bluuebunny/crossref_metadata_2025 huggingface dataset:
European guideline for the management of scabies
Authors: Salavastru C.M. , Chosidow O. , Boffa M.J. , Janier M. , Tiplica G.S.
Published: June 2017

Scabies is caused by Sarcoptes scabiei var. hominis. The disease can be sexually transmitted. Patients’ main complaint is nocturnal itch. Disseminated, excoriated, erythematous papules are usually seen on the anterior trunk and limbs. Crusted scabies occurs in immunocompromised hosts and may be associated with reduced or absent pruritus. Recommended treatments are permethrin 5% cream, oral ivermectin and benzyl benzoate 25% lotion. Alternative treatments are malathion 0.5% aqueous lotion, ivermectin 1% lotion and sulphur 6–33% cream, ointment or lotion. Crusted scabies therapy requires a topical scabicide and oral ivermectin. Mass treatment of large populations with endemic disease can be performed with a single dose of ivermectin (200 micrograms/kg of bodyweight). Partner management needs a look‐back period of 2 months. Screening for other STI is recommended. Patients and close contacts should avoid sexual contact until completion of treatment and should strictly observe personal hygiene rules when living in crowded spaces. Written information should be provided to suspected cases.
Catechol‐O‐Methyltransferase Genotype and Gait Speed Changes over 10 Years in Older Adults
Authors: Metti Andrea L. , Rosano Caterina , Boudreau Robert , Massa Robyn , Yaffe Kristine , Satterfield Suzanne , Harris Tamara , Rosso Andrea L.
Published: June 2017

Objectives

To determine the association between catechol‐O‐methyltransferase (COMT) genotype and 6‐m walk time and to determine whether these associations are quadratic in nature, similar to previously reported U‐shaped associations between dopamine and gait and cognition.

Design

Prospective cohort study.

Setting

Health, Aging and Body Composition Study.

Participants

Black (n = 850) and white (n = 1,352) men and women with a mean age of 73.5 ± 2.85 at baseline.

Measurements

Mixed models were used to assess the association between the COMT genotype and 6‐m walk time, cross‐sectionally and longitudinally over 10 years. Models were assessed unstratified and stratified according to race because allele distributions were different between white and black participants.

Results

There was a significant U‐shaped association between COMT genotype and 6‐m walk time: those with higher (Val/Val) and lower (Met/Met) dopamine slowed more over 10 years (0.22 ± 0.02 seconds per visit and 0.23 ± 0.02 seconds per visit, respectively) than those with the intermediate (Met/Val) dopamine (0.20 ± 0.02 seconds per visit) (P = .005). Stratified results showed a significant relationship in black (P = .01) but not white (P = .15) participants.

Conclusion

These findings indicate a role of dopaminergic regulation of gait speed in community‐dwelling older adults and of prefrontal cortex involvement in gait performance. Future work should investigate the molecular integrity of dopaminergic networks and gait changes over time and structural changes in the brain with COMT and gait decline in older adults.
The interaction between progranulin and prosaposin is mediated by granulins and the linker region between saposin B and C
Authors: Zhou Xiaolai , Sullivan Peter M. , Sun Lirong , Hu Fenghua
Published: June 2017

The frontotemporal lobar degeneration (FTLD) protein progranulin (PGRN) is essential for proper lysosomal function. PGRN localizes in the lysosomal compartment within the cell. Prosaposin (PSAP), the precursor of lysosomal saposin activators (saposin A, B, C, D), physically interacts with PGRN. Previously, we have shown that PGRN and PSAP facilitate each other's lysosomal trafficking. Here, we report that the interaction between PSAP and PGRN requires the linker region of saposin B and C (BC linker). PSAP protein with the BC linker mutated, fails to interact with PGRN and deliver PGRN to lysosomes in the biosynthetic and endocytic pathways. On the other hand, PGRN interacts with PSAP through multiple granulin motifs. Granulin D and E bind to PSAP with similar affinity as full‐length PGRN.

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Read the Editorial Comment for this article on page 154.
Experiences and needs of relatives of people with dementia in acute hospitals—A meta‐synthesis of qualitative studies
Authors: Burgstaller Melanie , Mayer Hanna , Schiess Cornel , Saxer Susi
Published: June 2017

Aims and objectives

To present an in‐depth analysis of existing qualitative literature concerning experiences and needs of the relatives of patients with dementia in hospitals.

Background

Relatives are an important resource for the care of patients with dementia in hospitals. They provide necessary information about the patient and can support the patient's care. Simultaneously, they are themselves vulnerable, having specific needs and experiences. A number of studies have been conducted that focus on the perspectives of the relatives. The synthesis of qualitative studies contributes to a more comprehensive understanding of recent study findings.

Design

A meta‐ethnographic synthesis of qualitative research findings was used.

Methods

The synthesis process followed six defined steps. We located relevant studies through searching the CINAHL, PubMed and PsycInfo databases and through searching journals and reference lists by hand. A list of metaphors was created and translated into one another. Identified metaphors were synthesised and interpreted as a new whole.

Results

Relatives of patients with dementia frequently experience a negative cycle of specific worries, negative feelings and resulting roles and functions in hospital due to negative care experiences.

