bluuebunny/crossref_metadata_2025 huggingface dataset:
Learning analytics in higher education: an analysis of case studies
Authors: Wong Billy Tak Ming
Published: September 2017

Purpose

The purpose of this paper is to present a systematic review of the mounting research work on learning analytics.

Design/methodology/approach

This study collects and summarizes information on the use of learning analytics. It identifies how learning analytics has been used in the higher education sector, and the expected benefits for higher education institutions. Empirical research and case studies on learning analytics were collected, and the details of the studies were categorized, including their objectives, approaches, and major outcomes.

Findings

The results show the benefits of learning analytics, which help institutions to utilize available data effectively in decision making. Learning analytics can facilitate evaluation of the effectiveness of pedagogies and instructional designs for improvement, and help to monitor closely students’ learning and persistence, predict students’ performance, detect undesirable learning behaviours and emotional states, and identify students at risk, for taking prompt follow-up action and providing proper assistance to students. It can also provide students with insightful data about their learning characteristics and patterns, which can make their learning experiences more personal and engaging, and promote their reflection and improvement.

Originality/value

Despite being increasingly adopted in higher education, the existing literature on learning analytics has focussed mainly on conventional face-to-face institutions, and has yet to adequately address the context of open and distance education. The findings of this study enable educational organizations and academics, especially those in open and distance institutions, to keep abreast of this emerging field and have a foundation for further exploration of this area.
The potential and challenges of MOOCs in Pakistan: a perspective of students and faculty
Authors: Ahmed Syed Saad , Khan Essa , Faisal Muhammad , Khan Sara
Published: September 2017

Purpose

The birth of massive open online courses (MOOCs) has instantly drawn the attention of scholars, academicians and learners. Millions of participants are learning through this freely accessible model of education. The purpose of this paper is to review the development of MOOCs, its characteristics and to explore its potential and challenges in Pakistan particularly.

Design/methodology/approach

The data were collected through interviews and focus group, and the respondents had completed at least one MOOC offering. This research used content and thematic analysis with the triangulation of methods and sources.

Findings

The finding of this study reflects that MOOCs are inspiring great number of learners in Pakistan despite of factors impeding the surge of e-learning. MOOCs in regional languages with better electricity and internet connectivity could be very useful for the rural areas’ people but it requires extra ordinary interest from government and academicians.

Research limitations/implications

This is an exploratory qualitative study highlighting the potential and challenges of MOOCs from the perspective of faculty and students. However, it does not incorporate the views of university officials. Similar study could consider university officials and university owner as respondents. In addition, future studies could also investigate the factors inhibiting completion of MOOCs.

Originality/value

Despite of the sharp rise of published literature on MOOCs, there is less contribution from the developing countries. This research enables us to develop better understanding of the potential and challenges of MOOCs in the social context of Pakistan.
A multi-objective evolutionary algorithm-based soft computing model for educational data mining
Authors: Tan Choo Jun , Lim Ting Yee , Bong Chin Wei , Liew Teik Kooi
Published: September 2017

Purpose

The purpose of this paper is to propose a soft computing model based on multi-objective evolutionary algorithm (MOEA), namely, modified micro genetic algorithm (MmGA) coupled with a decision tree (DT)-based classifier, in classifying and optimising the students’ online interaction activities as classifier of student achievement. Subsequently, the results are transformed into useful information that may help educator in designing better learning instructions geared towards higher student achievement.

Design/methodology/approach

A soft computing model based on MOEA is proposed. It is tested on benchmark data pertaining to student activities and achievement obtained from the University of California at Irvine machine learning repository. Additional, a real-world case study in a distance learning institution, namely, Wawasan Open University in Malaysia has been conducted. The case study involves a total of 46 courses collected over 24 consecutive weeks with students across the entire regions in Malaysia and worldwide.

Findings

The proposed model obtains high classification accuracy rates at reduced number of features used. These results are transformed into useful information for the educational institution in our case study in an effort to improve student achievement. Whether benchmark or real-world case study, the proposed model successfully reduced the number features used by at least 48 per cent while achieving higher classification accuracy.

Originality/value

A soft computing model based on MOEA, namely, MmGA coupled with a DT-based classifier, in handling educational data is proposed.
Analyzing students online learning behavior in blended courses using Moodle
Authors: Estacio Rosalina Rebucas , Raga Jr Rodolfo Callanta
Published: September 2017

Purpose

The purpose of this paper is to describe a proposal for a data-driven investigation aimed at determining whether students’ learning behavior can be extracted and visualized from action logs recorded by Moodle. The paper also tried to show whether there is a correlation between the activity level of students in online environments and their academic performance with respect to final grade.

Design/methodology/approach

The analysis was carried out using log data obtained from various courses dispensed in a university using a Moodle platform. The study also collected demographic profiles of students and compared them with their activity level in order to analyze how these attributes affect students’ level of activity in the online environment.

Findings

This work has shown that data mining algorithm like vector space model can be used to aggregate the action logs of students and quantify it into a single numeric value that can be used to generate visualizations of students’ level of activity. The current investigation indicates that there is a lot of variability in terms of the correlation between these two variables.

