bluuebunny/crossref_metadata_2025 huggingface dataset:
Procedure‐related risk of miscarriage following chorionic villus sampling and amniocentesis
Authors: Beta J. , Zhang W. , Geris S. , Kostiv V. , Akolekar R.
Published: April 2019

Objectives

To estimate the procedure‐related risks of miscarriage following chorionic villus sampling (CVS) and amniocentesis in a large unselected screened population, and to determine whether these risks are consistent with those reported in systematic reviews and meta‐analyses.

Methods

This was a retrospective cohort study carried out on data obtained from a large fetal medicine unit in the UK between January 2009 and May 2018. We included all women with singleton pregnancy who booked for pregnancy care at our unit before 20 weeks' gestation, after excluding those with multiple pregnancy, major fetal defect, pregnancy termination and loss to follow‐up. We estimated the risk of miscarriage in women who underwent a CVS or amniocentesis as well as in those who did not have an invasive procedure. The procedure‐related risk of miscarriage was estimated as risk difference (95% CI) between the two groups. Univariate and multivariate regression analyses were used to derive odds ratios (95% CI) and determine which maternal and pregnancy characteristics provided a significant contribution in the prediction of miscarriage and whether CVS or amniocentesis provided a significant independent contribution.

Results

During the study period, 45 120 singleton pregnancies were booked for pregnancy care at our hospital, of which 1546 had an invasive procedure. We excluded 1429 (3.2%) pregnancies due to fetal defects, termination of pregnancy or missing outcomes. Of the 43 691 pregnancies included in the study population, 861 underwent CVS and 375 amniocentesis. In pregnancies that underwent CVS, the risk of miscarriage was 1.5% (13/861), compared with 1.2% (476/39 152) in pregnancies that had first‐trimester combined screening and did not have an invasive procedure (P = 0.437). In pregnancies that underwent an amniocentesis, the risk of miscarriage was 0.8% (3/375), compared with 1.2% (491/42 463) in those that did not undergo an invasive procedure (P = 0.520). Univariate and multivariate regression analysis demonstrated that there was no significant contribution in the prediction of the risk of miscarriage from CVS (P = 0.399 and P = 0.592, respectively) or amniocentesis (P = 0.543 and P = 0.550, respectively). The risk of procedure‐related loss attributed to CVS was 0.29% (95% CI, −0.53 to 1.12%) and that following amniocentesis was −0.36% (95% CI, −1.26 to 0.55%), which was not significantly different from the risk in women who did not have any procedure.

Conclusions

The procedure‐related risks of miscarriage following CVS and amniocentesis in our study are considerably lower than those currently quoted and are consistent with the estimates of such risks reported by systematic reviews and meta‐analyses. Copyright © 2019 ISUOG. Published by John Wiley & Sons Ltd.
Characteristics of the Palynomorphs and Hydrocarbon Potential in the Continental Permian Raniganj Formation, Banespetali Nala, West Bengal
Authors: Sinha H. N. , Patel R. C. , Kumar B. A.
Published: April 2019

The youngest coal seam of the Raniganj Formation of upper Permian age has been critically examined for microfloral assemblages near to the continental P/T boundary of India. The study reveals a rich and diversified microfloral assemblages and it tentatively corresponds with long distances homotaxial beds of SE Turkey, Australia and Antarctica. Based on the microfloral assemblages, the dark shale occurring at the youngest coal seam of the Raniganj Formation tentatively assigns a Wordian to Capitanian (260-265Ma) age. Some of the forms such as Striatoabieites multistriatus, Protohaploxipinus sp., Striatopodocarpites fusus, Striatopodocorpites cancellatus, Praecolpatites sinuosus, Plicatipollenites gondwanensis have a wide range of distributions from low to high palaeo-latitudinal Gondwanan provinces. This attributes that these forms probably were not climate dependent, but other might vaguely be ascribed to be climatic sensitive. Apatite Fission Track (AFT) and maturation study based on spore/pollen coloration attributes to the possibility of small amount of liquid hydrocarbon and large commercial gas accumulations in the Raniganj Formation.
Why and how to support depsychiatrisation of adult transidentity in ICD-11: A French study
Authors: Askevis-Leherpeux Françoise , de la Chenelière Marie , Baleige Antoine , Chouchane Sarah , Martin Marie-Jeanne , Robles-García Rebeca , Fresán Ana , Quach Alexandre , Stona Anne-Claire , Reed Geoffrey , Roelandt Jean-Luc
Published: April 2019

Background:

For the 11th version of the International Classification of Diseases, the WHO recommended to rename transgender transidentity as “gender incongruence”, to remove it from the chapter of mental and behavioral disorders, and to put it in a new category titled “Conditions related to sexual health”. This should contribute to reduce stigmatisation while maintaining access to medical care. One argument in favor of depsychiatrisation is to demonstrate that essential features of gender identity disorders, namely psychological distress and functional impairment, are not necessarily reported by every transgender person, and may result from social rejection and violence rather than dysphoria itself. Initially confirmed in Mexico, these hypotheses were tested in a specific French medical context, where access to care does not require any prior mental health evaluation or diagnosis.

Method:

In 2017, 72 transgender persons completed retrospective interviews which focused on the period when they became aware that they might be transgender and perhaps would need to do something about it.

