bluuebunny/crossref_metadata_2025 huggingface dataset:
Coffee consumption and work satisfaction among Scandinavian anaesthesiologists: A survey
Authors: Do Hien Q. , Granholm Anders , Ellekjær Karen L. , Iepsen Ulrik W. , Estrup Stine , Marker Søren , Møller Morten Hylander
Published: September 2018

Background

It is a common prejudice that anaesthetic doctors are believed to have high coffee consumption. In this study, we aimed to assess the association between coffee drinking and work satisfaction among Scandinavian anaesthesiologists. We hypothesised that coffee consumption was positively correlated with work satisfaction.

Methods

We invited anaesthesiologists attending the 34th congress of The Scandinavian Society of Anaesthesiology and Intensive Care Medicine in Malmö, Sweden, September 2017 to participate in a paper‐based survey. We collected data on characteristics of the respondents, coffee drinking and work satisfaction, and compared coffee vs non‐coffee drinkers with regard to work satisfaction scored on a modified Wong‐Baker Faces Pain Rating Scale (Visual Analogue Scale from 0 to 10).

Results

A total of 271 anaesthesiologists participated in the survey, of which 265 (97.7%) of the questionnaires contained valid data. Some 143 (54.0%) of the respondents were women, the median (interquartile range, IQR) age was 41.0 (35.0‐49.5) years, and 242 (91.3%) were coffee drinkers. Coffee drinkers consumed median 4.0 (IQR: 2.5‐5.0) cups of coffee daily. Overall work satisfaction was median 8 (IQR: 8‐9), with no difference between respondents drinking coffee and those who did not (median 8 (IQR: 8‐9) vs 8 (IQR: 8‐9), Wilcoxon rank sum test, P = 0.62). Also, we found no association between work satisfaction and the number of cups of coffee consumed daily (r2 = 0.005, P = 0.24).

Conclusion

In this survey, we found high work satisfaction among Scandinavian anaesthesiologists, with no difference between coffee and non‐coffee drinkers.
Synergistic effects of marijuana abuse and HIV infection on neural activation during a cognitive interference task
Authors: Meade Christina S. , Bell Ryan P. , Towe Sheri L. , Chen Nan‐kuei , Hobkirk Andrea L. , Huettel Scott A.
Published: September 2018

Marijuana use, which is disproportionately prevalent among human immunodeficiency virus (HIV)‐infected persons, can alter activity in fronto‐parietal regions during cognitively demanding tasks. While HIV is also associated with altered neural activation, it is not known how marijuana may further affect brain function in this population. Our study examined the independent and additive effects of HIV infection and regular marijuana use on neural activation during a cognitive interference task. The sample included 93 adults who differed on marijuana (MJ) and HIV statuses (20 MJ+/HIV+, 19 MJ+/HIV‐, 29 MJ‐/HIV+, 25 MJ‐/HIV‐). Participants completed a counting Stroop task during a functional magnetic resonance imaging scan. Main and interactive effects on neural activation during interference versus neutral blocks were examined using a mixed‐effects analysis. The sample showed the expected Stroop effect for both speed and accuracy. There were main effects of MJ in the right and left inferior parietal lobules, with the left cluster extending into the posterior middle temporal gyrus and a main effect of HIV in the dorsal anterior cingulate cortex. There was an interaction in the left fronto‐insular cortex, such that the MJ+/HIV+ group had the largest increase in activation compared with other groups. Among MJ+, signal change in this cluster correlated positively with cumulative years of regular marijuana use. These results suggest that comorbid HIV and marijuana use is associated with complex neural alterations in multiple brain regions during cognitive interference. Follow‐up research is needed to determine how marijuana‐related characteristics may moderate HIV neurologic disease and impact real‐world functioning.
High‐intensity cannabis use is associated with retention in opioid agonist treatment: a longitudinal analysis
Authors: Socías Maria Eugenia , Wood Evan , Lake Stephanie , Nolan Seonaid , Fairbairn Nadia , Hayashi Kanna , Shulha Hennady P. , Liu Seagle , Kerr Thomas , Milloy M.‐J.
Published: September 2018

Background and Aims

Cannabis use is common among people on opioid agonist treatment (OAT), causing concern for some care providers. However, there is limited and conflicting evidence on the impact of cannabis use on OAT outcomes. Given the critical role of retention in OAT in reducing opioid‐related morbidity and mortality, we aimed to estimate the association of at least daily cannabis use on the likelihood of retention in treatment among people initiating OAT. As a secondary aim we tested the impacts of less frequent cannabis use.

Design

Data were drawn from two community‐recruited prospective cohorts of people who use illicit drugs (PWUD). Participants were followed for a median of 81 months (interquartile range = 37–130).

Setting

Vancouver, Canada.

Participants

This study comprised a total of 820 PWUD (57.8% men, 59.4% of Caucasian ethnicity, 32.2% HIV‐positive) initiating OAT between December 1996 and May 2016. The proportion of women was higher among HIV‐negative participants, with no other significant differences.

Measurements

The primary outcome was retention in OAT, defined as remaining in OAT (methadone or buprenorphine/naloxone‐based) for two consecutive 6‐month follow‐up periods. The primary explanatory variable was cannabis use (at least daily versus less than daily) during the same 6‐month period. Confounders assessed included: socio‐demographic characteristics, substance use patterns and social–structural exposures.