Practical implications

The value presented in the study can help instructors monitor course progression and enable them to rapidly identify which students are not performing well and adjust their pedagogical strategies accordingly.

Originality/value

A plan to continue the work by developing a complete dashboard style interface that instructors can use is already underway. More data need to be collected and more advanced processing tools are necessary in order to obtain a better perspective on this issue.
Migration as adaptation strategy to cope with climate change
Authors: Jha Chandan Kumar , Gupta Vijaya , Chattopadhyay Utpal , Amarayil Sreeraman Binilkumar
Published: September 2017

Purpose

This study aims to evaluate the link between climate/weather change and farmer migration in Bihar, India. The influence of cognitive conditions and climate-related stress on farmer migration decisions and the socioeconomic characteristics of migrating and non-migrating farm households are analysed. The focus is the role of migration in access to climate and agricultural extension services and the contribution of migration to enhanced farmer coping capacity.

Design/methodology/approach

A primary survey was conducted of farm households in seven districts of Bihar, India. Farmer perceptions of climate change were analysed using the mental map technique. The role of socioeconomic characteristics in farm household migration was evaluated using binary logistic regression, and the influence of migration on access to climate and agricultural extension services and the adaptive capacity of migrating households was investigated using descriptive statistics.

Findings

Climate-induced livelihood risk factors are one of the major drivers of farmer’s migration. The farmers’ perception on climate change influences migration along with the socioeconomic characteristics. There is a significant difference between migrating and non-migrating farm households in the utilization of instructions, knowledge and technology based climate and agriculture extension services. Benefits from receipt of remittance, knowledge and social networks from the host region enhances migrating households’ adaptive capacity.

Originality/value

This study provides micro-evidence of the contribution of migration to farmer adaptive capacity and access to climate and agricultural extension services, which will benefit analyses of climate-induced migration in other developing countries with higher agricultural dependence. In addition, valuable insights are delivered on policy requirements to reduce farmer vulnerability to climate change.
Observing alcohol drinking in licensed premises: a formative social marketing study
Authors: Buyucek Nuray , Knox Kathy , Rundle-Thiele Sharyn
Published: September 2017

Purpose

This paper aimed to examine the role of social factors and individual factors on alcohol drinking in a licensed premise.

Design/methodology/approach

An unobtrusive covert systematic observational study of 632 licensed premise patrons was conducted during May 2015.

Findings

Convergence between genders was observed with females drinking as much and as long as males; 57.9 per cent of patrons drank two and more servings, exceeding daily recommended amounts. Social factors such as group size are more influential on drinking than individual factors such as gender and smoking status. Serving practices such as straws and buying drinks in rounds influence the quantity of alcohol consumed.

Research limitations/implications

The study focussed on one licensed premise. Replication of the method outlined in the current study in different licensed venues, states and countries will permit the role of policy, drinking environments and drinking cultures to be understood.

Practical implications

Drinking patterns of both genders are converging. Thus, intervention efforts should target both genders.

Originality/value

This paper contributes a structured observation protocol that extends our understanding of alcohol drinking beyond quantity by incorporating observation of duration of consumption for each serve, permitting identification of social and environmental factors that can be used to lower licensed premise alcohol drinking.
Serum vascular endothelial growth factor A levels reflect itch severity in mycosis fungoides and Sézary syndrome
Authors: Sakamoto Minami , Miyagaki Tomomitsu , Kamijo Hiroaki , Oka Tomonori , Takahashi Naomi , Suga Hiraku , Yoshizaki Ayumi , Asano Yoshihide , Sugaya Makoto , Sato Shinichi
Published: September 2017

Angiogenesis is an important step to support progression of malignancies, including mycosis fungoides (MF) and Sézary syndrome (SS). Vascular endothelial growth factor (VEGF)‐A, a key player in angiogenesis, is secreted by tumor cells of MF/SS and its expression levels in lesional skin correlated with disease severity. In this study, we examined serum VEGF‐A levels in MF/SS patients. Serum VEGF‐A levels were elevated in patients with erythrodermic MF/SS and the levels decreased after treatment. Importantly, serum VEGF‐A levels positively correlated with markers for pruritus. We also found that VEGF‐A upregulated mRNA expression of thymic stromal lymphopoietin by keratinocytes. Taken together, our study suggests that VEGF‐A can promote progression and pruritus in MF/SS. Inhibition of VEGF‐A signaling can be a therapeutic strategy for patients with erythrodermic MF/SS.
The effect of alginates on in vitro gastric digestion of particulated whey protein
Authors: Koutina Glykeria , Ioannidi Eleni , Melo Nogueira Bárbara M , Ipsen Richard
Published: September 2017

The aim of the study was to investigate how microparticulated and nanoparticulated whey proteins mixed with alginate respond to simulated in vitro gastric digestion conditions at pH 3.0. Initially, particle size distributions and zeta potential were measured in all mixtures at pH 3.0. Particle size distributions as well as SDS‐PAGE were used to investigate the rate of protein degradation by pepsin during simulated in vitro gastric digestion. The complexation of nanoparticulated and microparticulated whey protein with alginates causes formation of insoluble and soluble complexes, which can resist pepsin degradation to a different degree. These results highlight the potential of developing new food products, which can enhance satiety.
An 8‐year follow‐up of anti‐vascular endothelial growth factor treatment with a treat‐and‐extend modality for neovascular age‐related macular degeneration
Authors: Berg Karina , Roald Anca B. , Navaratnam Jesintha , Bragadóttir Ragnheiður
Published: September 2017

Purpose

To investigate long‐term visual results of treatment with anti‐vascular endothelial growth factor (VEGF) agents for neovascular age‐related macular degeneration (nAMD) following a treat‐and‐extend regimen.