Results:

Results showed that psychological distress and functional impairment were not reported by every participant, that they may result from rejection and violence, and especially from rejection and violence coming from coworkers and schoolmates. Additional data showed that the use of health services for body transformation did not depend on distress and dysfunction. Finally, participants preferred ICD 11 to employ “transgender” or “transidentity” rather than “gender incongruence”.

Conclusion:

Results support depsychiatrisation. They are discussed in terms of medical, ethical, legal, and social, added values and implications of depsychiatrisation.
On the existence of cocycle-invariant Borel probability measures
Authors: MILLER BENJAMIN D.
Published: April 2019

We show that a natural generalization of compressibility is the sole obstruction to the existence of a cocycle-invariant Borel probability measure.
Evaluation of uncomplicated acute respiratory tract infection management in veterans: A national utilization review
Authors: Bohan Jefferson G. , Madaras-Kelly Karl , Pontefract Benjamin , Jones Makoto , Neuhauser Melinda M. , Bidwell Goetz Matthew , Burk Muriel , Cunningham Francesca ,   for the ARI Management Improvement Group
Published: April 2019

Background:

Antibiotics are overprescribed for acute respiratory tract infections (ARIs). Guidelines provide criteria to determine which patients should receive antibiotics. We assessed congruence between documentation of ARI diagnostic and treatment practices with guideline recommendations, treatment appropriateness, and outcomes.

Methods:

A multicenter quality improvement evaluation was conducted in 28 Veterans Affairs facilities. We included visits for pharyngitis, rhinosinusitis, bronchitis, and upper respiratory tract infections (URI-NOS) that occurred during the 2015–2016 winter season. A manual record review identified complicated cases, which were excluded. Data were extracted for visits meeting criteria, followed by analysis of practice patterns, guideline congruence, and outcomes.

Results:

Of 5,740 visits, 4,305 met our inclusion criteria: pharyngitis (n = 558), rhinosinusitis (n = 715), bronchitis (n = 1,155), URI-NOS (n = 1,475), or mixed diagnoses (>1 ARI diagnosis) (n = 402). Antibiotics were prescribed in 68% of visits: pharyngitis (69%), rhinosinusitis (89%), bronchitis (86%), URI-NOS (37%), and mixed diagnosis (86%). Streptococcal diagnostic testing was performed in 33% of pharyngitis visits; group A Streptococcus was identified in 3% of visits. Streptococcal tests were ordered less frequently for patients who received antibiotics (28%) than those who did not receive antibiotics 44%; P < .01). Although 68% of visits for rhinosinusitis had documentation of symptoms, only 32% met diagnostic criteria for antibiotics. Overall, 39% of patients with uncomplicated ARIs received appropriate antibiotic management. The proportion of 30-day return visits for ARI care was similar for appropriate (11%) or inappropriate (10%) antibiotic management (P = .22).

Conclusions:

Antibiotics were prescribed in most uncomplicated ARI visits, indicating substantial overuse. Practice was frequently discordant with guideline diagnostic and treatment recommendations.
Equilibrium positions of the elasto-inertial particle migration in rectangular channel flow of Oldroyd-B viscoelastic fluids
Authors: Yu Zhaosheng , Wang Peng , Lin Jianzhong , Hu Howard H.
Published: April 2019

In this paper, the lateral migration of a neutrally buoyant spherical particle in the pressure-driven rectangular channel flow of an Oldroyd-B fluid is numerically investigated with a fictitious domain method. The aspect ratio of the channel cross-section considered is 1 and 2, respectively. The particle lateral motion trajectories are shown for the bulk Reynolds number ranging from 1 to 100, the ratio of the solvent viscosity to the total viscosity being 0.5, and a Weissenberg number up to 1.5. Our results indicate that the lateral equilibrium positions located on the cross-section midline, diagonal line, corner and channel centreline occur successively as the fluid elasticity is increased, for particle migration in square channel flow with finite fluid inertia. The transition of the equilibrium position depends strongly on the elasticity number (the ratio of the Weissenberg number to the Reynolds number) and weakly on the Reynolds number. The diagonal-line equilibrium position occurs at an elasticity number ranging from roughly 0.001 to 0.02, and can coexist with the midline and corner equilibrium positions. When the fluid inertia is negligibly small, particles migrate towards the channel centreline, or the closest corner, depending on their initial positions and the Weissenberg number, and the corner attractive area first increases and then decreases as the Weissenberg number increases. For particle migration in a rectangular channel with an aspect ratio of 2, the transition of the equilibrium position from the midline, ‘diagonal line’ (the line where two lateral shear rates are equal to each other), off-centre long midline and channel centreline takes place as the Weissenberg number increases at moderate Reynolds numbers. An off-centre equilibrium position on the long midline is observed for a large blockage ratio of 0.3 (i.e. the ratio of the particle diameter to the channel height is 0.3) at a low Reynolds number. This off-centre migration is driven by shear forces, unlike the elasticity-induced rapid inward migration, which is driven by the normal force (pressure or first normal stress difference).
BETWEEN LIFE GIVER AND LEISURE: IDENTITY NEGOTIATION THROUGH SEAFOOD IN TURKEY
Authors: Knudsen Ståle
Published: April 2019

