bluuebunny/crossref_metadata_2025 huggingface dataset:
An interactive product customization framework for freeform shapes
Authors: Zhang Yunbo , Kwok Tsz Ho
Published: October 2017

Purpose

The purpose of this paper is to establish new computer-aided-design (CAD) framework to design custom product that is fabricated additive manufacturing (AM), which can produce complex three-dimensional (3D) object without additional tool or fixture. Additive manufacturing (AM) enables the fabrication of three-dimensional (3D) objects with complex shapes without additional tools and refixturing. However, it is difficult for user to use traditional computer-aided design tools to design custom products.

Design/methodology/approach

In this paper, the authors presented a design system to help user design custom 3D printable products based on some reference freeform shapes. The user can define and edit styling curves on the reference model using the interactive geometric operations for styling curve. Incorporating with the reference models, these curves can be converted into 3D printable models through the fabrication interface.

Findings

The authors tested their system with four design applications including a hollow patterned bicycle helmet, a T-rex with skin frame structure, a face mask with Voronoi patterns and an AM-specific night dress with hollow patterns.

Originality/value

The executable prototype of the presented design framework used in the customization process is publicly available.
Analysis of specimens from phase I of the 3D printing in Zero G technology demonstration mission
Authors: Prater Tracie , Bean Quincy , Werkheiser Niki , Grguel Richard , Beshears Ron , Rolin Terry , Huff Tim , Ryan Richard , Ledbetter Frank , Ordonez Erick
Published: October 2017

Purpose

Human space exploration to date has been limited to low Earth orbit and the moon. The International Space Station (ISS) provides a unique opportunity for researchers to prove out the technologies that will enable humans to safely live and work in space for longer periods and venture farther into the solar system. The ability to manufacture parts in-space rather than launch them from earth represents a fundamental shift in the current risk and logistics paradigm for human space exploration. The purpose of this mission is to prove out the fused deposition modeling (FDM) process in the microgravity environment, evaluate microgravity effects on the materials manufactured, and provide the first demonstration of on-demand manufacturing for space exploration.

Design/methodology/approach

In 2014, NASA, in cooperation with Made in Space, Inc., launched a 3D printer to the ISS with the goal of evaluating the effect of microgravity on the fused deposition modeling (FDM) process and prove out the technology for use on long duration, long endurance missions where it could leveraged to reduce logistics requirements and enhance crew safety by enabling a rapid response capability. This paper presents the results of testing of the first phase of prints from the technology demonstration mission, where 21 parts where printed on orbit and compared against analogous specimens produced using the printer prior to its launch to ISS.

Findings

Mechanical properties, dimensional variations, structural differences and chemical composition for ground and flight specimens are reported. Hypotheses to explain differences observed in ground and flight prints are also developed. Phase II print operations, which took place in June and July of 2016, and ground-based studies using a printer identical to the hardware on ISS, will serve to answer remaining questions about the phase I data set. Based on Phase I analyses, operating the FDM process in microgravity has no substantive effect on the material produced.

Practical implications

Demonstrates that there is no discernable, engineering significant effect on operation of FDM in microgravity. Implication is that material characterization activities for this application can be ground-based.

Originality/value

Summary of results of testing of parts from the first operation of 3D printing in a microgravity environment.
Modified curing protocol for improved strength of binder-jetted 3D parts
Authors: Watters Matthew P. , Bernhardt Michelle L.
Published: October 2017

Purpose

This paper aims to present a new curing protocol which improves part strength and provides better repeatability for full-part infiltration by varying binder saturation levels. The fully infiltrated parts were then investigated for their resistance to water.

Design/methodology/approach

Cylinders and spheres generated using various curing procedures and binder saturation levels were subjected to uniaxial compression to determine the effects on the resulting part strength. Additionally, fully cured parts were submerged in water for varying durations to determine the resistance to water. Parts were also weighed prior to and after submersion in water to determine any change in mass.

Findings

Increased part infiltration and improved strength were achieved using a modified curing protocol with a higher oven temperature during curing. Spheres cured following the modified curing protocol resulted in a 300 per cent increase in the average force required to crush spheres. Parts were shown to have repeatable infiltration depths from 8.8 mm to 10.1 mm. Additionally, fully cured parts submerged in water for durations longer than 12 hours developed a reduction in strength.

Originality/value

This study provides key methods to improve part strength and demonstrates a limitation on maximum dimensions of parts which should be considered to behave homogeneously. Parts generated following these guidelines can be effectively used in laboratory and engineering applications where high strength and homogeneous behavior is important.
Attuning to individual work routines and team performance
Authors: de Jong Jeroen P. , Fodor Oana C.
Published: October 2017

Purpose

The authors first examine the extent to which having an accurate understanding of and anticipate on one another’s work routines (defined as crossattuning) explains additional variance of team performance above and beyond other implicit coordination concepts such as team familiarity and transactive memory. Furthermore, the authors aim to propose that social sensitivity interacts with team size and team longevity in supporting the emergence of cross-attuning.

Design/methodology/approach

The authors first use a quasi-experimental design with 35 student-teams in Study 1 to test the discriminant validity of their construct. In Study 2, the authors use a field study with 66 work teams to test their hypotheses.

