bluuebunny/crossref_metadata_2025 huggingface dataset:
Towards Voice‐Inclusive Practice: Finding the Sustainability of Participation in Realising the Child's Rights in Education
Authors: Sargeant Jonathon
Published: September 2017

The United Nations Convention on the Rights of the Child offers educators a comprehensive reference for the implementation of transformational teaching practices. Ratified by most nation states it presents a clear mandate for supporting a range of rights uniquely elaborated for children, yet is routinely ignored in the development of educational policy and provision. Considering the burgeoning educational interest in student voice and participation, this study explores the relevance and application of the convention to educational practice. This article argues that theUNCRCis particularly relevant in education contexts seeking to enable and sustain child participation and voice.
Circumferential margin involvement after total mesorectal excision for mid or low rectal cancer: are all R1 resections equal?
Authors: Beaufrère A. , Guedj N. , Maggiori L. , Patroni A. , Bedossa P. , Panis Y.
Published: September 2017

Aim

Our aim was to assess the prognostic influence of the circumferential resection margin (CRM) exact value after total mesorectal excision for mid or low rectal cancer.

Methods

All patients (n = 321) who underwent total mesorectal excision from 2005 to 2013 were identified from a prospective database, including 49 (15%) who presented with a CRM ≤ 1 mm. Four groups were defined: group 1, CRM = 0 mm (n = 21); group 2, 0 < CRM ≤ 0.4 mm (n = 13); group 3, 0.4 < CRM ≤ 1 mm (n = 15); group 4, CRM > 1 mm (n = 272).

Results

After a mean follow‐up of 42 ± 26 months, locoregional recurrence rates were 8/21 (38%) in group 1, 3/13 (23%) in group 2, 0/12 (0%) in group 3 and 26/272 (10%) in group 4 (P < 0.001), leading to significantly impaired 3‐year locoregional recurrence‐free survival in group 1 (57% ± 13%) and group 2 (56% ± 15%) compared to group 3 (85% ± 10%, vs group 1, P = 0.021, vs group 2, P = 0.049) and to group 4 (89% ± 2%, vs group 1, P < 0.001, vs group 2, P < 0.001). In multivariate Cox analysis, a CRM ≤ 0.4 mm was identified as an independent factor impairing both locoregional recurrence‐free survival (OR 3.14, 95% CI 1.53–6.46; P = 0.002) and disease‐free survival (OR 2.15, 95% CI 1.28–3.63; P = 0.004).

Conclusion

Our study suggests that the prognosis after mid or low rectal cancer surgery was worse with a CRM ≤ 0.4 mm. The prognosis was similar in patients with a CRM > 0.4 mm or ≤ 1 mm and patients with an R0 resection.
A naturalistic longitudinal analysis of post‐detoxification outcomes in opioid‐dependent patients
Authors: Ivers Jo‐Hanna , Zgaga Lina , Sweeney Brion , Keenan Eamon , Darker Catherine , Smyth Bobby P. , Barry Joe
Published: September 2017

Introduction and Aims

To provide an assessment of outcomes in a cohort of opioid‐dependent patients post‐detoxification.

Design and Methods

This study employed an observational longitudinal cohort design. Patients who completed detoxification in the three major Drug Dependency Units in Ireland during a 14‐month period were included in the study (n = 143). Patients opting for one of the three pathways post‐detoxification (inpatient aftercare, outpatient aftercare or no formal aftercare) were assessed in the final week of detoxification and followed up after 3, 6 and 9 months. The primary outcome was abstinence following detoxification.

Results

A Cox (adjusted) model indicated participants who opted for outpatient aftercare treatment lapsed/relapsed at a rate of 52% higher than the inpatient aftercare group (hazard ratio = 1.52, 95% confidence interval 0.75–3.08, P = 0.24). Moreover, time to lapse/relapse was considerably shorter for the no formal aftercare group (hazard ratio = 7.68, 95% confidence interval 4.30–13.73, P = 5.75 × 10−12). Abstinence rates for outpatient aftercare and inpatient aftercare are about equal after 9 months.

Discussion and Conclusion

Patients who opt for aftercare post‐detoxification have significantly better outcomes at follow up when compared to no formal aftercare. In addition, patients’ intention to attend aftercare affected their outcomes regardless of eventual treatment path.
Peri‐operative continuation of metformin does not improve glycaemic control in patients with type 2 diabetes: A randomized controlled trial
Authors: Hulst A. H. , Polderman J. A. W. , Ouweneel E. , Pijl A. J. , Hollmann M. W. , DeVries J. H. , Preckel B. , Hermanides J.
Published: September 2017

Historically, metformin was withheld before surgery for fear of metformin‐associated lactic acidosis. Currently, however, this risk is deemed to be low and guidelines have moved towards the continuation of metformin. We hypothesized that continuing metformin peri‐operatively would lower postoperative serum glucose level without an effect on plasma lactate levels. We performed a single‐blind multicentre randomized controlled trial in people with type 2 diabetes mellitus scheduled for non‐cardiac surgery and continued (MF+ group) or withheld (MF‐ group) metformin before surgery. The main outcome measures were the differences in peri‐operative plasma glucose and lactate levels. We randomized 70 patients (37 MF+ group and 33 MF‐ group) with type 2 diabetes mellitus. Postoperative glucose levels were similar in the MF+ and the MF‐ groups (8.2 ± 1.8 vs 8.3 ± 2.3 mmol/L P = .95) Although preoperative lactate levels were slightly higher in the MF+ group compared with the MF‐ group (1.5 vs 1.2 mmol/L; P = .02), the postoperative lactate levels were not significantly different (1.2 vs 1.0 mmol/L; P = .18). In conclusion, continuation of metformin during elective non‐cardiac surgery does not improve glucose control or raise lactate levels to a clinically relevant degree.
New integrated approach to percutaneous mitral valvuloplasty combining Wilkins score with commissural calcium score and commissural area ratio
Authors: Gajjala Obul Reddy , Durgaprasad Rajasekhar , Velam Vanajakshamma , Kayala Sridhar Babu , Kasala Latheef
Published: September 2017

