bluuebunny/crossref_metadata_2025 huggingface dataset:
Norms and Social Constructivism in International Relations
Authors: Hoffmann Matthew J.
Published: May 2018

Social norms were conceptualized as aspects of social structure that emerged from the actions and beliefs of actors in specific communities; norms shaped those actions and beliefs by constituting actors’ identities and interests. Early constructivist work in the 1980s and early 1990s sought to establish a countervailing approach to the material and rational theories that dominated the study of international relations. Empirically oriented constructivists worked to show that shared ideas about appropriate state behavior had a significant impact on the nature and functioning of world politics. Initial constructivist studies of social norms can be divided into three areas: normative, socialization, and normative emergence. After making the case that norms matter and developing a number of theoretical frameworks to show how norms emerge, spread, and influence behavior, norms-oriented constructivists have shifted their attention to a new set of questions, and in particular compliance with the strictures of social norms and change in norms themselves. Ideas about whether actors reason about norms or through norms can be linked to behavioral logics, which provide conceptions of how actors and norms are linked. Two types of normative dynamics can be identified: the first is endogenous contestation; the second is compliance or diffusion. In order to better understand compliance with and contestation over norms either in isolation or together, it is necessary to pay more attention to the prior understanding of who is in the community. Another topic that requires further consideration in future research is the relationship between intersubjective and subjective reality.
Solar-Wind Origin
Authors: Cranmer Steven R.
Published: May 2018

The Sun continuously expels a fraction of its own mass in the form of a steadily accelerating outflow of ionized gas called the “solar wind.” The solar wind is the extension of the Sun’s hot (million-degree Kelvin) outer atmosphere that is visible during solar eclipses as the bright and wispy corona. In 1958, Eugene Parker theorized that a hot corona could not exist for very long without beginning to accelerate some of its gas into interplanetary space. After more than half a century, Parker’s idea of a gas-pressure-driven solar wind still is largely accepted, although many questions remain unanswered. Specifically, the physical processes that heat the corona have not yet been identified conclusively, and the importance of additional wind-acceleration mechanisms continue to be investigated. Variability in the solar wind also gives rise to a number of practical “space weather” effects on human life and technology, and there is still a need for more accurate forecasting. Fortunately, recent improvements in both observations (with telescopes and via direct sampling by space probes) and theory (with the help of ever more sophisticated computers) are leading to new generations of predictive and self-consistent simulations. Attempts to model the origin of the solar wind are also leading to new insights into long-standing mysteries about turbulent flows, magnetic reconnection, and kinetic wave-particle resonances.
Daily Life in the Jim Crow South, 1900–1945
Authors: Ritterhouse Jennifer
Published: May 2018

Distinctive patterns of daily life defined the Jim Crow South. Contrary to many observers’ emphasis on de jure segregation—meaning racial separation demanded by law—neither law nor the physical separation of blacks and whites was at the center of the early 20th-century South’s social system. Instead, separation, whether by law or custom, was one of multiple tools whites used to subordinate and exclude blacks and to maintain notions of white racial purity. In turn, these notions themselves varied over time and across jurisdictions, at least in their details, as elites tried repeatedly to establish who was “white,” who was “black,” and how the legal fictions they created would apply to Native Americans and others who fit neither category.

Within this complex multiracial world of the South, whites’ fundamental commitment to keeping blacks “in their place” manifested most routinely in day-to-day social dramas, often described in terms of racial “etiquette.” The black “place” in question was socially but not always physically distant from whites, and the increasing number of separate, racially marked spaces and actual Jim Crow laws was a development over time that became most pronounced in urban areas. It was a development that reveals blacks’ determination to resist racial oppression and whites’ perceived need to shore up a supposedly natural order that had, in fact, always been enforced by violence as well as political and economic power. Black resistance took many forms, from individual, covert acts of defiance to organized political movements. Whether in response to African Americans’ continued efforts to vote or their early 20th-century boycotts of segregated streetcars or World War I-era patterns of migration that threatened to deplete the agricultural labor force, whites found ways to counter blacks’ demands for equal citizenship and economic opportunity whenever and wherever they appeared.

In the rural South, where the majority of black Southerners remained economically dependent on white landowners, a “culture of personalism” characterized daily life within a paternalistic model of white supremacy that was markedly different from urban—and largely national, not merely southern—racial patterns. Thus, distinctions between rural and urban areas and issues of age and gender are critical to understanding the Jim Crow South. Although schools were rigorously segregated, preadolescent children could be allowed greater interracial intimacy in less official settings. Puberty became a break point after which close contact, especially between black males and white females, was prohibited. All told, Jim Crow was an inconsistent and uneven system of racial distinction and separation whose great reach shaped the South’s landscape and the lives of all Southerners, including those who were neither black nor white.
US–Mexico Borderlands and Religion
Authors: Martínez Anne M.
Published: May 2018