Findings

Study 1 shows that cross-attuning has a positive effect on team performance and that it explains additional variance above other implicit coordination-concepts. In Study 2, the authors confirm cross-attuning associates with supervisor-rated team performance and find that team social sensitivity is more positively related to cross-attuning in small teams with low longevity and in large teams with high longevity in comparison to large teams with low longevity.

Originality/value

The study of implicit coordination mechanisms in teams has primarily focused on having knowledge about other team members’ expertise and competencies and how teams cope with unexpected events. How teams deal with individual work routines – repetitive work-related behavior that is limited in considering alternative actions and the task environment – have received limited attention, despite the potential of these individual routines to thwart successful team task completion.
Conceptualising a Framework for Effective Performance Measurement in Cultural Precinct Development and Operation
Authors: Schulz Rebekah , Sense Andrew , Pepper Matthew
Published: October 2017

The purpose of this paper is to firstly identify and synthesise critical measurement themes in extant academic literature concerning performance measurement in cultural precincts. Secondly, the paper posits for consideration a holistic and systematic framework (which embraces those themes) for developing appropriate performance measures for cultural precincts. The outcomes in this paper (a) confirm and clarify the complexity of performance measurement needed, (b) furnish a framework for practitioners embarking on the development of such measures, and (c) indicate the conceptual and pragmatic challenges faced in developing and enacting appropriate and meaningful measures for cultural precincts. Consequently, this paper serves as a conceptual positioning paper and a practical embarkation point for practitioners willing to engage with and pursue this phenomenon. Thereby, it endorses more dialogue on and further research and analysis of performance measurement in government operated cultural precincts.
Macroscopic linguistic features of the Chinese writing of deaf individuals
Authors: Liu Haitao , Jin Huiyuan
Published: October 2017

Deaf individuals usually face more challenges in reading and writing, because they are often deprived of adequate spoken input from their infancy. Research on the language features of deaf individuals’ writing is abundant. However, their language structures have as yet been unexplored. In order to address this subject, this article uses the holistic approach of complex network theory. This study builds three syntactic dependency networks, the intent being to capture the macroscopic linguistic features in writing of deaf individuals. Three networks are constructed: one is created from a treebank of texts produced by deaf individuals, and the other two are created from two treebanks of spoken and written language samples produced by hearing people. A dependency‐based theory of syntax is used. The results indicate that the language system of individuals with deafness is structurally similar to that of hearing people, especially to that of their spoken language, but individuals with deafness tend to have lower language proficiency in both syntactic and lexical aspects. The rigid use of function words and less diversity of vocabulary might be part of the reason for the observed differences.
Inclusion: the role of special and mainstream schools
Authors: Shaw Anne
Published: October 2017

For children with special educational needs, seeds were sown for the move away from segregated settings to inclusion in mainstream settings following the 1978 Warnock Report. However, the ‘special versus mainstream school’ debate was re‐ignited in 2005 when Warnock recommended a more significant role for special schools than previously envisaged. Furthermore, an increase in special school placement has been reported, prompting this investigation of the role of special schools in the current climate of inclusion. Literature from Britain, Europe and New Zealand, including research that listens to ‘the voice of the child’, which compares experiences of children with special educational needs in special and mainstream schools, is reviewed. The findings give no clear indication that either setting leads to better outcomes. Tensions between the inclusion agenda and standards agenda are highlighted. It is concluded that special schools in reduced numbers are likely to remain a feature of the inclusive education system, with recommendations for the development of special–mainstream school partnership links. The quality of the setting, regardless of the type of setting, is emphasised, highlighting implications for staff training in special and mainstream schools. Further research comparing outcomes for children educated in different types of provision is recommended.
The new subversive geranium: some notes on the management of additional troubles in maximum security prisons
Authors: Liebling Alison , Williams Ryan J.
Published: October 2017

In this paper, we revisit King and McDermott's 1990 article on the social construction of ‘control problem’ prisoners and their management in high security prisons, in the light of our recent research on the location and building of trust in contemporary high security prisons. We examine how religious and race identities are now deeply implicated in the construction of risk, and we describe the procedures for and some of the consequences of managing the new risks of radicalization and extremist violence in prison. The analysis is based on observations and interviews with staff and prisoners in two main and two supplementary maximum‐security prisons in England and Wales.
The class pictures in citizens’ minds
Authors: Robison Joshua , Stubager Rune
Published: October 2017

Social class has traditionally played a key role in explaining social behaviour and cognition. However, recent analyses have been dominated by the view that the relevance of class for behaviour has dwindled in advanced industrial societies. We contest this view by focusing on the subjective components of class consciousness. Using a national survey of Danish citizens, we show that individuals continue to hold meaningful conceptions of classes, to identify with them and, moreover, to perceive substantial levels of differences between them with these latter beliefs being strongly structured by respondent class identification. These results are all the more intriguing because they stem from a high affluence/low inequality national context that should be a particularly good case for failing to find such rich class perceptions.
Identification and characterization of heat shock proteins in a parasitic wasp Chouioia cuneae (Hymenoptera: Eulophidae)
Authors: Pan Li‐Na , Wang Feng‐Zhu , Zhang Xin‐Yue , Zhao Yan‐Ni , Zhu Geng‐Ping , Li Min
Published: October 2017