Methods

Retrospective review of 155 patients who initiated treatment with bevacizumab for nAMD in one eye. At the final 8‐year visit, 40 patients (26%) remained for follow‐up. Mean change in best‐corrected visual acuity (BCVA) was calculated compared to baseline values.

Results

Mean BCVA improved significantly from baseline during the first year of treatment, with −0.11 logMAR units equivalent to 6.1 approximate Early Treatment Diabetic Retinopathy Study (approxETDRS) letters (p = <0.001). Mean BCVA was still significantly improved after 4 years of treatment for the entire group of patients and after 6 years of treatment for the subgroup of 40 patients who remained at the final 8‐year visit. Thereafter, BCVA gradually declined and at 8 years, there was a mean change of 0.05 logMAR units equivalent to 2.1 approxETDRS letters below baseline (p = 0.530). Mean number of injections during the first year was 6.1 ± 2.8 and during year 8 was 5.4 ± 3.5. At 5 years, fundus autofluorescence showed some degree of macular atrophy in all eyes. At the final 8‐year visit, 87.5% of the eyes had stable neovascular lesions with no fluid on optical coherence tomography (OCT).

Conclusion

In an everyday clinical setting, treatment of nAMD patients with a treat‐and‐extend modality provided improvement and stability of vision for several years. After 8 years of follow‐up, there was a decline in visual acuity (VA) that could be explained by macular atrophic development.
Persistent pain in neonates: challenges in assessment without the aid of a clinical tool
Authors: Boyle Elaine M. , Bradshaw Joanna , Blake Kathryn I.
Published: September 2017

Aim

Evaluation of comfort and pain in neonates is important for management. Specific signs of persistent pain in neonates remain undefined; few validated clinical tools assess persistent pain. We sought to determine (i) difficulty perceived by staff and parents in assessing comfort/persistent pain in babies, (ii) strategies employed when no clinical tool is used and (iii) variation between clinicians’ assessments.

Methods

Parent and staff questionnaires addressed difficulty in assessing pain/comfort in neonates and strategies used in making assessments.

Results

A total of 47 of 50 (94%) parents and 83 of 91 (91%) staff participated; 50% of staff reported it was moderately/very difficult to assess persistent pain, and 13% very easy; 75% of parents found it moderately/very easy and 23% difficult to assess their baby's comfort; 15% of parents thought staff found pain assessment difficult. Staff described 94 different factors indicative of comfort and 139 factors of persistent pain. Terminology differed widely and was often nonspecific; 67% of staff described forming a ‘general impression’.

Conclusion

Pain assessment is challenging for staff. Most parents feel confident in assessing their babies’ comfort, but may overestimate the ease with which staff can do so. Indicators of persistent pain/comfort are poorly defined; staff use differing, subjective assessments, which may complicate communication between carers.
A new negative allosteric modulator, AP14145, for the study of small conductance calcium‐activated potassium (KCa2) channels
Authors: Simó‐Vicens Rafel , Kirchhoff Jeppe E , Dolce Bernardo , Abildgaard Lea , Speerschneider Tobias , Sørensen Ulrik S , Grunnet Morten , Diness Jonas G , Bentzen Bo H
Published: September 2017

Background and Purpose

Small conductance calcium‐activated potassium (KCa2) channels represent a promising atrial‐selective target for treatment of atrial fibrillation. Here, we establish the mechanism of KCa2 channel inhibition by the new compound AP14145.

Experimental Approach

Using site‐directed mutagenesis, binding determinants for AP14145 inhibition were explored. AP14145 selectivity and mechanism of action were investigated by patch‐clamp recordings of heterologously expressed KCa2 channels. The biological efficacy of AP14145 was assessed by measuring atrial effective refractory period (AERP) prolongation in anaesthetized rats, and a beam walk test was performed in mice to determine acute CNS‐related effects of the drug.

Key Results

AP14145 was found to be an equipotent negative allosteric modulator of KCa2.2 and KCa2.3 channels (IC50 = 1.1 ± 0.3 μM). The presence of AP14145 (10 μM) increased the EC50 of Ca2+ on KCa2.3 channels from 0.36 ± 0.02 to 1.2 ± 0.1 μM. The inhibitory effect strongly depended on two amino acids, S508 and A533 in the channel. AP14145 concentration‐dependently prolonged AERP in rats. Moreover, AP14145 (10 mg·kg−1) did not trigger any apparent CNS effects in mice.

