bluuebunny/crossref_metadata_2025_split huggingface dataset:
The anatomical basis for transcutaneous auricular vagus nerve stimulation
Authors: Butt Mohsin F. , Albusoda Ahmed , Farmer Adam D. , Aziz Qasim 
Published: November 2019

AbstractThe array of end organ innervations of the vagus nerve, coupled with increased basic science evidence, has led to vagus nerve stimulation (VNS) being explored as a management option in a number of clinical disorders, such as heart failure, migraine and inflammatory bowel disease. Both invasive (surgically implanted) and non‐invasive (transcutaneous) techniques of VNS exist. Transcutaneous VNS (tVNS) delivery systems rely on the cutaneous distribution of vagal afferents, either at the external ear (auricular branch of the vagus nerve) or at the neck (cervical branch of the vagus nerve), thus obviating the need for surgical implantation of a VNS delivery device and facilitating further investigations across a wide range of uses. The concept of electrically stimulating the auricular branch of the vagus nerve (ABVN), which provides somatosensory innervation to several aspects of the external ear, is relatively more recent compared with cervical VNS; thus, there is a relative paucity of literature surrounding its operation and functionality. Despite the increasing body of research exploring the therapeutic uses of auricular transcutaneous VNS (tVNS), a comprehensive review of the cutaneous, intracranial and central distribution of ABVN fibres has not been conducted to date. A review of the literature exploring the neuroanatomical basis of this neuromodulatory therapy is therefore timely. Our review article explores the neuroanatomy of the ABVN with reference to (1) clinical surveys examining Arnold’s reflex, (2) cadaveric studies, (3) fMRI studies, (4) electrophysiological studies, (5) acupuncture studies, (6) retrograde tracing studies and (7) studies measuring changes in autonomic (cardiovascular) parameters in response to auricular tVNS. We also provide an overview of the fibre composition of the ABVN and the effects of auricular tVNS on the central nervous system. Cadaveric studies, of which a limited number exist in the literature, would be the ‘gold‐standard’ approach to studying the cutaneous map of the ABVN; thus, there is a need for more such studies to be conducted. Functional magnetic resonance imaging (fMRI) represents a useful surrogate modality for discerning the auricular sites most likely innervated by the ABVN and the most promising locations for auricular tVNS. However, given the heterogeneity in the results of such investigations and the various limitations of using fMRI, the current literature lacks a clear consensus on the auricular sites that are most densely innervated by the ABVN and whether the brain regions secondarily activated by electrical auricular tVNS depend on specific parameters. At present, it is reasonable to surmise that the concha and inner tragus are suitable locations for vagal modulation. Given the therapeutic potential of auricular tVNS, there remains a need for the cutaneous map of the ABVN to be further refined and the effects of various stimulation parameters and stimulation sites to be determined.
Transection rate at different areas of scalp during follicular unit extraction/excision (FUE)
Authors: Mohmand Mohammad Humayun , Ahmad Muhammad 
Published: November 2019

AbstractBackgroundAlthough the follicular unit excision/extraction (FUE) is regarded an easy procedure to perform, however, there are various factors which affect the outcome. The hair transection is dependent of various factors and the donor site characteristics affect largely.ObjectivesTo know the difference in transection rate on various areas of scalp during FUE.Materials and methodsThe study was conducted in 10 patients undergoing FUE after obtaining informed consent. In each patient, 1 row was marked with intervening 1 cm2. The row contained five boxes of 1 cm2. Harvesting of FUs was performed using 0.9 mm serrated punch. The procedures were performed with the patient in supine position with the surgeon sitting on head side. The harvested FUs were checked under microscope. Any transection was calculated. All the data was collected and analyzed statistically.ResultsThe total number of FUs and hair were more in center zone as compared to the sides. Whereas, the transection rate was lowest in the mid‐occipital zone as compared to the sides. Similarly, the FUs: hair ratio was more in the sides 1:1.85 as compared to 1:1.62 in central zone. The right and left sides also showed some variations. The transection was more on right side (17.7%) of the patient as compared to the left side (16.3%)ConclusionThe hair transection was more on sides than in the mid‐occipital area.
“It is still intense and not unambiguous.” Nurses' experiences in the euthanasia care process 15 years after legalisation
Authors: Bellens Marthe , Debien Elisa , Claessens Fien , Gastmans Chris , Dierckx de Casterlé Bernadette 
Published: November 2019

