bluuebunny/crossref_metadata_2025 huggingface dataset:
Very tight vs. tight control: what should be the criteria for pharmacologic therapy dose adjustment in diabetes in pregnancy? Evidence from randomized controlled trials
Authors: Caissutti Claudia , Saccone Gabriele , Ciardulli Andrea , Berghella Vincenzo
Published: November 2017

Introduction

There is inconclusive evidence from randomized controlled trials (RCTs) to support any specific criteria for pharmacologic therapy dose adjustment in diabetes in pregnancy. Our objective was to analyze the criteria for dose adjustment of pharmacologic treatment for diabetes mellitus (DM) in pregnancy.

Material and methods

Data sources: MEDLINE, OVID and Cochrane Library were searched from their inception to September 2017. Selection criteria included all trials of DM in pregnancy managed by oral hypoglycemic agents or insulin reporting criteria for pharmacologic therapy dose adjustment. RCTs in women with pregestational DM and gestational DM (GDM) were included. For each trial, data regarding glucose values used for pharmacologic therapy dose adjustment were extracted and carefully reviewed.

Results

Of 51 RCTs on therapy for GDM or pregestational DM, 17 (4230 women) were included as they reported criteria for pharmacologic therapy dose adjustment. Most of them (88%, 15/17) included women with GDM only. For RCTs including women with GDM, 12/16 (75%) used the two‐step approach, three (19%) the one‐step approach and one (6%) either the one‐ or two‐step approach. Regarding the type of initial therapy, 13 (77%) RCTs used different types and doses of insulin; nine (53%) used metformin; five (30%) used glyburide; and one (6%) used placebo. In most RCTs, glucose monitoring was assessed four times daily, i.e. fasting (all RCTs) and two hours (15 RCTs, 88%) after each of the three main meals – breakfast, lunch, and dinner. For fasting glucose target, all used a value <105 mg/dL; nine (53%) used 95 mg/dL as target. Of the 15 RCTs using a two‐hour postprandial value as target, 11 (73%) had 120 mg/dL as cutoff. Regarding the criteria for pharmacologic therapy dose adjustment, we found six different criteria. The majority of RCTs (9/17, 53%) used either one or two values per week higher than the target values, of which two‐thirds used only one value (35% of total), and one‐third (18% of total) two values. Five RCTs (29%) used >50%, one (6%) >30%, and one (6%) >20% of the values higher than the target value; one (6%) used the appearance of glycosuria.

Conclusions

When evaluating RCTs which included criteria for pharmacologic GDM therapy dose adjustment, the most common criterion for diagnosis was the two‐step test, and the most common used therapies were insulin and metformin. Regarding glucose monitoring, the most common frequency was four times per day, fasting and two hours after each main meal, using as target glucose values 95 and 120 mg/dL, respectively. Importantly, we found six different criteria for pharmacologic GDM therapy dose adjustment, with the majority using very tight criteria of either one or two values per week higher than the target values, of which two‐thirds used only one value, and one‐third used two values.
Placental development and function in women with a history of placenta‐related complications: a systematic review
Authors: Reijnders Ignatia F. , Mulders Annemarie G.M.G.J. , Koster Maria P.H.
Published: November 2017

Introduction

Women with a history of placenta‐related pregnancy complications, such as preeclampsia, intrauterine growth restriction or preterm delivery, have an increased risk for recurrence of such complications. This recurrence is likely the result of underlying endothelial dysfunction that leads to abnormal placentation, especially in complications with an early onset. This study provides an overview of biomarkers of placental development and function in pregnancies from women with a history of placenta‐related complications.

Material and methods

A systematic literature search was conducted limited to human studies and including keywords related to a history of placenta‐related complications and markers of placental development and function. Two independent reviewers assessed eligibility and quality of 1553 retrieved unique articles.

Results

Five articles reporting on placental development and function in women with an obstetric history of preeclampsia (n = 3), intrauterine growth restriction (n = 1) and preterm delivery (n = 2) were eligible for quality assessment. We identified associations between a history of preeclampsia and abnormal placental histological findings at term in the current pregnancy, but found contradictory results regarding presence of uterine artery notching. In women with a history of very preterm delivery (<32 weeks), one study showed associations with abnormal placental histology.

Conclusion

Literature on the association between a history of placenta‐related complications and placental development and function in subsequent pregnancies is scarce and studies are heterogeneous. However, literature shows that placenta‐related pregnancy complications are associated with subsequent placental histology.
Giving versus acting: Using latent profile analysis to distinguish between benevolent and activist support for global poverty reduction
Authors: Thomas Emma F. , McGarty Craig
Published: November 2017

There are a variety of ways that people can respond to inequality. This article considers the distinction between collective giving and collective acting, but also adopts a focus on the people who engage in those behaviours. Benevolent supporters engage in efforts to alleviate suffering through the transfer of money or provision of goods (‘giving’), while activist supporters engage in actions that aim to challenging an underlying injustice or exploitation (‘acting’). Using samples obtained through anti‐poverty non‐governmental organizations (N = 2,340), latent profile analysis suggested two qualitatively different forms of support for global poverty reduction: a benevolent supporter profile (defined by moderate levels of charitable support) and an activist supporter profile (defined by engagement in a suite of socio‐political actions). The two forms of support are predicted by different appraisals for, emotional reactions to (outrage v sympathy), and social change beliefs about, global injustice. Results highlight the theoretical and practical importance of considering subgroup differences in how social justice is pursued.
Sporadic primary hyperparathyroidism and stone disease: a comprehensive metabolic evaluation before and after parathyroidectomy
Authors: Marchini Giovanni S. , Faria Kauy V. M. , Torricelli Fábio C. M. , Monga Manoj , Srougi Miguel , Nahas William C. , Mazzucchi Eduardo
Published: November 2017

Objectives

To characterize the stone risk and the impact of parathyroidectomy on the metabolic profile of patients with primary hyperparathyroidism (PHPT) and urolithiasis.