With socioeconomic liberalization and development, especially since 1980, Turkey has witnessed rapid changes in consumption patterns and fashion styles. Often one fad rapidly follows another, creatively combining symbols of the Ottoman era, foreign influences, and regional traditions. Kandiyoti argues that “[t]here is little doubt that class cultures in Turkey are increasingly being shaped and redefined through the medium of consumption.” Thus, consumption has emerged recently as a central concern and analytical tool in historical, anthropological, and sociological works on Ottoman and Turkish society. One trend focuses on the secular high-income class' “globalized” consumption patterns and lifestyle, especially as expressed through shopping patterns and the commoditization of symbols of Turkish secularism. Another, more prevalent, trend is more concerned with the upwardly mobile Islamists' attempt at articulating their newly gained economic status through consumption. A third directs attention to the history of consumption and “the everyday” to counter a previous emphasis on production and state politics in the Ottoman Empire.
PRIVATE PUBLISHING IN THE NAHḌA
Authors: Ayalon Ami
Published: April 2019

The Arab cultural-literary “awakening” of the late 19th century, known as the nahḍa, represented the first phase of mass printing in the Middle East, a historic development of major implications. Underlying new trends in social, political, and cultural thought, it entailed the large-scale production of printed texts, introduction of new diffusion channels, and emergence of broad reading audiences. The present study explores one facet of these dynamic changes: the advent of private publishing first centered in Egypt and Lebanon. Through the individual prism of Khalil Sarkis—a Beirut printer, publisher, bookseller, and author (1842–1915)—the article examines early book- and journal-publishing initiatives by printers, bookshop owners, and others, as well as their motivations and dilemmas. The emerging scene illustrates a vivid and rapid cultural shift, arguably a kind of “printing revolution” akin to that which had occurred in early modern Europe.
THE OTTOMAN LEGACY IN COLD WAR MODERNIZATION
Authors: Citino Nathan J.
Published: April 2019

This article examines Americans' uses of the Ottoman-Turkish past to justify different approaches to “Third World” development. Such invocations exposed tensions within American liberalism and projected them onto Middle Eastern history. One interpretation criticized Tanzimat land reform to emphasize agrarian democracy as the impetus for the development process. Another, reflecting postwar liberals' predilection for elite authority, relegated democracy to the end of that process by embracing Kemalism as its model. The article concludes by arguing that Ottoman historians influenced the modernization paradigm as much as it did them. H. A. R. Gibb and Harold Bowen transmitted Ottoman reform discourses to social scientists through Islamic Society and the West, which the authors based on reform-era writings at a time when archival research was just beginning to transform Ottoman studies. Cold War intellectuals and bureaucrats appropriated their Ottoman predecessors' temporal and spatial perspectives in the effort to manage Third World change
Grain size effects in rime judgment across literacy development in German
Authors: Schmitterer Alexandra M. A. , Schroeder Sascha
Published: April 2019

Phonological similarity effects are biases to judge words as phonologically similar (i.e., rhyming), even if they are not. First found in rime awareness tasks in preliterates, these biases have recently also been found in proficient adult readers. In this study, we evaluated underlying phonological processing in rime judgment longitudinally, across literacy development. To this end, we created a new rime judgment task (rime; i.e., /t∙aɪ̯∙l/ - /z∙aɪ̯∙l/) with two distractor conditions that varied in size of phonological overlap (body; i.e., /t∙aɪ̯∙l/ - /t∙aɪ̯ ç/; nucleus; i.e., /t∙aɪ̯∙l/ - /r∙aɪ̯∙s/). The task was administered to a group of 61 German-speaking children at four time points across school entry and to 21 adults. Accuracy and latency responses were recorded. Results indicated that children and adults showed phonological similarity effects but the effect decreased gradually over time. However, preliterate children were more sensitive to large compared to small phonological overlap, while the same effect was significantly smaller in literate children and adults. Results suggest that preliterate children are more sensitive to larger grain sizes and become more sensitive to fine-grained units across literacy development. The findings are in line with the assumptions of the psycholinguistic grain size theory.
High-Gain Observer-Based Neural Adaptive Feedback Linearizing Control of a Team of Wheeled Mobile Robots
Authors: Sarrafan Neda , Shojaei Khoshnam
Published: April 2019

This paper addresses the neural network (NN) output feedback formation tracking control of nonholonomic wheeled mobile robots (WMRs) with limited voltage input. A desired formation is achieved based on the leader–follower strategy utilizing hyperbolic tangent saturation functions to reduce the risk of actuator saturation. The controller is developed by incorporating the high-gain observer and radial basis function (RBF) NNs using the inverse dynamics control technique. The high-gain observer is introduced to estimate velocities of the followers. The RBF NN preserves the robustness of the proposed controller against uncertain nonlinearities. The adaptive laws are also combined by a robust control term to estimate the weights of RBF NN, approximation errors, and bounds of unknown time-variant environmental disturbances. A Lyapunov-based stability analysis proves that all signals of the closed-loop system are bounded, and tracking errors are uniformly ultimately bounded. Finally, some simulations are carried out to show the effectiveness of the proposed controller for a number of WMRs.
Understanding Bachelorhood in Poverty-stricken and High Sex Ratio Settings: An Exploratory Study in Rural Shaanxi, China
Authors: Attané Isabelle , Eklund Lisa , Merli M. Giovanna , Bozon Michel , Angeloff Tania , Yang Bo , Li Shuzhuo , Pairault Thierry , Wang Su , Yang Xueyan , Zhang Qunlin
Published: April 2019