Findings

In adjusted analysis, at least daily cannabis use was positively associated with retention in OAT [adjusted odds ratio (aOR) = 1.21, 95% confidence interval (CI) = 1.04–1.41]. Our secondary analysis showed that compared with non‐cannabis users, at least daily users had increased odds of retention in OAT (aOR = 1.20, 95% CI = 1.02–1.43), but not less than daily users (aOR = 1.00, 95% CI = 0.87–1.14).

Conclusions

Among people who use illicit drugs initiating opioid agonist treatment in Vancouver, at least daily cannabis use was associated with approximately 21% greater odds of retention in treatment compared with less than daily consumption.
Making Bureaucracy Work: Patronage Networks, Performance Incentives, and Economic Development in China
Authors: Jiang Junyan
Published: September 2018

Patron–client networks are widely found in governments of transitional societies and are often seen as an impediment to effective governance. This article advances an alternative view that emphasizes their enabling effects. I argue that patron–client relations can be used to improve government performance by resolving principal–agent problems within political hierarchies. I substantiate this claim by examining how patronage networks shape economic performance of local governments in China. Using an original city–level panel data set between 2000 and 2011, and a new method that identifies patronage ties based on past promotions, I show that city leaders with informal ties to the incumbent provincial leaders deliver significantly faster economic growth than those without. I conduct additional analyses to rule out several important alternative explanations and provide evidence on the incentive‐enhancing mechanism. These findings highlight the importance of informal institutions for bureaucratic management and authoritarian governance.
Mycobacterium ulcerans disease management in Australian patients: the re‐emergence of surgery as an important treatment modality
Authors: O'Brien Daniel P. , Callan Peter , Friedman N. Deborah , Athan Eugene , Hughes Andrew , McDonald Anthony
Published: September 2018

With the demonstration of the effectiveness of antibiotic treatment, the management of Mycobacterium ulcerans disease has changed from a predominantly surgically to a predominantly medically treated disease. However, research among Australian patients has revealed that antibiotic treatment alone is associated with prolonged wound healing times, high rates of treatment toxicity, and the potential for significant tissue destruction associated with severe paradoxical reactions. We present the current state of M. ulcerans management in Barwon Health, Australia, where a close working relationship exists between the Plastic Surgical and Infectious Diseases units. Here treatment has evolved based on nearly 20 years of experience gained from managing more around 600 patients from a M. ulcerans epidemic on the nearby Bellarine and Mornington Peninsulas. In our experience, surgery has re‐emerged to play an important role in the treatment of M. ulcerans in improving the rate of wound healing, minimizing antibiotic associated toxicity and preventing further tissue loss associated with severe paradoxical reactions. For selected small lesions surgery without antibiotics may also be an effective treatment option, however aggressive surgical resection of lesions with wide margins through uninvolved tissue should no longer be performed. Furthermore, extensive excisional surgery that will require the use of split skin grafts and vascularized tissue flaps to repair skin defects should be avoided if possible.
Day case versus inpatient stay for excisional haemorrhoidectomy
Authors: Xia Weisi , Barazanchi Ahmed W. H. , MacFater Wiremu , Sammour Tarik , Hill Andrew G.
Published: September 2018

Background

Excisional haemorrhoidectomy has traditionally been performed on an inpatient basis due to concerns over post‐operative pain and urinary retention. Day case procedures are increasingly common. This study aims to investigate readmission rates following day case compared with inpatient haemorrhoidectomy.

Methods

A retrospective cohort review of all haemorrhoidectomies performed at Counties Manukau District Health Board, Auckland from January 2012 to December 2017 was queried from the hospital database. Readmission rates, reason for readmission, time to represent and length of stay within 30 days were recorded. Continuous data were analysed using Mann–Whitney U and Student's t‐tests. Categorical data were analysed using the Fisher's exact and chi‐squared tests.

Results

A total of 485 cases of excisional haemorrhoidectomy were performed, with 62 (12.8%) readmissions within 30 days. There were 170 patients who were treated as day cases with 19 (11.2%) readmissions; 315 patients stayed one night or longer with 43 (13.7%) readmissions (P = 0.97). The demographics of both groups were similar. Pain and bleeding were the most common reasons for readmission in both groups. There were no significant differences between rates of readmission, length of stay following readmission and time to readmission between day case and inpatient groups.

Conclusions

Day case surgery should be considered as an alternative to inpatient surgery for excisional haemorrhoidectomy and can be achieved without increase in hospital readmissions.
Karydakis procedure can be effectively performed in the lateral position
Authors: De Robles Marie S. , Seyfi Doruk , Zahid Assad , Young Christopher J.
Published: September 2018

Background

Karydakis published a large pilonidal series in 1992, reporting a recurrence rate of less than 1% and complication rate of 8.5%. The aim of this study was to compare the outcomes of Karydakis procedure (KP) performed in the lateral versus the prone position in a consecutive series.

Methods

Ninety‐seven consecutive patients undergoing a KP between March 2000 and February 2018 were retrospectively assessed. Patients with disease sinuses or fistulas extending from the midline to either left or right sides only were considered for KP in the contralateral side position.