Patients and Methods

We analysed the prospectively collected charts of patients treated at our stone clinic between January 2001 and January 2016 searching for patients with PHPT and urolithiasis. Imaging evaluation of the kidneys, bones and parathyroid glands was assessed. We analysed the demographic data, serum and urinary variables before and after parathyroidectomy. We used a paired t‐test, Fisher's test, Spearman's test and anova in the statistical analysis.

Results

A total of 51 patients were included. The mean patient age was 57.1 ± 12.1 years and 82.4% were women. Before parathyroidectomy, mean calcium and parathyroid hormone (PTH) levels were 11.2 ± 1.0 mg/dL and 331 ± 584 pg/dL, respectively. Hypercalcaemia was present in 84.3% of patients. All eight patients with normal calcium levels had elevated PTH levels. Only two patients did not have PTH above the normal range, although both had elevated calcium levels. The most common urinary disorders were low urinary volume (64.7%), hypercalciuria (60.8%), high urinary pH (41.2%) and hypocitraturia (31.4%). After parathyroidectomy, the number of patients with hypercalcaemia (n = 4; 7.8%), elevated PTH (n = 17; 33.3%) and hypophosphataemia (n = 3; 5.9%) significantly decreased (P < 0.001). The number of urinary abnormalities decreased and there was a reduction in urinary calcium (P < 0.001), pH (P = 0.001) and citrate levels (P = 0.003).

Conclusion

Individuals with PHPT and nephrolithiasis frequently have elevated baseline PTH and calcium levels. Low volume, hypercalciuria, high urinary pH, and hypocitraturia are the most frequent urinary disorders. Parathyroidectomy is effective in normalizing serum calcium and PTH levels, although other urinary metabolic may persist. Patients should be monitored for the need for citrate supplementation.
Intracorporeal robot‐assisted radical cystectomy, together with an enhanced recovery programme, improves postoperative outcomes by aggregating marginal gains
Authors: Tan Wei Shen , Tan Mae‐Yen , Lamb Benjamin W. , Sridhar Ashwin , Mohammed Anna , Baker Hilary , Nathan Senthil , Briggs Timothy , Tan Melanie , Kelly John D.
Published: November 2017

Objective

To assess the cumulative effect of an enhanced recovery after surgery (ERAS) pathway and minimally invasive robot‐assisted radical cystectomy with intracorporeal urinary diversion (iRARC) in comparison with open radical cystectomy (ORC) on length of hospital stay (LOS) and peri‐operative outcomes.

Materials and Methods

Between February 2009 and October 2017, 304 radical cystectomy cases were performed at a single institution (ORC, n = 54; robot‐assisted radical cystectomy [RARC], n = 250). Data were prospectively collected. We identified 45 consecutive ORC cases performed without ERAS before the commencement of the RARC programme (Cohort A), 50 consecutive iRARC cases performed without ERAS (Cohort B) and 40 iRARC cases with ERAS (Cohort C). The primary outcome measure was LOS, while secondary outcome measures included peri‐operative 90‐day complications and readmission rate. Complications were accessed using the Clavien–Dindo system.

Results

Patients in all cohorts were evenly matched with regard to age, sex, body mass index, neoadjuvant treatment, tumour stage, lymph node yield, previous pelvic radiotherapy and surgery, peri‐operative anaemia, as well as physiological state. Patients who underwent iRARC with ERAS had a significantly higher American Society of Anesthesiologists score (III–IV) and were more likely to receive neobladder reconstruction. The median (interquartile range) LOS was shorter in the iRARC with ERAS group (7 [6–10]) days than in the iRARC without ERAS group (11 [8–15]) days and the ORC group (17 [14–21] days). In a propensity score‐matched cohort of patients who underwent iRARC, patients who followed the ERAS pathway had significantly lower 90‐day readmission rates. Additionally, implementing ERAS in an iRARC cohort resulted in a significantly lower 90‐day all (P < 0.001) and gastrointestinal‐related complications (P = 0.001). The ERAS pathway and younger patients were independently associated with an LOS of ≤10 days on multinomial logistic regression.

Conclusion

A comprehensive ERAS programme can significantly reduce LOS in patients undergoing iRARC without increasing 90‐day readmission rates. An ERAS programme can augment the benefits of iRARC in improving peri‐operative outcomes. In studies comparing ORC and RARC, the presence or absence of an ERAS programme will be a confounding factor and only level 1 evidence can be interpreted reliably.
The neurovascular structure‐adjacent frozen‐section examination (NeuroSAFE) approach to nerve sparing in robot‐assisted laparoscopic radical prostatectomy in a British setting – a prospective observational comparative study
Authors: Mirmilstein George , Rai Bhavan Prasad , Gbolahan Olayinka , Srirangam Vinaya , Narula Ashish , Agarwal Samita , Lane Tim M. , Vasdev Nikhil , Adshead James
Published: November 2017

Objectives

To evaluate the neurovascular structure‐adjacent frozen‐section examination (NeuroSAFE) technique in a British setting in men undergoing robot‐assisted laparoscopic radical prostatectomy (RALP) .