Conclusions

Experiences of relatives are strongly influenced by the attitudes, expertise and communication that they receive from health professionals working in the hospital. The results clearly show how health professionals have the potential to break through the negative cycle and contribute to a more positive feeling about a patient's hospital stay.

Relevance to clinical practice

Structured and individually planned involvement of the relatives during the hospital care seems to be a key aspect for improving the experiences for the relatives and the patients with dementia. Collaboration with the relatives needs to be valued and supported by the organisation. Also a professional and defined frame for this area of responsibility needs to be provided.
Implementing two nurse practitioner models of service at an Australian male prison: A quality assurance study
Authors: Wong Ides , Wright Eryn , Santomauro Damian , How Raquel , Leary Christopher , Harris Meredith
Published: June 2017

Aims and objectives

To examine the quality and safety of nurse practitioner services of two newly implemented nurse practitioner models of care at a correctional facility.

Background

Nurse practitioners could help to meet the physical and mental health needs of Australia's growing prison population; however, the nurse practitioner role has not previously been evaluated in this context.

Design

A quality assurance study conducted in an Australian prison where a primary health nurse practitioner and a mental health nurse practitioner were incorporated into an existing primary healthcare service. The study was guided by Donabedian's structure, processes and outcomes framework.

Methods

Routinely collected information included surveys of staff attitudes to the implementation of the nurse practitioner models (n = 21 staff), consultation records describing clinical processes and time use (n = 289 consultations), and a patient satisfaction survey (n = 29 patients). Data were analysed descriptively and compared to external benchmarks where available.

Results

Over the two‐month period, the nurse practitioners provided 289 consultations to 208 prisoners. The presenting problems treated indicated that most referrals were appropriate. A significant proportion of consultations involved medication review and management. Both nurse practitioners spent more than half of their time on individual patient‐related care. Overall, multidisciplinary team staff agreed that the nurse practitioner services were necessary, safe, met patient need and reduced treatment delays.

Conclusions

Findings suggest that the implementation of nurse practitioners into Australian correctional facilities is acceptable and feasible and has the potential to improve prisoners' access to health services. Structural factors (e.g., room availability and limited access to prisoners) may have reduced the efficiency of the nurse practitioners' clinical processes and service implementation.

Relevance to clinical practice

Results suggest that nurse practitioner models can be successfully integrated into a prison setting and could provide a nursing career pathway.
Intensive care nurses’ experiences of caring for obese intensive care patients: A hermeneutic study
Authors: Robstad Nastasja , Söderhamn Ulrika , Fegran Liv
Published: June 2017

Aims and objectives

To obtain a deeper understanding of qualified intensive care nurses’ experiences of caring for obese patients in intensive care.

Background

Admission of obese patients with complex healthcare needs to intensive care units is increasing. Caring for obese critically ill patients can be challenging and demanding for the intensive care nurse because of the patients’ weight, critical situation and physical challenges. There is a gap in knowledge at present about qualified intensive care nurses’ experiences of caring for obese patients in intensive care units.

Design

A qualitative hermeneutic approach.

Method

The study took place in 2016 at intensive care units of two different hospitals. Semi‐structured individual interviews were conducted with 13 qualified intensive care nurses. The interviews were analysed according to a Gadamerian‐inspired research method.

Results

Intensive care nurses perceived caring for obese intensive care patients as emotionally demanding owing to these patients’ vulnerability, dissimilarity and physical challenges compared to normal weight patients. They experienced ambivalent feelings caring for these patients: while they endeavoured to provide good and equal care to all patients, they simultaneously held negative beliefs and attitudes towards obese patients. Furthermore, frustration arose among the intensive care nurses relating to the physically demanding care situations and an unwillingness to care for such patients among some colleagues.

Conclusion

The qualified intensive care nurses’ experiences of caring for obese patients revealed ambivalent feelings, attitudes and beliefs towards these patients, which must be considered in intensive care unit practice as well as in the education of these nurses.

Relevance to clinical practice

The results have implications for clinical practice with respect to increasing intensive care nurses’ awareness of their attitudes and beliefs towards obese intensive care patients and to improve the education of these nurses.
Construction of meaningful identities in the context of rheumatoid arthritis, motherhood and paid work: A meta‐ethnography
Authors: Feddersen Helle , Kristiansen Tine Mechlenborg , Andersen Pernille Tanggaard , Hørslev‐Petersen Kim , Primdahl Jette
Published: June 2017

Aims and objectives

To derive new conceptual understanding about how women with rheumatoid arthritis manage their illness, motherhood and paid work, based on a comprehensive overview of existing knowledge, gained from qualitative studies.

Background

Rheumatoid arthritis affects several social aspects of life; however, little is known about how women with rheumatoid arthritis simultaneously manage their illness, motherhood and paid work.

Design

Qualitative metasynthesis.

Methods

A qualitative metasynthesis informed by Noblit and Hare's meta‐ethnography was carried out, based on studies identified by a systematic search in nine databases.

Results

Six studies were included. Social interactions in the performance of three interdependent subidentities emerged as an overarching category, with three subcategories: subidentities associated with (1) paid work, (2) motherhood and (3) rheumatoid arthritis. Pressure in managing one of the subidentities could restrict the fulfilment of the others. The subidentities were interpreted as being flexible, situational, contextual and competing. The women strove to construct meaningful subidentities by taking into account feedback obtained in social interactions.