Heat shock proteins (HSPs) are known to be induced in response to various stress factors. Although HSPs have been studied in a number of insects, not much is known about HSPs in the natural enemies of insects, especially parasitoids. In this study, we identified and characterized five full‐length HSP genes (Cchsp40, Cchsp60, Cchsp70, Cchsp83, and Cchsp90) from an endoparasitic chalcid wasp, Chouioia cunea, which parasitizes the fall webworm, Hyphantria cunea pupae, a worldwide pest. The expression of Cchsps in response to temperature, pesticide stresses and UV radiation were also investigated by quantitative real‐time polymerase chain reaction (RT‐qPCR). The results showed that all five Cchsps were induced in response to hot and cold temperatures. Four pesticides induced the abundant expression of Cchsp70, Cchsp83 and Cchsp90 while ultraviolet radiation up‐regulated Cchsp40, Cchsp70, Cchsp83 and Cchsp90. These results indicate the different transcriptional profiles of the five different Cchsps in response to various abiotic stresses. The findings of this study provide insights into the response of C. cunea to abiotic stresses and insight into the use of this parasitoid in biological control strategies.
First record of the quarantine pest Atherigona (Atherigona) oryzae Malloch (Diptera: Muscidae) in Korea
Authors: Suh Sang Jae , Kwon Yong Jung
Published: October 2017

Occurrence of the invasive quarantine pest fly, Atherigona (Atherigona) oryzae Malloch, is hereby recorded for the first time in Gyeongsangbuk‐do Province, Korea. Morphological characteristics for accurate identification of the species, a list of hosts, and damage patterns are described to provide plant quarantine information for pest management.
mvmapper: Interactive spatial mapping of genetic structures
Authors: Dupuis Julian R. , Bremer Forest T. , Jombart Thibaut , Sim Sheina B. , Geib Scott M.
Published: October 2017

Characterizing genetic structure across geographic space is a fundamental challenge in population genetics. Multivariate statistical analyses are powerful tools for summarizing genetic variability, but geographic information and accompanying metadata are not always easily integrated into these methods in a user‐friendly fashion. Here, we present a deployable Python‐based web‐tool, mvmapper, for visualizing and exploring results of multivariate analyses in geographic space. This tool can be used to map results of virtually any multivariate analysis of georeferenced data, and routines for exporting results from a number of standard methods have been integrated in the R package adegenet, including principal components analysis (PCA), spatial PCA, discriminant analysis of principal components, principal coordinates analysis, nonmetric dimensional scaling and correspondence analysis. mvmapper's greatest strength is facilitating dynamic and interactive exploration of the statistical and geographic frameworks side by side, a task that is difficult and time‐consuming with currently available tools. Source code and deployment instructions, as well as a link to a hosted instance of mvmapper, can be found at https://popphylotools.github.io/mvMapper/.
International Legal Encounters with Democracy
Authors: Charlesworth Hilary
Published: October 2017

The language of democracy has become common in international law, the legal system that regulates relations between nation states. This interest in democracy has however largely ignored democracy at the international level and focused instead on national democratic standards. In this paper, I start by sketching the threadbare debates about democracy beyond political borders in international law and then turn to the way that international institutions have developed this concept, particularly in the peace and state‐building boom associated with the end of the Cold War. The two contexts for democracy have taken different directions. In the case of democracy at the international level, the discussion has become polarised between global North and South, with democracy being promoted by the South as an omnibus agenda to remedy economic and political inequalities. In the case of democracies within states, international lawyers have taken democracy to have a fixed form, associated with specific institutional practices and structures, limiting its capacity for transformation.
Patterns of substance use and mortality risk in a cohort of ‘hard‐to‐reach’ polysubstance users
Authors: Gjersing Linn , Bretteville‐Jensen Anne Line
Published: October 2017

Aims

To examine the mortality risk in a cohort of ‘hard‐to‐reach’ polysubstance users and its putative associations with substance use. Specifically, we estimated all‐cause mortality risk as a function of individual substance use indicators, and then as a function of their complex, ‘real‐life’ patterns as identified through latent class analysis (LCA).

Design

Prospective cohort study among street‐ and low‐threshold service‐recruited polysubstance users included between September and November 2013 and followed through the National Cause of Death Registry until 31 October 2015.

Setting

Seven Norwegian cities.

Participants

A total of 884 users of illegal opioids and/or stimulants. Of these, 357 were in opioid substitution treatment (OST) at the time of inclusion. Forty‐four participants died during follow‐up.

Measurements

Primary outcome: all‐cause mortality risk. Unadjusted and adjusted Cox proportional hazard (PH) regression models (covariates: male, age, homelessness/shelter use, overdose experience, OST status, years of injecting, individual substance use indicators, city, use patterns). LCA models estimated separately for those in and those not in OST due to measurement invariance.