The border between the United States and Mexico has artificially divided languages, cultures, landscapes, and religions for more than a century and a half. This region is the crossroads not only of Anglo-America and Latin America, but also of multiple empires; the Aztec, Spanish, and US empires each staked a claim on this region, leaving political, economic, cultural, and religious markers on the landscape and its peoples. These imperial bodies brought their preferred religious practices and religiously inspired social, economic, and political cultures, which reshaped populations and landscapes from the 15th century to the present. Religion has been a significant dimension of this region from prior to the arrival of the Spanish through the early 21st century.
Baptist Worship in Britain
Authors: Ellis Christopher J.
Published: May 2018

Baptists stand within the Free Church and Evangelical traditions. They baptize only those who profess personal faith, and they also give a high priority to evangelism. Although there is some variety around the world in this the fifth-largest Christian denomination, the main features of Baptist worship developed in Britain, where the Baptist story began. Emerging from the Radical Reformation at the beginning of the 17th century, British Baptists formed two main groups, each holding Calvinistic or Arminian theology, respectively. Both emphasized an ecclesiology in which the church was perceived to be a fellowship of believers and each rejected the baptism of infants. By the 19th century, most British Baptists held a common, though varied, evangelical theology, and this continues to characterize this denomination. The importance of scriptural preaching, extempore prayer, and the emergence of congregational hymn singing are all continuing features of Baptist worship.

The core aspects of Baptist spirituality can be seen in their worship, including giving due attention to scripture and its relevant application for the life and witness of the church; the importance of the devotional life and an openness to the Holy Spirit, as seen in extempore prayer; emphasis on the church as a fellowship of believers, as expressed in the communal nature of the Eucharist celebrated as the Lord’s Supper; and the importance of personal faith and the mission of the church, embodied in the baptism of believers and evangelistic preaching.
Secularism, Pluralism, and Publics in America
Authors: McCrary Charles
Published: May 2018

In the United States, religious, political, and social life has been structured by a public/private binary. Oftentimes, religion is understood as private and politics as public. This framework informs a religious/secular binary and carries important implications for the structure of American life. Particularly affected arenas include church-state relations; religious discourse in public life, including prophetic protest and religious nationalism; sexual regulation and the politics of morality; and norms of civic and civil discourse.

Real politics and consequences attend the definition of terms like “religious,” “secular,” and “pluralist.” Many observers have called the United States a secular, pluralist nation and, simultaneously, the most “religious” nation in the “developed world.” The perceived incongruities or affinities among these labels betray fundamental assumptions about religion and its place in public life. When public figures invoke the language and imagery of “civil religion,” for example, they may be understood to sacralize the public sphere or bring religion into the public or treat the nation’s “shared” symbols with a religious reverence. Although pluralism, as both a demographical description and a progressive goal, has been broadly championed amid growing religious diversity, certain groups, ideas, and practices have nevertheless remained excluded from the realms of public secularism and private (proper) religiosity. The politics are messy and often subtle, but the consequences can be stark. In these ways and more, American life has been shaped by the entwined concepts of secularism, pluralism, and publics.
Liberalism in the Spanish Atlantic
Authors: Breña Roberto
Published: May 2018

The role that liberals and liberalism played from the beginning of the crisis hispánica of 1808 until the death of Simón Bolívar in 1830 can be separated for analytical purposes in two different strands: the Peninsular and the Spanish American. This is a distinction that should be adopted with care, because in the end it can be considered that we are dealing with a single liberalism, the liberalismo hispánico. However, different historical, political, and social realities on each side of the Atlantic gave this liberalism different connotations. At first, Peninsulars and Spanish Americans worked in the same direction and with the same objective (the rejection of the French king that Napoleon imposed in the throne of Spain), but soon they parted ways in a practical, though not necessarily in a theoretical sense, at least concerning liberalism. In any case, contrary to what Western historiography has repeated for a long time, liberalism was a major player in the mundo hispánico during the Age of Revolutions. In fact, the term “liberal” used to define a political group made its first appearance in the Cortes (parliament or congress) that gathered in the Spanish port of Cádiz from 1810 to 1814. Nevertheless, the revolutionary contents of liberalism had to confront sociopolitical histories and realities that forced it to adapt itself to the prevailing social circumstances and to make concessions to other currents of thought and practices that do not coincide with the “liberal model” that still has ascendancy in Western historiography. This model tends to ignore the historical liberalisms that have existed in Europe, America, and other parts of the world since the “liberals” made their appearance in Spain more than two hundred years ago and in the Hispanic case in particular fails to address its radical character when considered against the Spanish Ancien régime. The result in the case of the mundo hispánico was an original and revolutionary doctrine that during the second and third decades of the 19th century transformed Hispanic politics on both sides of the Atlantic. The fact that these transformations were not consolidated or in the Peninsular case did not last for long does not diminish their importance for political and intellectual history.
Mexican Telenovelas
Authors: Benavides O. Hugo
Published: May 2018