Conclusions

The subidentities associated with paid work and motherhood are competing subidentities. Paid work is given the highest priority, followed by motherhood and illness is the least attractive subidentity. Because of the fluctuating nature of the illness, the women constantly reconstruct the three interdependent subidentities.

Relevance to clinical practice

When healthcare professionals meet a woman with rheumatoid arthritis, they should consider that she might not accept the subidentity as an ill person. Health professionals should not expect that women will prioritise their illness in their everyday life. This could be included in clinical conversation with the women.
A Model of Monetary Policy and Risk Premia
Authors: DRECHSLER ITAMAR , SAVOV ALEXI , SCHNABL PHILIPP
Published: June 2017

We develop a dynamic asset pricing model in which monetary policy affects the risk premium component of the cost of capital. Risk‐tolerant agents (banks) borrow from risk‐averse agents (i.e., take deposits) to fund levered investments. Leverage exposes banks to funding risk, which they insure by holding liquidity buffers. By changing the nominal rate the central bank influences the liquidity premium, and hence the cost of taking leverage. Lower nominal rates make liquidity cheaper and raise leverage, resulting in lower risk premia and higher asset prices, volatility, investment, and growth. We analyze forward guidance, a “Greenspan put,” and the yield curve.
The Macroeconomics of Shadow Banking
Authors: MOREIRA ALAN , SAVOV ALEXI
Published: June 2017

We build a macrofinance model of shadow banking—the transformation of risky assets into securities that are money‐like in quiet times but become illiquid when uncertainty spikes. Shadow banking economizes on scarce collateral, expanding liquidity provision, boosting asset prices and growth, but also building up fragility. A rise in uncertainty raises shadow banking spreads, forcing financial institutions to switch to collateral‐intensive funding. Shadow banking collapses, liquidity provision shrinks, liquidity premia and discount rates rise, asset prices and investment fall. The model generates slow recoveries, collateral runs, and flight‐to‐quality effects, and it sheds light on Large‐Scale Asset Purchases, Operation Twist, and other interventions.
High‐level βIII‐tubulin overexpression occurs in most head and neck cancers but is unrelated to clinical outcome
Authors: Nienstedt Julie C. , Gröbe Alexander , Clauditz Till , Simon Ronald , Muenscher Adrian , Knecht Rainald , Sauter Guido , Moebius Christoph , Blessmann Marco , Heiland Max , Pflug Christina
Published: June 2017

Background

βIII‐tubulin (TUBB3) is an isotype of microtubules, which are involved in crucial cellular roles including maintenance of cell shape, intracellular transport, and mitosis. Overexpression of TUBB3 was found to be associated with poor prognosis and resistance to tubulin‐binding drugs and in several solid tumors including head and neck squamous cell carcinomas (HNSCC). Considering the potential high importance of a prognostic biomarker in these cancers, this study aimed to investigate the clinical relevance of immunohistochemical TUBB3 expression in HNSCC.

Methods

Tissue microarray (TMA) sections containing samples from 667 cancers of oral cavity, oro‐ and hypopharynx, and larynx for which follow‐up data were available were analyzed for TUBB3 expression by immunohistochemistry.

Results

Over 90% of our analyzed cancers showed unequivocal cytoplasmic TUBB3 expression. Staining was considered weak in 69 (15.5%), moderate in 149 (33.5%), and strong in 188 (42.2%) of cancers. The frequent TUBB3 overexpression showed no significant correlation with pathological grading, tumor stage, nodal status, or surgical margin and had no impact on patient outcomes.

Conclusion

Despite lacking prognostic utility in HNSCC, the remarkable high prevalence of TUBB3 expression in HNSCC emphasizes its putative relevance as a target for future drugs targeting TUBB3.
The Effect of Intergroup Conflict on Ingroup Cooperation and Conformity: An Experimental Vignette Study
Authors: Yokota Kunihiro , Nakanishi Daisuke
Published: June 2017

In this study, we aimed to test the hypothesis that intergroup conflict would enhance not only ingroup cooperation, but also conformity (frequency‐dependent tendency). One hundred and eighty undergraduate students participated in a vignette experiment. They read four scenarios describing daily intergroup conflict situations, and rated behavioral intention for ingroup cooperation and frequency‐dependent tendency of ingroup members. In each vignette, level of intergroup conflict (weak/moderate) was manipulated by costs of defeat. The results supported the hypothesis in part that intergroup conflict enhanced both ingroup cooperation and conformity.
Parental attitudes toward pediatric use of complementary/alternative medicine in Turkey
Authors: Ustuner Top Fadime , Konuk Sener Dilek , Cangur Sengul
Published: June 2017

Purpose

This study was conducted to determine the pediatric usage of complementary/alternative medicine (CAM) by parents in Turkey, the incidence of using these methods, and the factors affecting their use.

Design and Methods

The sectional and relational design of the study included a sample of 497 parents who took children for treatment at the Maternity and Children's Hospital in Giresun, Turkey. Data for the study were collected via the Personal Information Form and the Evaluation Form for Complementary/Alternative Treatment Use. The data collection tools were filled out by the researchers during the face‐to‐face interviews. Data obtained from the study were analyzed by Pearson chi‐square, Fisher–Freeman–Halton and Fisher's exact (posthoc Bonferroni) tests and Z‐test.