Findings

The crude mortality rate was 2.52 per 100 person‐years. Standardized mortality ratio was 26.11 [95% confidence interval (CI) = 10.06–54.87] for women and 10.71 (95% CI = 6.39–16.81) for men. No single drug use indicator, such as ‘heroin injection’ or ‘number of drugs used’, was associated with the mortality risk. However, meaningful use patterns were identified; three OST and non‐OST patterns each. The non‐OST patterns ‘polysubstance injectors’ [hazard ratio (HR) = 3.45, 95% CI = 0.98–12.14] and ‘low frequent injectors’ (HR = 3.17, CI = 1.05–9.56) were associated significantly with the mortality risk even when adjusted for other known risk factors.

Conclusions

In a Norwegian prospective cohort study, ‘hard‐to‐reach’ polysubstance users had a more than 10 times higher mortality risk than the general population. Mortality risk was not a function of any single drug use indicator, but two distinct combinations of substances, frequencies and routes of administration were associated with the mortality risk.
Trends in age of smoking initiation in the Netherlands: a shift towards older ages?
Authors: Nuyts Paulien A. W. , Kuipers Mirte A. G. , Willemsen Marc C. , Kunst Anton E.
Published: October 2017

Background and aim

As smoking initiation generally occurs in adolescence, smoking prevention is targeted primarily at young adolescents (aged below 16 years). We hypothesize that, with the adoption of increasingly stronger youth access laws, a shift in the age of smoking initiation may have occurred.

Design

Repeated cross‐sectional survey.

Setting

The Netherlands.

Participants

A total of 13 163 respondents born between 1980 and 1995.

Measurements

In the 2010–15 National Health Survey we measured retrospectively self‐reported initiation rates per year of age by birth cohort (1980–83, 1984–87, 1988–91, 1992–95). Logistic regression analyses were performed to assess differences between cohorts, per sex and educational level.

Findings

Of those who started smoking, 67.2% initiated smoking between 12 and 16 years of age. Contrary to our hypothesis, no shift in initiation towards higher ages was observed. The peak age of initiation was 16 years for all cohorts. Initiation at ages 17–21 was lower in younger birth cohorts than in older birth cohorts [e.g. cohort 1993–95 versus 1980–83: odds ratio (OR) for initiating at 19–21 years = 0.45, 95% confidence interval (CI) = 0.31–0.64]. Trends in age of initiation were similar for males and females. Initiation at ages 15–17 decreased across cohorts for respondents in higher education levels, but not for those in lower education levels.

Conclusions

In the Netherlands, the peak age of smoking initiation did not shift throughour subsequent cohorts born between 1980 and 1995, suggesting that young adolescents remain the main target group for smoking initiation prevention policies.
Impulsivity predicts poorer improvement in quality of life during early treatment for people with methamphetamine dependence
Authors: Rubenis Adam J. , Fitzpatrick Rebecca E. , Lubman Dan I. , Verdejo‐Garcia Antonio
Published: October 2017

Background and aims

Methamphetamine dependence is associated with heightened impulsivity and diminished quality of life, but the link between impulsivity and changes in quality of life during treatment has not been examined. We aimed to investigate how different elements of impulsivity predict change in quality of life in the 6 weeks after engaging in treatment.

Design

Longitudinal, observational cohort study.

Setting

Public and private detoxification and rehabilitation facilities in metropolitan Melbourne, Australia.

Participants

One hundred and eight individuals with methamphetamine dependence (81 male) tested within 3 weeks of commencing treatment; 80 (74%) were followed‐up at 6 weeks.

Measurements

The Continuous Performance Test‐2 measured impulsive action (cognitive and motor impulsivity); the Delay Discounting Task measured impulsive choice. Quality of life was measured with the World Health Organization Quality of Life Scale—Brief, which includes social, psychological, physical and environment domains. Control variables included age, gender, estimated IQ, depression severity score, methamphetamine dependence severity score, cannabis dependence severity score and treatment modality.

Findings

We found that all three forms of impulsivity were significant predictors of change in the social domain: motor impulsivity (β = −0.54, P = 0.013), cognitive impulsivity (β = −0.46, P = 0.029) and impulsive choice (β = −0.26, P = 0.019). Change in the psychological domain was predicted significantly by motor impulsivity (β = −0.45, P = 0.046). Control variables of age and depression were associated significantly with changes in the physical domain.

Conclusions

In Australian methamphetamine‐dependent individuals, elevated impulsivity predicts lower improvement of social and psychological quality of life in the first 6–9 weeks of treatment.
Associations between methadone maintenance treatment and crime: a 17‐year longitudinal cohort study of Canadian provincial offenders
Authors: Russolillo Angela , Moniruzzaman Akm , McCandless Lawrence C. , Patterson Michelle , Somers Julian M.
Published: October 2017

Aims

To estimate and test the difference in rates of violent and non‐violent crime during medicated and non‐medicated methadone treatment episodes.

Design, Setting and Participants

The study involved linkage of population level administrative data (health and justice) for all individuals (n = 14 530) in British Columbia, Canada with a history of conviction and who filled a methadone prescription between 1 January 1998 and 31 March 2015. Methadone maintenance treatment was the primary independent variable and was treated as a time‐varying exposure. Each participant's follow‐up (mean: 8 years) was divided into medicated (methadone was dispensed) and non‐medicated (methadone was not dispensed) periods with mean durations of 3.3 and 4.6 years, respectively.

