bluuebunny/crossref_metadata_2025_split huggingface dataset:
The mind in psychotherapy: An interpersonal neurobiology framework for understanding and cultivating mental health
Authors: Siegel Daniel J. 
Published: April 2019

In this brief overview, I offer a conceptual approach to the mind that can support whatever clinical, research, public policy, or other approach you may be involved with. It seeks to help both the understanding and cultivating of mental health and well‐being in our world, and may be especially important in encouraging future psychotherapists to be systems‐oriented and multidisciplinary in their work. As the ideas of this framework have been published in a number of texts, I will simply have a brief listing of those and other selected publications at the end of this article and outline the main ideas and factual points as we move along.Practitioner points

Consilience across wide range of disciplines leads to an integrated framework defining the mind, mental health, and the strategies of intervention to cultivate well‐being.
Psychology across cultures: Challenges and opportunities
Authors: Edge Dawn , Lemetyinen Henna 
Published: April 2019

Large variations of inequalities in rates of mental health disorders and access to mental health care exist within and between countries. Globally, disparities range from countries where there is little provision to those where, despite the availability of evidence‐based mental health care, service access and outcomes are mediated by social factors such as socio‐economic status, race/ethnicity, and culture. This is salient because increasingly diverse populations are inevitably created with globalization. We posit that in multicultural contexts, effective therapeutic engagement requires therapists who are competent and confident to work with diversity and difference, utilizing insights into their own as well as their clients’ internal and external worlds. Although there are many reasons why psychotherapies can be insensitive and harmful, for example, the inherent power imbalance in therapeutic relationships, a lack of awareness of cultural and ethnic variation and needs are among them. Acquisition of ‘cultural competence’ and increasing availability of culturally‐adapted interventions should, in theory, enable practitioners to work with a range of individuals with whom they might have little in common. However, whilst cultural adaptation appears promising, there are concerns regarding its viability as a strategy for tackling disparities in access to psychological care. Evidence for cultural competency is patchy at best. We show how and why delivering effective psychotherapy in the twenty‐first century requires a paradigm shift from current approaches to truly integrated models, developed in collaboration with recipients of care. Coproducing interventions, training, and means of evaluating them with clients necessitates taking into consideration social contexts, alternative conceptualizations of mental health and disorders and difficulties, and what constitutes appropriate helpful interventions for psychological distress.Practitioner points

Upskilling therapists to work with diversity and difference is essential for effective delivery of psychological treatments.

Increasing the availability of culturally‐adapted interventions together with therapists who are sufficiently competent and confident to deliver them should enable practitioners to work with a range of individuals with whom they might have little in common.

Coproducing culturally appropriate means of responding to mental health difficulties, staff training and development, and service evaluation methods with clients necessitates taking into consideration social contexts, alternative explanatory models of mental health and ‘illness’, and what constitutes helpful interventions for psychological distress.
A novel CDKN2A variant (p16L117P) in a patient with familial and multiple primary melanomas
Authors: Li Christopher , Liu Tong , Liu Bin , Hernandez Rolando , Facelli Julio C. , Grossman Douglas 
Published: April 2019

AbstractGermline mutations in CDKN2A (p16) are commonly found in patients with family history of melanoma or personal history of multiple primary melanomas. The p16 tumor suppressor gene regulates cell cycle progression and senescence through binding of cyclin‐dependent kinases (CDK) and also regulates cellular oxidative stress independently of cell cycle control. We identified a germline missense (c.350T>C, p.Leu117Pro) CDKN2A mutation in a patient who had history of four primary melanomas, numerous nevi, and self‐reported family history of melanoma. This particular CDKN2A mutation has not been previously reported in prior large studies of melanoma kindreds or patients with multiple primary melanomas. Compared with wild‐type p16, the p16L117P mutant largely retained binding capacity for CDK4 and CDK6 but exhibited impaired capacity for repressing cell cycle progression and inducing senescence, while retaining its ability to reduce mitochondrial reactive oxygen species. Structural modeling predicted that the Leu117Pro mutation disrupts a putative adenosine monophosphate (AMP) binding pocket involving residue 117 in the fourth ankyrin domain. Identification of this new likely pathogenic variant extends our understanding of CDKN2A in melanoma susceptibility and implicates AMP as a potential regulator of p16.
Autonomic correlates of lifetime suicidal thoughts and behaviors among adolescents with a history of depression
Authors: Yang Xiao , Daches Shimrit , George Charles J. , Kiss Enikő , Kapornai Krisztina , Baji Ildikó , Kovacs Maria 
Published: April 2019