Telenovelas have a very recent history, yet from their impact and pervasiveness it would seem that they have always been part of the Mexican culture. Telenovelas did not make their appearance until the late 1950s, when televisions entered the Latin American market. This market explosion, however, was prefigured in radio-novelas (radio soap operas) and folletines (pamphletlike novels) from several decades before. Thus, telenovelas inherited the structure of the melodrama from both visual and aural media and fused them into one incredibly powerful medium of popular cultural representation. Since their development, telenovelas have had an important impact on people’s daily life, as they dramatically portray such controversial issues as illegitimate children, misplaced identity, the burden of social conventions, amorous rejection, and the ever-productive notion of forbidden desires, sexual and otherwise. Telenovelas and, more recently, narco-novelas, have been, and are, excellent vehicles for differing cultural and political embodiments, both in terms of hegemonizing constructs and resistance-filled agency within the country’s historical development. Moreover, telenovelas express the ongoing reconfiguration of social identities, hegemonic constraints, and popular culture in Latin America today.
#YoSoy132, Social Media, and Political Organization
Authors: Contreras Alcántara Javier
Published: May 2018

During the 2012 presidential election in Mexico, a movement arose that broke with the existing framework of political mobilizations. What began as a protest to call into question the past of one of the candidates became, with the assertion of their status as university students, a student and social movement that urged a discussion on the nature of Mexico’s democracy. The movement, called #YoSoy132 (#IAm132), became active on YouTube, Facebook, and Twitter, uniting young citizens from a generation that was beginning to distance itself from politics. Finally, following a series of debates on the path the country should take and the presidential election, the movement did not strengthen, but instead left behind a generation of young politicized citizens who now adopted new forms of socialization and organization for political action, which applied to further mobilizations. Since then, Mexico witnessed the emergence of new political players which have lifted the unease felt by the current political class.
Market Failures, the Environment, and Human Health
Authors: Morrissey Karyn
Published: May 2018

Knowledge of the important role that the environment plays in determining human health predates the modern public health era. However, the tendency to see health, disease, and their determinants as attributes of individuals rather than characteristics of communities meant that the role of the environment in human health was seldom accorded sufficient importance during much of the 20th century. Instead, research began to focus on specific risk factors that correlated with diseases of greatest concern, i.e., the non-communicable diseases such as cardiovascular disease, asthma, and diabetes. Many of these risk factors (e.g., smoking, alcohol consumption, and diet) were aspects of individual lifestyle and behaviors, freely chosen by the individual. Within this individual-centric framework of human health, the standard economic model for human health became primarily the Grossman model of health and health care demand.

In this model, an individual’s health stock may be increased by investing in health (by consuming health services, for example) or decreased by endogenous (age) or exogenous (smoking) individual factors. Within this model, individuals used their available resources, their budget, to purchase goods and services that either increased or decreased their health stock. Grossman’s model provides a consumption-based approach to human health, where individuals purchase goods and services required to improve their individual health in the marketplace. Grossman’s model of health assumes that the goods and services required to optimize good health can be purchased through market-based interactions and that these goods and services are optimally priced—that the value of the goods and services are reflected in their price.

In reality, many types of goods and services that are good for human health are not available to purchase, or if they are available they are undervalued in the free market. Across the environmental and health literature, these goods and services are, today, broadly referred to as “ecosystem services for human health.” However, the quasi-public good nature of ecosystem services for human health means that the private market will generate a suboptimal environment for both individual and public health outcomes. In the face of continued austerity and scarce public resources, understanding the role of the environment in human health may help to alleviate future health care demand by decreasing (or increasing) environmental risk (or benefits) associated with health outcomes. However, to take advantage of the role that the environment plays in human health requires a fundamental reorientation of public health policy and spending to include environmental considerations.
Youth Empowerment
Authors: Richards-Schuster Katie , Pritzker Suzanne , Rodriguez-Newhall Amanda
Published: May 2018

Youth empowerment examines young people’s agency, action, and engagement in change efforts to improve their situations. Its scholarship builds on empowerment constructs and frameworks to focus on the strengths that young people possess as they interact with other individuals and systems in their lives. In particular, youth empowerment rests on a core belief that young people are experts on their lives, with unique perspectives to bring to their communities. Empowerment functions on three core levels, focusing on strengthening individuals’ personal, interpersonal, and political power. This article explores key concepts that underlie personal, interpersonal, and political empowerment, while most deeply examining the core principles, practices, and strategies specific to young people’s political empowerment. Challenges commonly faced when seeking to empower young people are identified as well.
Kendall, Katherine A.
Authors: Healy Lynne M.
Published: May 2018

Katherine A. Kendall (1910–2010) served as Executive Director of the Council on Social Work Education and Secretary General of the International Association of Schools of Social Work (IASSW). She was a major contributor to the development of social work education globally and to internationalizing social work curriculum in the United States.
SciApps: a cloud-based platform for reproducible bioinformatics workflows
Authors: Wang Liya , Lu Zhenyuan , Van Buren Peter , Ware Doreen
Published: May 2018

Motivation

The rapid accumulation of both sequence and phenotype data generated by high-throughput methods has increased the need to store and analyze data on distributed storage and computing systems. Efficient data management across these heterogeneous systems requires a workflow management system to simplify the task of analysis through automation and make large-scale bioinformatics analyses accessible and reproducible.

