bluuebunny/crossref_metadata_2025 huggingface dataset:
A place for taxonomic profiling in the study of the coral prokaryotic microbiome
Authors: Hernandez-Agreda Alejandra , Leggat William , Ainsworth Tracy D
Published: April 2019

The enormous variability in richness, abundance and diversity of unknown bacterial organisms inhabiting the coral microbiome have challenged our understanding of their functional contribution to coral health. Identifying the attributes of the healthy meta-organism is paramount for contemporary approaches aiming to manipulate dysbiotic stages of the coral microbiome. This review evaluates the current knowledge on the structure and mechanisms driving bacterial communities in the coral microbiome and discusses two topics requiring further research to define the healthy coral microbiome. (i) We examine the necessity to establish microbial baselines to understand the spatial and temporal dynamics of the healthy coral microbiome and summarise conceptual and logistic challenges to consider in the design of these baselines. (ii) We propose potential mechanical, physical and chemical mechanisms driving bacterial distribution within coral compartments and suggest experiments to test them. Finally, we highlight aspects of the use of 16S amplicon sequencing requiring standardization and discuss its contribution to other multi-omics approaches.
The role of the GATA transcription factor AreB in regulation of nitrogen and carbon metabolism in Aspergillus nidulans
Authors: Chudzicka-Ormaniec Patrycja , Macios Maria , Koper Michał , Weedall Gareth D , Caddick Mark X , Weglenski Piotr , Dzikowska Agnieszka
Published: April 2019

In Aspergillus nidulans, nitrogen and carbon metabolism are under the control of wide-domain regulatory systems, including nitrogen metabolite repression, carbon catabolite repression and the nutrient starvation response. Transcriptomic analysis of the wild type strain grown under different combinations of carbon and nitrogen regimes was performed, to identify differentially regulated genes. Carbon metabolism predominates as the most important regulatory signal but for many genes, both carbon and nitrogen metabolisms coordinate regulation. To identify mechanisms coordinating nitrogen and carbon metabolism, we tested the role of AreB, previously identified as a regulator of genes involved in nitrogen metabolism. Deletion of areB has significant phenotypic effects on the utilization of specific carbon sources, confirming its role in the regulation of carbon metabolism. AreB was shown to regulate the expression of areA, tamA, creA, xprG and cpcA regulatory genes suggesting areB has a range of indirect, regulatory effects. Different isoforms of AreB are produced as a result of differential splicing and use of two promoters which are differentially regulated by carbon and nitrogen conditions. These isoforms are likely to be functionally distinct and thus contributing to the modulation of AreB activity.
The Role of Early Biologic Therapy in Inflammatory Bowel Disease
Authors: Berg Dana Rachel , Colombel Jean-Frederic , Ungaro Ryan
Published: April 2019

The goals for treatment of inflammatory bowel diseases (IBDs) are changing from elimination of symptoms toward complete disease control—a process that demands both clinical and endoscopic remission. This new IBD treatment paradigm has been shifting from a conventional “step-up” approach toward a more “top-down” early intervention treatment strategy. Recent studies suggest that the use of biologic agents, specifically those targeting tumor necrosis factor alpha, earlier in the treatment course improves patient outcomes and can prevent progression to irreversible bowel damage. Although the strategy of early intervention has accumulating evidence in Crohn’s disease, there is less evidence supporting its impact in ulcerative colitis.
Responses of seaweeds that use CO2 as their sole inorganic carbon source to ocean acidification: differential effects of fluctuating pH but little benefit of CO2 enrichment
Authors: Britton Damon , Mundy Craig N , McGraw Christina M , Revill Andrew T , Hurd Catriona L
Published: April 2019

Laboratory studies that test the responses of coastal organisms to ocean acidification (OA) typically use constant pH regimes which do not reflect coastal systems, such as seaweed beds, where pH fluctuates on diel cycles. Seaweeds that use CO2 as their sole inorganic carbon source (non-carbon dioxide concentrating mechanism species) are predicted to benefit from OA as concentrations of dissolved CO2 increase, yet this prediction has rarely been tested, and no studies have tested the effect of pH fluctuations on non-CCM seaweeds. We conducted a laboratory experiment in which two ecologically dominant non-CCM red seaweeds (Callophyllis lambertii and Plocamium dilatatum) were exposed to four pH treatments: two static, pHT 8.0 and 7.7 and two fluctuating, pHT 8.0 ± 0.3 and 7.7 ± 0.3. Fluctuating pH reduced growth and net photosynthesis in C. lambertii, while P. dilatatum was unaffected. OA did not benefit P. dilatatum, while C. lambertii displayed elevated net photosynthetic rates. We provide evidence that carbon uptake strategy alone cannot be used as a predictor of seaweed responses to OA and highlight the importance of species-specific sensitivity to [H+]. We also emphasize the importance of including realistic pH fluctuations in experimental studies on coastal organisms.
The Distribution of Consumption Expenditure in Sub-Saharan Africa: The Inequality Among All Africans
Authors: Jirasavetakul La-Bhus Fah , Lakner Christoph
Published: April 2019