Results

It was determined that 97.7% of the parents had used at least one CAM method. Moreover, the parents had used CAM methods mostly for respiratory complaints. The CAM methods were most commonly used for the symptoms of fever, diarrhea, and cough. It was observed that the most commonly used alternative methods in the past were vitamin/mineral remedies, cold treatments, and hodja (Islamic teacher) consultations, while the most common alternative methods currently used are massage, music, and cold treatment. In addition, the differences found between CAM users in terms of sociodemographic characteristics were not statistically significant.

Practice Implications

: It is crucial for nurses to learn the characteristics of the health/disease treatments used by those with whom they work in order to increase the efficiency of the service they provide. Thus, it was recommended that nurses should be knowledgeable and aware of the benefits/side effects, treatment methods, and contraindications of CAM.
Paediatric intensive care nurses' decision‐making around gastric residual volume measurement
Authors: Tume Lyvonne N , Latten Lynne , Kenworthy Lindsay
Published: June 2017

Background

Measuring gastric residual volume (GRV) to guide enteral feeding is a common nursing practice in intensive care units, yet little evidence supports this practice. In addition, this practice has been shown to potentially contribute to inadequate energy delivery in intensive care, which remains a problem in critically ill children.

Aims

We aimed to explore paediatric intensive care nurses' decision‐making surrounding this practice.

Methods

This is a cross‐sectional electronic survey in a single mixed general and cardiac surgical PICU in the UK.

Results

The response rate was 59% (91/154), and responding nurses were experienced, with a mean PICU experience of 10·5 years (SD 8·09). The three main reasons for stopping or withholding enteral feeds were: the volume of GRV obtained (67%), the appearance of this gastric aspirate (40%) and the overall clinical condition of the child (23%). Most nurses reported checking GRV primarily to determine ‘feed tolerance’ (97%) as well as confirming feeding tube position (94%). Nurses' perceived harms from high GRV were: the risk of pulmonary aspiration (44%), malabsorption of feeds (20%) and the risk of vomiting (19%). GRV was measured frequently in this PICU, with 58% measuring GRV before every feed, 27% measuring every 4 h and 17% measuring every 6 h. The majority of nurses (84%) stated they would be worried or very worried if they could not measure GRV routinely.

Conclusions

PICU nurses' decision‐making surrounding initiating and withholding enteral feeds and determining ‘feed tolerance’ remains heavily based on GRV. PICU nurses have significant fears around patient harm if they do not measure GRV routinely.

Relevance to clinical practice

This nursing practice is likely to be one of the factors that impair the delivery of enteral nutrition in critically ill children, and as such, its validity and usefulness needs to be challenged and studied in future research.
Dreams and creative problem‐solving
Authors: Barrett Deirdre
Published: June 2017

Dreams have produced art, music, novels, films, mathematical proofs, designs for architecture, telescopes, and computers. Dreaming is essentially our brain thinking in another neurophysiologic state—and therefore it is likely to solve some problems on which our waking minds have become stuck. This neurophysiologic state is characterized by high activity in brain areas associated with imagery, so problems requiring vivid visualization are also more likely to get help from dreaming. This article reviews great historical dreams and modern laboratory research to suggest how dreams can aid creativity and problem‐solving.
Transferring connections: Friend and sibling attachments' importance in the lives of singles
Authors: BRUMBAUGH CLAUDIA CHLOE
Published: June 2017

Broadly speaking, attachment theorists have argued that the unconscious, social–cognitive process oftransferenceis one of the mechanisms underlying attachment stability and coherence. This study assessed the transference of friend and sibling attachments and examined differences between single and romantically coupled individuals. Attachment‐related feelings transferred to new individuals who resembled friends and siblings, and this process was especially true for single people. Having more siblings corresponded to greater attachment security for all participants, and larger friend networks buffered singles specifically from attachment insecurity. In general, friend and sibling relationships appeared to be more influential for single individuals, pointing to the importance of these significant others in singles' lives.
Preferred intervention strategies to improve dietary and physical activity behaviors among African‐American mothers and daughters
Authors: Reed Monique , Julion Wrenetha , McNaughton Diane , Wilbur JoEllen
Published: June 2017

Objective

The objective of this study was to identify cultural‐ and age‐appropriate intervention strategies to improve dietary and physical activity (PA) behaviors in African‐American adolescent daughters and their mothers.

Design and sample

A convergent parallel mixed methods design with interactive quantitative and qualitative measures was used. Twenty‐four 9th‐ and 10th‐grade African‐American daughters from a large urban high school and their mothers participated.

Measures

Measures included the 2013 Youth Risk Behavior Surveillance System dietary and PA questions, 2013 Behavioral Risk Factor Surveillance System dietary and PA questions, and BMI. Focus group questions covered preferred intervention formats and strategies for delivering a dietary and PA intervention.

Results

Fifty‐five percent of daughters and 92% of mothers were overweight/obese. Mothers tended to prefer the group format (mothers/daughters together or mothers together) for delivering a dietary and PA intervention, while the daughters’ delivery preferences were mixed. Top mother/daughter dyad strategy preferences for both dietary and PA were goal setting and use of rewards/prizes.