Results

We developed SciApps, a web-based platform for reproducible bioinformatics workflows. The platform is designed to automate the execution of modular Agave apps and support execution of workflows on local clusters or in a cloud. Two workflows, one for association and one for annotation, are provided as exemplar scientific use cases.

Availability and implementation

https://www.sciapps.org

Supplementary information

Supplementary data are available at Bioinformatics online.
Sex differences in factors associated with metabolic syndrome among Korean adults without diabetes mellitus: results from the Korea National Health and Nutrition Examination Survey from 2010 to 2013
Authors: Lee Kyoungjin , Lee Hyangkyu , Park Jeongok , Jee Sun Ha
Published: May 2018

Objectives

The purpose of this study was to examine sex differences in factors associated with metabolic syndrome in Korean adults without diabetes mellitus.

Study design

Cross-sectional design.

Methods

The dataset of Korea National Health and Nutrition Examination Survey from 2010 to 2013 was used. Among a total of 33552 adults aged ≥30, subjects who (i) were diagnosed or had been treated for diabetes mellitus, (ii) had a fasting blood glucose level of 126 mg/dL or higher or (iii) had a glycosylated haemoglobin level of 6.5% or higher were excluded. Subjects who had anaemia or were pregnant were also excluded. Finally, 9406 subjects were included in this study. Sex differences in subjects’ characteristics were assessed with Student’s t-test and chi-square test. Logistic regressions were used to examine factors associated with metabolic syndrome by sex.

Results

The prevalence of metabolic syndrome in Korean adults overall without diabetes mellitus was 12.2%. Glycosylated haemoglobin from 5.7 to 6.5 and increased body mass index were independently associated with metabolic syndrome in both men and women. Current smoking, age and age square were significantly associated with metabolic syndrome in men, whereas age and illiteracy were significantly associated with it in women.

Conclusions

This study confirmed that glycosylated haemoglobin and body mass index can be important indicators of metabolic syndrome in Korean adults without diabetes mellitus.
Improving Inferences About Null Effects With Bayes Factors and Equivalence Tests
Authors: Lakens Daniël , McLatchie Neil , Isager Peder M , Scheel Anne M , Dienes Zoltan
Published: May 2018

Researchers often conclude an effect is absent when a null-hypothesis significance test yields a nonsignificant p value. However, it is neither logically nor statistically correct to conclude an effect is absent when a hypothesis test is not significant. We present two methods to evaluate the presence or absence of effects: Equivalence testing (based on frequentist statistics) and Bayes factors (based on Bayesian statistics). In four examples from the gerontology literature, we illustrate different ways to specify alternative models that can be used to reject the presence of a meaningful or predicted effect in hypothesis tests. We provide detailed explanations of how to calculate, report, and interpret Bayes factors and equivalence tests. We also discuss how to design informative studies that can provide support for a null model or for the absence of a meaningful effect. The conceptual differences between Bayes factors and equivalence tests are discussed, and we also note when and why they might lead to similar or different inferences in practice. It is important that researchers are able to falsify predictions or can quantify the support for predicted null effects. Bayes factors and equivalence tests provide useful statistical tools to improve inferences about null effects.
On the Maximal Directional Hilbert Transform in Three Dimensions
Authors: Di Plinio Francesco , Parissis Ioannis
Published: May 2018

We establish the sharp growth rate, in terms of cardinality, of the $L^p$ norms of the maximal Hilbert transform $H_\Omega $ along finite subsets of a finite order lacunary set of directions $\Omega \subset \mathbb{R}^3$, answering a question of Parcet and Rogers in dimension $n=3$. Our result is the first sharp estimate for maximal directional singular integrals in dimensions greater than 2. The proof relies on a representation of the maximal directional Hilbert transform in terms of a model maximal operator associated to compositions of 2D angular multipliers, as well as on the usage of weighted norm inequalities, and their extrapolation, in the directional setting.
Theorizing Collective Trauma in International Political Economy
Authors: Lerner Adam B
Published: May 2018

While existing literature on collective trauma in international relations represents a vital (albeit inchoate) contribution to the field, to date, it has largely analyzed collective trauma’s impact as primarily psychological and sociocultural. This essay argues that a complete vision of collective trauma in IR must incorporate not only these more intangible dimensions but also how its legacy is reified materially over time in economic conditions—distinguishing the trauma of those with the resources to “work through” and those without. I begin this essay with a novel conception of collective trauma that draws upon existing traditions’ insights but also facilitates mediation between collective trauma’s material and sociocultural dimensions. Employing this definition, I then outline three analytical frameworks via which future scholarship can address collective trauma in international economic relations. First, scholarship can incorporate a notion of the trauma of poverty. Second, scholars can analyze the loss of economic opportunity that trauma entails as akin to Dominick LaCapra’s concept of structural trauma of absence. Finally, scholarship can examine collective trauma’s ability to break down trust in institutions and the impact this breakdown has on international economic relations.
IDH mutation status is associated with distinct vascular gene expression signatures in lower-grade gliomas
Authors: Zhang Lei , He Liqun , Lugano Roberta , Roodakker Kenney , Bergqvist Michael , Smits Anja , Dimberg Anna
Published: May 2018

Background

Vascular gene expression patterns in lower-grade gliomas (LGGs; diffuse World Health Organization [WHO] grades II–III gliomas) have not been thoroughly investigated. The aim of this study was to molecularly characterize LGG vessels and determine if tumor isocitrate dehydrogenase (IDH) mutation status affects vascular phenotype.