Results

Surgery was carried out for primary pilonidal disease in 71 patients (73%) and for recurrent disease in 26 patients (27%). The majority (62%) of pilonidal tracts veered off from the midline to either the left or right side only. Wound complications, mostly minor skin separation, occurred in 37 patients (38%). Disease recurrence occurred in eight patients (8%). There was no difference between patients who had KP in a lateral position compared with those operated in a prone position regarding wound complications (41% versus 35%, P = 0.675), disease recurrence (9% versus 7%, P = 1.000), mean operating time (64.6 min versus 66.6 min, P = 0.259) and mean length of hospital stay (1 day for both groups).

Conclusions

Pilonidal surgery in the lateral position has potential benefits for patient safety, patient comfort and theatre efficiency. The clinical results of this series show that the KP can be performed safely and effectively with the patient in the lateral position for most cases of pilonidal disease.
Clinical evaluation of anal intraepithelial neoplasia: are we missing the boat?
Authors: Yeoh Adrian , Bell Stephen , Farmer Chip , Carne Peter , Skinner Stewart , Chin Martin , Warrier Satish
Published: September 2018

Background

Anal intraepithelial neoplasia (AIN) is dysplasia in the epithelium of the anus and is a pre‐malignant condition associated with a low rate of progression to invasive squamous cell carcinoma (SCC). The natural history of progression for AIN to anal SCC is poorly defined. This study aims to review our experience with AIN and investigate the natural history of progression.

Methods

Data on all patients with AIN from January 2005 to December 2015 were retrospectively reviewed. Three separate databases were searched – Colorectal, Radiation Oncology and Infectious Diseases. All databases were cross‐referred to obtain a complete but non‐duplicated data set. Electronic charts were reviewed to obtain clinical information.

Results

Twenty‐eight patients were identified with AIN of various grades. There were 25 males, three females. Twenty of the male patients were human immunodeficiency virus (HIV) positive. Mean length of follow up was 56 months. Complete regression of AIN to normal was noted in 13 patients (46%). Four patients had persisting AIN III with no evidence of regression or malignant transformation. Nine patients with pre‐existing AIN developed SCC (32%). Seven were positive for HIV infection (all males). Median time to progression was 36 months. None of the patients demonstrated clear linear pattern of progression of AIN to SCC.

Conclusion

High grade AIN may progress to anal SCC and surveillance is indicated. The exact natural history of progression for AIN is difficult to predict. There is no linear progression over time evident. HIV patients with AIN are at higher risk of developing SCC.
Optical coherence tomography angiography and microvascular changes in diabetic retinopathy: a systematic review
Authors: Johannesen Sunniva Kruse , Viken Julie Nilssen , Vergmann Anna Stage , Grauslund Jakob
Published: September 2018

To use optical coherence tomography angiography (OCTA) to evaluate foveal microvascular changes in diabetes by comparing the area of foveal avascular zone (FAZ) in healthy controls and patients with diabetes with no diabetic retinopathy (NDR) as well as different stages of diabetic retinopathy (DR). A systematic literature search was performed based on the population, intervention, comparison and outcome (PICO) strategy by two independent reviewers. The search was performed in PubMed, Embase and Cochrane Library, including keywords ‘diabetes mellitus’, ‘DR’ and ‘OCTA’. Of 358 studies initially identified, 215 studies were screened after duplicate removal. Of these, we included 12 (nine cross‐sectional and three retrospective) studies in this review. With the data at hand, it was not possible to perform a meta‐analysis. The selected studies included patients with NDR (n = 8), non‐proliferative diabetic retinopathy (NPDR, n = 8) and proliferative diabetic retinopathy (PDR, n = 6). Several of the studies provided information for more than one diabetic group. In general, there was a trend towards a larger area of FAZ in patients with diabetes. As compared to healthy controls, this was reported in patients with NDR (five of eight studies), NPDR (seven of eight studies) and PDR (six of six studies). Optical coherence tomography angiography (OCTA) is non‐invasively able to identify foveal capillary non‐perfusion as an early event in DR. In some studies, this has even been identified in patients without clinically identifiable microvascular lesions. Longitudinal studies would be needed to examine if OCTA‐findings are able to predict long‐term structural and functional outcome.
Pseudoexfoliation and aortic aneurysm: a long‐term follow‐up study
Authors: Ekström Curt , Wilger Sophia , Wanhainen Anders
Published: September 2018

Purpose

To study the relationship between pseudoexfoliation (PEX) and aortic aneurysm in a population with a high prevalence of PEX.

Methods

Survival analyses were performed in a cohort of 735 residents aged 65–74 years, examined in a population survey in the municipality of Tierp, Sweden, 1984–1986. To expand the sample size, 1040 people were recruited by means of glaucoma case records established at the Eye Department in Tierp in 1978–2007. In this way, the cohort comprised 1775 subjects, representing more than 25 400 person‐years at risk. Medical records and autopsy reports were reviewed to identify subjects diagnosed with aneurysm. Those with a follow‐up time shorter than 1 year were excluded.

Results

By the end of the study in September 2017, 60 new cases of aortic aneurysm had been found. Of these cases, 23% (14 subjects) were affected by PEX at baseline, compared with 28% among subjects without aneurysm. No association between PEX and aortic aneurysm was found (hazard ratio 0.97; 95% confidence interval 0.53–1.77).