Patients and Methods

We retrospectively analysed our prospectively maintained database of patients who underwent RALP between November 2008 and February 2017. We examined preoperative pathological and functional parameters, intraoperative nerve sparing (NS), postoperative histology, as well as functional and oncological follow‐up. We compared those who had a NeuroSAFE approach and those who had NS without NeuroSAFE. We also compared all the RALPs before and after the introduction of NeuroSAFE. Statistical analysis was done using the two‐tailed t‐test and chi‐squared analysis.

Results

This single surgeon series included 417 RALPs, including 120 NeuroSAFEs. The NeuroSAFE cohort had a greater proportion of D'Amico high‐risk disease (30.8% vs 9.6%, P < 0.001), higher Gleason scores and higher pT stage compared to the non‐NeuroSAFE NS cohort. After the introduction of NeuroSAFE, more preoperatively potent men underwent bilateral NS with pT2 disease (84.6% vs 66.3%, P = 0.002) and more overall NS were performed in patients with pT3 disease (65.1% vs 36.7%, P = 0.012). Overall positive surgical margin (PSM) rates were lower in the NeuroSAFE cohort compared to those who had NS without NeuroSAFE (9.2% vs 17.8%, P = 0.04). The 12‐month potency rates were also higher in the NeuroSAFE cohort for both bilateral (77.3% vs 50.9%, P = 0.009) and unilateral (70.6% vs 40%, P = 0.04) NS. Pad‐free continence was also higher in the NeuroSAFE group (85.7% vs 70.9%, P = 0.019), but there was no significant difference between those who were wearing ≤1 safety pad. Although we only had short‐term oncological follow‐up, it did not significantly differ between the two groups.

Conclusion

Adoption of NeuroSAFE allowed us to offer NS in higher risk patients, whilst reducing PSM rates and at the same time improving potency at 12 months.
Need for multiscale planning for conservation of urban bats
Authors: Gallo Travis , Lehrer Elizabeth W. , Fidino Mason , Kilgour R. Julia , Wolff Patrick J. , Magle Seth B.
Published: November 2017

For over a century there have been continual efforts to incorporate nature into urban planning. These efforts (i.e., urban reconciliation) aim to manage and create habitats that support biodiversity within cities. Given that species select habitat at different spatial scales, understanding the scale at which urban species respond to their environment is critical to the success of urban reconciliation efforts. We assessed species–habitat relationships for common bat species at 50‐m, 500‐m, and 1 km spatial scales in the Chicago (U.S.A.) metropolitan area and predicted bat activity across the greater Chicago region. Habitat characteristics across all measured scales were important predictors of silver‐haired bat (Lasionycteris noctivagans) and eastern red bat (Lasiurus borealis) activity, and big brown bat (Eptesicus fuscus) activity was significantly lower at urban sites relative to rural sites. Open vegetation had a negative effect on silver‐haired bat activity at the 50‐m scale but a positive effect at the 500‐m scale, indicating potential shifts in the relative importance of some habitat characteristics at different scales. These results demonstrate that localized effects may be constrained by broader spatial patterns. Our findings highlight the importance of considering scale in urban reconciliation efforts and our landscape predictions provide information that can help prioritize urban conservation work.
Coherence in the Visual Imagination
Authors: Vertolli Michael O. , Kelly Mary Alexandria , Davies Jim
Published: November 2017

An incoherent visualization is when aspects of different senses of a word (e.g., the biological “mouse” vs. the computer “mouse”) are present in the same visualization (e.g., a visualization of a biological mouse in the same image with a computer tower). We describe and implement a new model of creating contextual coherence in the visual imagination called Coherencer, based on the SOILIE model of imagination. We show that Coherencer is able to generate scene descriptions that are more coherent than SOILIE's original approach as well as a parallel connectionist algorithm that is considered competitive in the literature on general coherence. We also show that co‐occurrence probabilities are a better association representation than holographic vectors and that better models of coherence improve the resulting output independent of the association type that is used. Theoretically, we show that Coherencer is consistent with other models of cognitive generation. In particular, Coherencer is a similar, but more cognitively plausible model than the C3 model of concept combination created by Costello and Keane (2000). We show that Coherencer is also consistent with both the modal schematic indices of perceptual symbol systems theory (Barsalou, 1999) and the amodal contextual constraints of Thagard's (2002) theory of coherence. Finally, we describe how Coherencer is consistent with contemporary research on the hippocampus, and we show evidence that the process of making a visualization coherent is serial.
Interannual bumble bee abundance is driven by indirect climate effects on floral resource phenology
Authors: Ogilvie Jane E. , Griffin Sean R. , Gezon Zachariah J. , Inouye Brian D. , Underwood Nora , Inouye David W. , Irwin Rebecca E.
Published: November 2017

