‐year, multiple‐session longitudinal study in which we presented auditory sequences of syllables, co‐presented with pictures of aliens, for immediate serial recall by a group of children (8–9 years) and by an adult group. The repetition of one Hebb sequence was explicitly announced, while the repetition of another Hebb sequence was unannounced and, therefore, implicit. Despite their overall inferior recall performance, the children showed better offline retention of the implicit Hebb sequence, compared with adults who showed a significant decrement across the delays. Adults had gained more explicit knowledge of the implicit sequence than children, but this could not explain the age‐dependent decline in the delayed memory for it. There was no significant age‐effect for delayed memory of the explicit Hebb sequence, with both age groups showing retention. Overall performance by adults was positively correlated with measures of post‐learning awareness. Performance by children was positively correlated with vocabulary knowledge. We conclude that children outperform adults in the retention over time of implicitly learned phonological sequences that will gradually consolidate into novel word‐forms. The findings are discussed in the light of maturational differences for implicit versus explicit memory systems that also play a role in language acquisition. A video abstract of this article can be viewed at: https://youtu.be/G5nOfJB72t4
Predictive coding in auditory perception: challenges and unresolved questions
Authors: Denham Susan L. , Winkler István
Published: December 2017

Predictive coding is arguably the currently dominant theoretical framework for the study of perception. It has been employed to explain important auditory perceptual phenomena, and it has inspired theoretical, experimental and computational modelling efforts aimed at describing how the auditory system parses the complex sound input into meaningful units (auditory scene analysis). These efforts have uncovered some vital questions, addressing which could help to further specify predictive coding and clarify some of its basic assumptions. The goal of the current review is to motivate these questions and show how unresolved issues in explaining some auditory phenomena lead to general questions of the theoretical framework. We focus on experimental and computational modelling issues related to sequential grouping in auditory scene analysis (auditory pattern detection and bistable perception), as we believe that this is the research topic where predictive coding has the highest potential for advancing our understanding. In addition to specific questions, our analysis led us to identify three more general questions that require further clarification: (1) What exactly is meant by prediction in predictive coding? (2) What governs which generative models make the predictions? and (3) What (if it exists) is the correlate of perceptual experience within the predictive coding framework?
A role for activity‐dependent epigenetics in the development and treatment of major depressive disorder
Authors: Nagy C. , Vaillancourt K. , Turecki G.
Published: December 2017

Chronic stressors, during developmental sensitive periods and beyond, contribute to the risk of developing psychiatric conditions, including major depressive disorder (MDD). Epigenetic mechanisms including DNA methylation and histone modifications, at key stress response and neurotrophin genes, are increasingly implicated in mediating this risk. Although the exact mechanisms through which stressful environmental stimuli alter the epigenome are still unclear, research from the learning and memory fields indicates that epigenomic marks can be altered, at least in part, through calcium‐dependent signaling cascades in direct response to neuronal activity. In this review, we highlight key findings from the stress, MDD, and learning and memory fields to propose a model where stress regulates downstream cellular functioning through activity‐dependent epigenetic changes. Furthermore, we suggest that both typical and novel antidepressant treatments may exert positive influence through similar, activity‐dependent pathways.