Methods

Gene expression was analyzed using an in-house dataset derived from microdissected vessels and total tumor samples from human glioma in combination with expression data from 289 LGG samples available in the database of The Cancer Genome Atlas. Vascular protein expression was examined by immunohistochemistry in human brain tumor tissue microarrays (TMAs) representing WHO grades II–IV gliomas and nonmalignant brain samples. Regulation of gene expression was examined in primary endothelial cells in vitro.

Results

Gene expression analysis of WHO grade II glioma indicated an intermediate stage of vascular abnormality, less severe than that of glioblastoma vessels but distinct from normal vessels. Enhanced expression of laminin subunit alpha 4 (LAMA4) and angiopoietin 2 (ANGPT2) in WHO grade II glioma was confirmed by staining of human TMAs. IDH wild-type LGGs displayed a specific angiogenic gene expression signature, including upregulation of ANGPT2 and serpin family H (SERPINH1), connected to enhanced endothelial cell migration and matrix remodeling. Transcription factor analysis indicated increased transforming growth factor beta (TGFβ) and hypoxia signaling in IDH wild-type LGGs. A subset of genes specifically induced in IDH wild-type LGG vessels was upregulated by stimulation of endothelial cells with TGFβ2, vascular endothelial growth factor, or cobalt chloride in vitro.

Conclusion

IDH wild-type LGG vessels are molecularly distinct from the vasculature of IDH-mutated LGGs. TGFβ and hypoxia-related signaling pathways may be potential targets for anti-angiogenic therapy of IDH wild-type LGG.
Antagonistic Activity and the Mechanism of Bacillus amyloliquefaciens DH-4 Against Citrus Green Mold
Authors: Chen Kai , Tian Zhonghuan , Luo Yuan , Cheng Yunjiang , Long Chao-an
Published: May 2018

Citrus fruit usually suffer significant losses during the storage and transportation stages. Green mold, a postharvest rot of citrus fruit caused by Penicillium digitatum, is one of the most serious fungal diseases. In this study, the antagonist strain DH-4 was identified as Bacillus amyloliquefaciens according to morphological observation and 16S ribosomal DNA analysis. In addition, it showed broad antifungal activity, especially the suppression of Penicillium spp. The culture filtrate of strain DH-4 exhibited apparent activity against P. digitatum in vitro and in vivo. In storage, the culture filtrate with DH-4 in it showed a better antiseptic effect. The antifungal substances in the culture filtrate, produced by strain DH-4, displayed stable activity in various extreme conditions. In addition, the antifungal substances in the culture filtrate were identified as macrolactin, bacillaene, iturins, fengycin, and surfactin by ultraperformance liquid chromatography (UPLC) electrospray ionization mass spectrometry analysis. The UPLC fractions containing these antifungal compounds were basically heat tolerant and all responsible for the antagonistic activity against P. digitatum. Transmission electron microscope observation indicated that the antifungal substances might cause abnormalities in the P. digitatum cellular ultrastructure, which could be the possible mode of action of B. amyloliquefaciens against P. digitatum. In addition, it was confirmed via scanning electron microscope analysis that the main way it inhibited P. digitatum was by secreting antimicrobial compounds without direct interaction. This study contributes to the understanding of the mechanism of B. amyloliquefaciens against citrus green mold as well as providing a potential application for the biocontrol of postharvest rot diseases in citrus fruit.
An Unflinching Exploration of Trauma and Obesity
Authors: Brown Theresa
Published: May 2018

Roxane Gay's Hunger and why it matters for nurses.
Aromatherapy Relieves Nausea in ED Patients
Authors: Rosenberg Karen
Published: May 2018

According to this study:

In patients presenting to the ED with nausea or vomiting who don't require immediate intravenous access, nasally inhaled isopropyl alcohol with or without oral ondansetron can provide greater relief than ondansetron alone.
High-Fluence Light-Emitting Diode–Generated Red Light Modulates the Transforming Growth Factor-Beta Pathway in Human Skin Fibroblasts
Authors: Mamalis Andrew , Jagdeo Jared
Published: May 2018

BACKGROUND

Skin fibrosis is a significant medical problem with limited available treatment modalities. The key cellular characteristics include increased fibroblast proliferation, collagen production, and transforming growth factor-beta (TGF-B)/SMAD pathway signaling. The authors have previously shown that high-fluence light-emitting diode red light (HF-LED-RL) decreases cellular proliferation and collagen production.