Climate change can influence consumer populations both directly, by affecting survival and reproduction, and indirectly, by altering resources. However, little is known about the relative importance of direct and indirect effects, particularly for species important to ecosystem functioning, like pollinators. We used structural equation modelling to test the importance of direct and indirect (via floral resources) climate effects on the interannual abundance of three subalpine bumble bee species. In addition, we used long‐term data to examine how climate and floral resources have changed over time. Over 8 years, bee abundances were driven primarily by the indirect effects of climate on the temporal distribution of floral resources. Over 43 years, aspects of floral phenology changed in ways that indicate species‐specific effects on bees. Our study suggests that climate‐driven alterations in floral resource phenology can play a critical role in governing bee population responses to global change.
Hepatic and hippocampal cytochrome P450 enzyme overexpression during spontaneous recurrent seizures
Authors: Runtz Leonie , Girard Benoit , Toussenot Marion , Espallergues Julie , Fayd'Herbe De Maudave Alexis , Milman Alexandre , deBock Frederic , Ghosh Chaitali , Guérineau Nathalie C. , Pascussi Jean‐Marc , Bertaso Federica , Marchi Nicola
Published: November 2017

Objective

Available evidence points to a role of cytochrome P450 (Cyp) drug biotransformation enzymes in central nervous system diseases, including epilepsy. Deviations in drug pharmacokinetic profiles may impact therapeutic outcomes. Here, we ask whether spontaneous recurrent seizure (SRS) activity is sufficient to modulate the expression of major Cyp enzymes in the liver and brain.

Methods

Unilateral intrahippocampal (IH) kainic acid (KA) injections were used to elicit nonconvulsive status epilepticus (SE), epileptogenesis, and SRS, as monitored by video‐electroencephalography. Intraperitoneal (IP) KA injection was used to trigger generalized tonic‐clonic SE. KA‐injected mice and sham controls were sacrificed at 24‐72 hours and 1 week post‐SE (IH or IP KA), and during the chronic stage (SRS; 6 weeks post‐IH KA). Liver and brain tissues were processed for histology, real‐time quantitative polymerase chain reaction, Western blot, or microsomal enzymatic assay. Cyp2e1, Cyp3a13, glial fibrillary acidic protein (GFAP), IBA1, xenobiotic nuclear receptors nr1i2 (PXR), nr1i3 (CAR) and nr3c1 (glucocorticoid receptor [GR]) expression was examined. Serum samples were obtained to assay corticosterone levels, a GR activator.

Results

A significant increase of Cyp3a13 and Cyp2e1 transcript level and protein expression was found in the liver and hippocampi during SRS, as compared to control mice. In the ipsilateral hippocampus, Cyp2e1 and Cyp3a protein upregulation during SRS positively correlated to GFAP expression. GFAP+, and not IBA1+, cells colocalized with Cyp2e1 or Cyp3a expression. In the liver, a trend increase in Cyp3a microsomal activity was found during SRS as compared to control mice. The transcript levels of the Cyp upstream regulators GR, xenobiotic nr1i2, and nr1i3 receptors were unchanged at SRS. Corticosterone levels, a GR ligand, were increased in the blood post‐SE.

Significance

SRS modifies Cyp expression in the liver and the hippocampus. Nuclear receptors or inflammatory pathways are candidate mechanisms of Cyp regulation during seizures.
The relation between cortisol and functional connectivity in people with and without stress‐sensitive epilepsy
Authors: den Heijer Jonas M. , Otte Willem M. , van Diessen Eric , van Campen Jolien S. , Lorraine Hompe E. , Jansen Floor E. , Joels Marian , Braun Kees P. J. , Sander Josemir W. , Zijlmans Maeike
Published: November 2017

Objective

The most common reported seizure‐precipitant is stress. We recently showed a biologic basis for stress sensitivity of seizures: cortisol levels in people with stress‐sensitive epilepsy correlated with focal interictal epileptiform discharges (IEDs) on electroencephalography (EEG). Here we aimed to determine whether the effect of cortisol on the epileptic brain is global or focal, and whether cortisol affects all brains or just those of stress‐sensitive people. Because epilepsy is associated with changes in functional brain connectivity, we studied the relationship between cortisol and changes in global and focal (node‐centered) functional connectivity measures for individuals with stress‐sensitive and non–stress‐sensitive epilepsy.

Methods

Seventeen people with epilepsy underwent long‐term (>24 h) EEG recording. During the first 5 h after waking, saliva was collected every 15 min for cortisol measurements. Theta‐band functional connectivity was assessed for every 15 min of the recording. We calculated the average phase‐lag index (PLI) between all channels as a measure of global functional connectivity. We used network Strength, the averaged PLI per channel, as focal functional connectivity measure. We correlated cortisol, global, and focal functional connectivity (Strength) with IED frequency using linear mixed models. Analyses were split for people with and without stress‐sensitivity of seizures.

Results

Cortisol was negatively correlated with global functional connectivity in people with stress‐sensitive seizures (estimate −0.0020; P < .01), whereas not in those without stress‐sensitivity (estimate −0.0003; P = .46). This relationship occurred irrespective of the presence of IEDs on a channel (channels without IEDs and stress‐sensitivity: estimate −0.0019; P < .01, non–stress‐sensitive −0.0003; P = .41). Global and focal functional connectivity were negatively correlated with IED frequency, irrespective of stress sensitivity of seizures or channel type.