Coupled with the social practice of female hypergamy, the male surplus within the never-married population means that today's Chinese marriage market is extremely tight in particular for men from a rural background and the least privileged socio-economic categories. Drawing on quantitative data from a survey conducted in 2014–2015, this article sheds light on the situation of single men who are past prime marriage age in three rural districts of Shaanxi particularly affected by this phenomenon. It compares single men's characteristics to those of their married counterparts and offers insights into the heterogeneity of single men with the aim of challenging some commonly accepted assumptions about bachelorhood in rural China. Results suggest a strong internalization of the various characteristics, centred on being able to offer social mobility to a potential wife, that a man is expected to have to be attractive to women in a context where women have more choice in mate selection. We conclude that mate selection is highly marked by class, social norms, social interactions, health, generation and age, and requires the mobilization of certain amounts of individual, social and economic resources. Unwanted bachelorhood would thus be better understood using an intersectional approach rather than mainly in numeric terms.
Risk factor analysis, antimicrobial resistance and pathotyping ofEscherichia coliassociated with pre- and post-weaning piglet diarrhoea in organised farms, India
Authors: VinodhKumar O. R. , Singh B. R. , Sinha D. K. , Pruthvishree B. S. , Tamta Shika , Dubal Z. B. , Karthikeyan R. , Rupner Ramkumar N. , Malik Y. S.
Published: April 2019

A cross-sectional study was conducted from 2014 to 2017 in 13 organised pig farms located in eight states of India (Northern, North-Eastern and Southern regions) to identify the risk factors, pathotype and antimicrobial resistance ofEscherichia coliassociated with pre- and post-weaning piglet diarrhoea. The data collected through questionnaire survey were used to identify the risk factors by univariable analysis, in which weaning status, season, altitude, ventilation in the shed, use of heater/cooler for temperature control in the sheds, feed type, water source, and use of disinfectant, were the potential risk factors. In logistic regression model, weaning and source of water were the significant risk factors. The piglet diarrhoea prevalence was almost similar across the regions. Of the 909 faecal samples collected (North – 310, North-East – 194 and South – 405) for isolation ofE. coli, pathotyping and antibiotic screening, 531E. coliwere isolated in MacConkey agar added with cefotaxime, where 345 isolates were extended spectrumβ-lactamase (ESBL) producers and were positive forblaCTX-M-1 (n= 147),blaTEM (n= 151),qnrA (n= 98),qnrB (n= 116),qnrS (n= 53),tetA (n= 46),tetB (n= 48) andsul1 (n= 54) genes. Multiple antibiotic resistance (MAR) index revealed that 14 (2.64%) isolates had MAR index of 1. On the virulence screening ofE. coli, 174 isolates harboured alone or combination ofStx1,Stx2,eaeA,hlyA genes. The isolates from diarrhoeic and post-weaning samples harboured higher number of virulence genes than non-diarrhoeic and pre-weaning. Alleviating the risk factors might reduce the piglet diarrhoea cases. The presence of multidrug-resistant and ESBL-producing pathogenicE. coliin piglets appears a public health concern.
LAPIDARY CRAFT PRODUCTION AT 17:S3E1 AND 18:S3E1, THE TLAJINGA DISTRICT, TEOTIHUACAN
Authors: Widmer Randolph J.
Published: April 2019

A total of 84 two-liter soil samples from Proyecto Arqueológico Tlajinga Teotihuacan (PATT) sites 17:S3E1, 18:S3E1, and the Street of the Dead excavations were fine-screened through 1-mm mesh and were sorted to retrieve tiny artifacts. The raw lapidary stone and marine shell material was then analyzed to assess the presence and intensity of artifact production. These data were also compared with the lapidary material of nearby 33:S3W1. A robust multicraft lapidary production was revealed. Sequins and stemmed trapezoid pendants were manufactured from slate, greenstone, marine shell, and mica, with slate being the predominant raw material being worked. A reduction sequence for slate sequins was developed based on the various shapes of slate materials that indicated the stages of production. Importantly, this lapidary craft production was not recognized from surface collections prior to excavation.
Gospel and Order in the Rule of St Benedict
Authors: Boakes Norman
Published: April 2019

Members of the Church of England are part of an ordered Church with a given liturgy. That order is deeply embedded in our story and today all clergy and lay ministers function and carry out their ministries on the authorisation of the bishop of the diocese. The Church of England is an institution which has its rules, laws and codes of conduct. Because we have no doctrinal formulations of our own, the liturgy in the Church of England expresses much of our theology. While there have been many changes in liturgy, a given liturgy, or a liturgical structure within which certain texts are prescribed, is part of how we are.
Modulation of neurohormonal activity after treatment of children in heart failure with carvedilol
Authors: Giardini Alessandro , Formigari Roberto , Bronzetti Gabriele , Prandstraller Daniela , Donti Andrea , Bonvicini Marco , Picchio Fernando M.
Published: April 2019