OBJECTIVE

Herein, the authors investigate the ability of HF-LED-RL to modulate the TGF-B/SMAD pathway.

MATERIALS AND METHODS

Normal human dermal fibroblasts were cultured and irradiated with a commercially available hand-held LED array. After irradiation, cell lysates were collected and levels of pSMAD2, TGF-Beta 1, and TGF-Beta I receptor were measured using Western blot.

RESULTS

High-fluence light-emitting diode red light decreased TGF-Beta 1 ligand (TGF-B1) levels after irradiation. 320 J/cm2 HF-LED-RL resulted in 59% TGF-B1 and 640 J/cm2 HF-LED-RL resulted in 54% TGF-B1, relative to controls. 640 J/cm2 HF-LED-RL resulted in 62% pSMAD2 0 hours after irradiation, 65% pSMAD2 2 hours after irradiation, and 95% 4 hours after irradiation, compared with matched controls. High-fluence light-emitting diode red light resulted in no significant difference in transforming growth factor-beta receptor I levels compared with matched controls.

CONCLUSION

Skin fibrosis is a significant medical problem with limited available treatment modalities. Light-emitting diode–generated red light is a safe, economic, and noninvasive modality that has a body of in vitro evidence supporting the reduction of key cellular characteristics associated with skin fibrosis.
β Cell replacement: improving on the design
Authors: Castro-Gutierrez Roberto , Michels Aaron W. , Russ Holger A.
Published: May 2018

Purpose of review

Here we summarize recent advancements in β cell replacement as a therapy for type 1 diabetes.

Recent findings

β cell replacement therapy has been proposed as a cure for type 1 diabetes with the introduction of the Edmonton protocol for cadaveric islet transplantation. To allow widespread use of this approach, efforts have focused on establishing an abundant source of insulin-producing β cells, protecting transplanted cells from ischemia-mediated death, immune rejection, and re-occurring autoimmunity. Recent developments addressing these issues include generation of insulin-producing cells from human pluripotent stem cells, different encapsulation strategies and prevention of ischemia upon transplant.

Despite significant advances in generating functional β cells from human pluripotent stem cells, several key challenges remain in regard to the survival of β cell grafts, protection from (auto-) immune destruction and implementation of additional safety mechanisms before a stem cell-based cell replacement therapy approach can be widely applied. Taking current findings into consideration, we outline a multilayered approach to design immune-privileged β cells from stem cells using state of the art genome editing technologies that if successfully incorporated could result in great benefit for diabetic patients and improve clinical results for cell replacement therapy.
Prospective evaluation of the performance and interobserver variation in endoscopic ultrasound staging of rectal cancer
Authors: El Hajj Ihab I. , DeWitt John , Sherman Stuart , Imperiale Thomas F. , LeBlanc Julia K. , McHenry Lee , Cote Gregory A. , Johnson Cynthia S. , Al-Haddad Mohammad
Published: May 2018

Background

Treatment and prognosis of patients with rectal adenocarcinoma (RAC) are dependent on accurate locoregional staging.

Objectives

The aim of this study was to measure the performance characteristics of rectal endoscopic ultrasound (EUS) compared with surgical pathology, and to assess the interobserver variation of rectal EUS in the staging of RAC.

Patients and methods

Patients referred for rectal EUS staging of a recently diagnosed RAC were prospectively enrolled between 2012 and 2016. Tandem EUS exams were performed by two independent endosonographers (ES1 and ES2) blinded to each other’s findings.

Results

Ninety-five patients were enrolled. Seventy-five (79%) underwent curative intent tumor resection, including 30 without neoadjuvant therapy. In this latter group, the sensitivity, specificity, and accuracy of transrectal ultrasonography staging were 75, 83, and 82% for uT1; 50, 65, and 58% for uT2; 56, 81, and 73% for T3; 72, 44, and 63% for N0, and 38, 75, and 63% for N1, respectively. Experienced operators rendered a more accurate N stage and were less likely to overstage compared with less experienced ones (P=0.01 and 0.02, respectively). Overall, T staging agreement between endosonographers was substantial (κ=0.61) and N stage agreement was moderate (κ=0.45).

Conclusion

Rectal EUS is more accurate in staging T1 and T3 tumors compared with T2 tumors. Interobserver agreement of rectal EUS in rectal cancer staging is generally good.
Addressing sexual and reproductive health in adolescents and young adults with intellectual and developmental disabilities
Authors: Walters Frinny Polanco , Gray Susan Hayden
Published: May 2018

Purpose of review

This review provides support for promoting the sexual health of adolescents and young adults with developmental disabilities, and particularly those with intellectual disabilities. It offers guidance for pediatricians on incorporating counseling on sexuality and reproductive healthcare, socially appropriate behavior, and sexual abuse prevention for adolescents and young adults with developmental disabilities into healthcare visits. Additionally, it provides resources for developmentally appropriate sexuality education in the home and community to allow access to the comprehensive sexual and reproductive healthcare patients deserve.