Conclusion

In this population‐based study, we were unable to verify a relationship between PEX and the development of aortic aneurysm.
A qualitative study of attitudes to and perceptions of betel quid consumption and its oral health implications in Taiwan
Authors: Tamí‐Maury Irene , Ma Wei‐Fen , Lin Mi‐Ting , Lin Cheng‐Chieh , Tsai Ming‐Hsiu , Li Chia‐Ing , Li Tsai‐Chung , Krukrubo Rosetta , Gritz Ellen R.
Published: September 2018

Objectives

Betel quid (BQ) chewing is extremely prominent in South and Southeast Asia because it considered by users to be of social, cultural and religious importance.BQchewing has been recognized as a risk factor for oral premalignant lesions and oral cancer. BecauseBQchewing has become a severe health risk in Taiwan, the development of prevention and cessation programmes is essential. The purpose of this study was to explore the attitudes and perceptions associated withBQconsumption and its oral health implications in an attempt to inform the development of health promotion initiatives andBQcessation efforts in Taiwan, where the dental profession could have a pivotal role in preventing and controllingBQuse among persons at risk.

Methods

This qualitative study used data gathered from focus groups and individual interviews. A convenience sample of 41 adults from Jhushan and Lugu Townships (Nantou County) and Taichung City, Taiwan, participated in this study (27 men, 14 women; 31 Han, 10 aboriginals from the Paiwan tribe; mean age 40.3,SD9.2 years).

Results

Among the seven themes that emerged from the original study, five (Initiation, Health Risk Perception, Health Consequences, Withdrawal Symptoms and Help from Healthcare Providers) had oral/dental implications.

Conclusions

Our study highlights research areas relevant to further investigation, such as incorporating briefBQprevention and cessation counselling when early oral and dental signs associated withBQconsumption are detected. Undertaking behavioural interventions in dental settings might help to reduce the prevalence ofBQchewing in Taiwan.
Detecting deterrence from patrol data
Authors: Dobson Andrew D. M. , Milner‐Gulland E. J. , Beale Colin M. , Ibbett Harriet , Keane Aidan
Published: September 2018

The threat posed to protected areas by the illegal killing of wildlife is countered principally by ranger patrols that aim to detect and deter potential offenders. Deterring poaching is a fundamental conservation objective, but its achievement is difficult to identify, especially when the prime source of information comes in the form of the patrols’ own records, which inevitably contain biases. The most common metric of deterrence is a plot of illegal activities detected per unit of patrol effort (CPUE) against patrol effort (CPUE‐E). We devised a simple, mechanistic model of law breaking and law enforcement in which we simulated deterrence alongside exogenous changes in the frequency of offences under different temporal patterns of enforcement effort. The CPUE‐E plots were not reliable indicators of deterrence. However, plots of change in CPUE over change in effort (ΔCPUE‐ΔE) reliably identified deterrence, regardless of the temporal distribution of effort or any exogenous change in illegal activity levels as long as the time lag between patrol effort and subsequent behavioral change among offenders was approximately known. The ΔCPUE‐ΔE plots offered a robust, simple metric for monitoring patrol effectiveness; were no more conceptually complicated than the basic CPUE‐E plots; and required no specialist knowledge or software to produce. Our findings demonstrate the need to account for temporal autocorrelation in patrol data and to consider appropriate (and poaching‐activity‐specific) intervals for aggregation. They also reveal important gaps in understanding of deterrence in this context, especially the mechanisms by which it occurs. In practical applications, we recommend the use of ΔCPUE‐ΔE plots in preference to other basic metrics and advise that deterrence should be suspected only if there is a clear negative slope. Distinct types of illegal activity should not be grouped together for analysis, especially if the signs of their occurrence have different persistence times in the environment.
High‐speed photography of water drop impacts on sand and soil
Authors: Lardier N. , Roudier P. , Clothier B. , Willmott G. R.
Published: September 2018

Summary

The way that water drops impact on soil is of widespread importance for soil science, particularly in the context of irrigation and erosion. With modern high‐speed photography techniques, impacts on granular materials are becoming more widely studied, but the variation in particle‐size distribution of soil presents particular challenges. Here, the impacts of individual water drops on two contrasting soil textures (pure sand and a loamy soil) have been studied with high‐speed photography, and compared at Weber numbers between 50 and 750. Granular samples with wider distributions of particle sizes produce larger variations in experimental outcomes. For the sand, which contained >98% particles between 60 μm and 2 mm in size, the typical outcome involved spreading and retraction of the drop to a circular profile with a raised rim. The loamy soil had greater surface roughness than the sand, with a wider distribution of particle sizes, so that the spread of the drop was more anisotropic, involved more movement of target particles and often involved droplet breakup into satellite drops. Overall outcomes were best described by a gravity‐dominated cratering mechanism, and the scaling exponent for the crater diameter with respect to impact energy was 0.22 ± 0.03. Dynamic penetration studies enabled visualization of granular motion below the surface, and both static and dynamic penetration results illustrated a transition between inertial and viscous regimes over time. As the water content of the soil was increased, droplet breakup was initially encouraged before capillary imbibition dominated at water contents close to 10%v/v. This research is useful for understanding how rain and irrigation, which comprise many millimetre‐scale drops, influence large‐scale hydraulic properties in soil, including surface sealing.

Highlights

Drop impact on to soil is important, but its systematic study is difficult because of variation in soil particle sizes.

High‐speed photography was used to study drop impacts on to a pure sand and loamy soil, and analysed quantitatively.

