bluuebunny/crossref_metadata_2025_split huggingface dataset:
Rehabilitation in lung diseases: ‘Education’ component of pulmonary rehabilitation
Authors: Blackstock Felicity C. , Evans Rachael A. 
Published: May 2019

ABSTRACTPulmonary rehabilitation (PR) is a complex intervention with described core components of individualized exercise training and inter‐disciplinary education in international guidelines. Compared to the overwhelming evidence of benefit for exercise training, the education component has received little attention. Educating patients about their symptoms and disease management appears intuitive to improve their health, but how and when is less clear. PR has provided an opportunity for educational activities and traditionally this has been delivered in the form of didactic lectures. The field is evolving and challenges are apparent raising important questions. What is the purpose and outcomes of the education component? Do specific diseases require specific education or PR programmes? How to provide interdisciplinary education? Is the timing optimal within the disease trajectory (most patients are referred to PR with moderate to severe disease)? Can technology help? Our review explores the recent evidence for the ‘education’ component of PR synthesizing the global guidelines. We discuss the challenges for patients as learners, healthcare professionals as educators and propose future directions for this core component of PR.
Rethinking Resilience Analytics
Authors: Eisenberg Daniel , Seager Thomas , Alderson David L. 
Published: May 2019

AbstractThe concept of “resilience analytics” has recently been proposed as a means to leverage the promise of big data to improve the resilience of interdependent critical infrastructure systems and the communities supported by them. Given recent advances in machine learning and other data‐driven analytic techniques, as well as the prevalence of high‐profile natural and man‐made disasters, the temptation to pursue resilience analytics without question is almost overwhelming. Indeed, we find big data analytics capable to support resilience to rare, situational surprises captured in analytic models. Nonetheless, this article examines the efficacy of resilience analytics by answering a single motivating question: Can big data analytics help cyber–physical–social (CPS) systems adapt to surprise? This article explains the limitations of resilience analytics when critical infrastructure systems are challenged by fundamental surprises never conceived during model development. In these cases, adoption of resilience analytics may prove either useless for decision support or harmful by increasing dangers during unprecedented events. We demonstrate that these dangers are not limited to a single CPS context by highlighting the limits of analytic models during hurricanes, dam failures, blackouts, and stock market crashes. We conclude that resilience analytics alone are not able to adapt to the very events that motivate their use and may, ironically, make CPS systems more vulnerable. We present avenues for future research to address this deficiency, with emphasis on improvisation to adapt CPS systems to fundamental surprise.
Eyberg Child Behavior Inventory (ECBI): Normative data, psychometric properties, and associations with socioeconomic status in Finnish children
Authors: Sorsa Johanna , Fontell Tuija , Laajasalo Taina , Aronen Eeva T. 
Published: May 2019

Assessment of behavioral disorders is one of the most commonly encountered tasks in child psychiatry. The Eyberg Child Behavior Inventory (ECBI) is a widespread measurement tool used for assessing conduct problems, though the psychometric properties of the tool have varied in different samples. In this study, the ECBI was evaluated in a Finnish population based sample of children aged 4 to 12 years (n = 1,715). Factor structure and internal consistency of the ECBI and associates of behavioral problems in Finnish children were evaluated. The results showed that a unidimensional one‐factor solution for the ECBI intensity scale was the best fit for the data. The ECBI mean scores were considerably higher in our sample compared to other Nordic countries. Boys scored higher than girls on both ECBI scales, and the mean scores decreased with child's age. Socioeconomic status (SES) was weakly connected to the ECBI scores. Our results highlight the need for country specific reference norms in order to improve the clinical utility of evidence‐based measures for assessing conduct problems.
Preschoolers prefer in‐group to out‐group members, but equally condemn their immoral acts
Authors: Schuhmacher Nils , Kärtner Joscha 
Published: May 2019