Background

Present echocardiographic scoring systems for percutaneous mitral valvuloplasty (PMV) have limitations, and no scoring system is significant determinant of procedural outcome. In this study, we assess the relationship between various echocardiographic parameters and scoring systems with immediate outcomes and test an integrated approach by combining Wilkins score with other parameters.

Methods

One hundred two patients who had undergone PMV were included in this prospective observational study. Preprocedural mitral valve morphology was assessed and categorized using Wilkins score, Sutaria scoring system, and Nunes quantitative scoring system.

Results

Optimal PMV results were obtained in 84 patients (82.35%), and suboptimal PMV results were obtained in 18 patients (17.65%). Using Nunes scoring system, suboptimal PMV results were obtained in 9 (37.5%) patients of high‐risk group (n=24), 8 (13.8%) of intermediate‐risk group (n=58), and one (5%) patient of low‐risk group (n=20). Using Wilkins scoring system, in patients having score>8 (n=16) suboptimal results were obtained in 5 (31.7%) and in patients having score<8 (n=86) suboptimal results were obtained in 13 (15.1%). Using Sutaria scoring system, in patients having score 3 to 4 (low risk, n=68) suboptimal results were obtained in 6 (8.8%), and in patients having score 0‐2 (high risk, n=34) suboptimal results were obtained in 12 (35.3%) patients.

Conclusion

All echocardiographic scores have significant limitations, and an integrative approach is mandatory. Combining traditional Wilkins score with Sutaria score and commissural area ratio better predicts procedural outcomes.
Correlation between myocardial deformation on three‐dimensional speckle tracking echocardiography and cardiopulmonary exercise testing
Authors: Li Mei , Lu Yaran , Fang Cui , Zhang Xiaorong
Published: September 2017

Purpose

Heart failure (HF) is a multifactorial entity that combines derangements in both systolic and diastolic function. The relationship between systolic and diastolic function and exercise capacity is not fully understood. We sought to determine the mechanisms linking cardiac function and exercise tolerance in patients with HF.

Methods

One hundred fifty‐six subjects with different cardiac function levels were included in the study. Subjects’ 2D echocardiographic, 3D speckle tracking echocardiographic, and cardiopulmonary exercise testing (CPET) data were collected.

Result

The amount of untwisting at 25% of the untwist duration (25%Untwist) and global longitudinal peak systolic strain (GLS) showed the best positive correlations with peak oxygen uptake (peakVO2) (r = .41; P < .001 and r = .32; P < .001, respectively), while the left ventricular ejection fraction (EF) was weakly correlated with peakVO2. The 25%Untwist value was negatively correlated with the carbon dioxide equivalent slope (VE/VCO2) (r = −.49; P < .001). Both E/e and the left atrium volume index (LA index) exhibited good positive correlations with VE/VCO2 (r = .39; P < .01 and r = .32; P < .001). In the multiple regression analysis, the best predictive model for the peakVO2 included the 25%Untwist, GLS, and E/e, explained 64% of the variation in peakVO2, with 25%Untwist explaining 17.6% of the variation. Including EF in the model explained only 3.1% of the variation in peakVO2. In a multivariable model for VE/VCO2, 25%Untwist was the strongest independent predictor, explaining 23% of the variance in VE/VCO2.

Conclusion

Left ventricular early diastolic function is a modest independent predictor of aerobic exercise capacity. The 25%Untwist value is a good indicator of cardiac diastolic function.
A quality control exercise in the echo laboratory: Reduction in inter‐observer variability in the interpretation of pulmonary hypertension
Authors: Patton Daniel M. , Enzevaie Atoosa , Day Andrew , Sanfilippo Anthony , Johri Amer M.
Published: September 2017

Background

Right ventricular systolic pressure (RVSP) estimated by echocardiography is critical for the initial screening and follow‐up of pulmonary hypertension (PH). Inter‐observer variability (IOV) in RVSP can impact clinical decision making. This study assessed whether a simple guideline‐based teaching intervention could reduce the IOV in RVSP interpretation.

Methods and Results

Eleven participants in a high‐volume tertiary level echocardiography laboratory underwent an assessment of the baseline IOV in the assessment of RVSP for a series of transthoracic echocardiograms (TTE), depicting various degrees of PH among 8 cases each before and after a teaching intervention. The inter‐observer variance (root‐mean‐square error) decreased from 26.0 mm Hg2 (5.1 mm Hg) at baseline to 5.8 mm Hg2 (2.4 mm Hg) post‐teaching intervention (P = .025). The corresponding inter‐class coefficient (ICC) increased from 0.89 to 0.98. Several factors relating to image acquisition and interpretation were identified as contributing to IOV in RVSP. The outcome was the development of a practical tool to mitigate these factors.