Conclusions and Implications

AP14145 is a negative allosteric modulator of KCa2.2 and KCa2.3 channels that shifted the calcium dependence of channel activation, an effect strongly dependent on two identified amino acids. AP14145 prolonged AERP in rats and did not trigger any acute CNS effects in mice. The understanding of how KCa2 channels are inhibited, at the molecular level, will help further development of drugs targeting KCa2 channels.
Childhood socioeconomic conditions and teeth in older adulthood: Evidence from SHARE wave 5
Authors: Listl Stefan , Broadbent Jonathan M. , Thomson W. Murray , Stock Christian , Shen Jing , Steele Jimmy , Wildman John , Heilmann Anja , Watt Richard G. , Tsakos Georgios , Peres Marco A. , van der Heijden Geert , Jürges Hendrik
Published: September 2017

Objectives

Dental diseases are the most common chronic diseases worldwide. Healthy teeth are vital for quality of life, particularly diet and nutrition. However, little information exists to inform health policymakers about potentially long‐lasting influences of early‐life conditions. The purpose of this study was to investigate the relation between early‐life socioeconomic conditions and number of natural teeth at age 50 and above.

Methods

Analyses were conducted on cross‐sectional data from the Survey of Health, Ageing and Retirement in Europe (SHARE wave 5), which includes information on 41 560 respondents aged 50 years or older from 14 European countries and Israel. Using SHARE life history information, a series of regression models (OLS, Tobit) were estimated to analyse the relationship between socioeconomic conditions in earlier life and the number of teeth at age 50+.

Results

Childhood socioeconomic background was associated with the number of natural teeth at age 50 and above, even after controlling for current determinants of oral health. Respondents who had had more than 25 books in their childhood household had a mean 1.4 (95% CI: 1.2‐1.5) more teeth than respondents with fewer books. Respondents who reported poor financial conditions during childhood had a mean 0.6 (95% CI: 0.3‐0.9) fewer teeth than respondents who reported better financial conditions in childhood.

Conclusion

These findings substantiate the association between socioeconomic conditions in the early years of life and tooth retention to older adulthood and highlight the long‐lasting relation between childhood living conditions and oral health through the lifecourse.
Grandmaternal smoking increases asthma risk in grandchildren: A nationwide Swedish cohort
Authors: Lodge C. J. , Bråbäck L. , Lowe A. J. , Dharmage S. C. , Olsson D. , Forsberg B.
Published: September 2017

Background

There is growing interest in exposures prior to conception as possible risk factors for offspring asthma. Although partially supported by evidence from limited human studies, current evidence is inconsistent and based on recall of exposure status.

Objective

We aimed to investigate grandmaternal smoking during pregnancy and the risk of asthma in grandchildren using prospectively collected population‐based data.

Methods

Information on grandmaternal and maternal smoking during pregnancy and grandchild use of asthma medications was collected from national Swedish registries. Associations between grandmaternal smoking during pregnancy (10‐12 weeks) and asthma medication use in grandchildren were investigated using generalized estimating equations. Ages at which asthma medications were prescribed classified childhood asthma into never, early transient (0‐3 years), late onset (3‐6 years) and early persistent (0‐3 and 3‐6 years) phenotypes.

Results

From 1982 to 1986, 44 583 grandmothers gave birth to 46 197 mothers, who gave birth to 66 271 grandchildren (born 1996‐2010). Children aged 1‐6 years had an increased asthma risk if their grandmothers had smoked during pregnancy, with a higher risk for more exposure (10+ cigs/d; adjusted OR 1.23; 1.17, 1.30). Maternal smoking did not modify this relationship.

Conclusions & Clinical Relevance

Children had an increased risk of asthma in the first 6 years of life if their grandmothers smoked during early pregnancy, independent of maternal smoking. Importantly, this exhibited a dose‐response relationship and was associated with a persistent childhood asthma phenotype. These findings support possible epigenetic transmission of risk from environmental exposures in previous generations.
Common variants in DLG1 locus are associated with non‐syndromic cleft lip with or without cleft palate
Authors: Mostowska A. , Gaczkowska A. , Żukowski K. , Ludwig K.U. , Hozyasz K.K. , Wójcicki P. , Mangold E. , Böhmer A.C. , Heilmann‐Heimbach S. , Knapp M. , Zadurska M. , Biedziak B. , Budner M. , Lasota A. , Daktera‐Micker A. , Jagodziński P.P.
Published: September 2017