This paper uses a set of national household surveys to study the regional Sub-Saharan Africa distribution of consumption expenditure among individuals during 1993–2008. The analysis puts the disparities in living standards that exist among all persons in Africa into context with the disparities that exist within and between African countries. We find some evidence that African interpersonal inequality has increased, but this depends on the measure of inequality. The Africa-wide Gini increased from 53% in 1993 to 56% in 2008 in the full sample, compared with an increase from 54% to 56% in the balanced sample of countries. In the full sample, this result is robust to alternative measures of inequality, while in the balanced sample, some bottom-sensitive measures show a decline. Disparities in living standards between countries have increased, while there has been no systematic increase in within-country inequality. For the Africa-wide distribution, the growth of consumption expenditure (from household surveys) has been low (between 0.9% and 1.6% per year depending on the sample). This growth has been uneven such that the richest 5% of Africans received around 40% of the total gains.
Is research on patient portals attuned to health equity? A scoping review
Authors: Antonio Marcy G , Petrovskaya Olga , Lau Francis
Published: April 2019

Objective

Our scoping review examined how research on patient portals addresses health equity. Questions guiding our review were: 1) What health equity concepts are addressed in patient portal research—both explicitly and implicitly? 2) What are the gaps? 3) Is the potential for ehealth-related health inequities explicitly acknowledged in studies on patient portals? 4) What novel approaches and interventions to reduce health inequities are tested in patient portal research?

Materials and Methods

We searched 4 databases. Search terms included “patient portal” in combination with a comprehensive list of health equity terms relevant in ehealth context. Authors independently reviewed the papers during initial screening and full-text review. We applied the eHealth Equity Framework to develop search terms and analyze the included studies.

Results

Based on eHealth Equity Framework categories, the main findings generated from 65 reviewed papers were governance structures, ehealth policies, and cultural and societal values may further inequities; social position of providers and patients introduces differential preferences in portal use; equitable portal implementation can be supported through diverse user-centered design; and intermediary strategies are typically recommended to encourage portal use across populations.

Discussion

The predominant focus on barriers in portal use may be inadvertently placing individual responsibility in addressing these barriers on patients already experiencing the greatest health disparities. This approach may mask the impact of the socio-technical-economic-political context on outcomes for different populations.

Conclusion

To support equitable health outcomes related to patient portals we need to look beyond intermediary initiatives and develop equitable strategies across policy, practice, research, and implementation.
Age- and gender-dependent D-amino acid oxidase activity in mouse brain and peripheral tissues: implication for aging and neurodegeneration
Authors: Kim Soo Hyeon , Shishido Yuji , Sogabe Hirofumi , Rachadech Wanitcha , Yorita Kazuko , Kato Yusuke , Fukui Kiyoshi
Published: April 2019

D-amino acid oxidase (DAO) is a flavoenzyme, catalysing oxidative deamination of D-amino acids to produce corresponding α-keto acids, ammonia and hydrogen peroxide. In our search for DAO activity among various tissues, we developed a sensitive assay based on hydrogen peroxide production involving enzyme-coupled colorimetric assay with peroxidase. We first optimized buffer components to extract DAO protein from mouse tissues. Here we show that DAO activity was detected in kidney, cerebellum, medulla oblongata, midbrain and spinal cord, but not in liver. In addition, we observed that DAO activity and expression were decreased in thoracic and lumbar regions of spinal cord in aged mice when compared with young mice, indicating that decreased DAO is involved in motoneuron degeneration during senescence. We also found gender difference in DAO activity in the kidney, suggesting that DAO activity is influenced by sexual dimorphism. We newly detected DAO activity in the epididymis, although undetected in testis. Furthermore, DAO activity was significantly higher in the caput region than corpus and cauda regions of epididymis, indicating that D-amino acids present in the testis are eliminated in epididymis. Taken together, age- and gender-dependent DAO activity in each organ may underlie the human pathophysiology regulated by D-amino acid metabolism.
Life Table Parameters of the Zoophytophagous Predator Brontocoris tabidus (Heteroptera: Pentatomidae) on Introduced and Native Plants
Authors: de Medeiros Rômulo Sátiro , Vinha Germano Lopes , Zanuncio José Cola , Wilcken Carlos Frederico , de Menezes Claubert Wagner Guimarães , Soares Marcus Alvarenga , Carvalho Amélia Guimarães
Published: April 2019

Brontocoris tabidus Signoret (Heteroptera: Pentatomidae) is a zoophytophagous predator of lepidopteran defoliators of eucalyptus in Brazil. This predator complements its diet with plants, which is fundamental for its population maintenance. The objective was to evaluate the B. tabidus development, reproduction, and life table parameters in the field on Eucalyptus cloeziana F. Muell. (T1), Psidium guajava Linn (Myrtales: Myrtaceae) (T2), or without plants (T3). The parameters estimated were: net reproductive rate (Ro); generation duration (DG); time for the population to double in size (TD); intrinsic population growth rate (rm), survival rate (lX), specific fertility (mx), life expectancy (ex), and mortality risk (qx). Ro, DG, TD, and rm were higher in the T1 and T2 than in T3. Plant presence favored the lx, mx, and qx. Ex values were 36.1 and 56.9 in the T3 and T1, respectively. The B. tabidus fertility, longevity, and life table parameters improvement on E. cloeziana and P. guajava plants are due to the water and nutrients obtained from them. B. tabidus can be reared with Tenebrio molitor Linnaeus (Coleoptara: Tenebrionidae) pupae on E. cloeziana or P. guajava plants in the field.
Health State of Syrian Children and Their Parents in a German Refugee Camp
Authors: Nehring Ina , Schlag Eva , Qirjako Eni , Büyükyaglioglu Cigdem , Mall Volker , Sattel Heribert , Sack Martin , Henningsen Peter , Aberl Sigrid
Published: April 2019