Measurements

Socio‐demographics of participants were examined along with the main outcomes of violent and non‐violent offences.

Findings

During the first 2 years of treatment (≤ 2.0 years), periods in which methadone was dispensed were associated with a 33% lower rate of violent crime [0.67 adjusted hazard ratio (AHR), 95% confidence intervals (CI) = 0.59, 0.76] and a 35% lower rate of non‐violent crime (0.65 AHR, 95% CI = 0.62, 0.69) compared with non‐medicated periods. This equates to a risk difference of 3.6 (95% CI = 2.6, 4.4) and 37.2 (95% CI = 33.0, 40.4) fewer violent and non‐violent offences per 100 person‐years, respectively. Significant but smaller protective effects of dispensed methadone were observed across longer treatment intervals (2.0 to ≤ 5.0 years, 5.0 to ≤ 10.0 years).

Conclusions

Among a cohort of Canadian offenders, rates of violent and non‐violent offending were lower during periods when individuals were dispensed methadone compared with periods in which they were not dispensed methadone.
Complete kinetic follow‐up of symptoms and complement parameters during a hereditary angioedema attack
Authors: Veszeli N. , Kőhalmi K. V. , Kajdácsi E. , Gulyás D. , Temesszentandrási G. , Cervenak L. , Farkas H. , Varga L.
Published: October 2017

We studied the kinetics of C1‐inhibitor (C1‐INH) and other complement parameters in a self‐limited edematous attack (EA) in a patient with hereditary angioedema due to C1‐INH deficiency to better understand the pathomechanism of the evolution, course, and complete resolution of EAs. C1‐INH concentration and functional activity (C1‐INHc+f), C1(q,r,s), C3, C4, C3a, C4a, C5a, and SC5b‐9 levels were measured in blood samples obtained during the 96‐hour observation period. The highest C1‐INHc+f, C4, and C1(q,r,s) levels were measured at baseline, and their continuous decrease was observed during the entire observation period. C4 depletion started at prodromal phase, and C4 was lowest after the maximum severity peak. Compared to baseline, C4a level was four times higher 7 hours before the onset of the attack. C1‐INH did not increase after resolution of the attack suggesting that factors other than C1‐INH may be important in this process. C4a may be a useful biomarker for the prediction of EAs.
Component‐resolved diagnosis and beyond: Multivariable regression models to predict severity of hazelnut allergy
Authors: Datema M. R. , van Ree R. , Asero R. , Barreales L. , Belohlavkova S. , de Blay F. , Clausen M. , Dubakiene R. , Fernández‐Perez C. , Fritsche P. , Gislason D. , Hoffmann‐Sommergruber K. , Jedrzejczak‐Czechowicz M. , Jongejan L. , Knulst A. C. , Kowalski M. , Kralimarkova T. Z. , Le T.‐M. , Lidholm J. , Papadopoulos N. G. , Popov T. A. , del Prado N. , Purohit A. , Reig I. , Seneviratne S. L. , Sinaniotis A. , Versteeg S. A. , Vieths S. , Zwinderman A. H. , Mills E. N. C. , Fernández‐Rivas M. , Ballmer‐Weber B.
Published: October 2017

Background

Component‐resolved diagnosis (CRD) has revealed significant associations between IgE against individual allergens and severity of hazelnut allergy. Less attention has been given to combining them with clinical factors in predicting severity.

Aim

To analyze associations between severity and sensitization patterns, patient characteristics and clinical history, and to develop models to improve predictive accuracy.

Methods

Patients reporting hazelnut allergy (n = 423) from 12 European cities were tested for IgE against individual hazelnut allergens. Symptoms (reported and during Double‐blind placebo‐controlled food challenge [DBPCFC]) were categorized in mild, moderate, and severe. Multiple regression models to predict severity were generated from clinical factors and sensitization patterns (CRD‐ and extract‐based). Odds ratios (ORs) and areas under receiver‐operating characteristic (ROC) curves (AUCs) were used to evaluate their predictive value.

Results

Cor a 9 and 14 were positively (OR 10.5 and 10.1, respectively), and Cor a 1 negatively (OR 0.14) associated with severe symptoms during DBPCFC, with AUCs of 0.70‐073. Combining Cor a 1 and 9 improved this to 0.76. A model using a combination of atopic dermatitis (risk), pollen allergy (protection), IgE against Cor a 14 (risk) and walnut (risk) increased the AUC to 0.91. At 92% sensitivity, the specificity was 76.3%, and the positive and negative predictive values 62.2% and 95.7%, respectively. For reported symptoms, associations and generated models proved to be almost identical but weaker.