Conclusions

A simple structured teaching intervention successfully reduced IOV in the measurement of RVSP in a high‐volume echo laboratory.
The Moscamed Regional Programme: review of a success story of area‐wide sterile insect technique application
Authors: Enkerlin W.R. , Gutiérrez Ruelas J.M. , Pantaleon R. , Soto Litera C. , Villaseñor Cortés A. , Zavala López J.L. , Orozco Dávila D. , Montoya Gerardo P. , Silva Villarreal L. , Cotoc Roldán E. , Hernández López F. , Arenas Castillo A. , Castellanos Dominguez D. , Valle Mora A. , Rendón Arana P. , Cáceres Barrios C. , Midgarden D. , Villatoro Villatoro C. , Lira Prera E. , Zelaya Estradé O. , Castañeda Aldana R. , López Culajay J. , Ramírez y Ramírez F. , Liedo Fernández P. , Ortíz Moreno G. , Reyes Flores J. , Hendrichs J.
Published: September 2017

The Mediterranean fruit fly, Ceratitis capitata (Wiedemann) (Diptera: Tephritidae), is considered one of the most important pests worldwide because of its direct damage to fruit and vegetable production, and restrictions imposed to commercialization of horticultural commodities by countries free of the pest. It was introduced to Brazil in 1901 and to Costa Rica in 1955, from where it spread across the Central American region, reaching Guatemala and Mexico in 1976 and 1977, respectively. In response, the governments of Guatemala, Mexico, and the USA joined efforts to (1) contain further northward spread of the pest, (2) eradicate it from the areas it had invaded in southern Mexico, and (3) in the longer term eradicate it from Guatemala and eventually from the rest of Central America. To this effect, cooperative agreements were subscribed between the three countries and also between the USA and Belize. This allowed regional cooperation against the Mediterranean fruit fly and the creation of the Moscamed Programme. The programme was the first area‐wide large‐scale application of the sterile insect technique (SIT) against this pest. By 1982, the Programme had achieved its first two objectives with the containment of the northward advance of the pest, and its eradication from the areas it had invaded in the states of Chiapas and Oaxaca in southern Mexico. Furthermore, by 1985 the Mediterranean fruit fly had been eradicated from areas in Guatemala located at the border with Mexico. Since then, the programme has had years with significant territorial advances in the eradication of the pest from areas within Guatemala, combined with years when it had setbacks resulting in losses of the territorial gains. Nevertheless, during 4 decades, the programme has effectively served as an effective containment barrier maintaining the Mediterranean fruit fly‐free status of Belize, Mexico, and the USA. It has also protected and increased the Mediterranean fruit fly‐free areas in Guatemala. As a result, it has protected the assets of horticultural producers and contributed during this period to the development of multibillion dollar export industries in these countries. This paper provides an historical review of the programme and describes briefly how technological innovations and decision‐making tools have contributed to programme efficiency. It also discusses how non‐technical and external factors have limited the eradication process and further programme advance within the Central American region.
The association between specific types of childhood adversity and attenuated psychotic symptoms in a community sample
Authors: Mongan David , Shannon Ciaran , Hanna Donncha , Boyd Adrian , Mulholland Ciaran
Published: September 2017

Aim

This study aimed to examine the relationship between types of childhood adversity and attenuated psychotic symptoms in a general population sample, and to determine the predictive role of other psychosocial factors such as resilience, coping style and social support.

Methods

An online survey was conducted with a US‐based general population sample of 748 participants (aged 18 to 35 years) using Amazon's Mechanical Turk (an online crowd‐sourcing service). Participants completed the Adverse Childhood Experiences Questionnaire (ACE‐Q), the Prodromal Questionnaire (PQ‐16), the Brief COPE Scale, the Brief Resilience Scale (BRS), the Multidimensional Scale of Perceived Social Support and the Neighbourhood Cohesion Scale. A series of backwards stepwise hierarchical regression analyses was employed to determine the predictors of PQ‐16 score.

Results

Participants reported an average of 2.99 attenuated psychotic symptoms (from a total of 16), and an average of 2.77 childhood adversities (from a total of 10). In the final model, the specific types of childhood adversity which significantly predicted PQ‐16 score were verbal abuse, sexual abuse and physical neglect. Resilience, as well as the coping styles of self‐distraction, denial, substance use, emotional support, venting, religion and self‐blame, were significant predictors; perceived social support and neighbourhood cohesion were not. This model predicted 33% of the variance in PQ‐16 score.

Conclusions

The results of this study support the association between childhood adversity and attenuated psychotic symptoms in the general population. Resilience and coping styles were also important predictive factors. These data suggest potential strategies on which to focus for early intervention and prevention.
Patient value: Perspectives from the advocacy community
Authors: Addario Bonnie J , Fadich Ana , Fox Jesme , Krebs Linda , Maskens Deborah , Oliver Kathy , Schwartz Erin , Spurrier‐Bernard Gilliosa , Turnham Timothy
Published: September 2017