Results show how granular samples with wider distributions of particle sizes produce more variation in experimental outcomes.

The maximum extent of drop spreading was best described by a scaling model developed for planetary cratering.
Toward understanding genomic instability, mitochondrial dysfunction and aging
Authors: Fakouri Nima B. , Hou Yujun , Demarest Tyler G. , Christiansen Louise S. , Okur Mustafa N. , Mohanty Joy G. , Croteau Deborah L. , Bohr Vilhelm A.
Published: September 2018

The biology of aging is an area of intense research, and many questions remain about how and why cell and organismal functions decline over time. In mammalian cells, genomic instability and mitochondrial dysfunction are thought to be among the primary drivers of cellular aging. This review focuses on the interrelationship between genomic instability and mitochondrial dysfunction in mammalian cells and its relevance to age‐related functional decline at the molecular and cellular level. The importance of oxidative stress and key DNA damage response pathways in cellular aging is discussed, with a special focus on poly (ADP‐ribose) polymerase 1, whose persistent activation depletes cellular energy reserves, leading to mitochondrial dysfunction, loss of energy homeostasis, and altered cellular metabolism. Elucidation of the relationship between genomic instability, mitochondrial dysfunction, and the signaling pathways that connect these pathways/processes are keys to the future of research on human aging. An important component of mitochondrial health preservation is mitophagy, and this and other areas that are particularly ripe for future investigation will be discussed.
Land surface greening suggests vigorous woody regrowth throughout European semi‐natural vegetation
Authors: Buitenwerf Robert , Sandel Brody , Normand Signe , Mimet Anne , Svenning Jens‐Christian
Published: September 2018

The satellite record has revealed substantial land surface “greening” in the northern hemisphere over recent decades. Process‐based Earth system models (ESMs) attribute enhanced vegetation productivity (greening) to CO2 fertilisation. However, the models poorly reproduce observed spatial patterns of greening, suggesting that they ignore crucial processes. Here, we explore whether fine‐scale land cover dynamics, as modified by ecological and land‐use processes, can explain the discrepancy between models and satellite‐based estimates of greening. We used 500 m satellite‐derived Leaf Area Index (LAI) to quantify greening. We focus on semi‐natural vegetation in Europe, and distinguish between conservation areas and unprotected land. Within these ecological and land‐use categories, we then explored the relationships between vegetation change and major climatic gradients. Despite the relatively short time‐series (15 years), we found a strong overall increase in LAI (i.e., greening) across all European semi‐natural vegetation types. The spatial pattern of vegetation change identifies land‐use change, particularly land abandonment, as a major initiator of vegetation change both in‐ and outside of protected areas. The strongest LAI increases were observed in mild climates, consistent with more vigorous woody regrowth after cessation of intensive management in these environments. Surprisingly, rates of vegetation change within protected areas did not differ significantly from unprotected semi‐natural vegetation. Overall, the detected LAI increases are consistent with previous, coarser‐scale, studies. The evidence indicates that woody regrowth following land abandonment is an important driver of land surface greening throughout Europe. The results offer an explanation for the large discrepancies between ESM‐derived and satellite‐derived greening estimates and thus generate new avenues for improving the ESMs on which we rely for crucial climate forecasts.
Loss of only the smallest patches will reduce species diversity in most discrete habitat networks
Authors: Deane David C. , He Fangliang
Published: September 2018

Under many global‐change scenarios, small habitat patches are the most vulnerable to destruction. For example, smaller ponds are at greater risk in a drying climate and their loss would remove any obligate aquatic individuals present. We asked what proportional loss of species diversity from metacommunities comprised of discrete habitat patches should be expected from attrition (complete loss) of only the smallest patches under such a premise. We analyzed 175 published datasets for different taxonomic groups (vertebrates, invertebrates, and plants) and habitat types (islands, habitat islands, and fragments). We simulated the destruction of only the smallest patches to an approximate 20% of total area (range: 15.2%–24.2%) and analyzed species loss. Mean [± 95% CI] species loss was 12.7% [10.8, 14.6], although 18.3% of datasets lost no species. Four broad patterns of species loss were evident, reflecting underlying differences in minimum area requirements and the degree of species turnover among patches. Regression modeling showed species loss increased with greater species turnover among patches (βSIM) and decreased with greater area scaling of diversity (i.e., larger power‐law island species–area relationship exponents). Losses also increased with greater numbers of single‐patch endemics and with increasing proportions of patches destroyed. After accounting for these predictors, neither taxonomic group nor habitat type increased explained variation in species loss. Attrition of the smallest patches removed species in >80% of metacommunities, despite all larger patches and >75% of total area remaining intact. At both 10% and 20% area reduction, median species loss across all datasets was around 50% higher than predicted from methods based on the species–area relationship. We conclude that any mechanism of global change that selectively destroys small habitat patches will lead to imminent extinctions in most discrete metacommunities.
Primary productivity is related to niche width in the Australian Wet Tropics
Authors: Burley Hugh M. , Mokany Karel , Laffan Shawn W. , Williams Kristen J. , Metcalfe Dan , Murphy Helen T. , Ford Andrew , Harwood Tom D. , Ferrier Simon
Published: September 2018

Aim

A key ecological debate is whether ecosystem functions are distinctly influenced by biological diversity across broad scales. Although recent work has emphasized the importance of links between ecosystem functions and measures of ecological specialization as proxies of biodiversity, few studies have analysed macroecological relationships empirically in diverse environments. We tested whether gross primary productivity (GPP) in the Australian Wet Tropics (WT) was distinctly related to community‐level measures of the ecological specialization of component tree species across climate space, after accounting for climate drivers.