Conclusion

A model combining CRD with clinical background and extract‐based serology is superior to CRD alone in assessing the risk of severe reactions to hazelnut, particular in ruling out severe reactions.
Can point‐of‐care ultrasound predict spinal hypotension during caesarean section? A prospective observational study
Authors: Zieleskiewicz L. , Noel A. , Duclos G. , Haddam M. , Delmas A. , Bechis C. , Loundou A. , Blanc J. , Mignon A. , Bouvet L. , Einav S. , Bourgoin A. , Leone M.
Published: October 2017

Spinal anaesthesia for elective caesarean section is associated with maternal hypotension, secondary to alteration of sympathetic tone and hypovolemia, in up to 70% of cases. Measurement of the subaortic variation in the velocity time integral (VTI) after passive leg raising allows prediction of fluid responsiveness. Our objective, in this prospective single‐centre observational study, was to assess the ability of change in VTI after 45° passive leg raising to predict hypotension after spinal anaesthesia. Ultrasound measurements were performed just before elective caesarean section. Anaesthesia, intravenous coloading and prophylactic vasopressor treatment were standardised according to current guidelines. We studied 40 women. Hypotension occurred in 17 (45%) women. The area (95%CI) under the receiver operating characteristics (ROC) curve for the prediction of spinal hypotension was 0.8 (0.6–0.9; p = 0.0001). Seventeen women had a change in VTI with leg elevation ≤ 8%, which was predictive for not developing hypotension, and 11 had a change ≥ 21%, predictive for hypotension. The grey zone between 8% and 21%, with inconclusive values, included 12 women. We suggest that cardiac ultrasound provides characterisation of the risk of hypotension following spinal anaesthesia at elective caesarean section, and therefore may allow individualised strategies for prevention and management.
Dynamic ultrasound‐guided short‐axis needle tip navigation technique vs. landmark technique for difficult saphenous vein access in children: a randomised study
Authors: Hanada S. , Van Winkle M. T. , Subramani S. , Ueda K.
Published: October 2017

Dynamic ultrasound‐guided short‐axis needle tip navigation is a novel technique for vascular access. After venipuncture, the needle and catheter are further advanced within the vessel lumen under real‐time ultrasound guidance with constant visualisation of the needle tip in the short‐axis view. This can minimise the risk of transfixing the cannulated vessel. We compared two techniques for non‐visible saphenous vein cannulation under general anaesthesia in children weighing ≥ 3 kg and less than four years of age: dynamic ultrasound‐guided short‐axis needle tip navigation technique (ultrasound group) vs. landmark technique. Venous cannulation was performed by three experienced anaesthetists. The primary outcome measure was first‐attempt success rate. Success rate within 10 min was a secondary outcome. A total of 102 patients were randomly allocated to either the ultrasound group or the landmark group. First‐attempt success rate was 90% in the ultrasound group compared with 51% in the landmark group, p<0.001, difference 39%, 95% confidence interval (CI) of the difference 23–55%. Success rate within 10 min was 92% in the ultrasound group compared with 63% in the landmark group, p = 0.001, difference 29%, 95%CI of the difference 14–45%. We conclude that, when performed by experienced anaesthetists, the dynamic ultrasound‐guided short‐axis needle tip navigation technique improved non‐visible saphenous vein cannulation in children compared with the landmark technique.
Environmentality on the Canadian Prairies: Settler‐Farmer Subjectivities and Agri‐Environmental Objects
Authors: Laforge Julia M.L. , McLachlan Stéphane M.
Published: October 2017

State and institutional actors have been shaping settler‐farmer subjectivities in order to transform the landscape and thus the history and geography of the Canadian Prairies. This paper expands the application of environmentality from its origins in colonial forestry to interrogate agriculture on prairie landscapes. The Canadian state used the technologies of environmentality to influence “common sense” attitudes and behaviours, which acted to deterritorialize Indigenous communities and then manipulated their subjectivities to guarantee settler‐farmer access to land. Later, institutions and states moulded settler‐farmer subjectivities of correct farming behaviour in an effort to convert soil, water, and seeds into economic resources. These environmental objects, in turn, acted upon settler‐farmer subjects by setting biophysical and genetic limits such as soil fertility, water quality and quantity, and plant hardiness and disease resistance. Resisting environmentality requires understanding processes of subjugation while also creating counter‐narratives of “good” farming behaviour and Indigenous‐settler relations.
Children in out‐of‐home care are at high risk of somatic, dental and mental ill health
Authors: Randsalu L S , Laurell L
Published: October 2017

Aim

The Swedish Social Board has implemented a support strategy to guide out‐of‐home care for children, which translates as children's needs in focus (CNIF) and includes a systematic health assessment. It was fully introduced into the Skåne province in 2012 and our study covered the first four years of the CNIF health assessments, from 2012 to 2015.

Methods

We studied children aged 0–17 years in out‐of‐home care who had been referred by social workers for a CNIF health assessment, using their medical records to investigate both their health and the value of the health assessments.

Result

From 2012 to 2015, only 409 (6%) of the 11 413 children in out‐of‐home care were referred for health assessments. Their health issues included depression and anxiety (29%), poor dental health (30%), seeking medical care for traumatic injuries (36%), previous contact with child psychiatry services (38%) and missed medical appointments (36%), dental appointments (36%) and child health programme appointments (39%). In addition, 10% of the girls and 9% of the boys were obese.