AbstractSuicidal thoughts and behaviors (STBs) have been associated with emotion dysregulation and atypical responses to affective and stressful stimuli. To investigate the psychophysiology involved, we measured changes in respiratory sinus arrhythmia (RSA) and cardiac pre‐ejection period (PEP; indexing parasympathetic and sympathetic functioning, respectively) in response to stressful‐ and sadness‐eliciting laboratory probes. Our sample included adolescents with a history of depression and STBs (n = 177), adolescents with a history of depression but no history of STBs (n = 47), and healthy controls (n = 175). The outcome of interest was the most severe form of clinician‐rated STBs across the subject’s lifetime. In partial support of our hypotheses, during the stressful task, adolescents with a history of depression and STBs did not evidence the RSA decrease that was exhibited by controls and displayed greater PEP shortening compared to ever‐depressed adolescents with no lifetime STBs. No group differences were found in either RSA or PEP reactivity to the sadness‐eliciting stimulus. As expected, severity of STBs was positively correlated with the extent of PEP shortening during the stressful task. The results suggest that adolescents with a history of depression and STBs experience blunted parasympathetic responses to stress along with compensatory efforts. Our findings contribute to a better understanding of STBs among youths and underscore that future studies should examine physiological risk factors for these psychopathological outcomes.
Home deaths of children under 5 years in rural South Africa: a population‐based longitudinal study
Authors: Price Jessica , Willcox Merlin , Kabudula Chodziwadziwa Whiteson , Herbst Kobus , Kahn Kathleen , Harnden Anthony 
Published: April 2019

AbstractObjectivesTo determine the proportion of under‐5 deaths that occurred at home in rural South Africa, whether care was sought prior to death, and determinants of home deaths amongst those who sought care.MethodsVerbal autopsy data were used for all under‐5 deaths, 2000–2015, in two health and demographic surveillance system sites. Trends in place of death and care‐seeking were assessed. Associations between sociodemographic factors and home death despite seeking care were assessed by multivariate logistic regressions.ResultsThere were 3760 under‐5 deaths; 1954 (53%) at home and 1510 (41%) in health facilities. Eighty‐four per cent of children who died at home accessed healthcare during their final illness. Amongst neonates for whom care was sought, those who were 8–27 days old were more likely to die at home than those who were 0–7 days old (OR = 5.56, 95%CI 2.69–11.55, P < 0.001). Factors associated with home death of infants and young children despite seeking care included low maternal education (OR = 1.71, 95%CI 1.31–2.24, P < 0.001), larger household size (OR = 1.56, 95%CI 1.17–2.06, P = 0.002), traditional medicine use (OR = 2.33, 95%CI 1.75–3.12, P < 0.001) and Mozambican descent (OR = 1.47, 95%CI 1.06–2.03, P = 0.020). The proportion of HIV‐related deaths that occurred at home fell from 60% in 2008–2011 to 39% in 2012–2015 ( χ2 = 13.86, P < 0.001).ConclusionMore than half of under‐5 deaths in rural South Africa occurred at home although healthcare was sought for most children, highlighting that home deaths are not simply a function of poor care‐seeking. Interventions should target high‐risk sociodemographic groups.
Population genomics reveals a fine‐scale recombination landscape for genetic improvement of cotton
Authors: Shen Chao , Wang Nian , Huang Cong , Wang Maojun , Zhang Xianlong , Lin Zhongxu 
Published: April 2019

