bluuebunny/crossref_metadata_2025 huggingface dataset:
Coping with darkness: The adaptive response of marine picocyanobacteria to repeated light energy deprivation
Authors: Coe Allison , Biller Steven J. , Thomas Elaina , Boulias Konstantinos , Bliem Christina , Arellano Aldo , Dooley Keven , Rasmussen Anna N. , LeGault Kristen , O’Keefe Tyler J. , Greer Eric L. , Chisholm Sallie W.
Published: October 2020

The picocyanobacteriaProchlorococcusandSynechococcusare found throughout the ocean’s euphotic zone, where the daily light:dark cycle drives their physiology. Periodic deep mixing events can, however, move cells below this zone, depriving them of light for extended periods of time. Here we demonstrate thatProchlorococcusandSynechococcuscan adapt to tolerate repeated periods of light energy deprivation. Cyanobacterial cultures kept in the dark for 3 days and then returned to the light initially required 18-26 days to resume growth, but after multiple rounds of dark exposure the strains began to regrow after only 1-2 days. This dark-tolerant phenotype was stable and heritable; cultures retained the trait across at least 18-21 generations even when grown in a standard 13:11 light:dark cycle. We found no genetic differences between the dark-tolerant and parental strains ofProchlorococcusNATL2A, indicating that an epigenetic change is responsible for the adaptation. To begin to explore this possibility, we asked whether DNA methylation – an epigenetic mechanism in bacteria – occurs inProchlorococcus. LC-MS/MS analysis showed that while DNA methylations, including 6mA and 5mC, are found in some otherProchlorococcusstrains, no methylations were detected in either the parental or dark-tolerant strain used in our experiments –i.e. the NATL2A strain. These findings suggest thatProchlorococcusutilizes a yet-to-be-determined epigenetic mechanism to adapt to the stress of extended light energy deprivation.
Behavioral and genomic sensory adaptations underlying the pest activity ofDrosophila suzukii
Authors: Durkin Sylvia M. , Chakraborty Mahul , Abrieux Antoine , Lewald Kyle M. , Gadau Alice , Svetec Nicolas , Peng Junhui , Kopyto Miriam , Langer Christopher B. , Chiu Joanna C. , Emerson J.J. , Zhao Li
Published: October 2020

Studying how novel phenotypes originate and evolve is fundamental to the field of evolutionary biology as it allows us to understand how organismal diversity is generated and maintained. However, determining the basis of novel phenotypes is challenging as it involves orchestrated changes at multiple biological levels. Here, we aim to overcome this challenge by using a comparative species framework combining behavioral, gene expression, and genomic analyses to understand the evolutionary novel egg-laying substrate-choice behavior of the invasive pest speciesDrosophila suzukii. First, we used egg-laying behavioral assays to understand the evolution of ripe fruit oviposition preference inD. suzukiias compared to closely related speciesD. subpulchrellaandD. biarmipes, as well asD. melanogaster. We show thatD. subpulchrellaandD. biarmipeslay eggs on both ripe and rotten fruits, suggesting that the transition to ripe fruit preference was gradual. Secondly, using two-choice oviposition assays, we studied howD. suzukii, D. subpulchrella, D. biarmipesandD. melanogasterdifferentially process key sensory cues distinguishing ripe from rotten fruit during egg-laying. We found thatD. suzukii’s preference for ripe fruit is in part mediated through a species-specific preference for stiff substrates. Lastly, we sequenced and annotated a high-quality genome forD. subpulchrella. Using comparative genomic approaches, we identified candidate genes involved inD. suzukii’s ability to seek out and target ripe fruits. Our results provide detail to the stepwise evolution of pest activity inD. suzukii, indicating important cues used by this species when finding a host, and the molecular mechanisms potentially underlying their adaptation to a new ecological niche.
Influences of time of day on generalization
Authors: Tandoc Marlie C. , Bayda Mollie , Poskanzer Craig , Cho Eileen , Cox Roy , Stickgold Robert , Schapiro Anna C.
Published: October 2020