Non‐syndromic cleft lip with or without cleft palate (nsCL/P) is a common craniofacial anomaly with a complex and heterogeneous aetiology. Knowledge regarding specific genetic factors underlying this birth defect is still not well understood. Therefore, we conducted an independent replication analysis for the top‐associated variants located within the DLG1 locus at chromosome 3q29, which was identified as a novel cleft‐susceptibility locus in our genome‐wide association study (GWAS). Mega‐analysis of the pooled individual data from the GWAS and replication study confirmed that common DLG1 variants are associated with the risk of nsCL/P. Two single nucleotide polymorphisms (SNPs), rs338217 and rs7649443, were statistically significant even at the genome‐wide level (Ptrend = 9.70E−10 and Ptrend = 8.96E−09, respectively). Three other SNPs, rs9826379, rs6805920 and rs6583202, reached a suggestive genome‐wide significance threshold (Ptrend < 1.00E−05). The location of the strongest individual SNP in the intronic sequence of the gene encoding DLG1 antisense RNA suggests that the true causal variant implicated in the risk of nsCL/P may affect the DLG1 gene expression level rather than structure of the encoded protein. In conclusion, we identified a novel cleft‐susceptibility locus at chromosome 3q29 with a DLG1 as a novel candidate gene for this common craniofacial anomaly.
Efficacy of patients' preferred exercise modalities in chronic obstructive pulmonary disease: A parallel‐group, randomized, clinical trial
Authors: Wu Meng , Zhou Lu‐Qian , Li Shi , Zhao Su , Fan Hui‐Jun , Sun Jie‐Min , Li Xiao‐Nan , Luo Jian , Wang An‐Qi , Wu Jian‐Ping , Li Xiao‐Ying , Zhang Jin‐Nong
Published: September 2017

Introduction

Physical exercise effectively improves health‐related quality of life in patients with chronic obstructive pulmonary disease (COPD). However, application of this medical intervention is problematic, due to poor adherence to the exercise program or unawareness of the significance of this intervention.

Objective

To determine whether COPD patients who adopted personal‐preferred exercise modalities (PPEMs) for daily training would demonstrate sustained benefits due to improved adherence.

Methods

Stable COPD patients were randomly assigned to the daily PPEMs group or the control group (without extra exercise apart from daily life activities). All other treatments were similar. The primary outcome was the health‐related quality of life (HRQoL), measured with St. George's Respiratory Questionnaire (SGRQ) score at 12 months. Other measures included the Borg dyspnea score, 6‐min walking distance (6MWD) and lung function variables.

Results

The intention‐to‐treat (ITT) population included 94 patients, 68 of them completed the study protocol over 12 months (the PP‐population). A greater decline of SGRQ score (improvement of HRQoL) in the PPEMs group than that in the controls was demonstrated over 12 months (–19.1 vs −9.0 in the ITT population and −19.1 vs −8.7 in the PP population, P ≤ .001 for all comparisons), the reduction exceeded the minimal clinically important difference of ≥ 4 points. The PPEMs group also showed a greater reduction than the control group in Borg score at 12 months in the ITT and the PP population as well (P < .01). No significant improvement was found in 6MWD or in lung function variables.

Conclusions

COPD patients could benefit from extra daily PPEMs, and the gain may sustain at least for 1 year.
“Crossing the River by Feeling the Gold”: The Asian Infrastructure Investment Bank and the Financial Support to the Belt and Road Initiative
Authors: Gabusi Giuseppe
Published: September 2017

China's Belt and Road Initiative (BRI) is, above all, a connectivity project. As connectivity requires financial support, in the past few years China has undertaken several institution‐building activities at the national and international level, mainly in the financial and economic sector, showing a new propensity to influence global economic governance. In particular, the establishment of the Asian Infrastructure Investment Bank (AIIB) has drawn attention worldwide. How does this institution‐building process connect with BRI? Are these institutions just a vehicle for exporting China's capital and overcapacity, or do they signal a potential wider challenge to the post‐World War II liberal international order? By analyzing the first loans approved by the bank, the present paper argues that far from representing a China‐led challenge to the Western‐led liberal order, the AIIB, while promoting Chinese commercial and geopolitical interests, shows the resilience of the global financial regime created by the West.
Isolation by oceanic distance and spatial genetic structure in an overharvested international fishery
Authors: Truelove Nathan K. , Box Stephen J. , Aiken Karl A. , Blythe‐Mallett Azra , Boman Erik M. , Booker Catherine J. , Byfield Tamsen T. , Cox Courtney E. , Davis Martha H. , Delgado Gabriel A. , Glazer Bob A. , Griffiths Sarah M. , Kitson‐Walters Kimani , Kough Andy S. , Pérez Enríquez Ricardo , Preziosi Richard F. , Roy Marcia E. , Segura‐García Iris , Webber Mona K. , Stoner Allan W.
Published: September 2017

Aim

A detailed understanding of spatial genetic structure (SGS) and the factors driving contemporary patterns of gene flow and genetic diversity are fundamental for developing conservation and management plans for marine fisheries. We performed a detailed study of SGS and genetic diversity throughout the overharvested queen conch (Lobatus gigas) fishery. Caribbean countries were presented as major populations to examine transboundary patterns of population differentiation.

Location

Nineteen locations in the greater Caribbean from Anguilla, the Bahamas, Belize, Caribbean Netherlands, Honduras, Jamaica, Mexico, Turks and Caicos, and the USA.

Methods

We genotyped 643 individuals with nine microsatellites. Population genetic and multivariate analyses characterized SGS. We tested the alternate hypotheses: (1) SGS is randomly distributed in space or (2) pairwise genetic structure among sites is correlated with oceanic distance (IBOD).

Results

Our study found that L. gigas does not form a single panmictic population in the greater Caribbean. Significant levels of genetic differentiation were identified between Caribbean countries (FCT = 0.011; p = .0001), within Caribbean countries (FSC = 0.003; p = .001), and among sites irrespective of geographic location (FST = 0.013; p = .0001). Gene flow across the greater Caribbean was constrained by oceanic distance (p = .0009; Mantel r = .40), which acted to isolate local populations.