All health‐care systems are under financial pressure and many have therefore developed value frameworks to assist decision making regarding access to treatment. Unfortunately, many frameworks simply reflect the clinically focused values held by health‐care professionals rather than outcomes that also matter to patients. It is difficult to define one single homogeneous set of patient values as these are shaped by social, religious and cultural factors, and health‐care environment, as well as many factors such as age, gender, education, family and friends and personal finances. Instead of focusing on an aggregated set of values, frameworks should attempt to incorporate the broader range of outcomes that patients may regard as more relevant. Patient advocates are well placed to advise assessment bodies on how particular therapies will impact the patient population under consideration and should be closely involved in developing value frameworks. In this paper, a group of patient advocates explore the varying definitions of patient value and make positive recommendations for working together to strengthen the patient voice in this area. The authors call on framework developers, the patient advocacy and research communities, the health‐care industry and decision‐makers to undertake specific actions to ensure patient value is included in current and future value frameworks. This is justified on compassionate and economic grounds: better health outcomes result when patients receive treatment tailored to individual needs. Paying attention to the patient perspective also results in better use of resources—a goal that should appeal to all stakeholders.
Molecular genotyping of the non‐invasive encapsulated follicular variant of papillary thyroid carcinoma
Authors: Kim Tae Hyuk , Lee Minju , Kwon Ah‐Young , Choe Jun‐Ho , Kim Jung‐Han , Kim Jee Soo , Hahn Soo Yeon , Shin Jung Hee , Chung Man Ki , Son Young Ik , Ki Chang‐Seok , Yim Hyun Sook , Kim Yoo‐Li , Chung Jae Hoon , Kim Sun Wook , Oh Young Lyun
Published: September 2017

Aims

The non‐invasive encapsulated follicular variant of papillary thyroid carcinoma (FVPTC) has been managed as a low‐risk malignancy. Recently, a proposal was made to reclassify this tumour type as a premalignant lesion and rename it non‐invasive follicular thyroid neoplasm with papillary‐like nuclear features (NIFTP). This study aims to provide the first comprehensive study on molecular genotype–phenotype correlations of encapsulated FVPTC.

Methods and results

This study was performed on 177 consecutive FVPTCs from January 2014 to April 2016. These were classified as non‐invasive encapsulated FVPTC (n = 74) invasive encapsulated FVPTC (n = 51), and infiltrative FVPTC (n = 52), according to standard criteria, by two independent pathologists. Genetic alterations and other clinicopathological information were compared. BRAFV600E was found in 12.2% (non‐invasive) and 11.8% (invasive) of encapsulated FVPTCs, and in 34.6% of infiltrative FVPTCs (P = 0.001). Mutation in encapsulated FVPTCs was limited to cases with rare or abortive papillae. RET–PTC1 and RET–PTC3 rearrangements were present (11.5%) only in infiltrative FVPTCs. In contrast, NRAS, HRAS and KRAS mutations were observed more often in encapsulated FVPTCs (48.6% in non‐invasive and 66.7% in invasive) than in infiltrative FVPTCs (15.4%) (P < 0.001). Preoperative cytological examination did not distinguish between non‐invasive and invasive encapsulated FVPTCs, whereas infiltrative FVPTC was more likely to be Bethesda class V/VI than the encapsulated type (60.4% versus 38.1%; P = 0.01).

Conclusions

There were no differences in clinicopathological or molecular profiles between non‐invasive and invasive encapsulated FVPTCs, except in vascular and capsular invasion. Therefore, the diagnosis of NIFTP, like that of follicular adenoma, may require surgical resection and exclusion of those tumours with any papillae.
Prevalence of mental illness within families in a regional child‐focussed mental health service
Authors: Naughton Michael F. A. , Maybery Darryl J. , Goodyear Melinda
Published: September 2017

Nearly 50% of all mental illnesses begin in childhood before the age of 14 years, and over 20% of parents have a mental illness. Few studies have examined the co‐occurrence of mental illnesses in parents and children. In the present study, we examined the extent of mental illness within families of 152 clients attending an Australian regional child and adolescent mental health service (CAMHS). A cross‐sectional study design was employed involving a case record review and clinician‐completed questionnaire of the children and youth attending a CAMHS. It was found that 79% of these children were living with a parent with mental illness. The predominant diagnosis of both child and parent was an anxiety or mood disorder, and many families had co‐occurring risk factors of domestic violence and limited social supports. The findings in this Australian cohort are similar to those of other international research. While novel in nature, the present study has highlighted the extent of both mental illness and scarce supports for both children and parents in the same family. The findings indicate the need for a coordinated multiservice delivery of appropriate and consistent family‐focussed interventions, responding to both mental illness and social supports for children and parents. Further research should examine specific components of family need and support, as seen through the eyes of the child and their parent.
Systolic orthostatic hypotension is related to lowered cognitive function: Findings from the Maine‐Syracuse Longitudinal Study
Authors: Torres Rachael V. , Elias Merrill F. , Crichton Georgina E. , Dore Gregory A. , Davey Adam
Published: September 2017

The aim of the present study was to examine the relationship between orthostatic changes in blood pressure (BP) and cognition, with consideration given to cardiovascular risk factors and lifestyle variables. The cross‐sectional analysis included 961 community‐dwelling participants of the Maine‐Syracuse Longitudinal Study, for whom BP clinic measures (five sitting, five recumbent, and five standing) were obtained. Eighteen percent of participants had orthostatic hypotension (fall in systolic BP ≥20 mm Hg or diastolic BP ≥10 mm Hg upon standing) and 6% had orthostatic hypertension (rise in systolic BP ≥20 mm Hg). Orthostatic hypotension and hypertension defined using traditional criteria were unrelated to cognition with covariate adjustment. However, an examination of systolic and diastolic BP change independently revealed that participants with systolic orthostatic hypotension had poorer global cognition, verbal memory, and scanning and tracking scores than those with normal systolic BP change. The authors conclude that systolic orthostatic hypotension is significantly associated with reduced cognitive function.
Differential diversifications of South American and Eastern Asian disjunct genera Bocconia and Macleaya (Papaveraceae)
Authors: Li Jianhua , Murray K. Gregory , Li Pan , Brown Kenneth
Published: September 2017

