bluuebunny/crossref_metadata_2025_split huggingface dataset:
Osteocytes and mechanical loading: The Wnt connection
Authors: Bullock Whitney A. , Pavalko Frederick M. , Robling Alexander G. 
Published: May 2019

Structured AbstractBone adapts to the mechanical forces that it experiences. Orthodontic tooth movement harnesses the cell‐ and tissue‐level properties of mechanotransduction to achieve alignment and reorganization of the dentition. However, the mechanisms of action that permit bone resorption and formation in response to loads placed on the teeth are incompletely elucidated, though several mechanisms have been identified. Wnt/Lrp5 signalling in osteocytes is a key pathway that modulates bone tissue's response to load. Numerous mouse models that harbour knock‐in, knockout and transgenic/overexpression alleles targeting genes related to Wnt signalling point to the necessity of Wnt/Lrp5, and its localization to osteocytes, for proper mechanotransduction in bone. Alveolar bone is rich in osteocytes and is a highly mechanoresponsive tissue in which components of the canonical Wnt signalling cascade have been identified. As Wnt‐based agents become clinically available in the next several years, the major challenge that lies ahead will be to gain a more complete understanding of Wnt biology in alveolar bone so that improved/expedited tooth movement becomes a possibility.
Extracellular vesicle identification in tooth movement models
Authors: Holliday L. Shannon , Truzman Estella , Zuo Jian , Han Guanghong , Torres‐Medina Rosemarie , Rody Wellington J. 
Published: May 2019

Structured AbstractExtracellular vesicles (EVs) are 30‐150 nm in diameter vesicles released by cells that serve important intercellular regulatory functions. EVs include exosomes and microvesicles. Exosomes form in multivesicular bodies and are released extracellularly as the multivesicular bodies fuse with the plasma membrane. Microvesicles bud directly from the plasma membrane. Here, we examine methods that are available or emerging to detect and study EVs during orthodontic tooth movement (OTM). EV's involvement in regulating bone remodelling associated with OTM may be demonstrated by adding isolated EVs to an animal model to change the rate of tooth movement. Exosomes in multivesicular bodies might be detected by immunogold labelling of markers in sections from the tooth and jaw and detection by electron microscopy. Gingival crevicular fluid (GCF) is enriched in EVs. Detection and characterization of EVs released by osteoclasts during resorption have been described, and this information could be used to analyse EVs in OTM models. Regulatory EVs may be enriched in the GCF from teeth that are being moved or are undergoing root resorption. Emerging approaches, including nanoparticle tracking, ExoView and micro‐ and nanofluidics, show promise for studying EVs in the GCF. Techniques that amplify signal, including polymerase chain reaction (PCR), provide the sensitivity necessary to utilize EVs from GCF as biomarkers. Studies of the role of EVs in OTM will provide fresh insight that may identify means for enhancing OTM procedures. EVs in GCF may include biomarkers for bone remodelling during OTM, orthodontic‐associated root resorption, and other dental pathologies.
Locating and Representing Pain
Authors: Gozzano Simone 
Published: May 2019

AbstractTwo views on the nature and location of pain are usually contrasted. According to the first, experientialism, pain is essentially an experience, and its bodily location is illusory. According to the second, perceptualism or representationalism, pain is a perceptual or representational state, and its location is to be traced to the part of the body in which pain is felt. Against this second view, the cases of phantom, referred and chronic pain have been marshalled: all these cases apparently show that one can be in pain while not having anything wrong in her body. Pain bodily location, then, would be illusory. I this paper I shall defend the representational thesis by presenting an argument against experientialism while conceding that the appearance/reality distinction collapses. A crucial role in such identification is played by deictics. In reporting that we feel pain here, the deictic directly refers to the bodily part as coinciding with the part as represented. So, pain location is not illusory. The upshot is that the body location is part and parcel of the representational content of pain states, a representation build up from the body map.
Exercise‐based cardiac rehabilitation is associated with a normalization of the heart rate performance curve deflection
Authors: Heber Stefan , Sallaberger‐Lehner Marina , Hausharter Maria , Volf Ivo , Ocenasek Helmuth , Gabriel Harald , Pokan Rochus 
Published: May 2019