More than 1 million Syrian refugees have sought asylum in Europe since 2011. Disastrous conditions in their country and an arduous flight increased the risk for the emergence of physical and mental problems, especially in children. We performed a comprehensive medical and psychological examination in 96 Syrian refugee children aged 0–14 years in a German reception camp. Parents were interviewed and answered questions on health, flight and living conditions. In the children, we found most frequently somatic and in particular dental problems, incomplete immunization state and mental disorders. Post-traumatic stress disorder (PTSD) was diagnosed in 30.2 per cent of the children. Fifty-seven per cent of the parents reported somatic complaints; most of them were neurological (e.g. headache) and sleep disorders. Syrian refugee children show a significant rate of PTSD, somatic disorders and incomplete immunization state. The separation from family members during flight and physical complaints of the parents were identified as risk factors for PTSD in the children of our study. Early combined acute and preventive health-care management for children and their parents is indicated.
Fluorescence-Based Measurement of Real-Time Kinetics of Protoporphyrin IX After 5-Aminolevulinic Acid Administration in Human In Situ Malignant Gliomas
Authors: Kaneko Sadahiro , Suero Molina Eric , Ewelt Christian , Warneke Nils , Stummer Walter
Published: April 2019

BACKGROUND

Five-aminolevulinic acid (5-ALA) is well established for fluorescence-guided resections of malignant gliomas by eliciting the accumulation of fluorescent protoporphyrin IX (PpIX) in tumors. Because of the assumed time point of peak fluorescence, 5-ALA is recommended to be administered 3 h before surgery. However, the actual time dependency of tumor fluorescence has not yet been evaluated in humans and may have important implications.

OBJECTIVE

To investigate the time dependency of PpIX by measuring fluorescence intensities in tumors at various time points during surgery.

METHODS

Patients received 5-ALA (20 mg/kg b.w.) 3 to 4 h before surgery. Fluorescence intensities (FI) and estimated tumor PpIX concentrations (CPPIX) were measured in the tumors over time with a hyperspectral camera. CPPIX was assessed using hyperspectral imaging and by evaluating fluorescence phantoms with known CPPIX.

RESULTS

A total of 201 samples from 68 patients were included in this study. On average, maximum values of calculated FI and CPPIX were observed between 7 and 8 h after 5-ALA administration. FI and CPPIX both reliably distinguished central strong and marginal weak fluorescence, and grade III compared to grade IV gliomas. Interestingly, marginal (weak) fluorescence was observed to peak later than strong fluorescence (8-9 vs 7-8 h).

CONCLUSION

In human in Situ brain tumor tissue, we determined fluorescence after 5-ALA administration to be maximal later than previously thought. In consequence, 5-ALA should be administered 4 to 5 h before surgery, with timing adjusted to internal logistical circumstances and factors related to approaching the tumor.
Medical Merchandising and Legal Procedure in Late Sixteenth-Century Spain: The Case of Petroleum as Imported Medicine
Authors: Bergman Ted Lars Lennart
Published: April 2019

This article examines the historical context and particular case of Italian merchant Guido Mondones (also named as ‘Modones’) who sold petroleum as medicine in Spain in the late sixteenth century. The first two-thirds of the article uses printed sources as a way to demonstrate that this merchant was likely not disadvantaged by being a foreigner and itinerant. Nor would he have been considered a suspect for selling oil with healing properties, as it was a fully accepted practice, including among university-trained professionals. All the materials for Mondones’s particular case are archival and contained within a lawsuit from Valladolid that contains a wealth of information about the merchant’s relationship with legal and medical authorities. Through these sources, we learn that he managed to be financially successful by navigating Spain’s particular medical–legal landscape at the time and skillfully defending himself against accusations of tax evasion and selling false medicine.
Children Born to Mothers with Rash During Zika Virus Epidemic in Brazil: First 18 Months of Life
Authors: Vianna Renata Artimos de Oliveira , Lovero Kathryn Lynn , Oliveira Solange Artimos de , Fernandes Alexandre Ribeiro , Santos Teresa Cristina Sarmet dos , Lima Luiz Cláudio Santos de Souza , Carvalho Fabiana Rabe , Quintans Maria Dolores Salgado , Bueno Arnaldo Costa , Torbey Ana Flávia Malheiros , Souza Aurea Lucia Alves Azevedo Grippa de , Farias Armanda de Oliveira Pache de , Camacho Luiz Antonio Bastos , Riley Lee Woodland , Cardoso Claudete Aparecida Araújo
Published: April 2019

Objective

To better understand the clinical spectrum and course of congenital Zika syndrome (CZS) during the first 18 months of life of children whose mothers had rash during pregnancy.

Methods

This longitudinal observational study evaluated the clinical progress from birth until 18 months of life of children of mothers who developed rash during or up to 3 months before gestation. Maternal rash occurred from November 2015 to May 2017. The study subjects were divided into three groups: children whose mothers tested positive by RT-qPCR for Zika virus (ZIKV) (Group 1), children whose mothers tested negative by RT-qPCR for ZIKV (Group 2), and children whose mothers did not undergo any testing for ZIKV (Group 3) but tested negative for other congenital infections.