SummaryRecombination breaks up ancestral linkage disequilibrium, creates combinations of alleles, affects the efficiency of natural selection, and plays a major role in crop domestication and improvement. However, there is little knowledge regarding the variation in the population‐scaled recombination rate in cotton. We constructed recombination maps and characterized the difference in the genomic landscape of the population‐scaled recombination rate between Gossypium hirsutum and G. arboreum and sub‐genomes based on the 381 sequenced G. hirsutum and 215 G. arboreum accessions. Comparative genomics identified large structural variations and syntenic genes in the recombination regions, suggesting that recombination was related to structural variation and occurred preferentially in the distal chromosomal regions. Correlation analysis indicated that recombination was only slightly affected by geographical distribution and breeding period. A genome‐wide association study (GWAS) was performed with 15 agronomic traits using 267 cotton accessions and identified 163 quantitative trait loci (QTL) and an important candidate gene (Ghir_COL2) for early maturity traits. Comparative analysis of recombination and a GWAS revealed that the QTL of fibre quality traits tended to be more common in high‐recombination regions than were those of yield and early maturity traits. These results provide insights into the population‐scaled recombination landscape, suggesting that recombination contributed to the domestication and improvement of cotton, which provides a useful reference for studying recombination in other species.
Reexamination of the chromium‐51–labeled posttransfusion red blood cell recovery method
Authors: Francis Richard O. , Mahajan Sonia , Rapido Francesca , La Carpia Francesca , Soffing Mark , Divgi Chaitanya , Yeh Randy , Mintz Akiva , Leslie Lenhurst , Agrest Irina , Karafin Matthew S. , Ginzburg Yelena , Shaz Beth H. , Spitalnik Steven L. , Schwartz Joseph , Thomas Tiffany , Fu Xiaoyun , Amireault Pascal , Buffet Pierre , Zimring James C. , D'Alessandro Angelo , Hod Eldad A. 
Published: April 2019

BACKGROUNDThe chromium‐51–labeled posttransfusion recovery (PTR) study has been the gold‐standard test for assessing red blood cell (RBC) quality. Despite guiding RBC storage development for decades, it has several potential sources for error.METHODSFour healthy adult volunteers each donated an autologous, leukoreduced RBC unit, aliquots were radiolabeled with technetium‐99m after 1 and 6 weeks of storage, and then infused. Subjects were imaged by single‐photon‐emission computed tomography immediately and 4 hours after infusion. Additionally, from subjects described in a previously published study, adenosine triphosphate levels in transfusates infused into 52 healthy volunteers randomized to a single autologous, leukoreduced, RBC transfusion after 1, 2, 3, 4, 5, or 6 weeks of storage were correlated with PTR and laboratory parameters of hemolysis.RESULTSEvidence from one subject imaged after infusion of technetium‐99m–labeled RBCs suggests that, in some individuals, RBCs may be temporarily sequestered in the liver and spleen immediately following transfusion and then subsequently released back into circulation; this could be one source of error leading to PTR results that may not accurately predict the true quantity of RBCs cleared by intra‐ and/or extravascular hemolysis. Indeed, adenosine triphosphate levels in the transfusates correlated more robustly with measures of extravascular hemolysis in vivo (e.g., serum iron, indirect bilirubin, non–transferrin‐bound iron) than with PTR results or measures of intravascular hemolysis (e.g., plasma free hemoglobin).CONCLUSIONSSources of measurement error are inherent in the chromium‐51 PTR method. Transfusion of an entire unlabeled RBC unit, followed by quantifying extravascular hemolysis markers, may more accurately measure true posttransfusion RBC recovery.
Reducing ethnic disparity in access to high‐quality HLA‐matched cord blood units for transplantation: analysis of the Canadian Blood Services' Cord Blood Bank inventory
Authors: Allan David , Kiernan Jeffrey , Gragert Loren , Dibdin Nicholas , Bartlett Daniel , Campbell Todd , Mostert Karen , Halpenny Michael , Ganz Kathy , Maiers Martin , Petraszko Tanya , Elmoazzen Heidi 
Published: April 2019

BACKGROUNDLaunched in 2013, Canadian Blood Services' Cord Blood Bank (CBS' CBB) has built a high‐quality, ethnically diverse cord blood repository that aims to reduce ethnic disparity in accessing suitable units for transplantation.METHODS AND RESULTSAs of December 2016, 2000 units have been banked. The self‐reported maternal ethnicity was 58% non‐Caucasian. Overall, 26% of units were classified as multi‐ethnicity with Caucasian (84%) most frequently observed in combination with Asian, First Nations (predominant indigenous peoples in Canada south of the Arctic Circle), or African ethnicity. Utilization scores that incorporate total nucleated and CD34+ cell counts in the CBS' CBB were associated with greater likelihood of utilization compared with the international inventory of units (p < 0.05). The distribution of utilization scores was similar for Caucasians compared with non‐Caucasians (p < 0.05). Using HLA genotypes of cord blood units and their mothers, we determined probable ethnic assignments for each haplotype using HaploStats (National Marrow Donor Program). Significant increases in HLA‐match likelihoods are predicted for all ethnicities as the inventory grows to its target of 10,000 units and the gap in HLA‐match likelihoods for Caucasian and non‐Caucasian patients progressively declines.CONCLUSIONSThe CBS' CBB inventory is predicted to have high HLA‐matching likelihoods across a broad spectrum of ethnic groups, improving access to high‐quality stem cell products for all patients.
Improvements in red blood cell transfusion utilization following implementation of a single‐unit default for electronic ordering
Authors: Warner Matthew A. , Schaefer Kalli K. , Madde Nageswar , Burt Jennifer M. , Higgins Andrew A. , Kor Daryl J. 
Published: April 2019