AbstractPrevious research has shown that young children robustly display in‐group favoritism; that is, they favor in‐group over out‐group members. Moreover, preschoolers also consider information on morality in their evaluations of others. In the present study, we integrated both aspects: In particular, fifty‐six 4‐ to 6‐year‐old preschoolers were assigned to minimal groups and observed either prosocial or antisocial acts conducted by either an in‐group or an out‐group member. After observing these behaviors, children's liking and sharing were significantly higher for moral compared to immoral actors. In addition, children's liking and sharing were substantially higher for in‐group compared to out‐group actors. However, when children were directly asked to morally evaluate the actor's conduct, no in‐group favoritism emerged: In particular, children evaluated immoral acts conducted by an in‐group or an out‐group agent as equally bad/wrong and similarly claimed that these acts deserve punishment. These findings demonstrate that preschoolers differentially weigh information on group membership and moral valence depending on the type of evaluation, namely sharing and liking versus explicit moral evaluations of others’ conduct.
Surgical decompression, with or without adjunctive therapy, for palliative treatment of primary vertebral osteosarcoma in dogs
Authors: Dixon Alexandra , Chen Annie , Rossmeisl John H. , Sturges Beverly , Vernau Karen , Levine Jonathan M. , Otamendi Arturo , Early Peter , Partnow Alix , Curtis Lara , Thomovsky Stephanie , Packer Rebecca A. , Mauler Daniela A. 
Published: May 2019

AbstractVertebral osteosarcoma (OSA) is the most common primary vertebral tumor in dogs, however studies examining the survival time after surgical decompression of these tumors are limited. There is also limited information regarding the benefit of adjunctive treatments such as radiation therapy or chemotherapy in these patients. The goal of this study was to determine survival time of dogs with primary vertebral OSA after palliative decompressive surgery alone and combined with radiation therapy and/or chemotherapy. Records from 22 client‐owned dogs diagnosed with primary vertebral OSA and treated with decompressive surgery were collected retrospectively from eight referral institutions. Survival time was assessed for dogs treated with surgery alone as well as dogs who received adjunctive radiation therapy and/or chemotherapy. Median survival time in the 12 dogs treated with surgery alone was 42 days (range: 3‐1333 days). The three dogs treated with surgery and chemotherapy had a median survival time of 82 days (range: 56‐305 days). Only one dog was treated with surgery and radiation therapy; this dog survived 101 days. Six dogs were treated with surgery, radiation therapy and chemotherapy; these dogs had a median survival time of 261 days (range: 223‐653 days). Cause of death in all cases that survived the initial postoperative period was euthanasia secondary to confirmed or suspected tumor regrowth. The results of this study suggest that definitive radiation therapy, possibly combined with concurrent chemotherapy, significantly improves survival in dogs treated with palliative decompressive surgery for vertebral OSA and should be the treatment of choice in selected cases.
Hypofractionated radiotherapy in nine dogs with unresectable solitary lung adenocarcinoma
Authors: Kawabe Mifumi , Kitajima Yuka , Murakami Mami , Iwasaki Ryota , Goto Sho , Sakai Hiroki , Mori Takashi 
Published: May 2019

AbstractAlthough lung lobectomy is the most common treatment option for dogs with solitary lung tumors, surgery often cannot be performed at the time of diagnosis. In this retrospective, case series study, we described the effects of hypofractionated radiotherapy for tumor mass reduction in nine dogs with solitary lung adenocarcinoma that were later considered for surgical resection, and we assessed the tolerability of the radiation protocol. Tumors were deemed unresectable by the attending veterinarian. The dose prescription was 7.0‐12.0 Gy/fraction in four to seven fractions, administered weekly for a total dose of 40‐50 Gy. Treatment planning prioritized normal tissue dose constraints. The median interval between the last radiotherapy session and maximum tumor size reduction was 56 (range: 26‐196) days, with six and three dogs exhibiting a partial response and stable disease, respectively. Although acute and late radiation‐induced toxicity to the skin and/or lungs developed in all nine dogs, it was self‐limiting or improved with short‐term anti‐inflammatory treatment. Tumor progression after initial size reduction was confirmed in three dogs at 62, 126, and 175 days, respectively, after the last radiotherapy session. Seven of the nine dogs underwent lobectomy a median of 68 days after radiotherapy when tumors were in partial response or stable disease or at the time of progression, and five received systemic chemotherapy concurrent with or after radiotherapy. These findings suggest that hypofractionated radiotherapy for canine solitary lung adenocarcinoma is useful when the tumor is large or when surgery cannot be performed immediately after diagnosis.
Evaluation of surgical models for training veterinary students to perform enterotomies
Authors: Grimes Janet A. , Wallace Mandy L. , Schmiedt Chad W. , Parks Andrew H. 
Published: May 2019