Results

Between April 2016 and July 2018, we studied 108 children: 43 in Group 1, 26 in Group 2 and 39 in Group 3. The majority of children were admitted into the study within 6 months of life. CZS was diagnosed in 26 children, equally distributed in Groups 1 and 3. Of 18 children with microcephaly, 6 were in Group 1 (1 postnatal) and 12 were in Group 3 (5 postnatal). Maternal rash frequency was 10 times higher during the first trimester than in the other trimesters (OR: 10.35; CI 95%: 3.52–30.41). CZS was diagnosed during the follow-up period in 14 (54%) cases. Developmental delays and motor abnormalities occurred in all children and persisted up to 18 months. Epilepsy occurred in 18 (69%) of the cases.

Conclusions

Infants born of mothers exposed to ZIKV during pregnancy showed progression of developmental, motor and neurologic abnormalities even if they were born asymptomatic. Continued postnatal monitoring of such newborns is necessary to preclude disability-associated complications.
Prevalence and potential risk factors for gastrointestinal parasitic infections in children in urban Bissau, Guinea-Bissau
Authors: von Huth Sebastian , Kofoed Poul-Erik , Holmskov Uffe
Published: April 2019

Background

Gastrointestinal (GI) parasitic infections cause significant morbidity and mortality in tropical and subtropical countries. We aimed to investigate the prevalence of GI parasitic infections in children from Bissau, Guinea-Bissau and to identify the possible risk factors for these infections.

Methods

We performed an observational study on two comparable cohorts of children 2–15 y of age: one study covering health care–seeking children (n=748) and one study covering children from the background population (n=851). A total of 1274 faecal samples from the two cohorts were investigated for parasites by microscopy and the risk factors for infection were identified by logistic regression.

Results

Intestinal parasitic infections were found in 54.8% of health care–seeking children and 55.5% of children from the background population. Helminth infections were more common among health care–seeking children and were mainly due to hookworms. Pathogenic protozoa included Entamoeba histolytica/dispar and Giardia lamblia. The risk factors for infections included increasing age, household crowding and poor sanitation and water supply.

Conclusions

We found a high prevalence of intestinal parasites among both health care–seeking children and children from the background population. Compared with previous studies, we found a decreasing prevalence of intestinal helminths. This study further identifies potential risk factors for infections, including inadequate sanitation and water supply.
Multilocus Genotypes of the Wheat Leaf Rust Fungus Puccinia triticina in Worldwide Regions Indicate Past and Current Long-Distance Migration
Authors: Kolmer J. A. , Ordoñez M. E. , German S. , Morgounov A. , Pretorius Z. , Visser B. , Goyeau H. , Anikster Y. , Acevedo M.
Published: April 2019

Many plant pathogenic fungi have a global distribution across diverse ecological zones and agricultural production systems. Puccinia triticina, the wheat leaf rust fungus, is a major pathogen in many wheat production areas of the world. The objective of this research was to determine the genetic relatedness of P. triticina in different worldwide regions. A total of 831 single-uredinial isolates collected from 11 regions were characterized for multilocus genotype at 23 simple sequence repeat loci and for virulence to 20 lines of wheat with single genes for leaf rust resistance. A total of 424 multilocus genotypes and 497 virulence phenotypes were found. All populations had high heterozygosity and significant correlation between virulence and molecular variation, which indicated clonal reproduction. The populations from North America and South America, Central Asia and Russia, and the Middle East and Europe were closely related for multilocus genotypes and many individual isolates from other continental regions were closely related. Twenty-seven multilocus genotypes were found in more than one continental region, and 13 of these had isolates with identical virulence phenotypes. The wide geographic distribution of identical and highly related multilocus genotypes of P. triticina indicated past and more recent migration events facilitated by the spread of clonally produced urediniospores.
In the Eye of the Storm: Immune‐mediated Toxicities Associated With CAR‐T Cell Therapy
Authors: Garcia Borrega Jorge , Gödel Philipp , Rüger Maria Adele , Onur Özgür A. , Shimabukuro‐Vornhagen Alexander , Kochanek Matthias , Böll Boris
Published: April 2019

The success of chimeric antigen receptor (CAR)‐T cell therapy with impressive response rates in hematologic malignancies but also promising data in solid tumors came along with the cognition of unexpected, potentially life‐threatening immune‐mediated toxicities, namely the cytokine release syndrome (CRS) and neurotoxicity recently referred to as “immune effector cell‐associated neurotoxicity syndrome” (ICANS). These toxicities require urgent diagnostic and therapeutic interventions and targeted modulation of key cytokine pathways represents the mainstay of CRS treatment. However, as the underlying mechanisms of ICANS are not well understood, treatment options remain limited and further investigation is warranted.

Importantly, after the recent market approval of 2 CAR‐T cell constructs, the application of CAR‐T cells will expand to nonacademic centers with limited experience in the management of CAR‐T cell‐associated toxicities.