Conclusions

These findings suggest several dietary and PA obesity intervention strategies that can guide obesity prevention efforts for African‐American daughters and their mothers.
Increasing the pipeline and diversity of doctorally prepared nurses: Description and preliminary evaluation of a health disparities summer research program
Authors: Salerno John P. , Gonzalez‐Guarda Rosa , Hooshmand Mary
Published: June 2017

Despite calls to increase the number and diversity of doctorally prepared nurses, recent data indicate a severe shortage of PhD‐prepared nurses, especially those of racial/ethnic minority backgrounds. This is concerning, given that evidence indicates that racial/ethnic minority PhD‐prepared nurses are well‐positioned to address health disparities, by attending to the needs/concerns of medically underrepresented groups. The purpose of this article is to describe and provide a preliminary evaluation of a summer research program for minority nursing students. Online surveys were administered to assess for student satisfaction, knowledge gains, attitudes toward research, and intentions to pursue a PhD among minority undergraduate nursing students (N = 6) participating in the 10‐week program. Favorable trends were observed related to satisfaction, knowledge gains, and attitudes toward research. Fifty percent of the sample intended to pursue a PhD immediately after the program, compared to none before the program, and this result was maintained at 1‐year post‐program. The summer research program appears to be a promising strategy for increasing the number/diversity of PhD‐prepared nurses. More research on the implementation of programs exposing minority nursing students to health disparities research is needed to strengthen evidence that similar programs can serve to increase the pipeline of diverse doctorally prepared nurses.
Helicobacter pyloriSeropositivity and Childhood Neurodevelopment, the Rhea Birth Cohort in Crete, Greece
Authors: Karachaliou Marianna , Chatzi Leda , Michel Angelika , Kyriklaki Andriani , Kampouri Mariza , Koutra Katerina , Roumeliotaki Theano , Chalkiadaki Georgia , Stiakaki Eftichia , Pawlita Michael , Waterboer Tim , Kogevinas Manolis , de Sanjose Silvia
Published: June 2017

Background

Limited evidence exists on the association between exposure toHelicobacter pyloriinfection early in life, including fetal life, and neurodevelopment in childhood.

Methods

We used prospective data on 352 mother–child pairs and cross‐sectional data on 674 children to assess the association of maternal and child'sH. pyloriseropositivity correspondingly on child's neurodevelopment at age four in the Rhea birth cohort in Crete, Greece. Blood levels of immunoglobulin G antibodies to 12H. pyloriproteins were measured using multiplex serology. Child's neurodevelopment at age four was assessed using the McCarthy Scales of Children's Abilities. Linear regression models were used to explore the associations after adjusting for potential confounders.

Results

Helicobacter pyloriseroprevalence (95% CI) in cord blood, representing maternal status, was 41.5% (36.3%, 46.8%) and in 4 years old children was 6.5% (95% CI 4.8%, 8.7%). Children ofH. pyloriseropositive mothers had lower score in the general cognitive (−3.87, 95% CI −7.02, −0.72), verbal (−2.96, 95% CI −6.08, 0.15), perceptual performance (−3.37, 95% CI −6.60, −0.15), quantitative (−2.85, 95% CI −6.28, 0.58), and memory scale (−3.37, 95% CI −6.67, −0.07) compared to those of seronegative mothers. Seropositivity in cord blood specifically to GroEl and NapA – two of the 12H. pyloriproteins investigated – was associated with lower scores in almost all scales. At age four,H. pyloriseropositive children performed worst in neurodevelopment assessment compared to their seronegative counterparts although no association reached statistically significant level.

Conclusions

Helicobacter pyloriinfection in early life may be an important but preventable risk factor for poor neurodevelopment.
Antidepressant Use in Pregnancy and the Risk of Attention Deficit with or without Hyperactivity Disorder in Children
Authors: Boukhris Takoua , Sheehy Odile , Bérard Anick
Published: June 2017

Background

The association between antidepressant (AD) use during pregnancy and the risk of attention deficit with or without hyperactivity disorder (ADHD) in children is debated. We investigated the risk of ADHD associated with overall and class‐specific antidepressant exposure in utero.

Methods

We designed a register‐based cohort study using the Quebec Pregnancy/Children Cohort (QPC). A total of 144 406 singleton full‐term live‐born from 1998 to 2009 were included. Cox proportional hazards regression models were used to estimate unadjusted and adjusted hazard ratio with 95% confidence interval (CI).

Results

During 542 897 person‐years of follow‐up, 4564 (3.2%) infants were identified with ADHD. The mean age at first ADHD diagnosis was 6.3 ± 2.3 years (range 0–11 years), and the mean age at first ADHD medication use was 7.0 ± 1.5 years. Adjusting for potential confounders, including maternal history of depression/anxiety and ADHD, AD use during the 2nd or 3rd trimester of pregnancy was associated with an increased risk of (HR 1.3, 95% CI 1.0, 1.6; 134 exposed cases). More specifically, tricyclic use was associated with an increased risk of ADHD (HR 1.8, 95% CI 1.0, 3.1; 16 exposed cases); SSRI and SNRI use were not associated with increased ADHD risk.