Location

Wet Tropics, Australia.

Time period

1976–2012.

Major taxa studied

Nine hundred and forty‐eight WT tree species.

Methods

Using all geographically valid herbarium records for WT trees, we quantified the realized climatic niche widths using continental surfaces for maximum temperature of the warmest period and total annual rainfall. The median realized niche width for all tree species occurring at 510 sites was used to approximate ecological specialization within communities. To separate climatic effects on GPP, we applied a novel analysis using the difference in GPP and the difference in median community realized niche width between site pairs with similar climatic conditions. Linear models were then run on the difference in GPP between site pairs (response) and the difference in climatic niche widths (predictor).

Results

For climatically similar sites in drier areas, GPP was higher in sites composed of species with narrower temperature niches (average R2 = 0.087, average t‐statistic = −3.45). Conversely, for climatically similar sites in drier areas, GPP was lower in sites composed of species with narrower rainfall niches (average R2 = 0.171, average t‐statistic = 5.06).

Main conclusions

Wet Tropics sites with more thermal specialists had higher productivity, whereas sites with more moisture specialists had lower productivity. These findings suggest that physiological specialization across climate space can influence primary productivity at broad scales, but in inconsistent ways.
Prevalence of depressed mood and loss of interest among community‐dwelling older people: Large‐scale questionnaire survey and visiting intervention
Authors: Okamura Tsuyoshi , Ura Chiaki , Miyamae Fumiko , Sugiyama Mika , Inagaki Hiroki , Ayako Edahiro , Hiroshi Murayama , Motokawa Keiko , Awata Shuichi
Published: September 2018

Aim

Late‐life depression is identified less often by general practitioners than depression in younger adults, but failure to have late‐life depression recognized in a primary care setting can have fatal consequences. The aim of the present study was to examine the prevalence of depressed mood and loss of interest, and identify associated factors among community‐dwelling older adults in a large‐scale study.

Methods

A questionnaire was mailed to all residents (n = 132 005) aged ≥65 years in one Tokyo district. The questionnaire asked about depressed mood and loss of interest. It also included items measuring sociodemographic variables, physical health‐related variables, psychological variables, socioeconomic variables, attitude to the community and the Dementia Assessment Sheet for Community‐based Integrated Care System ‐ 21 items.

Result

In total, 19.5% of community‐dwelling older people had experienced a depressed mood or loss of interest during the past month. This group also showed increased frailty and a negative attitude towards the community, and were less likely to be economically disadvantaged (although more likely to have had a childhood economic disadvantage). The multivariate analysis showed that increased frailty had the strongest relationship with depressed mood. Survey respondents who had either of these conditions were more likely to receive support from the community‐based integrated support center.

Conclusions

The present study showed a high prevalence of depressed mood and loss of interest among older people. Frailty was a significant factor, suggesting that collaboration is essential between primary care geriatrics and geriatric psychiatry. Geriatr Gerontol Int 2018; 18: 1567–1572.
Investigation of small intestinal lesions in dialysis patients using capsule endoscopy
Authors: Nakajima Fumitaka , Furumatsu Yoshiyuki , Yurugi Takatomi , Amari Yoshifumi , Iida Takeshi , Fukui Takayuki , Kuramoto Takanori
Published: September 2018

Introduction: Although gastrointestinal hemorrhage is an important complication for dialysis patients, the details of many points remain unclear with regard to small intestinal lesions.

Methods: Capsule endoscopy was performed in fecal occult blood‐positive dialysis (n =16) and non‐dialysis (n = 20) patients after upper and lower gastrointestinal endoscopies failed to reveal hemorrhagic lesions.

Findings: Erosive lesions were observed in 50.0% (8/16) and 25.0% (5/20) of the dialysis and non‐dialysis groups, respectively. Vascular lesions were observed in 62.5% (10/16) and 25.0% (5/20), respectively. Vascular lesions were observed at a significantly higher rate in the dialysis patients (P = 0.041), but no significant difference was noted in erosive lesions (P = 0.188). Of patients taking proton pump inhibitor (PPI), Non‐Steroidal Anti‐Inflammatory Drugs, and antiplatelet drugs, only oral PPI administration was associated with vascular lesions (P = 0.02).

Discussion: In dialysis patients, vascular lesions are the most common among small intestinal lesions, suggesting that they may have caused previously unexplained gastrointestinal hemorrhage in dialysis patients. It was also suggested that the frequent use of PPI may be a cause of small intestinal lesions.
Distinguishing the Imago Dei from the Soul
Authors: Churchouse Matthew J.
Published: September 2018

This article contends that the ‘structural’ view of the imago Dei, which identifies the image of God with (or as being a property of) the human soul, requires revision in light of exegesis of Genesis 1, and that philosophical reflection following aftersuch exegesis reveals that the imago Dei needs to be distinguishedconceptually from the soul. In dialogue with, and (grateful) response to, Joshua Farris ‐ the most recent proponent of the (or ‘a’) structural view, the article counters the position, arguing that instead of the image of God being (a property of) the human soul(entailing a human having a body contingently), the emphasis of Scripture is that the image of God is a human in their entirety (a view entailing their having an immaterial soul).
Oral vitamin D3 5000 IU/day as an adjuvant in the treatment of atopic dermatitis: a randomized control trial
Authors: Sánchez‐Armendáriz Karen , García‐Gil Ana , Romero Cesar A. , Contreras‐Ruiz José , Karam‐Orante Marcia , Balcazar‐Antonio Denek , Domínguez‐Cherit Judith
Published: September 2018

Background

Vitamin D has immunomodulatory effects both in the innate and adaptive immune systems, and there is growing scientific evidence demonstrating its relevance in inflammatory processes such as AD.