Main conclusions

Gene flow over the spatial scale of the entire Caribbean basin is constrained by oceanic distance, which may impede the natural recovery of overfished L. gigas populations. Our results suggest a careful blend of local and international management will be required to ensure long‐term sustainability for the species.
High local trait variability in a globally invasive cyanobacterium
Authors: Bolius Sarah , Wiedner Claudia , Weithoff Guntram
Published: September 2017

During the last couple of decades, invasive species have become a worldwide problem in many freshwater systems. Besides higher plants and animals, microbes, in particular the potentially toxic cyanobacterium Cylindrospermopsis raciborskii, has attracted increasing attention, due to its spread towards temperate zones of the northern and southern hemisphere. A number of advantageous functional traits and a high intraspecific plasticity have been suggested to explain its invasion success.

The aim of this study was to examine intraspecific functional trait variability in 12 different isolates of C. raciborskii originating from different lakes in an invaded region in Northeast Germany. We measured growth rate, C:N:P ratios, chlorophyll‐a content and the abundance of heterocysts under nutrient‐replete and phosphorus‐limited conditions. Moreover, the isolate‐specific morphology and grazing losses by an herbivorous rotifer, as a top‐down force, were studied.

DNA fingerprinting revealed that all isolates were genetically different. C. raciborskii exhibited a large variability in all measured traits among isolates. The C:P, N:P and Chl‐a:C ratios differed by a factor of two or more. The trait variability among isolates was higher under nutrient‐replete conditions, except for the C:P ratio, which varied most during phosphorus limitation. The susceptibility to grazing, calculated as maximum ingestion rates of the rotifer Brachionus calyciflorus on C. raciborskii, varied most among isolates, but was not related to any of the measured physiological or morphological traits, i.e. no trade‐off was found.

Ecological and genetic clustering did not match, indicating that the genetic relationship based on DNA fingerprinting did not cover ecological differences.

Our results show a high trait variability within locally occurring and partly co‐occurring C. raciborskii isolates. No overall trade‐offs between the measured functional traits were found. This demonstrates the ecological relevance of linking multiple traits, e.g. competitive and consumptive. Furthermore, this study emphasises the importance of analysing more than one strain of a species, as different strains show different trait values potentially relevant for their invasibility and the field of general trait‐based ecology.
Continental‐extent patterns in amphibian malformations linked to parasites, chemical contaminants, and their interactions
Authors: Haas Sarah E. , Reeves Mari K. , Pinkney Alfred E. , Johnson Pieter T. J.
Published: September 2017

Widespread observations of malformed amphibians across North America have generated both concern and controversy. Debates over the causes of such malformations—which can affect >50% of animals in a population—have continued, likely due to involvement of multiple causal factors. Here, we used a 13‐year dataset encompassing 53,880 frogs and toads from 422 wetlands and 42 states in the conterminousUSAto test hypotheses relating abnormalities and four categories of potential drivers: (i) chemical contaminants, (ii) land use practices, (iii) parasite infection, and (iv) targeted interactions between parasites and pesticides. Using a hierarchically nested, competing‐model approach, we further examined how these associations varied spatially among geographic regions. Although malformations were rare overall (average = 1.6%), we identified 96 hotspot sites with 5%–25% abnormal individuals. Using the full dataset of 934 collections (without data on parasite infection), malformation frequency was best predicted by the presence of oil and gas wells within the watershed. Among collections also examined for parasite infection (n = 154), average parasite load and its interaction with pesticide application positively predicted malformations: wetlands with a greater abundance of the trematodeRibeiroia ondatraewere more likely to have malformed amphibians, but these effects were strongest when pesticide application was also high, consistent with prior experimental research. Importantly, however, the influence of these factors also varied regionally, helping explain divergent results from previous studies at local scales; parasite infection was more influential in the West and Northeast, whereas pesticide application and oil/gas wells correlated with abnormalities in the Northeast, Southeast, and western regions of theUSA. These results, based on the largest systematic sampling of amphibian malformations, suggest that increased observations of abnormal amphibians are associated with both parasite infection and chemical contaminants, but that their relative importance and interaction strength varied with the spatial extent of the analysis.
Hypoxia and hypothermia as rival agents of selection driving the evolution of viviparity in lizards
Authors: Pincheira‐Donoso Daniel , Jara Manuel , Reaney Ashley , García‐Roa Roberto , Saldarriaga‐Córdoba Mónica , Hodgson Dave J.
Published: September 2017

Aim

The evolution of key innovations promotes adaptive radiations by opening access to new ecological opportunity. The acquisition of viviparity (live‐bearing reproduction) has emerged as one such innovation explaining reptile proliferations into extreme climates. By evolving viviparity, females provide embryos with internally stable environments to complete development. The classical hypothesis suggests that natural selection for viviparity arises from low temperatures in cold climates, which promote prolonged egg retention in the mother's body. An alternative hypothesis proposes that declines in atmospheric oxygen at high elevations create natural selection for embryo retention to provide them with optimal oxygen levels during development. However, although experimental studies support the negative effects of low oxygen on egg development, this ‘hypoxia’ hypothesis has never been tested quantitatively. Here, we compete the hypoxia hypothesis against the ‘cold‐climate’ hypothesis, using a highly diverse lizard genus.