Extracting shared structure across our experiences allows us to generalize our knowledge to novel contexts. How do different brain states influence this ability to generalize? Using a novel category learning paradigm, we assess the effect of both sleep and time of day on generalization that depends on the flexible integration of recent information. Counter to our expectations, we found no evidence that this form of generalization is better after a night of sleep relative to a day awake. Instead, we observed an effect of time of day, with better generalization in the morning than the evening. This effect also manifested as increased false memory for generalized information. In a nap experiment, we found that generalization did not benefit from having slept recently, suggesting a role for circadian rhythms apart from sleep. We found, however, that this time of day effect appears to be sensitive to category structure and to task engagement more generally. We propose that a state of lowered inhibition in the morning may facilitate spreading activation between otherwise separate memories, promoting this form of generalization.
Press xenobiotic disturbance favors deterministic assembly with a shift in function and structure of bacterial communities in sludge bioreactors
Authors: Santillan Ezequiel , Seshan Hari , Wuertz Stefan
Published: October 2020

Disturbance is thought to affect community assembly mechanisms, which in turn shape community structure and the overall function of the ecosystem. Here, we tested the effect of a continuous (press) xenobiotic disturbance on the function, structure, and assembly of bacterial communities within a wastewater treatment system. Two sets of four-liter sequencing batch reactors were operated in triplicate with and without the addition of 3-chloroaniline for a period of 132 days, following 58 days of acclimation after inoculation with sludge from a full-scale treatment plant. Temporal dynamics of bacterial community structure were derived from 16S rRNA gene amplicon sequencing. Community function, structure and assembly differed between press disturbed and undisturbed reactors. Temporal partitioning of assembly mechanisms via phylogenetic and non-phylogenetic null modelling analysis revealed that deterministic assembly prevailed for disturbed bioreactors, while the role of stochastic assembly was stronger for undisturbed reactors. Our findings are relevant because research spanning various disturbance types, environments and spatiotemporal scales is needed for a comprehensive understanding of the effects of press disturbances on assembly mechanisms, structure, and function of microbial communities.

Graphical abstract
Optimization design of building isolation structure based on sustainable benefit analysis
Authors: Wu Jia
Published: October 2020

Purpose

The study shows that with the progress of building technologies and building materials, the scale of buildings has increased. But in earthquake-prone areas, large-scale buildings mean higher risks; therefore improving the seismic capacity of buildings is an important measure to reduce the risk of buildings.

Design/methodology/approach

In this study, the isolation structure of buildings was introduced briefly, and the cost-benefit based optimization model of the isolation structure was constructed. The optimization of the isolation structure was carried out from the perspective of benefit analysis. Then, two buildings with the same structure were analyzed as examples. One kept the original isolation structure, and the other optimized the isolation structure with the optimization model.

Findings

The final results showed that the optimized isolation structure had a lower input cost ratio, i.e. it had a higher benefit in the same whole life cycle, and the expected loss cost of the structure produced in the same life cycle was lower.

Originality/value

In conclusion, the optimization model of the isolated structure based on benefit analysis can effectively improve the benefit of building isolation structure produced in the whole life cycle.
Study on the tearing behaviour of woven shirting fabrics – the effect of yarn and fabric properties
Authors: Safari Gorjan Elnaz , Ezazshahabi Nazanin , Mousazadegan Fatemeh
Published: October 2020

Purpose

Occurrence of fabric rupture is a problem that can influence fabric performance during wear. In this regard, fabric tearing resistance is considered by manufacturers and consumers and enhancing tear resistance through optimization of related parameters is beneficial.

Design/methodology/approach

In this study, the tearing resistance of a series of shirting fabrics with various weave patterns and weft densities were investigated by both static and dynamic tear test methods. Moreover, the constituent yarn's frictional and tensile behaviour was evaluated and their relation with tear resistance was analysis.