Recent findings

Adolescents and young adults with developmental disabilities often do not receive developmentally appropriate sexual health education, and this is associated with poor sexual health outcomes and increased rates of sexual abuse in this population.

Pediatricians should discuss sexual health with all patients, including adolescents and young adults with developmental disabilities. They are well suited to provide sexual health education and inform families about appropriate sexual health resources.
Update in the management of acne in adolescence
Authors: Mwanthi Muithi , Zaenglein Andrea L.
Published: May 2018

Purpose of review

This review will update the pediatric provider on recent data on the pathogenesis and treatment of acne in adolescent patients. A special focus was made to summarize recent guidelines and fill in several identified practice gaps.

Recent findings

Our understanding of the pathogenesis of acne is greatly expanding and data is emerging to tie diet, particularly the role of IGF-1 with inflammation in acne. Additionally, stronger recommendations to limit antibiotic usage in acne are being made worldwide. Although retinoids are considered the base of most effective acne treatment strategies, data suggests that all providers need to emphasize their importance in maintenance of acne.

An effective acne management strategy targets multiple pathogenic factors in acne, using a retinoid as the foundation. Systemic antibiotics for moderate-to-severe acne should be used for acute management, then discontinued at 3–4 months, while maintaining on topical treatments. If therapy is ineffective, alternate treatments, such as combined oral contraceptives in females or isotretinoin, should be promptly employed to prevent prolonged psychological impact and cutaneous scarring.
How the definition of acceptable antigens and epitope analysis can facilitate transplantation of highly sensitized patients with excellent long-term graft survival
Authors: Heidt Sebastiaan , Haasnoot Geert W. , Claas Frans H.J.
Published: May 2018

Purpose of review

Highly sensitized patients awaiting a renal transplant have a low chance of receiving an organ offer. Defining acceptable antigens and using this information for allocation purposes can vastly enhance transplantation of this subgroup of patients, which is the essence of the Eurotransplant Acceptable Mismatch program. Acceptable antigens can be determined by extensive laboratory testing, as well as on basis of human leukocyte antigen (HLA) epitope analyses.

Recent findings

Within the Acceptable Mismatch program, there is no effect of HLA mismatches on long-term graft survival. Furthermore, patients transplanted through the Acceptable Mismatch program have similar long-term graft survival to nonsensitized patients transplanted through regular allocation. Although HLA epitope analysis is already being used for defining acceptable HLA antigens for highly sensitized patients in the Acceptable Mismatch program, increasing knowledge on HLA antibody – epitope interactions will pave the way toward the definition of acceptable epitopes for highly sensitized patients in the future.

Allocation based on acceptable antigens can facilitate transplantation of highly sensitized patients with excellent long-term graft survival.
Barriers to Care for Persons With Sickle Cell Disease
Authors: Brennan-Cook Jill , Bonnabeau Emily , Aponte Ravenne , Augustin Christina , Tanabe Paula
Published: May 2018

Purpose and Objectives:

The purpose of this discussion is to review the barriers to care for patients with sickle cell disease (SCD). Chronic pain and the perception of addiction, implicit bias, frequent hospitalizations and emergency department visits, clinician and patient knowledge deficits, and SCD stigma all impede the ability to provide evidence-based care for patients with SCD. Case managers can coordinate and advocate for appropriate care that improves patient outcomes.

Primary Practice Setting:

This discussion is relevant to case managers working with patients with SCD in the clinic, hospital, and emergency department.

Findings/Conclusions:

Case managers can serve an important advocacy role and intervene to improve the coordination of services and efficient use of resources. This will lead to improved quality of life and optimal health care utilization for persons with SCD.

Implications for Case Management Practice:

As a constant member of the health care team, the case manager may be the only health care team member who has a broad knowledge of the patient's experience of acute and chronic pain, usual state of health, social behavioral health needs, and how these factors may affect both inpatient and outpatient health care use and health outcomes. This article explores the barriers to care and suggests specific interventions within the role of the case manager that can improve care delivered and ultimately contribute to improved patient outcomes. Specifically, these interventions can improve communication among members of the health care team. Case manager interventions can guide coordination, prevent hospital readmissions, reduce health care utilization, and contribute to overall improved patient quality of life and health outcomes.
Practical Nurses' Lived Experience of Returning to School
Authors: Chachula Kathryn , Smith Mary , Hyndman Kathryn
Published: May 2018

The lived experience of licensed practical nurses (LPNs) pursuing Bachelor of Nursing (BN) education is not commonly studied in Canada. The aim was to understand the transition experience of LPNs who bridged into a BN program. Max van Manen's phenomenological methodology was used through use of a semistructured interview guide to explore the lived experience of LPNs who pursued baccalaureate nursing education. Five themes were found: seeking advancement; stepping back into the student role; juggling work, school, and family; struggling to be understood; and seeing things differently. In summary, LPN-to-BN students have a well-developed sense of identity as nurses. These students can benefit from a specifically designed, stand-alone bridge course to situate them within a BN program that leads to successful fulfillment of entry-to-practice competencies for RN licensure.
Acquisition of Fire Safety Knowledge and Skills With Virtual Reality Simulation
Authors: Rossler Kelly L. , Sankaranarayanan Ganesh , Duvall Adrianne
Published: May 2018

Background

Prelicensure nursing students seeking to enter perioperative nursing need preparatory fire safety knowledge and skills training to participate as a member of an operating room (OR) team.