AbstractObjectiveTo compare surgical models for teaching enterotomies to students.Study designProspective, randomized study.Sample populationSecond‐year veterinary students (n = 59) and faculty surgeons/surgery residents (n = 19).MethodsParticipants performed an enterotomy on each of 3 models (equine cadaver intestine, SurgiReal small intestine simulator, and SynDaver canine bowel) and completed a survey comparing them to either an enterotomy on an anesthetized pig (students) or intestinal surgery experience (faculty/residents). Surveys results were compiled and analyzed.ResultsBoth student and faculty/resident groups rated cadaver intestine as more similar to live intestine compared with the synthetic models for incision, tissue handling, mucosal eversion, needle passage, knot tying, and best preparing for live intestine. Students rated SynDaver as more similar to live intestine than SurgiReal for incision and ranked SurgiReal as more similar to live intestine than SynDaver for mucosal eversion. There was no difference between the ranks assigned to SurgiReal and SynDaver for faculty/residents. Faculty/residents responded most often that cadaver intestine would be the model they recommend for training students.ConclusionCadaver intestine was the model most similar to live intestine for all variables tested. SurgiReal and SynDaver models were comparable to each other but did not simulate live intestine as well as cadaver intestine.Clinical significanceCadaver intestine more closely approximated live intestine compared with either synthetic model. SurgiReal and SynDaver may be adequate alternatives if cadaver intestine is unavailable.
Cardiovascular and respiratory profiles during the sleep–wake cycle of rats previously submitted to chronic intermittent hypoxia
Authors: Bazilio Darlan S. , Bonagamba Leni G. H. , Moraes Davi J. A. , Machado Benedito H. 
Published: May 2019

New Findings
What is the central question of this study?
Chronic intermittent hypoxia (CIH) causes increased arterial pressure (AP), sympathetic overactivity and changes in expiratory modulation of sympathetic activity. However, changes in the short‐term sleep–wake cycle pattern after CIH and their potential impact on cardiorespiratory parameters have not been reported previously.

What is the main finding and its importance?
Exposure to CIH for 10 days elevates AP in wakefulness and sleep but does not cause major changes in short‐term sleep–wake cycle pattern. A higher incidence of muscular expiratory activity was observed in rats exposed to CIH only during wakefulness, indicating that active expiration is not required for the increase in AP in rats submitted to CIH.

AbstractChronic intermittent hypoxia (CIH) increases arterial pressure (AP) and changes sympathetic–respiratory coupling. However, the alterations in the sleep–wake cycle after CIH and their potential impact on cardiorespiratory parameters remain unknown. Here, we evaluated whether CIH‐exposed rats present changes in their short‐term sleep–wake cycle pattern and in cardiorespiratory parameters. Male Wistar rats (∼250 g) were divided into CIH and control groups. The CIH rats were exposed to 8 h day−1 of cycles of normoxia (fraction of inspired O2 = 0.208, 5 min) followed by hypoxia (fraction of inspired O2 = 0.06, 30–40 s) for 10 days. One day after CIH, electrocorticographic activity, cervical EMG, AP and heart rate were recorded for 3 h. Plethysmographic recordings were collected for 2 h. A subgroup of control and CIH rats also had the diaphragm and oblique abdominal muscle activities recorded. Chronic intermittent hypoxia did not alter the time for sleep onset, total time awake, durations of rapid eye movement (REM) and non‐REM (NREM) sleep and number of REM episodes in the 3 h recordings. However, a significant increase in the duration of REM episodes was observed. The AP and heart rate were increased in all phases of the cycle in rats exposed to CIH. Respiratory frequency and ventilation were similar between groups in all phases, but tidal volume was increased during NREM and REM sleep in rats exposed to CIH. An increase in the incidence of active expiration during wakefulness was observed in rats exposed to CIH. The data show that CIH‐related hypertension is not caused by changes in the sleep–wake cycle and suggest that active expiration is not required for the increase in AP in freely moving rats exposed to CIH.
Intracellular calcium stores mediate metaplasticity at hippocampal dendritic spines
Authors: Mahajan Gaurang , Nadkarni Suhita 
Published: May 2019