Findings

According to the outcomes, the fabric firmness and density and friction of yarns affect the tear resistance, reversely. However an improvement in yarn's tenacity can raise the tear resistance.

Originality/value

In this study it was aimed to not only consider influence of both static and dynamic tear test approach on the tearing performance of fabrics regarding their structural parameters, the impact of the constituent's yarn properties include tensile behaviour and friction coefficient on the tearing performance of fabric considered, as well.
Power relations in the production of historical context in disaster inquiry reporting
Authors: Furey Mary A. , Corrigan Lawrence T. , Helms Mills Jean
Published: October 2020

Purpose

This study aims to examine the textual performance of the Ocean Ranger Disaster inquiry, thus responding to recent calls to “practice context” in historical writing. This study goes beyond the epistemological assumptions about the grounds for knowing about the past as the authors explore how history is produced in the context of power relations.

Design/methodology/approach

This paper imagines history-making as a storytelling performance. The authors combine critical historiography and critical sensemaking because these qualitative perspectives help us to understand the composition of the Ocean Ranger Royal Commission Report.

Findings

This case study makes a contribution within the genre of disaster inquiry reporting. The study explains how a formal historical record (the public inquiry report) may be created and how the report is related to aspects of power embedded in a writer’s sense of reality.

Social implications

The Ocean Ranger Disaster continues to be of tremendous importance to the people of Newfoundland, Canada. There have been numerous studies of the disaster, but these have been overwhelmingly focused on technical matters. To authors’ knowledge, this study is the first to consider the inquiry from an historical context perspective.

Originality/value

The study site enables reflection on a question not often asked in the management history literature: How can we critically understand the composition of an official disaster inquiry report in the context of its power relations?
Paramedicine and mental health: a qualitative analysis of limitations to education and practice in Ontario
Authors: Ford-Jones Polly Christine , Daly Tamara
Published: October 2020

Purpose

Paramedics increasingly attend to mental health-related emergencies; however, there has been little evaluation of the mental health training for paramedics. This study aims to analyze the fit between paramedicine pedagogy, patient needs and the conditions for paramedics’ skill development.

Design/methodology/approach

Data were collected in a single, qualitative, critical ethnographic case study of pre-hospital mental health and psychosocial care in paramedicine in Ontario, Canada. Transcripts from interviews (n = 46), observation (n ∼ 90h) and document analysis were thematically analyzed using a constant comparative method. The study is theoretically grounded in a feminist political economy framework.

Findings

Tensions are explored in relation to the pedagogy of paramedicine and the conditions of work faced by paramedics. The paper presents challenges and insufficiencies with existing training, the ways in which certain work and training are valued and prioritized, increased emergency care and training needs and the limitations of training to improving care.

Research limitations/implications

Recommendations include more comprehensive didactic training, including the social determinants of health; scenario training; practicum placements in mental health or social services; collaboration with mental health and social services to further develop relevant curriculum and potential inclusion of service users.

Originality/value

This paper addresses the lack of mental health pedagogy in Ontario and internationally and the need for further training pre-certification and while in the workforce. It presents promising practices to ameliorate mental health training and education for paramedics.
Constructing definition of smart cities from systems thinking view
Authors: Singh Anita , Singla A.R.
Published: October 2020

Purpose

On review of literature on “Smart Cities”, it can be asserted that there are multiple definitions of the term “Smart Cities”; however, a universally accepted definition of “Smart Cities” has not been adopted till date. In these circumstances of uncertainty, this paper aims to propose a conclusive definition of “Smart Cities” from systems thinking view.

Design/methodology/approach

The key properties, components and dimensions of “Smart Cities” were identified through text analysis of existing definitions of smart cities in literature using tools such as word cloud, network graph, bubble chart, mind map and web chart of top keywords. The definitions were further subjected to principal component analysis to identify the key components such as characteristics and enablers of “Smart Cities”. The concept of “Smart Cities” was then examined from systems thinking view, to arrive at a systemic understanding of the concept, as it examines the key elements of Government, Citizens and Business using the Golden Circle tool (Why, What and How). Thereon, the interactions between these elements were scrutinized by drawing a Systemigram, which aided in constructing the definition of “Smart Cities”. Thereafter, the validity of the definition was empirically tested by applying it to a set of cities and testing the efficiency of cities through data envelopment analysis.