Here, we review the current evidence of CRS and ICANS pathophysiology, diagnostics, and treatment.
Seroprevalence of Anti-HIV-1, Anti-HIV-2, Hepatitis B Surface Antigen, and Anti-HCV in Eye Donors in a Tertiary Eye Hospital, Chennai, India, in the Past 13 years (2005–2017)
Authors: Kulandhai Lily Therese , Bhagavathi Hema , Krishnan Selvi , Krishnan Kaviyarasan , Balasubramaniyam Mahalakshmi , Madhavan Hajib Naraharirao
Published: April 2019

Purpose:

To understand the seroprevalence of HIV, hepatitis B surface antigen (HBsAg), and hepatitis C virus (HCV) in serum samples collected from eye donors between 2005 and 2017 at Sankara Nethralaya, Chennai, India.

Method:

The reports of 7136 eye donors serologically screened for antibodies to HIV-1 and HIV-2, HBsAg, and antibodies to HCV were retrospectively analyzed.

Result:

Among the 7136 serum samples screened during this study period, the serum samples of 14 donors (0.20%) were reactive to HIV-1 antibodies, 78 donors (1.09%) were positive for detection of HBsAg, and 37 donors (0.52%) were positive for HCV antibodies. Of interest, coinfections of HIV-1 and HBV, and HIV-1 and HCV were detected in 2 and 1 serum sample of the eye donors, respectively.

Conclusions:

This retrospective study indicates that there is a trend of reduction in the seropositivity for HIV, HBV, and HCV among eye donors in Chennai over the last decade.
Localization of Corneal Neovascularization Using Optical Coherence Tomography Angiography
Authors: Chan Szy Yann , Pan Chung Ting , Feng Yun
Published: April 2019

Purpose:

This article explores the application of optical coherence tomography angiography (OCTA) in assessing corneal neovascularization (CoNV) and investigates the features of CoNV in eyes with corneal transplantation.

Methods:

A pilot, case series, observational study was conducted to enroll patients who underwent corneal transplantation including penetrating keratoplasty (PKP) and deep lamellar keratoplasty (DLKP) with or without additional keratolimbal allograft transplantation. All patients were followed with a series of ophthalmologic examinations including slit-lamp photography and were then imaged with the anterior segment OCTA.

Results:

The study included 15 eyes of 14 patients (12 men; mean age of 37.4 ± 13.3 years), of which 9 eyes had undergone PKP and 6 eyes DLKP. OCTA was able to clearly identify the features of CoNV in eyes with significant CoNV and to confirm the presence of CoNV in eyes suspected of having CoNV. Four types of CoNV (superficial, stromal, fringe, and recipient-bed CoNV) were discovered by OCTA based on their location and depth. Superficial CoNV was mainly discovered in eyes that had undergone PKP (88.9% ± 11.1%), whereas the recipient-bed CoNV, once thought to be located in the host–graft interface, was discovered to grow in the host cornea only in eyes that had undergone DLKP (83.3% ± 16.7%). Comparing the assessment by 2 masked observers revealed a kappa value of 0.94, indicating excellent agreement.

Conclusions:

OCTA can be useful to visualize CoNV, which may be valuable in assessing corneal graft rejection.
Effects of Smoking and Physical Activity on the Pulmonary Function of Young University Nursing Students in Cáceres (Spain)
Authors: RICO-MARTÍN Sergio , DE NICOLÁS-JIMÉNEZ Jorge M. , MARTÍNEZ-ÁLVAREZ Mariana , CORDOVILLA-GUARDIA Sergio , SANTANO-MOGENA Esperanza , CALDERÓN-GARCÍA Julián F.
Published: April 2019

Background:

The simultaneous effect of physical activity (PA) and smoking on pulmonary function in young people remains unclear.

Propose:

The aim of this study was to determine the influence of smoking and PA on pulmonary function in young university students in Cáceres, Spain.

Methods:

A sample of 120 young nursing students was studied (60 smokers and 60 nonsmokers). All subjects underwent spirometry with a COPD-6 portable device, and their level of PA was quantified using the International Physical Activity Questionnaire. The influence of PA and smoking on pulmonary function was determined by comparing hypotheses.

Results:

Significant differences were observed between smokers and nonsmokers in terms of percent forced expiratory volume in 1 second, percent forced expiratory volume in 6 seconds, lung age, and the difference between lung age and chronological age (LA–CA) in those who practiced mild PA. In the subjects who performed moderate and vigorous PA, these differences were not noted. In the intragroup analysis, significant differences were observed in smokers in terms of percent forced expiratory volume in 1 second, percent forced expiratory volume in 6 seconds, lung age, and LA–CA; however, in the control group, differences were only observed in terms of lung age and LA–CA. These findings were confirmed in the multivariate analysis.

Conclusions/Implications for Practice:

Our findings confirmed a deterioration in pulmonary function in smokers who did not perform moderate or vigorous PA. The level of PA performed was positively related to pulmonary function in smokers, whereas in nonsmokers, improvements were only significant in LA–CA.
A Unique Case of a Pediatric Patient With Blastic Plasmacytoid Dendritic Cell Neoplasm, Guillain Barre Syndrome, and Hemophagocytic Lymphohistiocytosis
Authors: Penney Chelsea , Johnston Donna L. , Story Eden
Published: April 2019