Bocconia (10 species) and Macleaya (2 species) are two disjunct genera between South America and eastern Asia (EAS) in the Papaveraceae offering an opportunity to compare its biogeographic history with that of the well‐known disjunction between EAS and eastern North American (ENA). Our phylogenetic analyses of the chloroplast matK and rbcL gene sequences of Ranunculales including two species of Macleaya and six species of Bocconia supported the monophyly of Bocconia, Macleaya, and Chelidonioideae to which Bocconia and Macleaya belong. Nucleotide sequences of matK, rbcL, and nrDNA ITS supported the sister relationship of Bocconia and Macleaya. Biogeographic analyses of Chelidonioideae using S‐DIVA (statistical dispersal vicariance analysis) and DEC (dispersal extinction cladogenesis) methods inferred Eurasia as the most likely ancestral area of Bocconia and Macleaya and suggested no extinction events in either Bocconia or Macleaya. This agrees with the “Out‐of‐Asia” pattern of the EAS‐ENA disjunction. Molecular dating of Ranunculales with fossil‐based calibrations showed that Bocconia and Macleaya diverged in the late Eocene and early Oligocene, which is much earlier than most EAS‐ENA disjunct taxa. The disjunction may have formed via long distance dispersal or boreotropical connections via the North Atlantic and Bering land bridges. Both Bocconia and Macleaya diversified in the late mid‐Miocene, but Bocconia has apparently experienced a greater diversification probably aided by the evolution of the bird dispersal syndrome in fruit and seed after migration to South America. The greater diversification of Bocconia is also evidenced by the diverse leaf morphology and growth habit in response to colonization in various local habitats in South America.
Variation of the biotic neighbourhood and topographic effects on tree survival in an old‐growth temperate forest
Authors: Zhu Yu , Cai Huiying , Jiang Feng , Jin Guangze
Published: September 2017

Aims

Tree mortality can determine forest dynamics and succession, alter nutrient cycling and contribute to tree species co‐existence. Understanding the mechanisms that maintain species diversity is a central goal of community ecology. In this study, we incorporated survival data from a 10‐yr interval census to determine whether there is significant interspecies variation in the effects of biotic neighbourhood variables and whether there is significant spatial variation in the effects of topographic variables on tree survival in a broadleaved‐Korean pine temperate forest.

Location

Temperate forest, northeast China.

Methods

We used GLMM and geographically weighted GLM as well as their corresponding test approaches to determine whether there is significant interspecies variation in the effects of biotic neighbourhood variables over variable neighbourhood radii and whether there is significant spatial variation in the effects of topographic variables on tree survival across multiple spatial scales in an old‐growth temperate forest dynamics plot in northeast China.

Results

Our results showed that the effects of neighbourhood variables on tree survival varied among species and effects of topography varied over space. However, the results depended on the neighbourhood radius and spatial scale. The neighbourhood radius affected detection of variation in neighbourhood effects among species, and the spatial scale similarly affected detection of spatial variation in the effects of topography. The effect of conspecific neighbour density on survival varied more widely among species than that of the average phylogenetic dissimilarity of heterospecific neighbours, regardless of the neighbourhood radius. Moreover, the effect of elevation varied more widely over space than those of convexity and hill shade at any quadrat scale.

Conclusions

Our findings highlight that future studies should account for variations in the neighbourhood radius among species and/or circumstances as well as the spatial scale when assessing factors that contribute to species co‐existence in long‐lived organisms. Species leaf phenology, shade and drought tolerance and environmental filtering may explain these variations in the effects of neighbourhood and topographic variables on tree survival. Overall, our results indicate that both density dependence and resource niche partitioning are important mechanisms for maintaining biodiversity in this broad‐leaved Korean pine temperate forest.
The Meteoritical Bulletin, No. 104
Authors: Bouvier Audrey , Gattacceca Jérôme , Agee Carl , Grossman Jeffrey , Metzler Knut
Published: September 2017

Meteoritical Bulletin 104 contains 2279 meteorites including 12 falls (Annama, Cartersville, Creston, Diepenveen, Famenin, Izarzar, Nkayi, Porangaba, San Juan de Ocotán, Trâpeăng Rônoăs, Xinglongquan, Žd’ár nad Sázavou), with 1847 ordinary chondrites, 138 carbonaceous chondrites, 128 HED achondrites, 38 lunar meteorites, 24 ureilites, 22 Martian meteorites, 19 iron meteorites, 17 primitive achondrites, 14 enstatite chondrites, 10 mesosiderites, 9 Rumuruti chondrites, 5 pallasites, 4 ungrouped achondrites, 2 enstatite achondrites, 1 ungrouped chondrite, and 1 Kakangari chondrite, and with 996 from Antarctica, 790 from Africa, 337 from Asia, 111 from South America, 30 from North America, 11 from Oceania, and 4 from Europe. Note: 1 meteorite from Russia was counted as European.
In vivo visualization of the final stages of xylem vessel refilling in grapevine (Vitis vinifera) stems
Authors: Brodersen Craig R. , Knipfer Thorsten , McElrone Andrew J.
Published: September 2017

Embolism removal is critical for restoring hydraulic pathways in some plants, as residual gas bubbles should expand when vessels are reconnected to the transpiration stream. Much of our understanding of embolism removal remains theoretical as a consequence of the lack of in vivo images of the process at high magnification.