Findings

The Literature Review and definition analysis of “Smart Cities” have not only facilitated in identifying elements of widely accepted constructs of “Smart Cities” also helps in advancing a formal conceptual definition of “Smart Cities”. A formal definition, which is commonly accepted, would enable researchers in advancing theory and building measurement instruments for “Smart Cities”.

Originality/value

Given the fact that there is no uniform definition of “Smart Cities” leading to varying standards for conceptualization or construction of a “Smart City”, this paper attempts to propose a formal conceptual definition of “Smart Cities” from systems thinking view. Thus, this paper shall not only attempt to advance theory building of the concept of “Smart Cities” but shall also provide a reference to researchers and practitioners, to enable them to build appropriate measures for Smart Cities.
How does nutrition education contribute to the consumers’ use and attitudes towards food labels?
Authors: Ayaz Aylin , Dedebayraktar Damla , Inan-Eroglu Elif , Besler Halit Tanju , Buyuktuncer Zehra
Published: October 2020

Purpose

This study aims to determine the effects of nutrition knowledge on the use of nutrition facts labels in emerging adults by defining the nutrition education status.

Design/methodology/approach

For this cross-sectional study, 919 young adults, aged 18–24 years, were recruited. Participants trained by dietetic professional at least 2 h per week during the period of at least one education period were considered as having nutrition education. Food label use, specific circumstances and different food products were recorded. The participants were also asked about their attitudes regarding food label use with a questionnaire including 15 products.

Findings

Nutrition facts label is mainly used when buying a product for the first time, a product of an unknown brand or comparing different companies’ similar products, regardless of nutrition education status. Participants with nutrition education had a higher nutrition facts label use and they use the score for specific food products including breakfast cereal (p = 0.003), snacks (p < 0.001), beverages (p = 0.004), ready to eat soups (p = 0.004) and diet products for special occasions (p < 0.001). Mean total score of attitudes regarding food label use for participants who had nutrition education was found as 58.9 ± 6.1 and who did not have nutrition education was found as 51.7 ± 9.2 (p < 0.01).

Originality/value

Nutrition education, which is related to the nutrition facts label use, would be especially useful in helping people for the selection of healthier foods. As habits acquired from childhood will last for a lifetime, more effective nutrition education programs and nutrition label reading education programs should be designed. The findings need to be considered for promoting nutrition facts label use by developing nutrition education.
Surrogacy-led migration: reflections on the policy dilemmas
Authors: Ullah Akm Ahsan , Nawaz Faraha
Published: October 2020

Purpose

There is abundant research on surrogacy; however, migration scholars have not addressed surrogacy-driven migration. Policies related to surrogacy and surrogacy-led migration are under-researched. The paper argues that surrogacy-led migration or fertility/reproductive migration constitutes a significant part of mainstream migration. The purpose of this paper is to reflect on the policy dilemmas in various countries.

Design/methodology/approach

A total of 9 surrogate mothers (4 from India; 2 from Thailand, 2 from Indonesia and 1 from Nepal) and 8 commissioning parents (2 from Japan; 4 from Europe; 1 from the USA; 1 from Australia) and 2 doctors (1 from India and 1 from Thailand) selected on snowball basis were interviewed between 2014 and 2016 by using a checklist.

Findings

The deficiency and inconsistency of laws regarding surrogacy facilitated the growth of the surrogacy market. Therefore, a uniform policy would help to define and improve the surrogacy and surrogacy-led migration management.