Blastic plasmacytoid dendritic cell neoplasm is a rare hematopoietic malignancy with a poor prognosis that is seen primarily in the elderly population. We describe a pediatric patient with blastic plasmacytoid dendritic cell neoplasm who subsequently developed Guillain Barre syndrome followed by hemophagocytic lymphohistiocytosis. All 3 conditions are uncommon, particularly in the pediatric population. It is unclear whether this patient developed these disease states independently, whether they were due to a viral trigger or if she has an underlying immune dysfunction that could have contributed to the development of these conditions. The patient is currently in remission and awaiting further immune work-up.
Comparison of FDG PET/MRI and FDG PET/CT in Pediatric Oncology in Terms of Anatomic Correlation of FDG-positive Lesions
Authors: Uslu-Beşli Lebriz , Atay Kapucu Lütfiye Özlem , Karadeniz Ceyda , Akdemir Ümit Özgür , Pinarli Faruk Güçlü , Aydos Uğuray , Okur Arzu , Kaya Zühre , Samanci Cesur , Karabacak Neşe I.
Published: April 2019

The aims of our study were to compare F-18 fluorodeoxyglucose (FDG) positron-emission tomography/magnetic resonance imaging (PET/MRI) and PET/computed tomography (CT) in pediatric oncology patients in terms of anatomic correlation of FDG-positive lesions, and also to compare diffusion-weighted imaging (DWI) with PET to assess the correlation between apparent diffusion coefficient (ADC) values and standardized uptake value (SUV). Sequential PET/CT and PET/MRI images and/or whole-body DWI and ADC mapping in 34 pediatric patients were retrospectively analyzed. FDG-positive lesions were visually scored for CT, T1-weighted, T2-weighted, and DWI images separately in terms of anatomic correlation of FDG-avid lesions. Correlation analysis was performed for SUV parameters and ADC values. Among 47 FDG-positive lesions identified concurrently on PET/CT and PET/MRI, 37 were positive on CT and 46 were positive on at least one MRI sequence (P=0.012). Among 32 FDG-positive lesions for which DWI were available, 31 could be clearly depicted on DWI, resulting in significant difference compared with CT alone in the detection of FDG-positive lesions. No correlation was found between ADC and SUV. FDG PET/MRI exhibits better performance than PET/CT in terms of anatomic correlation of FDG-avid lesions. Therefore, PET/MRI may be more advantageous than PET/CT, not only due to reduced ionizing radiation dose but also for a better depiction of FDG-avid lesions in pediatric PET imaging.
Reliability and Validity of a Chinese-Version Normalization Assessment Measure for Primary Caregivers of Children With Cancer
Authors: Tsai Su-Hui , Chang Nien-Tzu , Cheng Su-Fen , Lee Ya-Ling
Published: April 2019

Background

“Normalization” refers to the process whereby a household with a chronically ill member returns to a normal life to reduce its distress. There has been no valid and reliable instrument to investigate such normalization in Taiwan.

Objective

The aims of this study were to develop and validate a Chinese version of the Normalization Assessment Measure for Caregivers of Children With Cancer (NAM-CCC).

Methods

Translation and revision of the Normalization Assessment Measure into Chinese. Psychometric testing was conducted on 241 caregivers of children with cancer who were treated at a medical center in northern Taiwan.

Results

The Cronbach’s α of the NAM-CCC (Chinese version) was .93. The construct validity was analyzed by exploratory factor analysis, and 1 factor was extracted. The known group validity indicated that the rate of normalization is higher in the follow-up stage than in the treatment stage (P < .00). The criterion-related validity of the Taiwan version of the World Health Organization Quality of Life assessment is 0.475 (P < .01). The content validity is 0.88 to 0.99.

Conclusion

The results indicate that the NAM-CCC possesses good reliability and validity when administered to caregivers of children with cancer in Taiwan.

Implications for Practice

The instrument can be used to measure normalization in the caregivers of children with cancer. In addition, it will help us understand what support these individuals require to construct normal lives.
End-of-Life Travel
Authors: Aisporna Cheryl , Erickson-Hurt Carma
Published: April 2019

Patients at end of life often express a desire to travel, and many have requests that go unfulfilled. Studies show that a majority of patients have a desire to return to their place of birth to die when presented with the option, yet goals-of-care conversations do not routinely include travel desires for numerous reasons. Patients faced with a life-limiting illness are at greater risk of depression, withdrawal, denial, anger, and feelings of helplessness. When palliative care teams assist patients with end-of-life travel, they empower them with a greater sense of control over the dying process. Improving goals-of-care conversations regarding medical travel begins with well-developed communication skills and a knowledge of available options. This article primarily focuses on the recommendation of medical travel as a goals-of-care comfort measure for the palliative care patient.
Perioperative Pain Management for the Chronic Pain Patient With Long-Term Opioid Use
Authors: Jackman Carina
Published: April 2019

In the United States nearly one in four patients presenting for surgery reports current opioid use. Many of these patients suffer from chronic pain disorders and opioid tolerance or dependence. Opioid tolerance and preexisting chronic pain disorders present unique challenges in regard to postoperative pain management. These patients benefit from providers who are not only familiar with multimodal pain management and skilled in the assessment of acute pain, but also empathetic to their specific struggles. Chronic pain patients often face stigmas surrounding their opioid use, and this may lead to underestimation and undertreatment of their pain. This article aims to review the challenges presented by these complex patients and provide strategies for treating acute postoperative pain in opioid-tolerant patients.
Croup Admissions
Authors: Maalouli Walid M. , Hodges James S.
Published: April 2019

Objective

This pilot study aims to identify potential predictors of postadmission interventions of hospitalized croup patients and derive a risk model aimed at reducing hospitalizations for croup.