The heart rate (HR) rises with increased power output, whereby in most healthy individuals, the slope of HR levels off with higher intensity. This corresponds to a downward deflection of the heart rate performance curve (HRPC). Conversely, in patients after myocardial infarction, an upward HRPC deflection is frequently observed that is especially pronounced in patients with compromised left ventricular ejection fraction. To investigate whether regular endurance training during cardiac rehabilitation might normalize HRPC, data of 128 male patients were analyzed. All patients performed three exercise tests: at baseline, after 6 weeks, and after 1 year. Ninety‐six patients exercised regularly according to guidelines for 1 year (training group, TG), and 32 stopped after 6 weeks (control group, CG). Similarly, upward‐deflected HRPCs were observed at baseline and after 6 weeks in both groups. After 1 year, TG patients had less upward‐deflected HRPCs compared with CG ones, corresponding to a partial normalization. Greater changes in HRPC deflection were associated with larger improvements in cardiorespiratory fitness. Our results might indicate improved myocardial function due to long‐term rehabilitation. Further, HRPC alterations over time should be considered when prescribing exercise intensities using a target HR, as deflection flattening might render the intensity of corresponding exercise insufficient.
Challenges in an X + Y ambulatory model
Authors: Ibrahim Walid , Adam Omeralfaroug , Mohamed Abdelaziz , Subahi Ahmed , Osman Lubna , Hassan Abubaker AI , Yassin Ahmed S , Thati Neelima , Weinberger Jarrett , Levine Diane 
Published: May 2019

SummaryBackgroundInternal medicine training requires significant exposure to ambulatory practice. Ensuring continuity of patient care is challenging, especially with intermittent ambulatory resident assignments. A popular scheduling model is an X + Y block system where residents rotate for X weeks on inpatient rotations followed by Y weeks on ambulatory clinics. Although benefits exist with the X + Y model, it has drawbacks, particularly for continuity of care: residents struggle to obtain follow‐up test results and return patient calls promptly. To provide patients with seamless continuity the programme assigned two Managing Clinic Continuity Care Residents (MCCCRs) to cover all tasks. The MCCCRs were soon overwhelmed by the number of tasks and became dissatisfied with the workflow, however, resulting in a low task‐completion rate.MethodIn our 4 + 1 model residents are divided into five cohorts, we created mini‐practice groups (MPGs) consisting of one resident from each cohort. Each week the resident in the clinic is assigned to act as the Practice Clinic Continuity of Care Resident (PCCCR) for the MPG. This individual is responsible for addressing the patient tasks of the other four residents in the MPG. For optimal performance, the previous two MCCCRs are now assigned for oversight only each week. We tracked task‐completion rates weekly and surveyed residents for satisfaction.ResultsFollowing the redistribution of responsibilities, the task‐completion rates improved from 75 to 97%. The MCCCR satisfaction rate for the workflow increased from zero to 63%, and the on‐time note completion rates increased from 21 to 67%.ConclusionModification of the X + Y model using the MPG structure ensured the timely completion of patient‐related tasks, and improved the overall experience for both patients and providers.Modification of the X + Y model using the MPG structure ensured the timely completion of patient‐related tasks, and improved the overall experience for both patients and providers
Robust abnormality detection methods for spatial search of radioactive materials
Authors: Jeong Myeong‐Hun , Sullivan Clair J. , Gao Yizhao , Wang Shaowen 
Published: May 2019