Hypothesis

If vitamin D3 promotes the skin immune system, then it should improve the response to treatment of patients with AD.

Methods

A randomized, double‐blind placebo‐controlled clinical trial was conducted, which included 65 patients with AD according to Hanifin–Rajka criteria and the severity scale (SCORAD). The patients were divided into two groups to receive either vitamin D3 5000 IU/day (n = 33) or placebo (n = 32), plus baseline therapy (topical steroid, soap substitute, and emollient) during 3 months.

Results

Fifty‐eight of the 65 enrolled subjects were included in the analysis. At the end of the intervention, the treated group achieved higher levels of 25(OH)D (P < 0.001). At week 12, those patients who registered serum levels of 25(OH)D ≥20 ng/ml, regardless of whether or not they had received supplementation, showed a lower SCORAD compared to those with levels <20 ng/ml (P < 0.001). Eighty percent of the patients with serum levels <20 ng/ml (n = 9) had moderate–severe AD despite standard treatment. Vitamin D levels ≥20 ng/ml associated with baseline therapy strongly favored remission of atopic dermatitis (P = 0.03). No significant differences were found between patients with serum levels of ≥20 ng/ml vs. ≥30 ng/ml.

Conclusions

Reaching serum levels of 25(OH)D > 20 ng/ml in conjunction with standard therapy is sufficient to achieve a reduction in severity (SCORAD) in patients with AD.
Simple risk assessment in prostate cancer patients treated with primary androgen deprivation therapy: The Korean Cancer Study of the Prostate risk classification
Authors: Choi Se Young , Ryu Jeman , You Dalsan , Hong Jun Hyuk , Ahn Hanjong , Kim Choung‐Soo
Published: September 2018

Objectives

To investigate the progression to castration‐resistant prostate cancer after primary androgen deprivation therapy, and to build a simple risk prediction model for primary androgen deprivation therapy patients based on the Japan Cancer of the Prostate Risk Assessment criteria.

Methods

A total of 602 patients who received primary androgen deprivation therapy were entered into the Korean Cancer Study of the Prostate database. The effect of prognostic factors was determined by multivariate analysis. For each patient, the weight of all factors was totaled to give Korean Cancer Study‐prostate scores; patients were divided into three risk groups according to their score. The probability of castration‐resistant prostate cancer, cancer‐specific survival and overall survival was estimated by Kaplan–Meier analysis.

Results

On multivariate analysis for castration‐resistant prostate cancer, the significant variables were initial prostate‐specific antigen (>40 ng/mL; 1 point), biopsy Gleason score (≥9; 1 point), clinical N1 (1 point), and non‐regional lymph node (1 point), bone (1 point) and visceral (1 point) metastasis. The Korean Cancer Study‐prostate scoring model was calculated on a scale of 0–6 (0: low, 1–2: intermediate, ≥3: high risk). The risk groups stratified castration‐resistant prostate cancer (P < 0.0001), cancer‐specific survival (P < 0.0001) and overall survival (P < 0.0001) by Kaplan–Meier curve. The Korean Cancer Study‐prostate model predicted castration‐resistant prostate cancer with a c‐index of 0.7242, cancer‐specific survival with a c‐index of 0.7036 and overall survival with a c‐index of 0.5890. The 5‐year estimated castration‐resistant prostate cancer/cancer‐specific death rates were 10.3%/6.3% in the low‐risk group, 48.4%/22.2% in the intermediate‐risk group and 81.7%/53.1% in the high‐risk group.

Conclusions

The Korean Cancer Study‐prostate risk classification, a modified Japan Cancer of the Prostate Risk Assessment model, is a simple scoring model for predicting oncological outcomes after primary androgen deprivation therapy.
Rights to the Oceans: Foundational Arguments Reconsidered
Authors: Nine Cara
Published: September 2018

This article examines theories of ocean rights based on the works of Hugo Grotius and Samuel von Pufendorf. Grotius's object‐centred view uses features of the natural world to justify claims to external objects. I show that Grotius's view is inadequate, because it relies on an outdated claim that oceanic resources are sufficiently abundant for anybody to use. Further, adaptations of his view are wanting, because they either rely on arbitrary distinctions or disregard the values of cultural minorities. Pufendorf's relational view constructs rights through the exercise of human will. While Pufendorf believes that agreements create rights, he also argues that property rights can be unilaterally acquired from the commons without express consent from others. The relational view is a viable alternative to the object‐centred view, because it both delimits territorial claims over the ocean to a ‘modest’ size and also respects cultural variability. A major aim of this article is to present Pufendorf's theory of territorial rights extended over oceans and to demonstrate how it is useful for assessing contemporary disputes. In the final sections, I apply the relational view to Canadian claims to the Northwest Passage, and I also sketch implications for assessing expanding claims to the seabed.
Sex differences in adherence to antihypertensive treatment in patients aged above 55: The French League Against Hypertension Survey (FLAHS)
Authors: Lefort Mathilde , Neufcourt Lola , Pannier Bruno , Vaïsse Bernard , Bayat Sahar , Grimaud Olivier , Girerd Xavier
Published: September 2018