Key points
Calcium (Ca2+) entry mediated by NMDA receptors is considered central to the induction of activity‐dependent synaptic plasticity in hippocampal area CA1; this description does not, however, take into account the potential contribution of endoplasmic reticulum (ER) Ca2+ stores.
The ER has a heterogeneous distribution in CA1 dendritic spines, and may introduce localized functional differences in Ca2+ signalling between synapses, as suggested by experiments on metabotropic receptor‐dependent long‐term depression.
A physiologically detailed computational model of Ca2+ dynamics at a CA3–CA1 excitatory synapse characterizes the contribution of spine ER via metabotropic signalling during plasticity induction protocols.
ER Ca2+ release via IP3 receptors modulates NMDA receptor‐dependent plasticity in a graded manner, to selectively promote synaptic depression with relatively diminished effect on LTP induction; this may temper further strengthening at the stronger synapses which are preferentially associated with ER‐containing spines.
Acquisition of spine ER may thus represent a local, biophysically plausible ‘metaplastic switch’ at potentiated CA1 synapses, contributing to the plasticity–stability balance in neural circuits.
AbstractLong‐term plasticity mediated by NMDA receptors supports input‐specific, Hebbian forms of learning at excitatory CA3–CA1 connections in the hippocampus. There exists an additional layer of stabilizing mechanisms that act globally as well as locally over multiple time scales to ensure that plasticity occurs in a constrained manner. Here, we investigated the role of calcium (Ca2+) stores associated with the endoplasmic reticulum (ER) in the local regulation of plasticity at individual CA1 synapses. Our study was spurred by (1) the curious observation that ER is sparsely distributed in dendritic spines, but over‐represented in larger spines that are likely to have undergone activity‐dependent strengthening, and (2) evidence suggesting that ER motility at synapses can be rapid, and accompany activity‐regulated spine remodelling. We constructed a physiologically realistic computational model of an ER‐bearing CA1 spine, and examined how IP3‐sensitive Ca2+ stores affect spine Ca2+ dynamics during activity patterns mimicking the induction of long‐term potentiation and long‐term depression (LTD). Our results suggest that the presence of ER modulates NMDA receptor‐dependent plasticity in a graded manner that selectively enhances LTD induction. We propose that ER may locally tune Ca2+‐based plasticity, providing a braking mechanism to mitigate runaway strengthening at potentiated synapses. Our study provides a biophysically accurate description of postsynaptic Ca2+ regulation, and suggests that ER in the spine may promote the re‐use of hippocampal synapses with saturated strengths.
O10 Effect of hemodialysis dose (spKt/V) on survival in patients on maintenance hemodialysis since childhood – a retrospective analysis
Authors: Gotta V , Atkinson A , Marsenic O , Pfister M 
Published: May 2019