AbstractRadiological dirty bombs and improvised nuclear devices pose a significant threat to both public health and national security. Growing networks of radiation sensors have been deployed by a number of offices within the U.S. and international agencies. Detecting such threats while minimizing false alarm rates presents a considerable challenge to homeland security and public health. This research aims to achieve a higher probability of detection with a lower probability of false alarms. It focuses on the local spatial instability of radiation levels in order to detect radioactive materials based on robust outlier detection methods. Our approach includes a three‐step abnormality detection method consisting of one‐dimensional robust outlier detection for all gamma‐ray counts, a density‐based clustering analysis, and a two‐dimensional robust outlier detection method using a bagplot, based on spatial associations. The effectiveness of the method proposed is demonstrated through a case study, wherein radioactive materials are detected in urban environments, and its performance is compared with alternative methods employing ak‐sigma approach, local Getis–Ord () statistic, and the goodness of fit of the Poisson distribution.
GIS&T pedagogies and instructional challenges in higher education: A survey of educators
Authors: Mathews Adam J. , Wikle Thomas A. 
Published: May 2019

AbstractAnyone involved in teaching the principles and applications of geographic information science and technology (GIS&T) understands the challenges of effective instruction within an environment subject to nearly constant change. Indeed, the dynamic nature of GIS&T introduces both new paradigms and increasingly powerful tools for exploring spatial relationships. However, while past efforts among educators and practitioners have identified knowledge and competencies important to GIS&T learning, less attention has been directed at methods used to teach GIS&T. For example, while some instructors employ traditional approaches such as lectures and structured laboratory exercises, others have shifted to active learning strategies such as “flipped classrooms” and collaborative, project‐oriented assignments. In this article, we assess the pedagogical approaches used to teach GIS&T courses through an Internet‐based survey of 318 college and university faculty. Our findings demonstrate that active learning pedagogies are becoming more firmly established, supplementing or replacing traditional teaching approaches. Contrary to our assumptions, age and teaching experience are not factors that influence the adoption of active learning strategies. Along with assessing instructional approaches, our survey identifies the challenges associated with teaching GIS&T, as identified by survey respondents.
A comparison of lancets and evaluation of various manoeuvres in reducing finger prick pain during pre‐donation haemoglobin estimation
Authors: Dubey A. , Sonker A. , Agarwal P. 
Published: May 2019

SummaryObjectivesThree different types of lancets have been compared to identify and implement the one that causes the least pain. Simple manoeuvres during the lancing procedure have been evaluated to determine their effectiveness in reducing the intensity of perceived pain.BackgroundPre‐donation haemoglobin estimation is performed by pricking the donor's finger with a lancet. Pain associated with the procedure causes fear and anxiety, which dissuades the donors from donating blood.MethodsIn 100 subjects, finger prick was performed using three different lancets, and the subjects were asked to score their pain on a numerical rating scale (NRS). A further 150 blood donors were subjected to routine finger pricking for Hb estimation and were asked to score their pain on an NRS. After 15 min, they underwent a second prick with application of a manoeuvre (breath holding, coughing trick or looking away) and again marked their pain scores on the NRS.ResultsParticipants reported the least pain scores with lancing devices that have a spring mechanism to retract the lancets soon after penetration into the skin. Breath holding and the cough trick manoeuvre reduced the perceived pain scores significantly.ConclusionLancing devices merit consideration for routine use, and a simple manoeuvre may be applied to reduce perceived pain.
Red blood cells donated by smokers: A pilot investigation of recipient transfusion outcomes
Authors: DeSimone Robert A. , Hayden Joshua A. , Mazur Chase A. , Vasovic Ljiljana V. , Sachais Bruce S. , Zhao Zhen , Goel Ruchika , Hsu Yen‐Michael S. , Racine‐Brzostek Sabrina E. , Cushing Melissa M. 
Published: May 2019