Background:In adults with heart failure, neurohormonal overstimulation is related to the progression of the disease, and influences prognosis. β-blockers, which modulate neurohormonal activation, now play an essential role in the pharmacological management of heart failure in adults, but their use in children is very limited.Patients and Methods:To investigate the effects of carvedilol administration on neurohormonal activation and left ventricular function, carvedilol was added to standard treatment for heart failure in 9 patients with dilated cardiomyopathy due to heart muscle disease. Standard treatment has been in place for at least 1 month. The protocol consisted in a baseline evaluation to assess neurohormonal activation, and echocardiographic evaluation of left ventricular function. This was followed by a final evaluation at 12 months from carvedilol loading. Carvedilol was started at 0.05 mg/kg/day, and increased every two weeks until the target dose of 0.8 mg/kg/day was reached.Results:Carvedilol administration was associated with a significant reduction in plasma norepinephrine (p = 0.00001), dopamine (p = 0.0001), aldosterone (p = 0.00001) and activation of the renin-angiotensin system (p = 0.0006). Similar reductions in vanilmandelic and homovanillic acid were noted. After 12 months, a positive remodeling took place, with significant reductions in end-diastolic (p = 0.004) and end-systolic diameters (p = 0.009), and an increase in left ventricular ejection fraction (p = 0.001). No adverse effects needing reduction or interruption in the dosage were noted in the run-in phase, nor in the period of maintenance.Conclusion:Carvedilol is a safe complement to standard therapy for heart failure in children, allowing a significant reduction of neurohormonal activation with evident benefits on both ventricular function and the clinical condition.
Surgery for mitral valvar disease in childhood: should we choose reconstruction or repair?
Authors: Alpagut Ufuk , Dayioglu Enver
Published: April 2019

Objective:Modern surgical techniques now offer the potential for reconstructing rather than replacing the mitral valve in those patients who require an operation during childhood. The purpose of this study was to assess the outcome in our centre following mitral valvar surgery in children.Methods:Between 1992 and 2002, 51 consecutive children, with a mean age of 12.5 ± 3.5 years, underwent surgical treatment of mitral valvar stenosis and/or insufficiency in the Cardiovascular Surgical Department of Istanbul University. Of the children, 20 underwent repair, whilst we replaced the valve in 31 patients. In one, we inserted a pulmonary valvar autograft in mitral position.Results:There were neither early nor late deaths in those who underwent mitral valvar repair. Similarly, there were no early deaths in those in whom the valve was replaced, but two patients died late, while six outgrew their prosthetic valves and required insertion of a further valve within 10 years of their first operations.Conclusion:Our experience shows that procedures designed to repair the mitral valve are effective and reliable when performed in children, with low mortality, and a lower incidence of reoperation when compared with those having replacement of the mitral valve.
Severe pulmonary hypertension secondary to a parachute-like mitral valve, with the left superior caval vein draining into the coronary sinus, in a girl with Turner's syndrome
Authors: van Heerde Marc , Hruda Jaroslav , Hazekamp Mark G.
Published: April 2019

A 17-year-old girl with Turner's syndrome underwent two cardiac operations due to severe mitral stenosis with pulmonary hypertension, caused by a parachute-like mitral valve. The anomaly was associated with persistence of the left superior caval vein, which drained to the coronary sinus, and non-compaction of the left ventricular myocardium. The association of these lesions is rare in patients with Turner's syndrome.
Ebstein's malformation in the setting of Down's syndrome
Authors: Bauk Lucas , Espinola-Zavaleta Nilda , Muñoz-Castellanos Luis
Published: April 2019

We report a patient with Down's syndrome referred to our Department of Echocardiography for evaluation after an episode of tachyarrhythmia. We diagnosed Ebstein's malformation. As far as we know, this association has been reported previously on only three occasions. We review these previous cases, describe our echocardiographic techniques, and discuss our experience.
Successful management of fetal hydrops due to congenitally complete atrioventricular block
Authors: Sivarajah Jacintha , Huggon Ian C. , Rosenthal Eric
Published: April 2019

At 32 weeks, a fetus was found to be hydropic with congenitally complete heart block in an asymptomatic mother who was positive to anti-Ro antibodies. Maternal therapy with oral salbutamol was successful in prolonging gestation for a period of 3 weeks so that preterm delivery was delayed until the 35th week of gestation. Following treatment with inotropes and diuretics, a permanent transvenous pacemaker was implanted at 8 weeks of age. The child is now thriving at 20 months of age.
Abstracts for the British Congenital Cardiac Association Annual Meeting: The Barbican, London, 24–25 November 2005: Winner of the Young Investigator's Prize: B-Type Natiuretic Peptide (BNP) as a marker of paediatric heart failure
Authors: Mangat J. , Carter C. , Foo Y. , Burch M.
Published: April 2019