BACKGROUNDThe prevention of excessive allogeneic red blood cell (RBC) transfusion is an important component of patient blood management initiatives. In this investigation, changes in transfusion behaviors following modification of computerized physician order entry (CPOE) procedures for RBC transfusions to a single‐unit default quantity were assessed.STUDY DESIGN AND METHODSThis is an observational cohort study of adults for whom nonemergency allogeneic RBC transfusions were ordered in the 2 years before and 2 years after the date of modification of the CPOE system to a single‐unit default (June 18, 2015). Changes in the frequency of single‐ versus multiunit RBC transfusion orders and other transfusion metrics were compared between preintervention and postintervention cohorts.RESULTSA total of 52,773 unique transfusion orders for 61,989 RBC units were included, of which 60,045 (96.9%) were transfused. Single‐unit orders increased annually, from 10,404 (74.1%) in the first year to 11,645 (88.6%) in the last year, while multiunit orders decreased by more than half (p < 0.0001). The number of RBC units transfused decreased by 13.9% from 32,528 in the preintervention cohort to 27,497 in the post intervention cohort (p < 0.0001) with an estimated reduction in transfusion‐related expenditures of nearly $4 million. The percentage of transfusions associated with a posttransfusion hemoglobin of10 g/dL or greater decreased by 34.5% (p < 0.0001).CONCLUSIONModification of the CPOE process such that nonemergency RBC transfusion orders were defaulted to a single unit was associated with decreased rates of multiunit RBC transfusion orders, lower transfusion volumes, and substantial cost savings.
Clinical findings associated with development of postoperative reflux and short‐term survival after small intestinal surgery in geriatric and mature nongeriatric horses
Authors: Boorman Sophie , Stefanovski Darko , Southwood Louise L. 
Published: April 2019

AbstractObjectiveTo determine risk factors, especially age, associated with postoperative reflux (POR; >2 L of reflux present upon intubation), high‐volume POR (≥20 L in 24 hours), and short‐term outcome after small intestinal (SI) surgery.Study designRetrospective case‐control study.Sample populationHorses aged ≥16 years (geriatric; range, 16–30; n = 44) and <16 years (mature; range, 2–15; n = 39) with an SI surgical lesion that survived general anesthesia and did not have a second exploratory celiotomy during the same visit.MethodsMedical records (2009–2015) were reviewed; perioperative variables were evaluated for associations with outcomes by using multivariable logistic regression.ResultsPostoperative reflux was associated with an increasing packed cell volume at admission (odds ratio [OR], 1.08; 95% CI, 1.00–1.16;P = .042) and presence of nasogastric reflux at admission (OR, 4.61; 95% CI, 1.3–15.69;P = .014). High‐volume POR was associated with an increasing glycemia at admission (OR, 1.19; 95% CI, 1.01–1.40;P = .041), presence of nasogastric reflux at admission (OR, 10.05; 95% CI, 2.21–45.74;P = .003), and SI resection (OR, 10.52; 95% CI, 1.81–61.25;P = .009). Increasing surgical time (OR, 2.50; 95% CI, 1.16–5.29;P = .019) and high‐volume POR (OR, 6.37; 95% CI, 2.12–19.12;P = .001) were associated with nonsurvival.ConclusionAge, considered as both a continuous variable and a categorical variable, was not associated with the development of POR, high‐volume POR, or nonsurvival.Clinical significanceAge does not influence the occurrence of POR and should not negatively impact an owner's decision to pursue surgery in aged horses.
Intermittent hypoxia impairs uterine artery function in pregnant mice
Authors: Badran Mohammad , Abuyassin Bisher , Ayas Najib , Laher Ismail 
Published: April 2019