Originality/value

This paper demonstrates the interplay of surrogacy and mainstream migration. This is a fresh addition to the study of migration.
Comparative corruption scandals in Macau: the cases of Ao Man-long and Ho Chio-meng
Authors: Lo Sonny S.H.
Published: October 2020

Purpose

This paper aims at comparing and contrasting the Ao Man-long scandal with the Ho Chio-meng case in Macau, drawing lessons from the two events and casting lights on the literature on corruption scandals.

Design/methodology/approach

The study used documentary research and interpretative and analytical approaches.

Findings

The two cases show considerable administrative discretion on the part of the principal officials involved, and remedial measures along the line of having more rigorous and frequent internal auditing may be necessary.

Originality/value

Original analyses were conducted together with literature review and documentary research. This paper would be of interest to scholars and practitioners concerned with how Macau combats corruption.
Teaching sustainable development in business sciences degrees: evidence from Portugal
Authors: Gomes Sónia Ferreira , Jorge Susana , Eugénio Teresa
Published: October 2020

Purpose

This paper aims to analyze the current state of integration of sustainable development (SD), in the academic curricula of Business Sciences degrees, including matters about Ethics, Corporate Social Responsibility and Sustainability. In this way, the paper explores how Portuguese public higher education institutions (HEI) contribute to teaching about sustainable development (TSD).

Design/methodology/approach

The study focuses on Business Sciences degrees. The webpages of all public HEI with BSc and MSc degrees in those areas in Portugal were analyzed, to obtain curricular plans and syllabus. Content analysis was performed on each of these elements of Accounting and Taxation and Management and Business Administration courses.

Findings

There is already some concern about addressing SD in Business Sciences, inasmuch as SD-related topics are taught in Accounting and Taxation and in Management and Business Administration degrees and courses. However, the analysis shows that TSD was integrated into the academic curricula in only 95 degrees (48.5%). Additionally, in these, there are only 79 compulsory curricular units that address this theme. Given the fact that the subject of SD is increasingly relevant, the paper evidence still much room for improvement, indicating that TSD is yet a big challenge for HEI.

Originality/value

TSD is increasingly important because of the growing globalization that requires skilled professionals able to assess the complex and controversial issues related to the topic, to achieve and implement the SD goals in 2030. The literature evidence lack of studies addressing the integration of the SD theme in academic curricula. This paper makes here a contribution by showing what HEI is teaching in the area of business studies. It also brings good implications for society, while showing that sustainability content is becoming more apparent within certain HEI courses. This could be used to create follow up research on what type of sustainability content is being included within the courses and the learning that is happening in students in regard to this sustainability content.
Optimization of machining characteristics for EDM of different nickel-based alloys by embodying of fuzzy, grey relational and Taguchi technique
Authors: Sharma Sahil , Vates Umesh Kumar , Bansal Amit
Published: October 2020

Purpose

In the current exploration, the machinability of three different nickel-based super-alloy materials (Inconel 625, Inconel 718 and Nimonic 90) was experimentally investigated by using a die-sinking electrical discharge machining (EDM). The effect of changing important input process parameters such as pulse on time (Ton), off time (Toff), peak current (Ip) and tool rotation (TR) was investigated to get optimum machining characteristics such as material removal rate, roughness, electrode wear rate and overcut.

Design/methodology/approach

Experimentation has been performed by using Taguchi L9 orthogonal design. An integrated route of fuzzy and grey relational analysis approach with Taguchi’s philosophy has been intended for the simultaneous optimization of machining output parameters.

Findings

The most approbatory factors for machining setting have been attained as: (Ton = 100 µs, Toff = 25 µs, Ip = 14 A, TR = 725 rpm) for machining of Inconel 625 and Inconel 718; and (Ton = 100 µs, Toff = 75 µs, Ip = 14 A, TR = 925 rpm) for machining of the Nimonic 90 material. Peak current has been observed as an overall influencing factor to achieve better machining process. Microstructural study through SEM has also been carried out to figure out the surface morphology for the EDMed Ni-based super alloys.