BACKGROUNDCurrent regulations do not require blood collection facilities to ask donors about cigarette smoking, and the prevalence of nicotine and its metabolites in blood products is not well established. Although smokers have higher hemoglobin (Hb) levels, smoking may adversely affect the quality of donated red blood cells through higher carboxyhemoglobin (COHb) content and premature hemolysis.STUDY DESIGN AND METHODSRed blood cell (RBC) unit segments from 100 unique donors were tested for nicotine and its metabolite cotinine by mass spectrometry and for COHb spectrophotometrically. Outcomes were evaluated retrospectively in adult non‐bleeding patients receiving single RBC units.RESULTSThirteen of 100 RBC segments (13%) were positive for cotinine at levels consistent with current smoking (> 10 ng/mL). The cotinine positive RBCs showed significantly greater COHb content compared to cotinine negative units (median 3.0% vs. 0.8%, p = 0.007). For patients transfused cotinine‐positive units, there was no significant change in their vital signs following transfusion and no transfusion reactions were observed. However, patients transfused cotinine‐positive units showed significantly reduced hematocrit and hemoglobin increments (median +1.2% and +0.4 g/dL) following transfusion compared to patients receiving cotinine negative units (median +3.6% and +1.4 g/dL) (p = 0.014).CONCLUSIONThirteen percent of RBC units tested positive for cotinine at levels consistent with active smoking, accordant with the estimated national smoking rate of 15.5%. Cotinine‐positive RBC units had greater COHb content and showed reduced hematocrit and hemoglobin increments following transfusion. These preliminary results should be validated in a larger cohort.
Enhancement of mouse diaphragm contractility in the presence of antagonists of GABAA and GABAB receptors
Authors: Lenina Oksana , Petrov Konstantin , Kovyazina Irina , Malomouzh Artem 
Published: May 2019

New Findings
What is the central question of this study?
Do GABA receptors play any role at the neuromuscular junction?

What is the main finding and its importance?
In the presence of either ionotropic or metabotropic GABA receptor antagonists, diaphragm muscle force production elicited by stimulating the motor nerve at ≥50 Hz was increased. Our data indicate the presence of GABAergic signalling at the neuromuscular junction.

AbstractDespite the signalling role of GABA in the brain and spinal cord, the role of this molecule in the peripheral nervous system and, in particular, at the neuromuscular junction remains practically unexplored. In the present work, the force of mouse diaphragm contractions was measured in the presence of blockers of metabotropic GABAB receptors (CGP 55845) and ionotropic GABAA receptors (picrotoxin) with various patterns of indirect and direct stimulation of muscle by trains of 40 pulses delivered at 10, 20, 50 and 70 Hz. It was found that neither blocker affected the diaphragm contractility caused by indirect stimulation through the motor nerve at 10 and 20 Hz. However, when the stimulation frequency was increased to 50 or 70 Hz, the force of subsequent contractions in the train (when compared with the amplitude of contraction in response to the first pulse) was increased by both CGP 55845 and picrotoxin. With direct stimulation of the diaphragm, no significant changes in the contraction force were detected at any frequency used. The results obtained support the following conclusions: (i) pharmacological inhibition of GABA receptors increases the contractile activity of skeletal muscle; and (ii) frequency‐dependent enhancement of GABA receptor activation takes place in the region of the neuromuscular junction.
E-cigarettes helped more smokers quit than nicotine replacement therapy
Authors: Cook Rob , Davidson Peter , Martin Rosie 
Published: May 2019

The studyHajek P, Phillips-Waller A, Przulj D, et al. A randomised trial of e-cigarettes versus nicotine-replacement therapy. N Engl J Med 2019;380:629-37.This trial was funded by the NIHR Health Technology Assessment Programme (12/167/135) and by Cancer Research UK.To read the full NIHR Signal, go to https://discover.dc.nihr.ac.uk/content/signal-000757/e-cigarettes-helped-more-smokers-quit-than-nicotine-replacement-therapy
Alcohol-related harm to others in England: a cross-sectional analysis of national survey data
Authors: Beynon Caryl , Bayliss David , Mason Jenny , Sweeney Kate , Perkins Clare , Henn Clive 
Published: May 2019