Methods

Data were collected on all croup hospitalizations for patients aged 1 month to 17 years admitted through a community hospital's emergency department (ED) between 2012 and 2017. Potential predictors were obtained from the electronic medical records including demographics, vital signs, ED length of stay, preintervention and postintervention Westley Croup Score (WCS), number of racemic epinephrine nebulizations administered, time to dexamethasone administration, preexisting conditions, and additional interventions during hospitalization. Statistical analysis used the outcome “patient received racemic epinephrine after hospital admission (yes/no)” to identify characteristics of the child or ED visit associated with that outcome. Preliminary analyses using stepwise logistic regression, tree models, and random forests suggested predictors, interactions among predictors, and the form of their association with the outcome. A final analysis used logistic regression.

Results

A total of 116 croup admissions were included, of which 19 (16%) received racemic epinephrine posthospitalization. These characteristics were identified as having some predictive power: sex, preexisting conditions, and preintervention and postintervention WCS, along with the interaction between sex and postintervention WCS. Logistic regression estimated an equation describing the probability of postadmission intervention, permitting the choice among admission thresholds giving different sensitivities and specificities.

Conclusions

There appear to be promising predictors in croup patients presenting to the ED, which might help stratify risk for interventions after the ED encounter and thus reduce the number of potentially avoidable admissions.
Correlation Between Neurologic Impairment Grade and Ambulation Status in the Adult Spina Bifida Population
Authors: Tita Anne C. , Frampton John R. , Roehmer Christian , Izzo Sara E. , Houtrow Amy J. , Dicianno Brad E.
Published: April 2019

Objective

The aim of the study was to identify which neurologic impairment scales correlate with ambulation status in adults with spina bifida.

Design

A retrospective chart review was performed on patients seen at the University of Pittsburgh Medical Center Adult Spina Bifida Clinic. Findings were graded using several neurologic impairment scales: two versions of the National Spina Bifida Patient Registry classification, the International Standards for Neurological Classification of Spinal Cord Injury motor level, and the Broughton Neurologic Impairment Scale. Ambulation ability was ranked using the Hoffer classification system.

Results

Data collected from 409 patient records showed significant correlations between Hoffer ambulation status and all neurologic impairment scales evaluated. The strongest correlation was noted with the Broughton classification (rs= −0.771,P< 0.001). High correlations were also noted with both versions of the National Spina Bifida Patient Registry: strength 3/5 or greater (rs= −0.763,P< 0.001), and strength 1/5 or greater (rs= −0.716,P< 0.001). For the International Standards for Neurological Classification of Spinal Cord Injury motor level, only a moderate correlation was observed (rs= −0.565,P< 0.001).

Conclusions

Multiple grading scales can be used to measure motor function in adult spina bifida patients. Although the Broughton classification seems to be the most highly correlated with ambulation status, the less complex National Spina Bifida Patient Registry scale is also highly correlated and may be easier to administer in busy clinic settings.

To Claim CME Credits

Complete the self-assessment activity and evaluation online at http://www.physiatry.org/JournalCME

CME Objectives

Upon completion of this article, the reader should be able to: (1) Explain the clinical significance of identifying ambulation status and maximizing ambulation potential in adults with spina bifida; (2) Describe each of the neurologic grading scales examined in this study, identifying potential shortcomings in applying them to the adult spina bifida population; and (3) Administer the National Spina Bifida Patient Registry (NSBPR) impairment scale motor assessment in a standard adult spina bifida outpatient clinic visit.

Level

Advanced

Accreditation

The Association of Academic Physiatrists is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.

The Association of Academic Physiatrists designates this Journal-based CME activity for a maximum of1.0 AMA PRA Category 1 Credit(s)™. Physicians should only claim credit commensurate with the extent of their participation in the activity.
Brain Functional Connectivity in Patients With Somatic Symptom Disorder
Authors: Kim Sun Mi , Hong Ji Sun , Min Kyoung Joon , Han Doug Hyun
Published: April 2019

Objective

The aim of the study was to evaluate whether individuals with somatic symptom disorder (SSD) display increased resting-state functional connectivity (FC) within and between the sensorimotor network (SMN), default mode network (DMN), salience network, and dorsal attention network (DAN).

Methods

Eighteen patients with SSD and 20 age- and sex-matched healthy control participants underwent resting-state functional magnetic resonance imaging. We used a seed-based correlation approach for the four brain networks.

Results

Patients with SSD had higher scores on the Somato-Sensory Amplification Scale (z = 5.22, p < .001) and Symptom Checklist-90-Revised-Somatization (z = 4.94, p < .001) and greater FC within the SMN, DMN, and salience network than healthy control participants. Patients with SSD also had increased FC between the SMN and DMN, SMN and salience network, SMN and DAN, and salience network and DAN (t = 5.10–7.47, all false discovery rate q < .05). The Somato-Sensory Amplification Scale scores correlated with FC between the SMN and salience network and between the SMN and DAN (r = .61–.82, all p < .003).