Here, we used in vivo X‐ray micro‐computed tomography (microCT) to visualize the final stages of xylem refilling in grapevine (Vitis vinifera) paired with scanning electron microscopy.

Before refilling, vessel walls were covered with a surface film, but vessel perforation plate openings and intervessel pits were filled with air. Bubbles were removed from intervessel pits first, followed by bubbles within perforation plates, which hold the last volumes of air which eventually dissolve. Perforation plates were dimorphic, with more steeply angled scalariform plates in narrow diameter vessels, compared with the simple perforation plates in older secondary xylem, which may favor rapid refilling and compartmentalization of embolisms that occur in small vessels, while promoting high hydraulic conductivity in large vessels.

Our study provides direct visual evidence of the spatial and temporal dynamics of the final stages of embolism removal.
Competition across diverse taxa: quantitative integration of theory and empirical research using global indices of competition
Authors: Fort Hugo , Segura Angel
Published: September 2017

A main limitation for quantitative assessments of the effect of species richness and competition intensity on ecosystem functions is that the number of model parameters to estimate for a S‐species community grows at least as S
2. We propose and evaluate a novel framework based on a set of global, i.e. for the whole community, indices of competition (GIC) that allows quantitative predictions of community productivity without knowing the entire community matrix. This framework also serves for comparisons among widely different taxa. These GICs were mostly evaluated in communities of primary producers and are expressible in terms of relative yields (mixture biomass/monoculture biomass), such as the relative yield total (RYT) − the total sum of relative yields − and the mean relative yield (MRY). Specifically: 1) we conducted a meta‐analysis of 166 published competition experiments covering a wide variety of communities − bacteria, protists, plankton, plants, fish, insects, mammals. For each experiment we computed the set of GICs. 2) We derived from the Lotka–Volterra competition model (LVCM) analytical expressions for the RYT and MRY in terms of the species richness and the mean value of the interspecific interaction coefficients. 3) We tested the agreement of such expressions with the corresponding empirical GICs computed in 1). The main findings are: First, the RYT (significantly different among taxonomic groups) increases with the species richness S; conversely the MRY (not different among groups) decreases with S. Second, these analytical expressions for the RYT and MRY, besides giving the above qualitative dependence on S, reproduce with accuracy these empirical GIC. Third, we thus show that our general formulas can be used to assess the effects of competition on global community attributes in cases with incomplete information on the LVCM parameters (i.e. when only a subset of these parameters is known).
Effects of esketamine sedation compared to morphine analgesia on hydrostatic reduction of intussusception: A case‐cohort comparison study
Authors: van de Bunt Jascha A. , Veldhoen Esther S. , Nievelstein Rutger A. J. , Hulsker Caroline C. C. , Schouten Antonius N. J. , van Herwaarden Maud Y. A.
Published: September 2017

Background

Hydrostatic or pneumatic reduction of intussusception is an invasive procedure that is stressful and may be painful for a child. Resistance of the child may increase the duration of the procedure and decrease success rate of reduction. Analgesia can help to reduce pain, but not necessarily resistance. General anesthesia increases success rate of reduction. However, it requires the presence of an anesthesiologist, and may lead to anesthesia‐related complications. Procedural sedation with esketamine could be a safe alternative.

Aim

The aim of this study was to compare hydrostatic reduction using morphine analgesia compared to procedural sedation with esketamine in terms of success rate, adverse events, and duration of reduction.

Methods

A retrospective case‐cohort comparison study was performed with two groups of patients who had undergone hydrostatic reduction for ileocolic intussusception and received morphine analgesia (n = 37) or esketamine sedation (n = 20). Until July 2013, reduction was performed after intravenously administered morphine. Hereafter, a new protocol for procedural sedation was implemented and reduction was performed after administration of esketamine. Cases were matched for age and duration of symptoms.

Results

No adverse events requiring intervention other than administration of oxygen were reported for either group. Success rate of reduction using esketamine sedation was 90% vs 70% using morphine analgesia, risk ratio (RR) 1.29, 95% CI[0.93‐1.77]. Recurrence rate using esketamine sedation was 10% vs 15% using morphine analgesia, RR 0.67, 95% CI[0.12‐3.57]. Reduction time was shorter using esketamine sedation (Median 5 minutes, IQR 9 minutes) vs morphine analgesia (Median 8 minutes, IQR 16 minutes, P = .04, Median difference 3, 95% CI[−1.50‐8.75]). Median hospital stay in the esketamine group was 1.5 days (IQR 1.8) vs 2 days (IQR 5.3) in the morphine group.

Conclusion

No serious adverse events were recorded. In comparison to morphine analgesia, with esketamine there was weak evidence for a higher success rate, lower recurrence rate, shorter duration, and shorter length of hospital stay.
Median effective dose of intranasal dexmedetomidine sedation for transthoracic echocardiography in pediatric patients with noncyanotic congenital heart disease: An up‐and‐down sequential allocation trial
Authors: Yu Qing , Liu Yang , Sun Mang , Zhang Jing , Zhao Yan , Liu Fengzhi , Li Shangyingying , Tu Shengfen
Published: September 2017

Background

Intranasal dexmedetomidine can provide adequate sedation during short procedures. However, previous literature investigating the single‐dose use of intranasal dexmedetomidine for sedation during transthoracic echocardiography in younger children is scarce, and the effects of age on sedation with intranasal dexmedetomidine remain controversial.