Location

South America.

Major taxa

Liolaemuslizards.

Methods

We use a multivariate dataset covering 121 species varying extensively in geographical and climatic distribution (including extreme thermal and oxygen gradients) and parity mode. Based on a new molecular phylogeny for the genus, we use phylogenetic logistic regressions to generate a range of models ranking environmental factors as a function of their effects on parity mode transitions.

Results

Elevation and oxygen declines were almost perfectly correlated, and both were identified as the dominant predictors of oviparity‐to‐viviparity transitions, whereas the role for temperature (dominated by the coldest winter temperatures and daily fluctuations) was significant but secondary. Overall, we showed that oxygen deprivation and low temperatures both play a role in the evolution of viviparity.

Main conclusions

Our findings support the role for selection from declines in oxygen concentrations as the primary driver behind viviparity. However, selection arising from cold temperatures and from reduced fluctuations in daily temperatures contributes to the evolution of these transitions by creating multivariate selection on parity mode.
A randomized clinical trial on the efficacy of a new oxalate‐containing sensitivity relief strip following professional vs self‐application
Authors: Drake MA , Lenton PA , Lunos SA
Published: September 2017

Objectives

The purpose of this study was to determine the efficacy of 3.14% dipotassium oxalate monohydrate‐containing strip on the relief of dentinal hypersensitivity (DH). A second objective was to determine whether there was a difference in DH levels when the strip was self‐applied vs applied by a dental professional.

Methods

Sixty subjects were randomized into self‐applied, professionally applied or placebo‐strip groups. Dentinal hypersensitivity was evaluated by a blinded examiner, using the Schiff Air Scale (SAS). A verbal rating scale (VRS) was also used to measure the subjects’ perception of pain. Measures were taken at baseline, 30 minutes, 4 and 8 weeks post‐treatment.

Results

There was a significant reduction in DH in all three groups (P ≤ .05) at 30 minutes and 8 weeks post‐treatment. At the 4‐week follow‐up, only the self‐ and professionally applied (active ingredient) groups had a significant reduction in DH compared to baseline. When comparing the reduction in DH levels between groups, the only significant difference occurred between the professionally applied treatment group and the placebo group at the 4‐week follow‐up. There were no significant differences in DH reduction levels achieved between the self‐ and professionally applied groups (P > .05).

Conclusions

This study confirmed the short‐term (4 weeks) effectiveness of a single application of 3.14% dipotassium oxalate monohydrate‐containing strip. Self‐ and professional application were not shown to be different.
Is there an increased risk of cervical neoplasia in atopic dermatitis patients treated with oral immunosuppressive drugs?
Authors: Garritsen F.M. , Verheijen R.H.M. , Gerestein C.G. , van Zuilen A.D. , Oosterhaven J.A.F. , van Dijk M. , Bruijnzeel‐Koomen C.A.F. , Schuttelaar M.L. , de Bruin‐Weller M.S.
Published: September 2017

Background

Oral immunosuppressive drugs are frequently prescribed in young women with atopic dermatitis (AD). Immunocompromised patients may have a higher risk of developing high‐risk HPV infections, cervical intra‐epithelial neoplasia (CIN) and cervical carcinoma. Most literature on patients using oral immunosuppressive drugs is available in organ transplant patients. Literature on the risk of developing cervical carcinoma in AD patients treated with oral immunosuppressive drugs is lacking. At this moment, there is no clear guideline/consensus on this topic, but in daily practice, questions arise concerning whether this risk is increased and whether more intensive screening in women using immunosuppressive drugs should take place.

Objective

To investigate the occurrence of cervical carcinoma in women with AD treated with oral immunosuppressive drugs.

Methods

In this retrospective cohort study in two university medical centres in the Netherlands, all female adult AD patients receiving oral immunosuppressive drugs (cyclosporine A, azathioprine, methotrexate, mycophenolate mofetil, enteric‐coated mycophenolate sodium and extended release tacrolimus) for more than 2 months between 1989 and 1 January 2014 were included. Patient files in the national histopathology register were screened for PAP3a, CIN I, CIN II, CIN III and cervical carcinoma.

Results

A total of 257 female AD patients with one or more treatment episodes from 1989 until 1 January 2014 were identified and included in this study. In 189 patients (73.5%), results of cervical examination were reported in the national histopathology database. Median total duration of treatment in these 189 women was 407.0 days (IQR 243.0–940.0). No cervical carcinoma during or following immunosuppressive therapy was found in our patient group.

Conclusions

No intensified screening programme for cervical neoplasia seems necessary for women with AD using oral immunosuppressive drugs.
Apremilast in psoriasis – a prospective real‐world study
Authors: Vujic I. , Herman R. , Sanlorenzo M. , Posch C. , Monshi B. , Rappersberger K. , Richter L.
Published: September 2017

Background

Apremilast is a novel oral phosphodiesterase‐4 inhibitor approved for psoriasis treatment. Randomized trials have documented its efficacy and safety, but data on real‐world patients are scarce.