Background: Paediatric heart failure can be difficult to assess. Symptoms vary widely in children who have poor ventricular function on echocardiogram. In addition exercise testing is not possible in young children. BNP has been used in adult heart failure and more recently in paediatrics. We investigated BNP in the setting of a paediatric heart failure and transplantation service to assess its usefulness as a clinical marker of heart failure. Method: Clinical and echocardiographic data were correlated to 126 BNP samples. Patients were 3 weeks to 16 years of age. Left ventricular end-diastolic dimension (LVEDd) was related to normal values for body surface area (z-score). Clinical status was defined using Ross and NYHA scores. Thirty four samples were from patients with normal ventricular function. Of the remainder, most were from patients with idiopathic dilated cardiomyopathy (38), anthracycline cardiotoxicity (15), congenital heart disease (25), viral myocarditis (6) and restrictive cardiomyopathy (6). Analysis: BNP was correlated to parametric data (fractional shortening (FS%)) with pearsons correlation coefficient. For non-parametric data (z-score, NYHA and Ross score), spearmans correlation coefficient was used. Results: Rising BNP levels correlate to deteriorating clinical status with significance to the 0.01 level (Ross and NYHA), Figure 1. There was also correlation, significant to the 0.01 level to FS%, Figure 2. Increasing BNP levels correlated to the increasing LVEDd z-score significant to the 0.05 level. Mean BNP: in ventricular dysfunction 634 pg/ml (S.E.M. = 80), in normal function 11.9 pg/ml (S.E.M. = 1.6). Conclusions: This is the largest study of BNP in paediatric heart failure. The stronger correlation of BNP to NYHA and ROSS than to LVEDD and FS% suggests a useful role in assessment of children with heart failure. We believe it is useful in the outpatient setting particularly when care is shared with general paediatricians. It also appears to be a useful addition in the assessment of heart failure and perhaps timing of transplantation in a specialist centre.
Abstracts for the British Congenital Cardiac Association Annual Meeting: The Barbican, London, 24–25 November 2005: Poster Presentations: Feasibility and safety of intravascular ultrasound for measurement of coronary atheroma burden in children after heart transplantation
Authors: Fenton Dr Matthew , Burch Michael
Published: April 2019

Purpose: Although intravascular ultrasound (IVUS) in children has been reported it is not widely used due to concerns over safety. Detailed analyses of measurements outlined by the ACC consensus statement on IVUS have not been reported in children. We report our safety and analysis data to date. Procedures: IVUS of the left anterior descending was performed with mechanised pullback concurrently with surveillance coronary angiography. Procedure and fluoroscopy screening times were compared with a second group of patients who experienced coronary angiography alone. Analysis was performed to measure vessel and lumen area, vessel and lumen diameters and intimal thickness for serial slices at fixed intervals from a distal identification point. Mean atheroma burden, mean maximum intimal thickness (MIT) and overall maximal intimal thickness were determined for each study. Results: Twenty-seven procedures were analysed. Table 1 shows patient demographics and information relating to IVUS analysis. Details of procedure and fluoroscopy time for both IVUS and coronary angiography groups are presented in Table 2. No complications were encountered. Routine coronary angiography was normal in all but one patient. Conclusions: We have demonstrated the safety of IVUS for coronary surveillance in children. When compared to coronary angiography alone procedure time and screening time are increased but we feel this is outweighed by the increased sensitivity of IVUS. Fifty-two percent of children have an IMT > 0.5 mm despite normal angiography. Such detailed analysis would appear central to future research into paediatric coronary disease.
Abstracts for the British Congenital Cardiac Association Annual Meeting: The Barbican, London, 24–25 November 2005: Poster Presentations: Severe coronary ostial stenosis after arterial switch operation detected by transthoracic Doppler echocardiography
Authors: Aburawi E. H. , Berg A. , Arheden H. , Karlsson M. , Jögi P. , Pesonen E.
Published: April 2019

Background: Asymptomatic proximal coronary artery stenosis after arterial switch operation (ASO) is rare, but a potentially life-threatening condition, that is reported to appear in up to 7%. Angiography, although considered the state-of-the-art method of diagnosis, is an invasive method, but has limitations for diagnosing ostial stenosis. We report changes in Doppler flow profile and coronary flow reserve (CFR) in two asymptomatic patients (9- and 10-year old) with left main coronary artery (LMCA) ostial stenosis after ASO. Methods: Coronary flow was assessed by Transthoracic pulsed and colour-flow Doppler echocardiography (TTDE). CFR was measured in one patient using adenosine infusion (140 mcg/kg/min) over 4 minutes. CFR was calculated as the ratio of reactive hyperaemia to basal average peak velocity (APV). Both children were investigated with coronary angiography. They had myocardial Single-photon Emission Computed Tomography (SPECT), and magnetic resonance imaging (MRI) at rest and after reactive hyperaemia with adenosine infusion. Both patients had balloon dilatation and Cypher select (drug eluted) stent. Results: On echocardiogram a flame-like colour-flow diastolic signal was detected at the stenotic coronary ostia. The maximal spectral velocities during baseline conditions over the stenotic ostia were over 1.9 and 2.0 m/s (normal 30 ± 10 cm/s). The post-stenotic CFR was haemodynmically significant with value of 1.3, normal adult range 2.5–4. Coronary angiography showed a significant ostial stenosis 90% in both patients. Myocardial SPECT and MRI at rest/adenosine infusion were consistent with severe myocardial ischemia in the territory of the left coronary artery. Normal coronary angiography and coronary flow studies after stenting. Conclusion: We suggest that coronary artery flow assessment should be an integral part of the TTDE in the follow up of children with ASO. Serious coronary artery stenosis can be detected with TTDE. Assessment of CFR provides information of the physiological significance of the coronary stenosis.
Abstracts for the British Congenital Cardiac Association Annual Meeting: The Barbican, London, 24–25 November 2005: Poster Presentations: 8 Years of fetal echocardiography in high-risk mothers: The Birmingham Women’s Hospital experience
Authors: Rasiah S. V. , Ewer A. K. , Miller P. , Wright J. G. , Kilby M. D.
Published: April 2019