Objective

This study was to determine the 50% effective dose and estimate the 95% effective dose of single‐dose intranasal dexmedetomidine to induce sedation in pediatric patients with noncyanotic congenital heart disease, and also determine the effect of age on the dose required for sedation.

Methods

Patients were stratified into three age groups of 1‐6 months, 7‐12 months, and 13‐36 months. Intranasal dexmedetomidine started at a dose of 2 μg kg−1 on the first patient. The dose of dexmedetomidine for each subsequent patient was determined by the previous patient's response using Dixon's up‐and‐down method with an interval of 0.25 μg kg−1. Sedation scale and recovery were assessed by the Modified Observer Assessment of Alertness and Sedation Scale and Modified Aldrete Recovery Score. The 50% effective dose was determined by Dixon's up‐and‐down method. In addition, both 50% effective dose and 95% effective dose were obtained using a probit regression approach. Other variables included sedation onset time, echocardiography time, wake‐up time, discharge time, heart rate, blood pressure, oxygen saturation, respiratory rate, and adverse events such as vomiting, regurgitation, and apnea.

Results

The study population was comprised of 70 patients. The 50% effective dose (95% confidence interval) and the 95% effective dose (95% confidence interval) of intranasal dexmedetomidine for sedation were 1.8 (1.58‐2.00) μg kg−1 and 2.2 (1.92‐5.62) μg kg−1 in patients aged 1‐6 months, 1.8 (1.61‐1.95) μg kg−1 and 2.1 (1.90‐2.85) μg kg−1 in patients aged 7‐12 months, 2.2 (1.92‐2.37) μg kg−1 and 2.7 (2.34‐6.88) μg kg−1 in patients aged 13‐36 months, respectively. The 50% effective dose in age group 13‐36 months was higher than those of age group 1‐6 months (P = .042) and 7‐12 months (P = .043). There were no differences in sedation onset time, echocardiography time, wake‐up time, and discharge time between groups. None of the patients experienced oxyhemoglobin desaturation, hypotension, or bradycardia during the procedure. No significant adverse events occurred.

Conclusion

Single‐dose of intranasal dexmedetomidine was an effective agent for patients under the age of 3 years requiring sedation for transthoracic echocardiography. The 50% effective dose of intranasal dexmedetomidine for transthoracic echocardiography sedation in children aged 13‐36 months was higher than in children <13 months.
Effect of availability of video laryngoscopy on the use of fiberoptic intubation in school‐aged children with microtia
Authors: Kondo Ichiro , Kobayashi Hidetsugu , Suga Yoshihumi , Suzuki Akihiro , Kiyama Shuya , Uezono Shoichi
Published: September 2017

Background

With the increasing popularity of video laryngoscopy during intubation of pediatric patients with normal or difficult airways, fiberoptic‐assisted tracheal intubation, traditionally considered the gold standard for difficult intubation, may become underused.

Aim

We aimed to assess the use of airway management techniques before and after introduction of video laryngoscopy in a cohort of school‐aged children with microtia, who are at increased risk of difficult intubation.

Methods

We retrospectively reviewed intubation devices used for all pediatric patients with microtia who had undergone reconstructive ear surgery at a single institution during the period January 2008 to December 2012. In each case, we identified the original airway management technique and success rate, as well as success rate for subsequent rescue techniques. The use of fiberoptic‐assisted tracheal intubation was compared before and after introduction of a pediatric blade for the Pentax‐AWS video laryngoscope.

Results

This study included 537 consecutive intubation procedures; 264 before and 273 after introduction of the pediatric airway scope. Elective use of fiberoptic‐assisted tracheal intubation for anticipated difficult intubation was significantly less after introduction of the pediatric airway scope (before: 19 of 79, 24% vs after: 3 of 79, 4%; odds ratio 8.02; 95% confidence interval, 2.27 to 28.39; P = .0003), which achieved a 100% success rate when used as the primary technique in both routine and difficult airways. All 5 cases of failed direct laryngoscopy were rescued by the pediatric airway scope, thus eliminating emergency use of fiberscopy.

Conclusion

Introduction of a pediatric video laryngoscope resulted in a substantial decrease in the use of fiberoptic‐assisted tracheal intubation. This change in intubation method might not influence the success rate of intubation in experienced hands but could be relevant for novice users.
Metabolite and transcript markers for the prediction of potato drought tolerance
Authors: Sprenger Heike , Erban Alexander , Seddig Sylvia , Rudack Katharina , Thalhammer Anja , Le Mai Q. , Walther Dirk , Zuther Ellen , Köhl Karin I. , Kopka Joachim , Hincha Dirk K.
Published: September 2017