Significance

People with stress‐sensitive epilepsy have a whole‐brain neuronal response to cortisol that is different from that of people with non–stress‐sensitive epilepsy. This offers a basis for understanding seizure genesis in stress‐sensitive epilepsy, which might require a different treatment approach.
Management Risk Incentives and the Readability of Corporate Disclosures
Authors: Chakrabarty Bidisha , Seetharaman Ananth , Swanson Zane , Wang Xu (Frank)
Published: November 2017

Managers with higher risk incentives (greater options vega) issue less readable disclosures. Firms in the top quartile of vega file annual reports that are about 15.4% more voluminous than those in the bottom quartile. The effect of vega on obfuscation remains after controlling for firm risk, operating complexities, accounting and auditor choices, chief executive officer changes, and an exogenous shock to option compensation. This effect is tempered by higher institutional ownership, lower management entrenchment, and greater analyst following. Obfuscation benefits managers by increasing return volatility (option value) and allowing greater earnings management. These findings document a new link between options and disclosure transparency.
Impact of preserved collateral veins on small‐for‐size grafts in living donor liver transplantation
Authors: Kim Seong Hoon , Lee Eung Chang , Park Sang Jae
Published: November 2017

Aim

Graft size is a critical issue in living donor liver transplantation (LDLT). We hypothesized that too much portal flow could possibly be diverted into pre‐existing collateral veins, alleviating small‐for‐size syndrome (SFSS) in LDLT. This study evaluated the impact of the preserved collateral veins in the outcomes of LDLT using a small‐for‐size graft.

Methods

For patient safety, a graft‐to‐recipient weight ratio (GRWR) <0.8% was strictly confined to patients with collateral veins (group A), and the patient group was compared in a 1:3 ratio to a matched group of patients with GRWR ≥0.8% (group B) using propensity score analysis.

Results

Forty and 120 patients were included in group A and B, respectively. No significant differences in baseline patient characteristics were observed between the two groups except for graft weight and GRWR. The lowest GRWR was 0.4%. The graft portal inflow showed no significant differences for 7 days after graft implantation, ranging from 1668 to 5100 mL/min. Small‐for‐size syndrome occurred in no patients (0.0%) in group A and in 10 (8.3%) in group B (P = 0.067). Overall survival rates at 1, 3, and 5 years were not different between the two groups (85.0%, 82.5%, and 82.5% vs. 92.5%, 86.7%, and 85.0%, respectively; P = 0.670).

Conclusion

Pre‐existing collateral veins saved during surgery may have a reserve buffer for excessive portal flow to obviate SFSS in LDLT.
Association between metabolic syndrome and gingival inflammation in obese children
Authors: Kâ K , Rousseau M‐C , Tran SD , Henderson M , Nicolau B
Published: November 2017

Background and objective

Our previous work showed a positive association between metabolic syndrome (MetS) and gingival crevicular fluid (GCF) tumour necrosis factor‐alpha (TNF‐α) in a sample of obese and non‐obese children. However, whether this association persists among obese children is unknown. We aim to investigate the extent to which MetS is associated with GCF TNF‐α level among obese children.

Methodology

We performed a cross‐sectional analysis using data from visit 1 of the QUebec Adipose and Lifestyle InvesTigation in Youth cohort. A total of 219 obese children aged 8‐10 years, for whom data were available for both MetS and TNF‐α, were included in our analysis. The independent variable, MetS, was defined according to the International Diabetes Federation recommendations. GCF samples were collected from the gingival sulcus using a paper strip, and the concentration of TNF‐α was determined by enzyme‐linked immunosorbent assay. Analyses included descriptive statistics and sex‐specific linear regression analyses adjusting for potential confounders.

Results

In this sample comprising only obese children, 24 (10.9%) had MetS. Among obese boys, those with MetS had 44.9% higher GCF TNF‐α (95% confidence interval: 16.5%‐73.3%) compared to those without MetS. No such association was detected in obese girls.

Conclusion

MetS was positively associated with GCF TNF‐α concentration in obese boys. These results suggest that obese boys with MetS may have a worse gingival health profile compared to their obese counterpart without MetS.
(Mis)Perceptions in Two‐ and Three‐Level Games: Detachment in Economic Partnership Agreement Negotiations
Authors: Weinhardt Clara , Moerland Anke
Published: November 2017

This article builds on the literature on trade negotiating constraints to advance a reconceptualization of Putnam's () two‐level game that accounts for the possibility of detachment. Limited institutional capacities for collecting and transmitting information about the domestic win‐set may prevent domestic constituents from exerting influence on the negotiator. This perspective sheds new light on the outcomes of negotiations in two‐level games, as they do not necessarily reflect actual win‐sets, but more likely the negotiator's (mis)perceptions or (mis)representations thereof. The article builds on an explorative case study of the Economic Partnership Agreement negotiations between the EU and the West African (2003–14) and the Caribbean (2003–07) regions. It relies on qualitative data, including over 60 interviews. The findings demonstrate that detachment meant that these controversial North–South trade agreements primarily reflected the negotiators' perceptions of the regions' interests or their own preferences, which raises doubts about their developmental impact and complicates their implementation.
Spatio‐Temporal Differentiation of Life Cycle Assessment Results for Average Perennial Crop Farm: A Case Study of Peruvian Cocoa Progression and Deforestation Issues
Authors: Raschio Giancarlo , Smetana Sergiy , Contreras Christian , Heinz Volker , Mathys Alexander
Published: November 2017