AbstractAims and objectivesTo explore how Flemish nurses working in hospitals and home care experience their involvement in the care of patients requesting euthanasia 15 years after the legalisation of euthanasia.BackgroundEuthanasia was legalised in Belgium in 2002. Despite prior research that charted the experiences of nurses in euthanasia care before and right after legalisation in Belgium, it remains unclear how Flemish nurses currently, 15 years after the legalisation, experience their involvement.DesignA grounded theory design, using semi‐structured in‐depth interviews.MethodsWe interviewed 26 nurses working in hospitals or in home care, who had experience with caring for patients requesting euthanasia. Data were collected using a purposive sample and then a snowball sample. Data collection and data analysis were conducted simultaneously. Data were analysed by using the Qualitative Analysis Guide of Leuven. The study adhered to the COREQ guidelines.ResultsCaring for a patient requesting euthanasia continues to be an intense experience characterised by ambivalence. The nature of euthanasia itself contributes to the intensity of this care process. The nurses described euthanasia as something unnatural and planned that generated many questions and doubts. Nevertheless, most interviewees stated that they were able to contribute to a dignified end of life and make a difference, giving them a profound feeling of professional fulfilment. However, when nurses were not able to contribute to good euthanasia care, they struggled with strong negative feelings and frustrations.ConclusionAlthough the results suggest some subtle shifts in nurses' experiences over time, they do not indicate perceptions of euthanasia as a normal practice by the nurses involved.Relevance to clinical practiceThe study reveals the need for more clarification of nurses' ethical responsibility in euthanasia care and their role as moral agents.
The relationship between perceived difficulty and reflection in the practice of discharge planning nurses in acute care hospitals: A nationwide observational study
Authors: Moriya Eiko , Nagao Noriko , Ito Shinya , Makaya Miyuki 
Published: November 2019

AbstractAims and objectivesTo clarify the characteristics and practice of discharge planning nurses in acute care hospitals and to elucidate the relationship between subjective difficulty perceived in practice and reflection.BackgroundThe importance of discharge planning for an effective transition from the hospital to a care facility is increasing. In acute care hospitals, however, it is not clear what discharge planning nurses are doing for patients who are highly dependent on medical treatment, the subjective difficulties they perceive in practical activities, and whether reflection by nurses can be expected to mitigate those difficulties.DesignCross‐sectional survey.MethodsThis survey was conducted in 2,379 acute care hospitals in Japan from 1 June–30 June 2018. The survey of discharge planning practice activities examined nine factors. A nurse who answered that he/she did reflect on his/her practices was defined as a self‐reflecting nurse. The STROBE statement checklists were completed.ResultsQuestionnaires were collected from 760 respondents (response rate = 32.1%). The discharge planning nurses had fewer than 36 months of experience with discharge planning. Among the nurses who had been involved in hospital discharge support for 13 months or more, the self‐reflecting nurses had fewer perceived difficulties in their practice activities than the non‐self‐reflecting nurses did.ConclusionsIt was shown that discharge planning nurses with 13 months or more of experience and who practiced reflection on their practical activities perceived less subjective difficulty. Reflection in daily practice may mitigate the subjective difficulty of practical activities experienced by discharge planning nurses, and the establishment of an effective training method that promotes such reflection is required.Relevance to clinical practiceIn the future, it will be necessary to construct and evaluate an effective education programme for discharge planning nurses that includes self‐reflection on practice cases.
Race/Ethnic Differences in Spatial Distance Between Adult Children and Their Mothers
Authors: Reyes Adriana , Schoeni Robert F. , Choi HwaJung 
Published: November 2019