Introduction: Congenital heart disease (CHD) affects 8 per 1000 live births and it is also responsible for 20% of neonatal deaths. Antenatal diagnosis of major CHD allows appropriate counselling and planning for delivery at a neonatal unit with appropriate intensive care and transport facilities. Birmingham Women’s Hospital provides a supra-regional specialist fetal echocardiography in high-risk mothers. Aim: To evaluate fetal echocardiography findings in high-risk mothers over an 8 year period. Method: We undertook a retrospective review of all pregnant women at high-risk of having a baby with congenital heart disease who underwent fetal echocardiography between 01/01/1997 and 31/12/2004 at Birmingham Women’s Hospital. Results: 3,963 mothers were referred for fetal echocardiography and a total of 5,568 fetal echocardiography examinations were carried out during this period. The main reasons for referral were: (i) previously affected child – 27% (ii) abnormal initial screening scan – 20.7% (iii) maternal cardiac condition – 9.5% (iv) infant of diabetic mothers – 8% and (v) increased fetal nuchal translucency – 3%. Seven hundred and twleve (17.9%) echocardiograms were reported as abnormal. The majority of the abnormalities were identified in mothers who had abnormal initial screening scan (62%). In addition, the echocardiogram was also abnormal in 9% of cases with increased fetal nuchal translucency and in 5.7% of infants of diabetic mothers. In those with previously affected child and maternal cardiac condition, the echocardiogram was abnormal in 2.5% and 2.6% respectively. Conclusion: Abnormal initial screening scans and increased nuchal translucency had the highest yield in identifying CHD in high-risk mothers. Infant of diabetic mothers also have an increased risk warranting fetal cardiac screening for CHD. Normal fetal echocardiogram provides reassurance for the remainder of parents.
Enhancing resilience and self-efficacy in the parents of children with disabilities and complex health needs
Authors: Whiting M. , Nash A.S. , Kendall S. , Roberts S.A.
Published: April 2019

Aim

The principal aim of this study was to develop, pilot and evaluate an intervention intended to support the development of resilience and self-efficacy in parents of children with disabilities or complex health needs.

Background

Previous research has found that families often experience physical, social and emotional stress in the context of living with and caring for their disabled child. The literature indicates that a key factor in determining how well the parents of these children cope with their situation may be how resilient and self-efficacious they are.

Methods

A total of 16 parents of children with complex needs and disabilities were engaged in a series of guided conversations delivered during six contact visits with nurse co-researchers (community children’s nurses who had received an intensive three-day preparation programme). The conversations, which were supported with additional material that was designed specifically for use in the study, were based around four key themes: emotional coping, practical coping, support networks and ‘you and your child’. The impact of the intervention was evaluated using both qualitative and quantitative measures.

Findings

When interviewed, parents reported increased self-belief and self-confidence and indicated that they felt better supported and stronger as a result of the intervention. This was consistent with the quantitative evaluation which identified significant improvements on scores for active coping and self-blame on the brief COPE inventory scale and for empathy and understanding and self-acceptance on the TOPSE scale. Scores on the self-report distress thermometer demonstrated a significant reduction in self-reported distress scores at the end of the intervention period.
Ausbildungsanregungen Betreuung Sterbender in der stationären	Versorgung
Authors: George Wolfgang M. , Herrmann Johannes
Published: April 2019

Zusammenfassung. Bereits während der ersten Arbeitseinsätze wird der überwiegende Teil der Pflegekräfte mit sterbenden Menschen konfrontiert. Auch bringt ein großer Teil der Auszubildenden bereits persönliche Vorerfahrungen mit, die in der inhaltlichen und curriculativen Ausgestaltung der Themen „Betreuung Sterbender“ und „palliative Pflege“ berücksichtigt werden sollten. Als eine Konsequenz aus einer empirischen Studie aus dem Jahr 2017 zeigte sich, dass die den Auszubildenden begleitende Funktion des Lehrers / Ausbilders gestärkt werden sollte.
Effects of Turbulent Hyporheic Mixing on Reach‐Scale Transport
Authors: Roche K. R. , Li A. , Bolster D. , Wagner G. J. , Packman A. I.
Published: April 2019

Turbulence causes rapid mixing of solutes and fine particles between open channel flow and coarse‐grained streambeds. Turbulent mixing is known to control hyporheic exchange fluxes and the distribution of vertical mixing rates in the streambed, but it is unclear how turbulent mixing ultimately influences mass transport at the reach scale. We used a particle‐tracking model to simulate local‐ and reach‐scale solute transport for a stream with coarse‐grained sediments. Simulations were first used to determine profiles of vertical mixing rates that best described solute concentration profiles measured within a coarse granular bed in flume experiments. These vertical mixing profiles were then used to simulate a pulse solute injection to show the effects of turbulent hyporheic exchange on reach‐scale solute transport. Experimentally measured concentrations were best described by simulations with a nonmonotonic mixing profile, with highest mixing at the sediment–water interface and exponential decay into the bed. Reach‐scale simulations show that this enhanced interfacial mixing couples in‐stream and hyporheic solute transport. Coupling produces an interval of exponential decay in breakthrough curves and delays the onset of power law tailing. High streamwise velocities in the hyporheic zone reduce mass recovery in the water column and cause breakthrough curves to exhibit steeper power law slopes than predictions from mobile‐immobile modeling theory. These results demonstrate that transport models must consider the spatial variability of streamwise velocity and vertical mixing for both the stream and the hyporheic zone, and new analytical theory is needed to describe reach‐scale transport when high streamwise velocities are present in the hyporheic zone.
Precipitation in the Tropics: A New View
Authors: Cook Terri
Published: April 2019