Conclusion

This study found high levels of wide‐ranging health issues. Despite national Swedish guidelines and policies, only 6% of the children in out‐of‐home care were referred by social workers for a CNIF health assessment.
High blood pressure in the young: why should we care?
Authors: Flynn Joseph T.
Published: October 2017

While primary hypertension (HTN) clearly occurs in children and adolescents, the approach of many providers to such patients can best be described as ambivalent: the condition may be recognised, but is not acted upon. Such ambivalence may stem from incomplete understanding of the effects of high blood pressure in the young, which in turn is related to the shortage of information on long‐term outcomes of primary childhood HTN. However, other evidence on the short‐ and long‐term effects of blood pressure elevation in childhood clearly shows that it is not a benign condition at all.

Conclusion

Childhood HTN warrants action to prevent adult cardiovascular disease.
ThePAC‐SYMquestionnaire for chronic constipation: defining the minimal important difference
Authors: Yiannakou Y. , Tack J. , Piessevaux H. , Dubois D. , Quigley E. M. M. , Ke M. Y. , Da Silva S. , Joseph A. , Kerstens R.
Published: October 2017

Background

The Patient Assessment of Constipation‐Symptoms (PAC‐SYM) questionnaire is frequently used in clinical trials of constipation. However, the threshold for reduction in totalPAC‐SYMscore used to define a clinical response on this 0‐4 point scale has not undergone formal appraisal, and its relationship with clinical benefit as perceived by patients has not been defined.

Aim

To determine the minimal important difference inPAC‐SYMscore, and the optimum cut‐off value for defining responders.

Methods

The minimal important difference was estimated using data from six international phase 3/4, double‐blind, randomised controlled trials of prucalopride in patients with chronic constipation (NCT01147926,NCT01424228,NCT01116206,NCT00485940,NCT00483886,NCT00488137), with anchor‐ and distribution‐based approaches. Five appropriate patient‐reported outcomes were selected as anchors. In addition, receiver operating characteristics (ROC) curve analyses were used to investigate responder discrimination for each anchor.

Results

Data from 2884 patients were included. Minimal important difference estimates ranged from –0.52 to –0.63 across the five anchors. Estimates were not affected by study location but were consistently lower for rectal symptoms than for abdominal and stool symptoms. Distribution‐based estimates were considerably lower than anchor‐based estimates.ROCcurve analyses showed optimum cut‐off scores for discriminating responders to be similar to anchor‐based minimal important difference estimates.

Conclusions

Anchor‐based methods gave consistent results for the minimal important difference, at approximately –0.6, and this value was close to theROC‐determined optimal cut‐off scores for responder discrimination. This value could be considered in clinical practice. A slightly more conservative threshold (eg –0.75) could be used in clinical trials to reduce the placebo response rate.
Morphological characterisation of the digestive tract of the catfish Lophiosilurus alexandri Steindachner, 1876 (Siluriformes, Pseudopimelodidae)
Authors: Mello Gabriel C. G. , Santos Marcella L. , Arantes Fábio P. , Pessali Thiago C. , Brito Marcelo F. G. , Santos José E.
Published: October 2017

The anatomical arrangement of the digestive tract and the length (cm) of the oesophagus and intestine of the catfish Lophiosilurus alexandri were described, and the intestinal coefficient was determined. L. alexandri oesophagus is short, in median position, and presents longitudinally folded mucosa, whilst its epithelium is stratified and non‐keratinised, with mucous, claviform and epithelial cells. Stomach has “C” shape, with folded mucosa along cardiac region, disordered in the fundic region, and directed to the sphincter in the pyloric region. Its epithelium is simple prismatic, and cardiac and fundic portions have gastric glands. Cranial intestine is formed by pyloric flexure and descending loop attached to the right side of stomach. Middle intestine is winding and positioned to the right of caudal portion of stomach. Caudal intestine is linear and with a median position up to the anus. Intestinal coefficient was 1.39 ± 0.30 cm. Epithelium is simple prismatic with brush border and contains epithelial and goblet cells. Caudal region has highest concentration of goblet cells. Were detected neutral glycoproteins, carboxylated and sulphated acid glycoconjugates for mucous cells and goblet cells, and neutral glycoproteins for the apical region of gastric epithelial cells. Morphological features could be related to piscivorous species feeding habit.
TREM2 expression in the human brain: a marker of monocyte recruitment?
Authors: Fahrenhold Marie , Rakic Sonja , Classey John , Brayne Carol , Ince Paul G. , Nicoll James A. R. , Boche Delphine ,   MRC‐CFAS
Published: October 2017