AbstractObjectiveThis brief study examines race/ethnic differences in geographic distance to mothers among adults in the United States.BackgroundRace/ethnic differences in rates of adult children living with their mothers in the United States are well documented, but spatial distances beyond shared housing are not.MethodSpatial distances between residential locations of adults aged 25 years and older and their biological mothers are estimated using the 2013 Panel Study of Income Dynamics for Hispanics, Blacks, and Whites. Multinomial logistic regression models and nonlinear decomposition techniques are used to assess the role of demographic factors, socioeconomic status, and health of the child and mother in accounting for race/ethnic differences in adult child–mother proximity.ResultsBlacks are more likely than Whites to live with their mother and more likely to live within 30 miles but not coresident, whereas Whites are more likely to live more than 500 miles away. Geographic proximity to the mother is distinct for Hispanics with nearly one third having their mother outside the United States. Demographic, socioeconomic, and health factors account for the fact that Blacks are about twice as likely as Whites to live with their mother but do not fully account for large White–Black differences in proximity outside the household. The most important factor accounting for White–Black differences is marital status for coresidence, but education for proximity in the United States beyond coresidence.ConclusionNew national estimates illustrate the complexity of race/ethnic differences in proximity to mothers that are not reflected in studies of coresidence.
On the Legacy of Christian Ethics in Comparative Religious Ethics
Authors: Twiss Sumner B. 
Published: November 2019

AbstractThis essay is an exploratory inquiry into possible Christian ethical residues in the field of comparative religious ethics (CRE), focusing particularly on the themes of tradition and canon, trajectories of ethical reflection, emancipatory criticism, common morality, and the notion of discipline. It is suggested that even if such traces exist, they may not be detrimental to the field as currently practiced.
Adrenergic reactions during N3 sleep arousals in sleepwalking and sleep terrors: The chicken or the egg?
Authors: Ledard Nahema , Artru Emilie , Colmenarez Sayago Patricia , Redolfi Stefania , Golmard Jean‐Louis , Carrillo‐Solano Marisol , Arnulf Isabelle 
Published: November 2019

AbstractTo understand the mechanisms of N3 sleep interruptions in patients with sleepwalking episodes and/or sleep terrors (SW/ST), we evaluated whether autonomic reactions preceded or accompanied behavioural arousals from NREM sleep stage N3. In 20 adult patients with SW/ST and 20 matched controls without parasomnia, heart rate and pulse wave amplitude were measured beat‐to‐beat during the 10 beats preceding and during the 15 beats succeeding a motor arousal from N3 sleep. Respiratory rate and amplitude were measured during the same 25 successive beats. In patients with SW/ST, the N3 arousals were associated with a 33% increase in heart rate, a 57% decrease in pulse wave amplitude (indicating a major vasoconstriction), a 24% increase in respiratory rate and a doubling of respiratory amplitude. Notably, tachycardia and vasoconstriction started 4 s before motor arousals. A similar profile (tachycardia and vasoconstriction gradually increasing from the 4 s preceding arousal and post‐arousal increase of respiratory amplitude, but no polypnea) was also observed, with a lower amplitude, during the less frequent 38 quiet N3 arousals in control subjects. Parasomniac arousals were associated with greater tachycardia, vasoconstriction and polypnea than quiet arousals, with the same pre‐arousal gradual increases in heart rate and vasoconstriction. Autonomic arousal occurs 4 s before motor arousal from N3 sleep in patients with SW/ST (with a higher adrenergic reaction than in controls), suggesting that an alarming event during sleep (possibly a worrying sleep mentation or a local subcortical arousal) causes the motor arousal.
Hepatitis C cure improved patient‐reported outcomes in patients with and without liver fibrosis in a prospective study at a large urban medical center
Authors: Sung Julie C. , Bosh Ciara , Wyatt Brooke , Miller Mark , Harty Alyson , Del Bello David , Knight Sterling , Dieterich Douglas T. , Perumalswami Ponni V. , Branch Andrea D. 
Published: November 2019