Purpose

This pilot study examined the effectiveness of the Virtual Electrosurgery Skill Trainer (VEST) on OR fire safety skills among prelicensure nursing students.

Methods

An experimental pretest-posttest design was used in this study. Twenty nursing students were randomized to a control or an intervention group. Knowledge and skills acquisition of OR fire safety were assessed.

Results

There were no statistically significant findings in knowledge for either group. Fisher exact test demonstrated significant relationships between the skills performance criteria of following emergency procedures for a fire and demonstrating PASS (pull-aim-squeeze-sweep) technique (P = .001).

Conclusions

Academic and hospital educators may consider incorporating virtual reality simulation to teach fire safety education or reinforce general fire safety practices to nursing students and novice nurses.
An Exploration of the Impact of Initial Timing of Physical Therapy on Safety and Outcomes After Concussion in Adolescents
Authors: Lennon Anne , Hugentobler Jason A. , Sroka Mary Claire , Nissen Katharine S. , Kurowski Brad G. , Gagnon Isabelle , Quatman-Yates Catherine C.
Published: May 2018

Background and Purpose:

Physical therapy (PT) is a management strategy increasingly recognized to facilitate recovery after concussion. The purpose of this study was to investigate the safety and outcomes of multimodal impairment-based PT at varying time points after injury in youth diagnosed with concussion.

Methods:

Data were extracted retrospectively from medical records for patients who received PT for concussion-related impairments. Patient records were categorized into 3 cohorts on the basis of the timing of PT implementation: 0-20 days following injury (early intervention), 21 to 41 days following injury (middle intervention), and 42 or more days following injury (late intervention). The primary outcome measure was Post-Concussion Symptom Inventory score from the beginning to the end of the PT episode of care. Additional outcome measures included number of PT sessions, duration of PT episode of care (days), and occurrence of unplanned visits to a health care provider.

Results:

A total of 120 patient records (mean age of 14.77 years) were analyzed. Thirty-three, 39, and 48 individuals were categorized into the early, middle, and late intervention cohorts, respectively. There were no significant differences between intervention cohorts with regard to symptom change on the Post-Concussion Symptom Inventory from the beginning to the end of the PT episode of care, unplanned health care visits, number of PT sessions, or duration of PT episode of care.

Discussion and Conclusions:

Early initiation of PT may be safe and tolerable. Future prospective studies are needed to explore the efficacy of PT services administered early following injury to help characterize an optimal care plan for youth following concussion.

Video Abstract availablefor more insights from the authors (see Supplemental Digital Content 1, available at: http://links.lww.com/JNPT/A210).
Neuropathic pain drives anxiety behavior in mice, results consistent with anxiety levels in diabetic neuropathy patients
Authors: Sieberg Christine B. , Taras Caitlin , Gomaa Aya , Nickerson Chelsea , Wong Cindy , Ward Catherine , Baskozos Georgios , Bennett David L.H. , Ramirez Juan D. , Themistocleous Andreas C. , Rice Andrew S.C. , Shillo Pallai R. , Tesfaye Solomon , Edwards Robert R. , Andrews Nick A. , Berde Charles , Costigan Michael
Published: May 2018

Background:

Epidemiological studies in patients with neuropathic pain demonstrate a strong association with psychiatric conditions such as anxiety; however, the precipitating pathology between these symptoms remains unclear. To investigate this, we studied the effects of lifelong stress on levels of neuropathic pain–like behavior and conversely, the effects of chronic neuropathic injury on anxiety-like status in male and female mice. In addition, we assayed this link in painful and painless diabetic peripheral neuropathy patients.

Methods:

Male and female mice were subject to ongoing life-stress or control living conditions. Baseline sensitivity and anxiety tests were measured followed by spared nerve injury (SNI) to the sciatic nerve. Subsequent sensory testing occurred until 3 weeks after SNI followed by anxiety tests between 4 and 6 weeks after SNI.

Results:

Levels of tactile or cold allodynia did not differ between adult mice subject to lifelong chronic stress, relative to nonstressed controls, for at least 3 weeks after SNI. By contrast, longer-term neuropathic mice of both sexes displayed pronounced anxiety-like behavior, regardless of exposure to stress. If sex differences were present, females usually exhibited more pronounced anxiety-like behavior. These ongoing anxiety behaviors were corroborated with plasma corticosterone levels in distinct animal groups. In addition, data from patients with painful and nonpainful diabetic neuropathy showed a clear relationship between ongoing pain and anxiety, with females generally more affected than males.

Discussion:

Taken together, these data demonstrate a strong link between chronic neuropathic pain and chronic anxiety, with the driver of this comorbidity being neuropathic pain as opposed to on-going stress.