Conclusion

This study suggests that AD use during the 2nd and 3rd trimester of pregnancy, specifically tricyclics, is an independent risk factor for ADHD in children above and beyond the risk associated with maternal depression/anxiety or ADHD. However, residual confounding by indication severity could not be completely ruled out.
Global transcriptome and coexpression network analyses reveal cultivar‐specific molecular signatures associated with seed development and seed size/weight determination in chickpea
Authors: Garg Rohini , Singh Vikash K. , Rajkumar Mohan Singh , Kumar Vinay , Jain Mukesh
Published: June 2017

Seed development is an intricate process regulated via a complex transcriptional regulatory network. To understand the molecular mechanisms governing seed development and seed size/weight in chickpea, we performed a comprehensive analysis of transcriptome dynamics during seed development in two cultivars with contrasting seed size/weight (small‐seeded, Himchana 1 and large‐seeded, JGK 3). Our analysis identified stage‐specific expression for a significant proportion (>13%) of the genes in each cultivar. About one half of the total genes exhibited significant differential expression in JGK 3 as compared with Himchana 1. We found that different seed development stages can be delineated by modules of coexpressed genes. A comparative analysis revealed differential developmental stage specificity of some modules between the two cultivars. Furthermore, we constructed transcriptional regulatory networks and identified key components determining seed size/weight. The results suggested that extended period of cell division during embryogenesis and higher level of endoreduplication along with more accumulation of storage compounds during maturation determine large seed size/weight. Further, we identified quantitative trait loci‐associated candidate genes harboring single nucleotide polymorphisms in the promoter sequences that differentiate small‐ and large‐seeded chickpea cultivars. The results provide a valuable resource to dissect the role of candidate genes governing seed development and seed size/weight in chickpea.
Anti‐D in a mother, hemizygous for the variant RHD*DNB gene, associated with hemolytic disease of the fetus and newborn
Authors: Quantock Kelli M. , Lopez Genghis H. , Hyland Catherine A. , Liew Yew‐Wah , Flower Robert L. , Niemann Frans J. , Joyce Arthur
Published: June 2017

BACKGROUND

Individuals with the partial D phenotype when exposed to D+ red blood cells (RBCs) carrying the epitopes they lack may develop anti‐D specific for the missing epitopes. DNB is the most common partial D in Caucasians and the clinical significance for anti‐D in these individuals is unknown.

STUDY DESIGN AND METHODS

This article describes the serologic genotyping results and clinical manifestations in two group D+ babies of a mother presenting as group O, D+ with alloanti‐D.

RESULTS

The mother was hemizygous for RHD*DNB gene and sequencing confirmed a single‐nucleotide change at c.1063G>A. One baby (group A, D+) displayed bilirubinemia at birth with a normal hemoglobin level. Anti‐A and anti‐D were eluted from the RBCs. For the next ongoing pregnancy, the anti‐D titer increased from 32 to 256. On delivery the baby typed group O and anti‐D was eluted from the RBCs. This baby at birth exhibited anemia, reticulocytosis, and hyperbilirubinemia requiring intensive phototherapy treatment from Day 0 to Day 9 after birth and was discharged on Day 13. Intravenous immunoglobulin was also administered. Both babies were heterozygous for RHD and RHD*DNB.

CONCLUSION

The anti‐D produced by this woman with partial D DNB resulted in a case of hemolytic disease of the fetus and newborn (HDFN) requiring intensive treatment in the perinatal period. Anti‐D formed by women with the partial D DNB phenotype has the potential to cause HDFN where the fetus is D+. Women carrying RHD*DNB should be offered appropriate prophylactic anti‐D and be transfused with D– RBCs if not already alloimmunized.
Thromboelastography may predict risk of grade 2 bleeding in thrombocytopenic patients
Authors: Opheim E. N. , Apelseth T. O. , Stanworth S. J. , Eide G. E. , Hervig T.
Published: June 2017

Background and objectives

Platelet count is used as a prophylactic platelet transfusion trigger, although evidence suggests that it is a poor predictor of bleeding. Thus, alternative tests are required. The primary objective of this study was to compare thromboelastography (TEG) parameters on days with and without bleeding symptoms. The secondary objectives were to investigate the relationship between TEG parameters and haematological variables, fever, C‐reactive protein (CRP) and platelet transfusion.

Materials and methods

This is a prospective, observational pilot study of 13 thrombocytopenic, haemato‐oncologic patients, over 17 cycles of chemotherapy. Bleeding assessment was performed daily together with a total platelet count (TPC), reticulated platelet per cent (RPP) and count (RPC), haemoglobin, mean platelet volume, white blood cell count (WBC), CRP and temperature. TEG analyses were performed on weekdays.

Results

TEG alpha angle was significantly lower on days with World Health Organization (WHO) grade 2 bleeding than on days without bleeding. Haematologic variables, CRP and platelet transfusion the previous day were associated with the outcome of TEG analysis, but fever was not.

Conclusion

We found a highly significant correlation between the TEG alpha angle and WHO grade 2 bleeding. This finding suggests that fibrinogen–platelet interactions may affect the bleeding risk in thrombocytopenic patients.
An anatomical study of plate‐rod fixation in feline tibiae
Authors: Gutbrod Andreas , Vincenti Simona , Kühn Karolin , Knell Sebastian Christoph , Schmierer Philipp Alexander , Pozzi Antonio
Published: June 2017

Objective

To investigate the feasibility of placing bi‐cortical cortex (B‐cort) or mono‐cortical locking screws (M‐lock) in a plate‐rod construct applied to the feline tibia in combination with different intramedullary (IM) pins.