AbstractPatient‐reported outcomes (PROs) are important measures of quality of life. Direct‐acting antiviral (DAA) drugs for hepatitis C virus (HCV) improved PROs in clinical trials. We prospectively evaluated the impact of DAA‐based HCV cure on PROs and liver‐related outcomes in real‐world patients at a large urban medical center. The short form (SF)‐36 and three additional validated instruments were used. F3‐4 fibrosis was defined as > 9.6 kPa by transient elastography (TE); S2‐3 steatosis was defined as > 270 dB/m by TE‐controlled attenuation parameter (CAP). Data were analysed by paired and unpaired t tests. Patients (n = 16) who did not achieve a sustained virologic response at 12 weeks (SVR12) were excluded. The study achieved its primary endpoint and showed a significant 30% improvement in the SF‐36 vitality score, measured baseline to SVR12: 63 versus 82, P < .001 (n = 111). Scores in 24 of 25 PRO domains improved at SVR12 (P < .05). Nearly all gains exceeded 5%, indicating their clinical significance. Transaminase values and liver stiffness improved (decreased) significantly, baseline to SVR12 (P < .005), but steatosis was unchanged (P = .58). Patients with baseline F0‐2 fibrosis and those with F3‐F4 fibrosis both improved in 22 domains. Patients with baseline S0‐S1 steatosis improved in more domains (23) than patients with S2‐S3 steatosis (19). At baseline, patients with F3‐F4 fibrosis and patients with S2‐3 steatosis had worse scores in certain PRO domains than patients with F0‐2 fibrosis or S0‐S1 steatosis, but this difference resolved by SVR12. HCV cure led to meaningful gains in PROs, and these findings may encourage patients to seek treatment.
A heme‐binding protein produced by Haemophilus haemolyticus inhibits non‐typeable Haemophilus influenzae
Authors: Latham Roger D. , Torrado Mario , Atto Brianna , Walshe James L. , Wilson Richard , Guss J. Mitchell , Mackay Joel P. , Tristram Stephen , Gell David A. 
Published: November 2019

AbstractCommensal bacteria serve as an important line of defense against colonisation by opportunisitic pathogens, but the underlying molecular mechanisms remain poorly explored. Here, we show that strains of a commensal bacterium, Haemophilus haemolyticus, make hemophilin, a heme‐binding protein that inhibits growth of the opportunistic pathogen, non‐typeable Haemophilus influenzae (NTHi) in culture. We purified the NTHi‐inhibitory protein from H. haemolyticus and identified the hemophilin gene using proteomics and a gene knockout. An x‐ray crystal structure of recombinant hemophilin shows that the protein does not belong to any of the known heme‐binding protein folds, suggesting that it evolved independently. Biochemical characterisation shows that heme can be captured in the ferrous or ferric state, and with a variety of small heme‐ligands bound, suggesting that hemophilin could function under a range of physiological conditions. Hemophilin knockout bacteria show a limited capacity to utilise free heme for growth. Our data suggest that hemophilin is a hemophore and that inhibition of NTHi occurs by heme starvation, raising the possibility that competition from hemophilin‐producing H. haemolyticus could antagonise NTHi colonisation in the respiratory tract.
The development of the cricoid cartilage and its implications for the use of endotracheal tubes in the pediatric population
Authors: Liu Shiqing , Qi Wenxu , Zhang Xiaohui , Dong Youjing 
Published: November 2019