Key points
Obstructive sleep apnoea (OSA) is a chronic condition characterized by intermittent hypoxia that induces oxidative stress and inflammation leading to cardiovascular disease.
Women can develop OSA during late pregnancy, which is associated with adverse maternal and fetal outcomes. However, the effects of OSA throughout pregnancy on fetoplacental outcomes are unknown.
Using a mouse model of intermittent hypoxia, we evaluated main uterine artery function, spiral artery remodelling, circulating angiogenic and anti‐angiogenic factors, and placental hypoxia and oxidative stress at gestational day 14.5 in pregnant mice.
Gestational intermittent hypoxia increased placental weight but decreased fetal weight, impaired uterine artery function, increased circulating angiogenic and anti‐angiogenic factors, and induced placental hypoxia and oxidative stress, but had no impact on spiral artery remodelling.
Our results suggest that pregnant women experiencing OSA during pregnancy could be at risk of maternal and fetal complications.
AbstractObstructive sleep apnoea (OSA) is characterized by chronic intermittent hypoxia (IH) and is associated with increased inflammation, oxidative stress and endothelial dysfunction. OSA is a common sleep disorder and remains under‐diagnosed; it can increase the risk of adverse maternal and fetal outcomes in pregnant women. We investigated the effects of gestational IH (GIH) on uterine artery function, spiral artery remodelling and placental circulating angiogenic and anti‐angiogenic factors in pregnant female mice. WT C57BL/6 mice (8 weeks) were exposed to either GIH ( 12%) or intermittent air ( 21%) for 14.5 days of gestation. Exposure to GIH reduced fetal weight but increased placental weight. GIH dams had higher plasma levels of oxidative stress (8‐isoprostane) and inflammatory markers (tumour necrosis factor‐α). GIH significantly reduced uterine artery function as indicated by reduced endothelium‐dependent vasodilatation and enhanced vasoconstriction. Plasma levels of placental angiogenic and anti‐angiogenic markers (soluble fms‐like tyrosine kinase‐1, soluble endoglin, angiogenic placental growth factor‐2 and vascular endothelial growth factor) were higher in pregnant mice exposed to GIH. There was no evidence of impaired spiral artery remodelling based on immunostaining with α‐smooth muscle actin and cytokeratin‐7, and also by measurements of lumen area. Immunostaining for markers of hypoxia (pimonidazole) and oxidative stress (4‐hydroxynonenal) were higher in mice exposed to GIH. Our data show that GIH adversely affects uterine vascular function and may be a mechanism by which gestational OSA leads to adverse maternal and fetal outcomes.
Fungi participate in the dysbiosis of gut microbiota in patients with primary sclerosing cholangitis
Authors: Lemoinne Sara , Kemgang Astrid , Ben Belkacem Karima , Straube Marjolène , Jegou Sarah , Corpechot Christophe ,   Saint-Antoine IBD Network, Chazouillères Olivier , Housset Chantal , Sokol Harry 
Published: April 2019

ObjectivePatients with primary sclerosing cholangitis (PSC) were previously shown to display a bacterial gut dysbiosis but fungal microbiota has never been examined in these patients. The aim of this study was to assess the fungal gut microbiota in patients with PSC.DesignWe analysed the faecal microbiota of patients with PSC and concomitant IBD (n=27), patients with PSC and no IBD (n=22), patients with IBD and no PSC (n=33) and healthy subjects (n=30). Bacterial and fungal composition of the faecal microbiota was determined using 16S and ITS2 sequencing, respectively.ResultsWe found that patients with PSC harboured bacterial dysbiosis characterised by a decreased biodiversity, an altered composition and a decreased correlation network density. These alterations of the microbiota were associated with PSC, independently of IBD status. For the first time, we showed that patients with PSC displayed a fungal gut dysbiosis, characterised by a relative increase in biodiversity and an altered composition. Notably, we observed an increased proportion of Exophiala and a decreased proportion of Saccharomyces cerevisiae. Compared with patients with IBD and healthy subjects, the gut microbiota of patients with PSC exhibited a strong disruption in bacteria-fungi correlation network, suggesting an alteration in the interkingdom crosstalk.ConclusionThis study demonstrates that bacteria and fungi contribute to gut dysbiosis in PSC.