ObjectivesTo estimate the prevalence, the frequency and the perpetrators of alcohol-related harm to others (AHTO) and identify factors associated with experiencing harm and aggressive harm.DesignCross-sectional survey.SettingEngland.ParticipantsAdults (general population) aged 16 and over.Outcome measuresPercentage of respondents who experienced harm. Socioeconomic and demographic factors associated with the outcomes. Outcomes were (1) experienced harm/did not experience harm and (2) experienced aggressive harm (physically threatened, physically hurt and forced/pressured into something sexual)/did not experience an aggressive harm (no aggressive harm plus no harm at all).ResultsData to support a response rate calculation were not collected; 96.3% of people surveyed completed the AHTO questions. The weighted sample was 4874; 20.1% (95% CI 18.9 to 21.4, N=980) reported experiencing harm in the previous 12 months and 4.6% (95% CI 4.0 to 5.4, N=225) reported experiencing an aggressive harm. Friends and strangers were the dominant perpetrators. Most harms (74.8%) occurred less than monthly. Factors associated with experiencing harm were: younger age (p<0.001), drinking harmfully/hazardously (p<0.001), white British (p<0.001 compared to other white groups and Asian groups and p=0.017 compared to black groups), having a disability (p<0.001), being educated (p<0.001 compared to no education) and living in private rented accommodation (p=0.004 compared with owned outright). Being in the family stage of life (defined as having children in the household) had significantly lower odds of harm (p=0.006 compared to being single), as did being retired (p<0.001 compared to being employed). Factors associated with experiencing an aggressive harm were similar.ConclusionsThis exploratory study, using data collected through the Alcohol Toolkit Survey, shows that AHTO affects 20.1% of the population of England. Even apparently minor harms, like being kept awake, can have a negative impact on health, while aggressive harms are clearly of concern. Using a standard methodology to measure harm across studies would be advantageous. Policies that focus on alcohol must take into consideration the impact of drinking on those other than the drinker.
Decomposing inequality in catastrophic health expenditure for self-reported hypertension household in Urban Shaanxi, China from 2008 to 2013: two waves’ cross-sectional study
Authors: Si Yafei , Zhou Zhongliang , Su Min , Wang Xiao , Lan Xin , Wang Dan , Gong Shaoqing , Xiao Xiao , Shen Chi , Ren Yangling , Zhao Dantong , Hong Zihan , Bian Ying , Chen Xi 
Published: May 2019

ObjectiveDespite the latest wave of China’s healthcare reform initiated in 2009 has achieved unprecedented progress in rural areas, little is known for specific vulnerable groups’ catastrophic health expenditure (CHE) in urban China. This study aims to estimate the trend of incidence, intensity and inequality of CHE in hypertension households (households with one or more than one hypertension patient) in urban Shaanxi, China from 2008 to 2013.MethodsBased on the fourth and the fifth National Health Service Surveys of Shaanxi, we identified 460 and 1289 households with hypertension in 2008 and 2013, respectively for our analysis. We classified hypertension households into two groups: simplex households (with hypertension only) and mixed households (with hypertension plus other non-communicable diseases). CHE would be identified if out-of-pocket healthcare expenditure was equal to or higher than 40% of a household’s capacity to pay. Concentration index and its decomposition based on Probit regressions were employed to measure the income-related inequality of CHE.ResultsWe find that CHE occurred in 11.2% of the simplex households and 22.1% of the mixed households in 2008, and the 21.5% of the simplex households and the 46.9% of mixed households incurred CHE in 2013. Furthermore, there were strong pro-poor inequalities in CHE in the simplex households (−0.279 and −0.283) and mixed households (−0.362 and −0.262) both in 2008 and 2013. The majority of observed inequalities in CHE could be associated with household economic status, household head’s health status and having elderly members.ConclusionWe find a sharp increase of CHE occurrence and the sustained strong pro-poor inequalities for simplex and mixed households in urban Shaanxi Province of China from 2008 to 2013. Our study suggests that more concerns are needed for the vulnerable groups such as hypertension households in urban areas of China.