Potato (Solanum tuberosum L.) is one of the most important food crops worldwide. Current potato varieties are highly susceptible to drought stress. In view of global climate change, selection of cultivars with improved drought tolerance and high yield potential is of paramount importance. Drought tolerance breeding of potato is currently based on direct selection according to yield and phenotypic traits and requires multiple trials under drought conditions. Marker‐assisted selection (MAS) is cheaper, faster and reduces classification errors caused by noncontrolled environmental effects. We analysed 31 potato cultivars grown under optimal and reduced water supply in six independent field trials. Drought tolerance was determined as tuber starch yield. Leaf samples from young plants were screened for preselected transcript and nontargeted metabolite abundance using qRT‐PCR and GC‐MS profiling, respectively. Transcript marker candidates were selected from a published RNA‐Seq data set. A Random Forest machine learning approach extracted metabolite and transcript markers for drought tolerance prediction with low error rates of 6% and 9%, respectively. Moreover, by combining transcript and metabolite markers, the prediction error was reduced to 4.3%. Feature selection from Random Forest models allowed model minimization, yielding a minimal combination of only 20 metabolite and transcript markers that were successfully tested for their reproducibility in 16 independent agronomic field trials. We demonstrate that a minimum combination of transcript and metabolite markers sampled at early cultivation stages predicts potato yield stability under drought largely independent of seasonal and regional agronomic conditions.
Risk factors for the development of antibody‐mediated rejection in highly sensitized pediatric kidney transplant recipients
Authors: Kim Irene K. , Choi Jua , Vo Ashley , Kang Alexis , Steggerda Justin , Louie Sabrina , Haas Mark , Mirocha James , Cohen J. Louis , Pizzo Helen , Kamil Elaine S. , Jordan Stanley C. , Puliyanda Dechu
Published: September 2017

ABMR remains a significant concern for early graft loss, especially for those who are HS against HLA antigens. We sought to determine the risk factors leading to ABMR in HS pediatric kidney transplant recipients. From January 2009 to December 2015, 16 HS pediatric kidney transplant patients at our center (age range 2‐21) were retrospectively reviewed for outcomes and risk factors for ABMR. All HS patients received desensitization with high‐dose IVIG/rituximab prior to transplant. Two groups were examined: ABMR+ (n = 7) and ABMR− (n = 9). Patient survival was 100%; however, one patient in the ABMR+ group suffered graft loss from ABMR 16 months post‐transplant. ABMR+ patients had higher Class I PRA at the time of transplant (Class I: 73.1 ± 19.1 vs 49.1 ± 28.3, P = .075), although not statistically significant. ABMR+ patients were more likely to have a history of transplant nephrectomy (P = .013). The characteristic that most strongly correlated with ABMR was the DSA‐RIS (P = .045), a scoring system used to quantify cumulative intensity of all DSA. In conclusion, DSA, as quantified by the RIS at the time of transplant, should be considered as part of the initial allocation strategy and patients with high RIS monitored closely for ABMR post‐transplant.
Induction of haem oxygenase‐1 increases infection of dog macrophages by L. infantum
Authors: Almeida B. F. M. , Silva K. L. O. , Venturin G. L. , Chiku V. M. , Leal A. A. C. , Bosco A. M. , Ciarlini P. C. , Lima V. M. F.
Published: September 2017

We aimed to induce and inhibit HO‐1, ascertaining its effect on infection rate, parasite load and the levels of superoxide, reactive oxygen species (ROS), nitric oxide (NO), TNF‐alpha and IL‐10 in cultured macrophages from healthy dogs infected by Leishmania infantum. Macrophages obtained from 15 healthy dogs were cultured alone or infected with L. infantum, with or without association of HO‐1 inducer and inhibitor. The infection rate and the parasite load were determined by the number of infected macrophages and number of promastigotes per macrophage, respectively. HO‐1 levels and gene expression, as well as IL‐10 and TNF‐alpha levels were also measured in these cultures. Superoxide, ROS and NO levels in macrophages were measured through flow cytometry. Induction of HO‐1 increased the infection rate and parasite load, while its inhibition decreased the infection rate and IL‐10 production. There was a positive correlation between HO‐1 and infection rate or parasite load. Increased infection rate was associated with decreased superoxide, ROS and NO levels. Induction of HO‐1 metabolism in dogs infected by L. infantum is possibly one of the mechanisms responsible for increasing the infection of macrophages, mainly through reduction in the oxidative and nitrosative metabolisms of these cells.
Policy Change: An Advocacy Coalition Framework Perspective
Authors: Pierce Jonathan J. , Peterson Holly L. , Hicks Katherine C.
Published: September 2017

One purpose of the Advocacy Coalition Framework (ACF) is to explain policy change. Previous holistic reviews of the ACF by Weible, Sabatier, and McQueen (2009) and Pierce, Peterson, Jones, Garrard, and Vu (2017) of the framework have not explicitly analyzed all the concepts and their interactions in a systematic manner. To address this gap and inform scholars and practitioners about past findings, strengths, weaknesses, and opportunities for future research, this article analyzes how the ACF's theory of policy change is applied to 148 policy processes among 67 journal articles from 2007 to 2014. Similar to Weible et al. (2009), this research finds the frequent use of multiple primary pathways to policy change, infrequent use of many of the ACF's concepts, a plurality of applications in the environment and energy domain, comparison of subsystems, and a need for greater clarity and transparency among applications. Unlike Weible et al. (2009), this article explores associations between primary pathways and policy domains, the frequency of associations between primary pathways and secondary components, policy change and stasis, and identifies threats to internal validity of key ACF concepts.
Commentary: Electronic Patient Records: Confronting the Implementation Challenge
Authors: Pedersen Kjeld Møller
Published: September 2017

Related Content: Hansen and Nørup (PAR November/December 2017)
The Promise and Perils of Reorganization
Authors: Nickels Ashley E.
Published: September 2017

Related Content: Balfour (PAR November/December 2017)

Related Content: Zeemering (PAR November/December 2017)

Related Content: Hamilton (PAR November/December 2017)

Related Content: Ali (PAR November/December 2017)

Related Content: Schachter (PAR November/December 2017)

Related Content: Holzer (PAR November/December 2017)