Methods

Twenty‐four feline tibiae of cats were divided into 4 groups, corresponding to IM pin sizes filling approximately 30% (1.0 mm), 40% (1.4 mm), 45% (1.6 mm), and 50% (1.8 mm) of the medullary canal. Computed tomography (CT) was performed to trace potential screw trajectories in each group. A 12‐hole, 2.4 mm locking compression plate was then applied on the medial aspect of the tibia. M‐lock and B‐cort screws were inserted subsequently in each plate hole. Success rates of screw insertion based on CT analysis and cadaveric simulation were compared with screw type, IM pin diameter, and anatomic location as variables.

Results

Screw insertion rates were underestimated on CT compared to cadaveric specimens. During cadaveric simulation, B‐cort screws could be inserted in all specimens in the 3 most proximal plate holes and in at least 1 of the 3 distal plate holes. The smallest pin size (30%) allowed placement of a greater number of B‐cort screws (P < .05) compared to other pins. Fewer B‐cort screws could be inserted in the distal diaphyseal region (P < .05) compared to other regions. A total of 99.3% of M‐lock screws could be inserted regardless of IMP size.

Clinical significance

Plate rod constructs can include bicortical screws in the proximal and distal metaphysis, and monocortical screws in the diaphysis, combined with an IM pin filling up to 50% of the medullary canal.
Autophagy activation, not peroxisome proliferator‐activated receptor γ coactivator 1α, may mediate exercise‐induced improvements in glucose handling during diet‐induced obesity
Authors: Rosa‐Caldwell Megan E. , Brown Jacob L. , Lee David E. , Blackwell Thomas A. , Turner Kyle W. , Brown Lemuel A. , Perry Richard A. , Haynie Wesley S. , Washington Tyrone A. , Greene Nicholas P.
Published: June 2017

New Findings

What is the central question of this study?

What are the individual and combined effects of muscle‐specific peroxisome proliferator‐activated receptor γ coactivator 1α (PGC‐1α) overexpression and physical activity during high‐fat feeding on glucose and exercise tolerance?

What is the main finding and its importance?

Our main finding is that muscle‐specific PGC‐1α overexpression provides no protection against lipid‐overload pathologies nor does it enhance exercise adaptations. Instead, physical activity, regardless of PGC‐1α content, protects against high‐fat diet‐induced detriments. Activation of muscle autophagy was correlated with exercise protection, suggesting that autophagy might be a mediating factor for exercise‐induced protection from lipid overload.

The prevalence of glucose intolerance is alarmingly high. Efforts to promote mitochondrial biogenesis through peroxisome proliferator‐activated receptor γ coactivator 1α (PGC‐1α) to mitigate glucose intolerance have been controversial. However, physical activity remains a primary means to alleviate the condition. The aim of this study was to determine the combined effects of muscle‐specific overexpression of PGC‐1α and physical activity on glucose handling during diet‐induced obesity. Wild‐type (WT, ∼20) and PGC‐1α muscle transgenic (MCK‐PGC‐1α, ∼20) mice were given a Western diet (WD) at 8 weeks age and allowed to consume food ab libitum throughout the study. At 12 weeks of age, all animals were divided into sedentary (SED) or voluntary wheel running (VWR) interventions. At 7, 11 and 15 weeks of age, animals underwent glucose tolerance tests (GTT) and graded exercise tests (GXT). At 16 weeks of age, tissues were collected. At 11 weeks, the MCK‐PGC‐1α animals had 50% greater glucose tolerance integrated area under the curve compared with WT. However, at 15 weeks, SED animals also had greater GTT integrated area under the curve compared with VWR, regardless of genotype; furthermore, SED animals demonstrated reduced exercise capacity compared with earlier time points, which was not seen in VWR animals. Voluntary distance run per day was correlated with GTT in VWR‐WT, but not VWR‐MCK‐PGC‐1α mice. Voluntary wheel running and genotype independently resulted in a greater LC3II/LC3I ratio, suggesting enhanced autophagosome formation, which was correlated with exercise‐induced improvements in GTT. In conclusion, artificially increasing mitochondrial content does not protect from lipid‐induced pathologies nor does it augment exercise adaptations. Physical activity ameliorates the effects of lipid overload‐induced glucose intolerance, an effect that appears to be related to enhanced activation of autophagy.
Intraglomerular gap junctions enhance interglomerular synchrony in a sparsely connected olfactory bulb network
Authors: Pouille Frederic , McTavish Thomas S. , Hunter Lawrence E. , Restrepo Diego , Schoppa Nathan E.
Published: June 2017

Key points

Despite sparse connectivity, population‐level interactions between mitral cells (MCs) and granule cells (GCs) can generate synchronized oscillations in the rodent olfactory bulb.

Intraglomerular gap junctions between MCs at the same glomerulus can greatly enhance synchronized activity of MCs at different glomeruli.

The facilitating effect of intraglomerular gap junctions on interglomerular synchrony is through triggering of mutually synchronizing interactions between MCs and GCs.

Divergent connections between MCs and GCs make minimal direct contribution to synchronous activity.