The application of spatially and temporally explicit information to increase result precision is gaining momentum in Life Cycle Assessment (LCA) studies. It is vital for the assessment of environmental impact of perennial crops with non‐productive years, grown in combination with shade crops. Available studies rely on differentiated life cycle inventory data for the inputs in LCA or application of adapted impact assessment methodologies. This study uses the identification of greenhouse gas emissions (GHG) hotspots (statistically significant clusters of farms with either high or low GHG emission values) estimated from average LCA results and assesses a relative deforestation risk in such hotspots. A total of 1892 farms in the Tocache province of San Martin region of Peru were evaluated between the year 2008 and 2010. Combination of average LCA results with farm size, age and deforestation progression allowed for the identification of areas and farms with a high relative risk of environmental impacts and potential deforestation. It was estimated that farms belonging to high‐GHG emission hotspots were twice more likely to expand their agricultural frontier and cause deforestation than farms in low‐GHG emission hotspots. Combining LCA with geo‐information systems and geostatistics is a viable path to explore the differentiation of assessment results, which might lead to faster, more accurate, and resource‐efficient ways to tackle environmental impacts while also accounting for important environmental impacts such as deforestation. Further research on the application of suggested approaches with other perennial crops and other geographical areas is needed.
Decision Support Algorithm for Evaluating Carbon Dioxide Emissions from Electricity Generation in the United States
Authors: Ryan Nicole A. , Johnson Jeremiah X. , Keoleian Gregory A. , Lewis Geoffrey M.
Published: November 2017

This article presents an algorithm to aid practitioners in determining the most appropriate method to estimate carbon dioxide emissions from an electricity load. Applications include sustainability assessments of products, processes, energy efficiency improvements, changes in generation infrastructure, and changes in electricity demand. Currently, there is no consensus on appropriate methods for calculating greenhouse gas emissions resulting from specific electricity loads. Previous research revealed significant differences in emissions when different methods were used, a situation that could result in divergent sustainability or policy recommendations. In this article, we illustrate the distribution of emissions estimates based on method characteristics such as region size, temporal resolution, average or marginal approaches, and time scales. Informed by these findings, a decision support algorithm is presented that uses a load's key features and an analyst's research question to provide recommendations on appropriate method types. We defined four different cases to demonstrate the utility of the algorithm and to illustrate the variability of methods used in previous studies. Prior research often employed simplifying assumptions, which, in some cases, can result in electricity being allocated to the incorrect generating resources and improper calculation of emissions. This algorithm could reduce inappropriate allocation, variability in assumptions, and increase appropriateness of electricity emissions estimates.
Alternatives for Targeting Women in Anti‐Smoking Campaigns: Insights from a Smoking Perceived Value Perspective
Authors: Montero‐Simó María José , Polo‐Peña Ana Isabel , Araque‐Padilla Rafael , Rey‐Pino Juan Miguel
Published: November 2017

Although public anti‐smoking campaigns have undoubtedly paid off, their scope has been rather limited. This paper aims to contribute to this debate and provide a theoretical foundation based on the perceptions of female smokers that could provide guidance for the planning and design of more effective anti‐smoking campaigns. To attain this end, this study resorts to the concept of Perceived Value (PV). A scale of measurement was drawn up from the conceptualization of the Smoking PV (SPV) founded on a review of the specialized literature on smoking habits and an empirical study drawn from a sampling of female smokers. Results offer empirical evidence on the utility of the SPV both to improve our understanding of the perceived smoker experience and to predict intentions to quit smoking.
Observational review of paediatric intraosseous needle placement in the paediatric emergency department
Authors: Pifko Elysha L , Price Amanda , Busch Carrie , Smith Curren , Jiang Yunyun , Dobson Joseph , Tuuri Rachel
Published: November 2017

Aim

Intraosseous (IO) access is a life‐saving option during resuscitations in the paediatric emergency department (PED). This study aimed to compare success rates and time to placement for Manual IO versus EZ‐IO needles in PED patients ≤8 and >8 kg.

Methods

This was a retrospective cross‐sectional descriptive study of IO use in a single‐centre tertiary PED from 2006 to 2014. Cases were identified through diagnosis codes for IO infusion, cardiopulmonary resuscitation and cardiac arrest and admissions to the intensive care unit. Categorical measures were compared with Z‐test for comparison of two proportions and continuous with Student's t‐tests.

Results

Of 1748 charts screened, 50 had an IO attempted. In patients ≤8 kg, Manual IO had success rate of 55% (17/31) versus 47% (8/17) for EZ‐IO (P = 0.61). In patients >8 kg, Manual had success rate of 100% (2/2) versus 93% (14/15) for EZ‐IO (P = 0.71). Manual performance was no different for ≤8 kg than >8 kg (P = 0.21), but EZ‐IO was less successful for ≤8 kg than >8 kg (P = 0.005).

In patients ≤8 kg, Manual IO had a shorter time to placement at 4.5 min versus 12.8 for EZ‐IO (P = 0.02).