Conclusions

Based on the results of the FC analysis between the SMN and salience network, we suggest that SSD may be associated with alterations of sensory-discriminative processing of pain and other somatic symptoms, which is influenced by affective processing. Based on the results of the FC analysis of the SMN and DAN, we suggest that patients with SSD have a deficit in attention, leading to misperception of external stimuli and failure to regulate bodily functions aimed at interactions with external stimuli.
Differences in player position running velocity at lactate thresholds among male professional German soccer players
Authors: Schwesig René , Schulze Stephan , Reinhardt Lars , Laudner Kevin G. , Delank Karl-Stefan , Hermassi Souhail
Published: April 2019

This study investigated the differences in running velocities at specific lactate thresholds among male German soccer players. One hundred fifty-two professional (3rd league: n=82; 4th league: n=70) male soccer players (mean ± SD; age: 24.7 ± 4.38 years, body mass: 80.7 ± 7.36 kg, body height: 1.83 ± 0.06 m) volunteered for the investigation. Players were categorized as goalkeepers, central defenders, central midfielders, wings and forwards. Players completed a treadmill test, at incremental speeds, to determine running velocity at different blood lactate concentrations (v2=2 mmol/l; v4=4 mmol/l; v6=6 mmol/l). Results indicate that, wings displayed the lowest body mass (76.2 ± 6.08 kg) and body height (1.79 ± 0.06 m). In contrast, goalkeepers were the tallest athletes in the whole sample (1.90 ± 0.03 m), forwards were the heaviest players (85.4 ± 6.03 kg). In addition, we detected the largest difference between positions for running velocity at the lactate threshold v2 (p=0.002). The running data revealed that only the goalkeepers had significantly lower velocities at the lactate thresholds compared to the field players. The central midfielders showed the highest performance level at the lactate thresholds (v2: 12.5 ± 1.20 km/h; v4: 15.2 ± 1.14 km/h; v6: 16.6 ± 1.13 km/h). In conclusion, this study provides soccer and position-specific reference data for the performance of male professional German soccer players in order to evaluate the running performance in a valid way. In this context, it is necessary to extend the database for the second and first league. Furthermore, it is important to assess the running performance during competition matches over the entire season in order to validate the endurance test performance data.
Electrical Energy Storage with Engineered Biological Systems
Authors: Salimijazi Farshid , Parra Erika , Barstow Buz
Published: April 2019

The availability of renewable energy technologies is increasing dramatically across the globe thanks to their growing maturity. However, large scale electrical energy storage and retrieval will almost certainly be a required in order to raise the penetration of renewable sources into the grid. No present energy storage technology has the perfect combination of high power and energy density, low financial and environmental cost, lack of site restrictions, long cycle and calendar lifespan, easy materials availability, and fast response time. Engineered electroactive microbes could address many of the limitations of current energy storage technologies by enabling rewired carbon fixation, a process that spatially separates reactions that are normally carried out together in a photosynthetic cell and replaces the least efficient with non-biological equivalents. If successful, this could allow storage of renewable electricity through electrochemical or enzymatic fixation of carbon dioxide and subsequent storage as carbon-based energy storage molecules including hydrocarbon and non-volatile polymers at high efficiency. In this article we compile performance data on biological and non-biological component choices for rewired carbon fixation systems and identify pressing research and engineering challenges.
Neural Correlates of Attitudes and Risk Perception for Food Technology Topics
Authors: Davis Tyler , LaCour Mark , Beyer Erin , Finck Jessica L. , Miller Markus F.
Published: April 2019

Food technologies provide numerous benefits to society and are extensively vetted for safety. However, many technological innovations still face high levels of skepticism from consumers. To promote development and use of food technologies, it is critical to understand the psychological and neurobiological processes associated with consumer acceptability concerns. The current study uses a neuroscience-based approach to understand consumer attitudes and perceptions of risk associated with food technologies and investigate how such attitudes impact consumer’s processing of information related to food technologies. We used functional magnetic resonance imaging (fMRI) to measure brain activation while participants processed infographics related to food technology topics. For technology topics perceived as riskier (antibiotics and hormones), activation was higher in areas of the lateral prefrontal cortex that are associated with decisional uncertainty. In contrast, technology topics that were viewed more favorably (sustainability and animal welfare) tended to activate the ventromedial prefrontal cortex, a region that processes positive affect and subjective value. Moreover, for information about hormones, the lateral PFC activation was associated with individual differences in resistance to change in risk perception. These results reveal how attitudes and risk perception relate to how the brain processes information about food technologies and how people respond to information about such technologies.
Neural dynamics of the attentional blink revealed by encoding orientation selectivity during rapid visual presentation
Authors: Tang Matthew F. , Ford Lucy , Arabzadeh Ehsan , Enns James T. , Visser Troy A.W. , Mattingley Jason B.
Published: April 2019

The human brain is inherently limited in the information it can make consciously accessible. When people monitor a rapid stream of visual items for two targets, they can typically report the first, but not the second target, if these appear within 200-500 ms of each other, a phenomenon known as the attentional blink (AB). No work has determined the neural basis for the AB, partly because conventional neuroimaging approaches lack the temporal resolution to adequately characterise the neural activity elicited by each item in a rapid stream. Here we introduce a new approach that can identify the precise effect of the AB on behaviour and neural activity. Specifically, we employed a multivariate encoding approach to extract feature-selective information carried by randomly-oriented gratings within a rapid serial stream. We show that feature selectivity is enhanced for correctly reported targets and suppressed when the same items are missed. By contrast, no such effects were apparent for irrelevant distractor items. Our findings point to a new theoretical account that involves both short- and long-range temporal interactions between visual items competing for consciousness.