Mutation in the triggering receptor expressed on myeloid cells (TREM) 2 gene has been identified as a risk factor for several neurodegenerative diseases including Alzheimer's disease (AD). Experimental studies using animal models of AD have highlighted a number of functions associated with TREM2 and its expression by microglial cells. It has therefore been assumed that this is also the case in humans. However, there is very limited information concerning the cellular expression of TREM2 in the human brain. As part of investigations of microglia using post‐mortem resources provided by the Medical Research Council Cognitive Function and Ageing Studies (MRC‐CFAS), we immunostained the cerebral cortex of 299 participants for TREM2 using the Sigma antibody HPA010917 and compared with the macrophage/microglial markers Iba1 and CD68. As expected, Iba1 and CD68 labeled microglia and perivascular macrophages. However, in most cases (284/299), the TREM2 antibody labelled monocytes within vascular lumens, but not microglia or perivascular macrophages. In contrast, in 5 out of 6 cases with acute infarcts, TREM2 immunoreaction identified cells within the brain parenchyma interpreted as recruited monocytes. Six cases with old infarcts contained phagocytic foamy macrophages which were CD68‐positive but TREM2 negative. Our observations, using the HPA010917 anti‐TREM2 antibody, suggest that TREM2 is not expressed by microglia but instead seems to be a marker of recruited monocytes in the human brain. This finding has implications with regards to the role of TREM2 as a risk factor, emphasizing the importance of systemic immune responses in the development and progression of Alzheimer's disease.
Esophageal adenocarcinoma microenvironment: Peritumoral adipose tissue effects associated with chemoresistance
Authors: Carraro Amedeo , Trevellin Elisabetta , Fassan Matteo , Kotsafti Andromachi , Lunardi Francesca , Porzionato Andrea , Dall'Olmo Luigi , Cagol Matteo , Alfieri Rita , Macchi Veronica , Tedeschi Umberto , Calabrese Fiorella , Rugge Massimo , Castoro Carlo , Vettor Roberto , Scarpa Marco
Published: October 2017

Peritumoral microenvironment affects cancer development and chemoresistance, and visceral adipose tissue may play a critical role. We aimed to identify depot‐specific adipose characteristics associated with carcinogenesis and resistance to neoadjuvant therapy in esophageal adenocarcinoma (EAC). We analyzed: (i) the peritumoral adipose tissue of rats following the induction of esophageal carcinogenesis; (ii) the peritumoral and distal (omental) adipose tissue of patients affected by EAC; (iii) adipose‐derived stem cells (ADSC) isolated from healthy patients and treated with conditioned medium (CM), collected from tumoral and adipose tissue of patients with EAC. In peritumoral adipose tissue of rats, CD34, CD31 and vascular endothelial growth factor (VEGF) expression increased progressively during EAC development. In patients with EAC, expression of CD34, CD45, CD90 and nucleostemin (NSTM) was higher in peritumoral than in distal adipose tissue and decreased in the presence of neoadjuvant therapy. Moreover, expression of NSTM, octamer‐binding transcription factor 4 (OCT‐4) and VEGF was higher in peritumoral (but not in distal) adipose tissue of chemoresistant patients. In ADSC, treatment with peritumoral adipose tissue CM increased the adipogenic potential and the expression of CD34, CD90, NSTM and OCT‐4. These effects were similar to those induced by cancer‐derived CM, but were not observed in ADSC treated with distal adipose tissue CM and were partially reduced by a leptin antagonist. Last, ADSC treated with peritumoral CM of chemoresistant patients displayed increased expression of NSTM, OCT‐4, leptin, leptin receptor, alpha‐smooth muscle actin (α‐SMA), CD34 and VEGF. These results suggest that peritumoral adipose tissue may promote, by paracrine signaling, the expression of depot‐specific factors associated with therapeutic resistance.
Development of a Cerebral Palsy Follow‐up Registry in Jordan (CPUP‐Jordan)
Authors: Almasri N. A. , Saleh M. , Abu‐Dahab S. , Malkawi S. H. , Nordmark E.
Published: October 2017

Aims

This study aims to describe the development of a Cerebral Palsy Follow‐up Registry in Jordan (CPUP‐Jordan) and to provide a baseline child and parent demographic information, birth history of the child participants, and distribution of the participants based on topographical distribution of cerebral palsy (CP) and functional classification systems.

Methods

The CPUP‐Jordan was developed using a similar framework of a follow‐up surveillance programme for persons with CP in Sweden (CPUP). Standard assessment forms were utilized to collect data related to child and family demographics, child birth history, and functional classifications and physiotherapy and occupational therapy assessments and interventions. Research assistants were trained to conduct the assessments. A secured web‐based system was developed to store data and disseminate knowledge maintained in the registry. Children with CP were included in the registry if they have confirmed diagnosis of CP. The ascertainment age of inclusion and the minimum age of survival required are 4 years.

Results

One hundred sixty‐seven children were registered between 2013 and 2015 (mean age is 3.6 ± 3.0 years). Forty‐two percent were born premature, and 48% were less than the normal birthweight. Perinatal causes were reported for 54% of the participants. The most common type of CP based on tone disturbance was spastic type, and the most common topographical distributions of motor dysfunction were quadriplegia followed by diplegia. Fifty‐six percent of the participants had severe limitation in ambulation; 48% had restricted manual abilities, and 47% had limited communication abilities even with familiar family members and partners.

Conclusions

The development of CPUP‐Jordan registry for children with CP proved to be both feasible and informative. The registry baseline descriptive data were similar to those reported in previous research in Jordan supporting validity of the data. The implementation of CPUP‐Jordan at national level is expected to have a positive impact on children with CP, clinicians, policymakers, and researchers.