Despite the availability of efficient therapies to reduce the risk of cardiovascular complications, poor adherence to antihypertensive (anti‐HTN) drugs is frequent, especially during the first year of treatment and among uncontrolled/resistant hypertensive patients. The aim of the study was to identify factors associated with adherence to anti‐HTN treatment and to examine whether they differ across sex. A total of 2743 treated hypertensive participants to the cross‐sectional Metascope survey (France, 2015) aged 55 years or more were included. The authors measured adherence to anti‐HTN treatment using the 6‐item Girerd compliance test. Variations in adherence were examined using the Rao‐Scott statistics and Poisson regression. Overall, 63.6% of participants were adherent to anti‐HTN treatment. Adherence was more frequent among women than men (69% vs 58%, P < 10−4). For both sexes, level of adherence was positively associated with age (P < 10−4), but inversely associated with number of anti‐HTN tablets, number of tablets taken for metabolic diseases, history of cardiovascular diseases, number of other chronic diseases (all P < 10−4). The inverse relationship between adherence and the number of anti‐HTN tablets significantly differed between sexes (P < 10−4): Adherence decreased sharply when taking two or more anti‐HTN tablets in men, whereas the decrease in women was only observed when taking three or more anti‐HTN tablets. This study suggests that adherence to anti‐HTN treatment is higher among women, decreases with the number of tablets prescribed, and differentially so across sex. Reducing the number of tablets for anti‐HTN treatment may improve adherence, especially among men and patients with multiple comorbidities.
The determination of the infectious status and prevalence of motile Aeromonas species isolated from disease cases in rainbow trout (Oncorhynchus mykiss) and aquarium fish
Authors: Duman Muhammed , Saticioglu Izzet Burcin , Janda J. Michael , Altun Soner
Published: September 2018

The aims of this study were to determine the prevalence and phylogenetic relationship of motile Aeromonas spp. that might be pathogenic species for rainbow trout in infected/mix infection cases (based upon different outbreaks on fish farms). A total of 99 motile Aeromonas isolates (and three reference strains) were analysed that were isolated from four different fish species in different sizes of fish (0.1–3,000 g), different months and water temperatures (6.1–21.2°C). The biochemical characteristics of the isolates were determined using conventional tests and a rapid test kit. Additionally, molecular identification was performed using the gyrB housekeeping gene region and with glycerophospholipid‐cholesterol acyltransferase polymerase chain reaction (GCAT‐PCR). The sequencing results obtained from the gyrB gene region were deposited in the GenBank database, and phylogenetic relationships were determined with the BioNumerics 7.6 database. Nearly half of the Aeromonas isolates that were isolated from rainbow trout showing signs of disease were determined to be possible infectious agents. Aeromonas species exhibit biochemical variability for many characters, so some Aeromonas species tested negative for GCAT‐PCR despite that this test was created especially for Aeromonas identification. The phylogenetic tree based upon gyrB contained 10 different phylogroups that were based on 96% cut‐off value in gyrB gene region.
Increased tau phosphorylation follows impeded dopamine clearance in a P301L and novel P301L/COMT‐deleted (DM) tau mouse model
Authors: Koppel Jeremy , Jimenez Heidy , Adrien Leslie , H. Chang Eric , Malhotra Anil K. , Davies Peter
Published: September 2018

In Alzheimer's disease, the phosphorylation of tau is a critical event preceding the formation of neurofibrillary tangles. Previous work exploring the impact of a dopamine blocking antipsychotic on tau phosphorylation in a tau transgenic model suggested that extracellular dopamine may play a regulatory role in the phosphorylation state of tau. In order to test this hypothesis, and in order to develop a mouse model of impaired dopamine metabolism and tauopathy, an extant P301L transgenic tau model of Alzheimer's disease and a novel P301L/catechol‐O‐methyltransferase deleted model (DM mouse) were treated with the norepinephrine reuptake inhibitor reboxetine, and prefrontal dopamine concentrations and the phosphorylated state of tau was quantified. In two experiments, male and female P301L+/+//COMT+/+ and P301L+/+//COMT−/− (DM) mice were treated with reboxetine 20 mg/kg IP. In one experiment, acutely following reboxetine injection, the prefrontal cortex of mice were microdialyzed for dopamine, and its metabolites, 3,4‐dihydroxyphenylacetic acid and homovanillic acid, utilizing the MetaQuant technique. In another experiment, acutely following reboxetine injections, tau phosphorylation was quantified in the frontal cortex, striatum, and hippocampus of the mice. Reboxetine injections were followed by significant increases from baseline in extracellular dopamine concentrations in P301L and DM mice, with significantly higher peak levels in the DM mice. Treatment was also followed by increases in tau phosphorylation spread throughout brain regions, with a larger impact on female mice. Extracellular dopamine concentrations exert an influence on the phosphorylation state of tau, with surges in dopamine associating with acute increases in tau phosphorylation.

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