BackgroundHemodialysis (HD) prescription significantly differs between pediatric and adult patients on maintenance HD, resulting in greater difference between prescribed and delivered HD dose.1,2 HD dose targets have formally not been evaluated for children, hence targets are mainly derived from adults (spKt/V >1.4; sp: single-pool model of urea distribution, K: urea clearance, t: duration of HD session, V: urea distribution volume). This analysis aimed to evaluate the relationship between delivered dialysis dose and survival in a large cohort of patients having started HD therapy in childhood.MethodsThis retrospective analysis included a cohort of patients < 30 years (y) on chronic HD treatment since childhood, having received thrice-weekly HD between 2004 and 2016 in outpatient DaVita dialysis centers. Survival while on HD (death from any cause) was investigated using Kaplan-Meier analysis stratified by age at start of HD (0–2, >2–6, >6–12, and >12–18 y), and three mean delivered dialysis dose levels (spKt/V < 1.4, 1.4–1.6, >1.6). Survival curves between subgroups were compared using the Log-rank test.Results1773 patients were included in the analysis, among n=34 having started HD at age of 0–2y, n=57 at >2–6y, n=244 at >6–12y, and n=1438 at >12–18y. Median follow-up on HD ranged between 1.5 (>2–6y) to 4.7 years (>6–12y) with maximal follow-up of 23 years. Death while on HD occurred in 1/34, 6/57, 26/244, and 101/1438 patients during recorded follow-up (p=0.075, n.s.). Patients with mean spKt/V < 1.4 had lower survival on HD than those with spKt/V >1.4–1.6 (p=0.019) and those with spKt/V >1.6 (p=0.035), with 10-year survival estimated to 75% (65.2–86.2%) versus 84.5% (78.5–90.9%) and 85.0% (80.8–89.5%), respectively.ConclusionsThis is the first study to report long term survival and its relationship with delivered HD dose in patients starting HD in childhood. Our results support targeting spKt/V(urea)>1.4 in children on chronic HD treatment.ReferencesGotta V, Marsenic O, Pfister M. Age- and weight-based differences in haemodialysis prescription and delivery in children, adolescents and young adults. Nephrol Dial Transplant 2018 Apr 18.Gotta V, Marsenic O, Pfister M. Understanding urea kinetic factors that enhance personalized hemodialysis prescription in children. ASAIO J 2019 Jan 14.Disclosure(s)M Pfister is a consultant at Quantitative Solutions a Certara Company. V Gotta has been supported for this project by the Research Fund for Junior Researchers, University of Basel, Switzerland. O Marsenic and A Atkinson declare no financial conflict of interest.
P65 Differentiating alprostadil associated fever from infectious fever: a retrospective case-control study of neonates with ductus dependent congenital heart disease in a Tertiary Care Center
Authors: Masarwa R , Soskin S , Vardi A , Paret G , Matok I 
Published: May 2019

BackgroundAlprostadil is used to maintain ductus patency in neonates with ductus dependent congenital heart disease (CHD), until corrective surgery. Fever is a common side effect of alprostadil and may also be a sign of infectious disease. We aimed to identify potential parameters that may differentiate infectious from alprostadil fever.MethodsRetrospective case-control study included all neonates with ductus dependent CHD, who were admitted at the Children´s Hospital in Ramat-Gan, Israel, from August 2003 to August 2017 and developed fever on alprostadil. Cases were defined as neonates with a positive bacterial culture and controls were defined as neonates with a negative culture. Multivariate cox-regression was conducted to identify potential parameters that may differentiate alprostadil from infectious fever.ResultsThree hundred and four neonates developed fever under alprostadil. Fifty five (18%) had a positive bacterial culture and 249 (82%) had a negative culture. In univariate analysis, the duration of alprostadil infusion was 95 hours (IQR 45–116) in the case group and 72 hours (IQR 49–215) in the control group (p=0.011). The time between alprostadil initiation and fever was longer for the case group: 14.13 hours (IQR 6.5–47.5) versus 12.96 (IQR 5–30.51), (p=0.039). In multivariate cox-regression, a more than 10% increase in neutrophil count before fever was significantly associated with an increased risk for infection (HR 6.14, 95% CI 1.94–19.42). A trend towards an association was observed with CRP ≥ 10 mg/dl before fever (HR 2.5, 95% CI 0.66–9.47) and in an increase ≥ 1000 micromol/L in WBC before fever (HR 1.74, 95% CI 0.58–5.21).ConclusionsIn neonates with CHD on alprostadil therapy, an increase in neutrophil count before the appearance of fever is associated with infection. Full sepsis work-up and is still warranted in neonates who develop fever under alprostadil. Further larger studies are needed to fully establish these results.Disclosure(s)The authors have no conflict of interests to disclose.