Objectives

We aim to characterize psoriasis patients treated with apremilast in a real‐world setting and calculate drug survival as an important measure of efficacy and compliance.

Methods

All patients with psoriasis who received apremilast between 1 April 2015 and 19 January 2017 were evaluated every 4 weeks, and we documented: age, weight, height, smoking status, family history of psoriasis, joint involvement, previous treatments, psoriasis area severity index (PASI) scores, and the onset and duration of adverse events (AE). Efficacy was analysed by PASI50, PASI75 and PASI90, reflecting the improvement of skin lesions compared to the PASI‐baseline. Kaplan–Meier statistics were used for drug survival estimates.

Results

Forty‐eight patients were included. The median apremilast drug survival was 12.5 weeks (range 1–87). Three patients (6.3%) reached PASI90, nine (18.8%) PASI75 and eight patients (16.7%) PASI50. Patient weight inversely correlated with a PASI50 response (P < 0.05, n = 37), and none of the obese patients (BMI > 30.0, n = 6) reached PASI75, compared to 32% of the non‐obese patients (BMI < 30.0, n = 31). Thirty‐one patients (64.6%) reported at least one AE, most frequently diarrhoea (n = 21, 43.8%), headache (n = 7, 14.6%) and joint pain (n = 5, 10.4%).

Conclusions

Despite differences between real‐world and trial patients, apremilast is safe and effective for the treatment of skin psoriasis in the daily practice. Up to 40% of patients will reach PASI50 or higher, but only few patients will reach PASI90. Bodyweight might affect drug efficacy.
Truncation Error Estimates in Process Life Cycle Assessment Using Input‐Output Analysis
Authors: Ward Hauke , Wenz Leonie , Steckel Jan C. , Minx Jan C.
Published: September 2017

Process life cycle assessment (PLCA) is widely used to quantify environmental flows associated with the manufacturing of products and other processes. As PLCA always depends on defining a system boundary, its application involves truncation errors. Different methods of estimating truncation errors are proposed in the literature; most of these are based on artificially constructed system complete counterfactuals. In this article, we review the literature on truncation errors and their estimates and systematically explore factors that influence truncation error estimates. We classify estimation approaches, together with underlying factors influencing estimation results according to where in the estimation procedure they occur. By contrasting different PLCA truncation/error modeling frameworks using the same underlying input‐output (I‐O) data set and varying cut‐off criteria, we show that modeling choices can significantly influence estimates for PLCA truncation errors. In addition, we find that differences in I‐O and process inventory databases, such as missing service sector activities, can significantly affect estimates of PLCA truncation errors. Our results expose the challenges related to explicit statements on the magnitude of PLCA truncation errors. They also indicate that increasing the strictness of cut‐off criteria in PLCA has only limited influence on the resulting truncation errors. We conclude that applying an additional I‐O life cycle assessment or a path exchange hybrid life cycle assessment to identify where significant contributions are located in upstream layers could significantly reduce PLCA truncation errors.
Impact of High Patient Volume on Midwifery Education in Kampala, Uganda
Authors: Rinne Jocelyn , Nabacwa Oliver Norah , Nabirye Rose Chalo , Shorten Allison
Published: September 2017

Purpose

The purpose of this study was to understand the barriers to midwifery education within a high‐volume hospital in Kampala, Uganda. Our aim was to determine students’ and midwives’ perceptions of the educational process in the context of a setting with high patient volume.

Research Question

We hypothesized that when compared with students, practicing midwives view high patient volume as a greater barrier to education.

Significance

Despite advances in maternal care, maternal and infant mortality in sub‐Saharan Africa have continued to lag behind the rest of the world. With an ongoing rise in pregnancies in this region, urgent attention is needed to better train, educate, and retain student midwives.

Methods

We conducted a cross‐sectional survey‐based study to identify challenges to midwifery education among students and midwives based at Mulago National Referral Hospital in Kampala. We surveyed 60 midwives and 51 midwifery students. Likert‐scale responses were dichotomized and chi‐square tests were used to examine differences in perceptions between students and midwives.

Results

We identified notable and significant differences in perceptions between midwives and midwifery students when examining the impact of patient volume on education and practice. These differences persisted across multiple questions relating to the educational process. When compared with students, a larger proportion of midwives felt that high patient volume impaired education relating to midwifery knowledge (33% vs 12%, P < .01) and clinical skills (43% vs 4%, P < .01), and contributed to high stress levels (75% vs 35%, P < .01).

Discussion

While there is ample research on educating midwives within a broader global context, limited research has explored how midwifery training is impacted by high patient volume. Student midwives may view high patient volume as an educational opportunity, while practicing midwives consider high patient volume a barrier to teaching. This difference may relate to a greater perceived responsibility for patient care by midwives. Our findings suggest that excessive patient volume may be impairing midwives’ ability to effectively teach their students the midwifery model of care while balancing their high patient workload. Additional research is urgently needed to identify how to support midwifery practice in health care environments with high patient demand.