Conclusion

We observed no difference in performance between Manual and EZ‐IO devices in children ≤8 kg, but the Manual IO were placed more quickly. We observed lower success rates with EZ‐IO devices in children ≤8 kg compared to >8 kg. Future investigations should focus specifically on training for IO placement in children ≤8 kg.
Phylogenetic reconstruction of the genus Triptilion (Asteraceae, Nassauvieae) based on nuclear and chloroplast DNA sequences
Authors: Jara‐Arancio Paola , Vidal Paula M. , Arroyo Mary T. K.
Published: November 2017

The genus Triptilion is endemic to central Chile, the Mendoza Province and western Patagonia in Argentina. It is currently composed of seven species: T. achilleae, T. benaventii, T. berteroi, T. capillatum, T. cordifolium, T. gibbosum, and T. spinosum. The main objectives of this paper were to determine the phylogenetic relationships of species of Triptilion. We also traced the evolution of annual and perennial life‐forms. Historically a close relationship has been described between genera Triptilion and Nassauvia. Phylogenetic analysis of the genus Triptilion and more closely related genera was undertaken using two nuclear (ITS, ETS) and two chloroplast (trnL‐F, rpl32‐trnL) markers. The topology of the Bayesian inference tree shows that the genus Triptilion is paraphyletic, because Nassauvia lagascae, the only representative of Nassauvia section Caloptilium grouped with T. achilleae, Clade I. The other species of Triptilion form two clades: Clade II composed of T. cordifolium and T. gibbosum and Clade III that includes T. benaventii, T. berteroi, T. capillatum, and T. spinosum. The genus Triptilion originated and diverged during the Miocene. The results of the life history reconstructions indicate that the common ancestor of Triptilion and Nassauvia was perennial. The annual habit appears to be derived in Triptilion. The life‐form of the common ancestor of Triptilion was ambiguous; it may have been annual or perennial.
Democratic Values, Religiosity, and Support for Same-Sex Marriage in Latin America
Authors: Dion Michelle L. , Díez Jordi
Published: November 2017

Latin America has been at the forefront of the expansion of rights for same-sex couples. Proponents of same-sex marriage frame the issue as related to human rights and democratic deepening; opponents emphasize morality tied to religious values. Elite framing shapes public opinion when frames resonate with individuals’ values and the frame source is deemed credible. Using surveys in 18 Latin American countries in 2010 and 2012, this article demonstrates that democratic values are associated with support for same-sex marriage while religiosity reduces support, particularly among strong democrats. The tension between democratic and religious values is particularly salient for women, people who live outside the capital city, and people who came of age during or before democratization.
Does Welfare Provision Promote Democratic State Legitimacy? Evidence from Brazil’s Bolsa Família Program
Authors: Layton Matthew L. , Donaghy Maureen M. , Rennó Lúcio R.
Published: November 2017

Conditional cash transfer programs may boost the electoral fortunes of incumbents among beneficiary groups, but do they also influence recipient attitudes toward state legitimacy? This article examines the relationship between Brazil's Bolsa Família program and recipients’ sense of the Brazilian state's political legitimacy, from 2007 to 2014. Using AmericasBarometer data and propensity score matching, this study provides evidence that targeted cash benefits correlate with citizens’ views of the state, but that this relationship is limited to increasing trust in core state institutions, local government, and incumbent political actors. Diffuse dimensions of regime legitimacy, including recipients’ sense of political community, support for regime principles, and retrospective perceptions of national economic performance, are largely unaffected by the receipt of targeted benefits. Over time, the evidence also suggests that the impact of program receipt on these measures of support remains largely unchanged.
The role of fathers in mammalian sex allocation
Authors: Douhard Mathieu
Published: November 2017

Parents should bias resource allocation towards the sex most likely to provide higher fitness returns by adjusting the birth sex ratio and/or through differential care of sons and daughters. Sex allocation research in mammals to date has been focused almost exclusively on maternal traits, but fathers may also play an important role. Future studies should investigate the influence of paternal quality on the fitness of sons and daughters, and possible conflicts of interest between mothers and fathers. There is also a crucial need for more studies examining whether relative levels of maternal care in sons and daughters depend on paternal quality.
Field anesthesia of juvenile Steller sea lions (Eumetopias jubatus) using inhalation anesthesia
Authors: Lian Marianne , Johnson Shawn , Gelatt Thomas , O'Hara Todd M. , Beckmen Kimberlee B. , Rea Lorrie D.
Published: November 2017

Between 1998 and 2008, 621 Steller sea lions (Eumetopias jubatus, SSL) were captured underwater by SCUBA divers and anesthetized with isoflurane (n = 602) or sevoflurane (n = 19). We found significantly faster induction time ( ± SD) for sevoflurane (11 ± 6 min) compared to isoflurane (14 ± 6 min), as well as an interaction between anesthetists using the isoflurane protocol. Severe hypothermia with temperatures <35°C were measured in 22% of all animals, and had significant associations with month, length of anesthesia, and sex. Mortality rate was low (0.33%). We conclude that both isoflurane and sevoflurane anesthesia were effective for field anesthesia to safely handle and sample SSL.
Primary prophylaxis of invasive fungal infections with posaconazole or itraconazole in patients with acute myeloid leukaemia or high‐risk myelodysplastic syndromes undergoing intensive cytotoxic chemotherapy: A real‐world comparison
Authors: Tormo Mar , Pérez‐Martínez Ariadna , Calabuig Marisa , Hernández‐Boluda Juan Carlos , Amat Paula , Navarro David , Solano Carlos
Published: November 2017