The first study to simultaneously investigate precipitation and cloud structures in tropical weather systems concludes observation systems significantly overestimate the height of raining clouds.
The Ice Nurseries of the Arctic Are Melting
Authors: Duncombe Jenessa
Published: April 2019

Ice formed in coastal nurseries along Russia’s Arctic coast is melting before it can float far offshore. Scientists are worried about what that means for wildlife.
Fireworks at Hearing on Climate Change and National Security
Authors: Showstack Randy
Published: April 2019

A Republican committee member hits former secretary of state John Kerry with an ill-informed charge of pseudoscience.
Effects of Tropospheric Vertical Wind Shear on Gravity Waves Generated by Tropical Cyclones
Authors: Wang Yuan , Zhang Lifeng , Zhang Yun , Guan Jiping
Published: April 2019

This study investigates the effects of tropospheric vertical wind shear on gravity waves generated by tropical cyclones using idealized tropical cyclone simulations with different vertical profiles of environmental zonal wind. It is found that without shear, gravity wave momentum fluxes are distributed uniformly over a broad spectral range, with fluxes in opposite directions showing symmetry. Westerly shear in the troposphere leads to asymmetry between eastward and westward momentum fluxes, resulting in net westward fluxes and a resultant westward drag forcing on the background flow in the lower stratosphere. Under westerly shear, the active momentum fluxes extend to shorter horizontal wavelengths, and contract to longer periods and slower phase speeds. In addition, clear local peaks appear at large horizontal wavelengths, long periods, and moderate phase speeds, particularly for westward momentum fluxes.
Thank You to Our 2018 Peer Reviewers
Authors: ten Brink Uri , Bernabe Yves , Ben‐Zion Yehuda , Parman Stephen W. , Savage Martha , Schmitt Doug , Tregoning Paul
Published: April 2019

Similar to the construction of physical buildings, the scientific edifice requires solid components of data, theory, and methodology at each phase of the “construction.” The peer review process provides the necessary “inspection” and the assurance that every step of the construction is solid, particularly in regard to the proper use of the scientific method. The peer‐review process helps improve the published work by providing constructive suggestions and by safe‐guarding against scientific work, later found to be built on shaky foundations. Because no single scientist has intimate knowledge of today's many aspects of Solid Earth Sciences, we rely on each other's expertise to serve as unbiased “inspectors” of published articles. Your considerable time and effort, spent reviewing JGR‐Solid Earth manuscript(s) during 2018, are sincerely appreciated by our editorial board and, more importantly, by the Solid Earth Science community at large. Thank you.
A bioinformatics investigation into the pharmacological mechanisms of the effect of Fufang Danshen on pain based on methodologies of network pharmacology
Authors: Sun Yantao , Yang Jie
Published: April 2019

Fufang Danshen (FFDS), a Chinese medicine formula widely used in the clinic, has proven therapeutic effects on pain relief. However, the mechanisms of these effects have not been elucidated. Here, we performed a systematic analysis to discover the mechanisms of FFDS in attenuating pain to gain a better understanding of FFDS in the treatment of other diseases accompanied by pain. Relevance analysis showed that Salvia miltiorrhizae was the best studied herb in FFDS. Most compounds in FFDS have good bioavailability, and we collected 223 targets for 35 compounds in FFDS. These targets were significantly enriched in many pathways related to pain and can be classified as signal transduction, endocrine system, nervous system and lipid metabolism. We compared Salvia miltiorrhizae and Panax notoginseng and found that they can significantly affect different pathways. Moreover, ten pain disease proteins and 45 therapeutic targets can be directly targeted by FFDS. All 45 therapeutic targets have direct or indirect connections with pain disease proteins. Forty-six pain disease proteins can be indirectly affected by FFDS, especially through heat shock cognate 71 kDa protein (HSPA8) and transcription factor AP-1 (JUN). A total of 109 targets of FFDS were identified as significant targets.
Gene Expression Profiles Associated with Brain Aging are Altered in Schizophrenia
Authors: Sabunciyan Sarven
Published: April 2019

Existence of aging associated transcriptional differences in the schizophrenia brain was investigated in RNA sequencing data from 610 postmortem Dorso-Lateral Pre-Frontal Cortex (DLPFC) samples in the CommondMind Consortium (CMC) and the psychENCODE cohorts. This analysis discovered that the trajectory of gene expression changes that occur during brain aging differed between schizophrenia cases and unaffected controls. Mainly, the identified gene expression differences between the diagnosis groups shrank in magnitude following 60 years of age. A differential expression analysis restricted to the 40 to 60 year age group identified 556 statistically significant loci that replicated and had highly consistent gene expression fold changes in the two cohorts. An interaction between age and diagnosis in the wider psychENCODE cohort was also detected. Gene set enrichment analysis discovered disruptions in mitochondria, RNA splicing and phosphoprotein gene pathways. The identified differentially expressed genes in the two cohorts were also significantly enriched in genomic regions associated with schizophrenia although no enrichment was observed for differentially expressed genes identified in the 40 to 60 year age group. This work implicates disruptions to the normal brain aging processes in the pathology of schizophrenia and demonstrates the need for age stratification in schizophrenia postmortem brain gene expression studies.