AbstractBackgroundThe rigid cricoid cartilage is functionally the narrowest portion of the larynx. There is some controversy over the shape of the pediatric cricoid cartilage in the transverse plane. It is important to understand the development of the cricoid cartilage so that endo‐traceheal tubes can be used more safely.AimTo determine changes in the internal diameter and shape of the cricoid cartilage during development and explore the implications of those changes for the selection of ETT type and size for children.MethodsThe cervical computed tomography scans were reviewed in patients aged 1‐20 years. After performing the multiplanar reconstruction and correcting the slant, the transverse and anteroposterior internal diameters of the inlet and outlet of the cricoid cartilage were measured, respectively. The angle between the arch and the lamina of the cricoid cartilage in the middle sagittal plane was measured. The ratios of transverse to anteroposterior diameter for the inlet and outlet of the cricoid cartilage were calculated, respectively.ResultsIn females, the internal diameters of the cricoid cartilage increased linearly with age. In males, the internal diameters of the cricoid cartilage exhibited a growth spurt during adolescence. The transverse diameter of the inlet was the smallest diameter of the cricoid cartilage, and the predicting formula of the transverse diameter of the inlet for children aged 1‐12 was 0.4 × age (year) + 5.1, R2 = .758. The angle between the arch and lamina of the cricoid cartilage and the ratios of transverse to anteroposterior diameter correlated weakly with age.ConclusionThe transverse inner diameter of the inlet is the smallest diameter of the cricoid cartilage. The “funnel shape” of the cricoid cartilage remains unchanged during development. The outer diameter should be considered when selecting an endotracheal tube.
Learning from methylomes: epigenomic correlates of Populus balsamifera traits based on deep learning models of natural DNA methylation
Authors: Champigny Marc J. , Unda Faride , Skyba Oleksandr , Soolanayakanahally Raju Y. , Mansfield Shawn D. , Campbell Malcolm M. 
Published: November 2019

SummaryEpigenomes have remarkable potential for the estimation of plant traits. This study tested the hypothesis that natural variation in DNA methylation can be used to estimate industrially important traits in a genetically diverse population of Populus balsamifera L. (balsam poplar) trees grown at two common garden sites. Statistical learning experiments enabled by deep learning models revealed that plant traits in novel genotypes can be modelled transparently using small numbers of methylated DNA predictors. Using this approach, tissue type, a nonheritable attribute, from which DNA methylomes were derived was assigned, and provenance, a purely heritable trait and an element of population structure, was determined. Significant proportions of phenotypic variance in quantitative wood traits, including total biomass (57.5%), wood density (40.9%), soluble lignin (25.3%) and cell wall carbohydrate (mannose: 44.8%) contents, were also explained from natural variation in DNA methylation. Modelling plant traits using DNA methylation can capture tissue‐specific epigenetic mechanisms underlying plant phenotypes in natural environments. DNA methylation‐based models offer new insight into natural epigenetic influence on plants and can be used as a strategy to validate the identity, provenance or quality of agroforestry products.
A survey in uncharted territory: A collaborative study to explore the approach to atopic dermatitis patient management in allopathy and naturopathy
Authors: Dhossche Julie , Corn Josh , Simpson Eric L. , Funk Tracy 
Published: November 2019

AbstractBackgroundAtopic dermatitis (AD) patients frequently use both conventional and complementary medicines for treatment. Allopathic and naturopathic providers may be unaware of each other's approach to AD diagnosis, skin care, and treatment, affecting patient and provider communication, patient safety, and potential for collaborative studies.ObjectiveTo identify core commonalities and differences in allopathic and naturopathic approach to AD.MethodsThirty allopathic and 21 naturopathic providers completed an 11‐question free‐text comment survey, covering patient education and evaluation, skin care, and treatment of AD. Qualitative content analysis detected key ideas and concepts, and word cloud analysis provided a quantitative visual representation of recurrent words in each group's responses.ResultsAll respondents indicated using similar physical features to diagnose AD. In both allopathic and naturopathic fields, the majority of providers did not perform routine testing for AD diagnosis. Skin care with moisturization and “soak‐and‐seal” bathing practices were routine in both fields. Naturopathic providers heavily emphasized the role of food and diet in AD pathogenesis, education, and management, while allopathic providers indicated little to no role for food and diet in AD. For treatment, allopathic providers favored topical steroids, phototherapy, and immunomodulators, whereas naturopathic providers recommended botanicals, supplements, and other complementary and alternative methods.ConclusionsProviders should be aware of the differences between allopathic and naturopathic providers and their approach to AD management, particularly concerning the role of food and diet. There may be opportunities to harmonize skin care regimens for patients given similar approach in both fields, and to collaborate further on studies of diet in AD and treatments not yet effectively tested.