This is an observational‐retrospective study comparing the real‐world outcomes associated with posaconazole vs itraconazole as prophylaxis treatments. Two hundred and ninety‐three patient admissions attributable to 174 patients were included in the study. Patients were treated with itraconazole (n = 114 admissions; 39%) or posaconazole (n = 179; 61%). Antifungal prophylaxis failure (APF) due to treatment‐related adverse events (in 34 out of 293 patient admissions; 11.6%) was more frequent in the posaconazole group (6.1% vs 15.1%; P = .024). There were 9 patient admissions for episodes of APF due to probable/proven breakthrough fungal infection (primary endpoint): 6 and 3 in the itraconazole and posaconazole group respectively (5.3% vs 1.7%; P = .095). All of them were associated with invasive pulmonary aspergillosis (IPA). APF was more frequent with itraconazole (65% vs 30%; P < .001), along with failure due to possible/probable/proven IPA (25% vs 10%; P = .002) and overall failure by any of the 3 different causes of prophylaxis failure (70% vs 38%; P < .001). In agreement with clinical trial data, this real‐world evidence supports the use of posaconazole over itraconazole in AML or MDS patients undergoing intensive chemotherapy.
Dried fruit and dental health – how strong is the evidence?
Authors: Sadler M. J.
Published: November 2017

Children's dental health in England has shown improvement in recent decades. However, 24.7% of 5 year‐olds have obvious decay, with the average number of affected teeth being 3.4, and tooth decay is the most common reason for hospital admissions in 5–9 year‐olds. Public Health England advises that foods and drinks containing free sugars are limited because of the increased risk of dental caries associated with frequent intakes. Although dried fruit contains more sugars than fresh fruit by weight due to the dehydration process, the portion size of dried fruit is 30 g compared with 80 g for fresh fruit. Additionally, these sugars are not defined as ‘free’ according to the current UK definition. However, unlike other sources of natural sugars, dried fruit is recommended to be eaten with meals only rather than as a snack because there is a supposition that it ‘sticks’ to teeth. A comprehensive review of the evidence published last year found a lack of good quality studies to support this advice. In the absence of data from intervention and cohort studies for effects of dried fruit on dental caries endpoints, studies of proxy measures of tooth demineralisation show inconsistent effects on plaque pH and acidogenicity. Measurement of net demineralisation, following consumption of raisins seven times a day for 10 days, showed comparable effects with fresh fruit and vegetables under similar conditions. Oral retention (‘sticking’) has been investigated in few subjects. The results do not demonstrate that dried fruit is worse in terms of oral clearance than alternative snack foods. More robust research with validated methods is needed before firm conclusions can be drawn about the retention of dried fruit, and hence its potential for adverse effects on teeth. This is important because eating traditional dried fruits can help towards the achievement of a number of dietary recommendations, including contributing to the 5 A DAY target and increasing fibre intake.
International Year of Pulses: Keeping the momentum beyond 2016
Authors: Xipsiti M. , Marzara S. , Calles T.
Published: November 2017

Pulses have been part of the human diet for centuries, yet their nutritional value is not well recognised and average consumption remains low. As nutrient‐dense foods, they contain substantial amounts of micronutrients and have an important role to play in the prevention of some deficiencies, such as iron, globally. Pulses are also a good source of protein and dietary fibre and may contribute to reduced risk of diet‐related non‐communicable diseases, such as type 2 diabetes and cardiovascular disease. Due to their nitrogen‐fixing properties, pulses support sustainable agricultural production and may help to achieve many of the 2030 Sustainable Development Goals. The International Year of Pulses 2016 raised awareness of the contribution of pulses to healthy, balanced diets, sustainable food production and food security globally. Moving forward, it is vital to keep the momentum of the year alive and continue to raise awareness of pulses as a nutritious and sustainable food and feed source.
Polyphenols and health: Interactions between fibre, plant polyphenols and the gut microbiota
Authors: Edwards C. A. , Havlik J. , Cong W. , Mullen W. , Preston T. , Morrison D. J. , Combet E.
Published: November 2017

A high‐fibre diet and one rich in fruit and vegetables have long been associated with lower risk of chronic disease. There are several possible mechanisms underpinning these associations, but one likely important factor is the production of bioactive molecules from plant‐based foods by the bacteria in the colon. This links to our growing understanding of the role of the gut microbiome in promoting health. Polyphenolic‐rich plant foods have been associated with potential health effects in many studies, but the bioavailability of polyphenol compounds, as eaten, is often very low. Most of the ingested molecules enter the large intestine where they are catabolised to smaller phenolic acids that may be the key bioactive effectors. Dietary fibres, present in plant foods, are also fermented by the bacteria to short‐chain fatty acids, compounds associated with several beneficial effects on cell turnover, metabolism and eating behaviour. Polyphenols and fibre are often eaten together, but there is a lack of research investigating the interaction between these two groups of key substrates for the colonic bacteria. In a project funded by the Biotechnology and Biological Sciences Research Council Diet and Health Research Industry Club, we are investigating whether combining different fibres and polyphenol sources can enhance the production of bioactive phenolic acids to promote health. This could lead to improved dietary recommendations and to new products with enhanced potential health‐promoting actions.