A dominant feature of the olfactory bulb response to odour is fast synchronized oscillations at beta (15–40 Hz) or gamma (40–90 Hz) frequencies, thought to be involved in integration of olfactory signals. Mechanistically, the bulb presents an interesting case study for understanding how beta/gamma oscillations arise. Fast oscillatory synchrony in the activity of output mitral cells (MCs) appears to result from interactions with GABAergic granule cells (GCs), yet the incidence of MC–GC connections is very low, around 4%. Here, we combined computational and experimental approaches to examine how oscillatory synchrony can nevertheless arise, focusing mainly on activity between ‘non‐sister’ MCs affiliated with different glomeruli (interglomerular synchrony). In a sparsely connected model of MCs and GCs, we found first that interglomerular synchrony was generally quite low, but could be increased by a factor of 4 by physiological levels of gap junctional coupling between sister MCs at the same glomerulus. This effect was due to enhanced mutually synchronizing interactions between MC and GC populations. The potent role of gap junctions was confirmed in patch‐clamp recordings in bulb slices from wild‐type and connexin 36‐knockout (KO) mice. KO reduced both beta and gamma local field potential oscillations as well as synchrony of inhibitory signals in pairs of non‐sister MCs. These effects were independent of potential KO actions on network excitation. Divergent synaptic connections did not contribute directly to the vast majority of synchronized signals. Thus, in a sparsely connected network, gap junctions between a small subset of cells can, through population effects, greatly amplify oscillatory synchrony amongst unconnected cells.
Pronounced limb and fibre type differences in subcellular lipid droplet content and distribution in elite skiers before and after exhaustive exercise
Authors: Koh Han‐Chow E. , Nielsen Joachim , Saltin Bengt , Holmberg Hans‐Christer , Ørtenblad Niels
Published: June 2017

Key points

Although lipid droplets in skeletal muscle are an important energy source during endurance exercise, our understanding of lipid metabolism in this context remains incomplete.

Using transmission electron microscopy, two distinct subcellular pools of lipid droplets can be observed in skeletal muscle – one beneath the sarcolemma and the other between myofibrils.

At rest, well‐trained leg muscles of cross‐country skiers contain 4‐ to 6‐fold more lipid droplets than equally well‐trained arm muscles, with a 3‐fold higher content in type 1 than in type 2 fibres.

During exhaustive exercise, lipid droplets between the myofibrils but not those beneath the sarcolemma are utilised by both type 1 and 2 fibres.

These findings provide insight into compartmentalisation of lipid metabolism within skeletal muscle fibres.

Although the intramyocellular lipid pool is an important energy store during prolonged exercise, our knowledge concerning its metabolism is still incomplete. Here, quantitative electron microscopy was used to examine subcellular distribution of lipid droplets in type 1 and 2 fibres of the arm and leg muscles before and after 1 h of exhaustive exercise. Intermyofibrillar lipid droplets accounted for 85–97% of the total volume fraction, while the subsarcolemmal pool made up 3–15%. Before exercise, the volume fractions of intermyofibrillar and subsarcolemmal lipid droplets were 4‐ to 6‐fold higher in leg than in arm muscles (P < 0.001). Furthermore, the volume fraction of intermyofibrillar lipid droplets was 3‐fold higher in type 1 than in type 2 fibres (P < 0.001), with no fibre type difference in the subsarcolemmal pool. Following exercise, intermyofibrillar lipid droplet volume fraction was 53% lower (P = 0.0082) in both fibre types in arm, but not leg muscles. This reduction was positively associated with the corresponding volume fraction prior to exercise (R2 = 0.84, P < 0.0001). No exercise‐induced change in the subsarcolemmal pool could be detected. These findings indicate clear differences in the subcellular distribution of lipid droplets in the type 1 and 2 fibres of well‐trained arm and leg muscles, as well as preferential utilisation of the intermyofibrillar pool during prolonged exhaustive exercise. Apparently, the metabolism of lipid droplets within a muscle fibre is compartmentalised.
Benchmark of the Compactness Potential of Adjustable Stiffness Mechanisms
Authors: Stücheli Marius , Daners Marianne Schmid , Meboldt Mirko
Published: June 2017

The VariLeg is an exoskeleton allowing a paraplegic to walk. It was used for competing on an obstacle course at the first Cybathlon. It integrates an adjustable stiffness in the knee joint to improve the walking performance. However, the adjustable stiffness mechanism (ASM) of the VariLeg is bulky and heavy, which hampers the handling of the exoskeleton. Hence, the choice of an ASM concept that only needs small springs is essential. This study benchmarks six state-of-the-art ASMs regarding their needed energy storage capacity, thus their potential for a high compactness. The benchmark is performed with the requirements of the VariLeg and a second requirements set, which can be fulfilled by all six ASMs. The benchmark can be transferred to other requirements as well. It is based on models of the ASMs with their design parameters optimized for the given requirements set. The benchmark reveals large differences between the performances of the investigated ASM concepts of up to a factor of five in the energy storage capacity. This compactness benchmark is a useful design tool to choose a suitable mechanism to realize a compact implementation. More compact ASMs will improve the handling of assistive robots with a physically adjustable stiffness, such as the VariLeg, to support handicapped people in everyday life.