Originality/value

The proposed machining variables and methodology has never been presented for Nimonic 90 alloy on die-sinking EDM.
Long‐term nitrogen enrichment does not increase microbial phosphorus mobilization in a northern coniferous forest
Authors: Forsmark Benjamin , Wallander Håkan , Nordin Annika , Gundale Michael J.
Published: October 2020

Nitrogen (N) deposition can enhance carbon (C) capture and storage in northern coniferous forests but it may also enhance the demand for phosphorus (P). While it is well established that long‐term N enrichment can decrease decomposition and enhance the accumulation of C in soils, it remains uncertain if a higher demand and acquisition of P influence soil C.

We studied microbial phosphorus mobilization and growth within a long‐term N enrichment experiment in a Norway spruce forest, where N deposition was simulated by adding 0, 12.5 or 50 kg N ha−1 year−1 for 21 years (n = 12), by incubating microbial ingrowth cores with needles and humus with low and high P content, and with sand with and without mineral apatite P.

Long‐term N enrichment had no effect on microbial P mobilization in needles and humus and did not enhance the positive effect that apatite had on fungal growth. However, it consistently strengthened the retention of C in the soil by decreasing decomposition of needle and humus, both with low and high P content, and by increasing fungal growth in sand‐filled ingrowth cores. Furthermore, we did not find any evidence that higher microbial P mobilization in response to N enrichment affected soil C storage.

These results show that long‐term N enrichment in relatively young soils dominated by coniferous trees and ectomycorrhizal fungi can have relatively small impact on microbial P mobilization from organic sources and on the potential to mobilize P from minerals, and subsequently that elevated P demand due to N enrichment is unlikely to lead to a reduction in the soil C accumulation rate.

A free Plain Language Summary can be found within the Supporting Information of this article.
Fact database of grassland vegetation in Japan
Authors: Shimoda Katsuhisa , Tsutsumi Michio , Higashiyama Masakazu , Nakagami Koji
Published: October 2020

This data paper reports vegetation census data collected in a network of 28 grassland sites in Japan. This is the largest grassland data set freely available in Japan. The network is the project “Grassland Dynamics in Japan” launched by the Ministry of the Agriculture and Forestry and Fisheries, Japan. It consists of semi‐natural and artificial grasslands (pasture and meadow) and covers from Hokkaido to Kyushu area in Japan. Twenty to 12 permanent plots were established in each grassland. Censuses of plant species emerged in 1 m2 quadrat were conducted every year from 1972 to 1982 at longest. The data provide species abundance, plant coverage (%) and length (cm) of 484 quadrats. The censuses adopted common census protocol, which provide good opportunities for meta‐analyses and comparative studies among grasslands. The data have been used for ecological studies as well as for animal production reports published by the National Agriculture and Food Research Organization in Japan.

The detailed Metadata for this abstract published in the Data Paper section of the journal is available in MetaCat in JaLTER at http://db.cger.nies.go.jp/JaLTER/metacat/metacat/ERDP-2020-22.1/jalter-en.
Complicated giant sigmoid diverticulum. Emergency laparoscopic approach is possible
Authors: Allué Cabañuz Marta , Elía Manuela , Gonzales Ariel G. , Chóliz Jorge
Published: October 2020

Introduction

Giant colonic diverticulum (GCD) is a rare complication of colonic diverticulosis. Patients have often non‐specific symptoms, and complication is exceptional.

Case Report

We report a case of an 87‐year‐old man with several admissions in the last year due to episodes of acute diverticulitis and CT scan image compatible with GCD that presents with pain and a palpable abdominal mass. In urgent CT scan GCD shows increased size reaching 12 cm. Laparoscopic sigmoidectomy with primary colorectal anastomosis was performed urgently. His postoperative course was plain and the patient was discharged after 5 days. Pathology reported a diverticular formation of 12 cm in diameter.

Discussion

Location and simultaneous acute diverticular disease are the main criteria for deciding the surgical approach.

Colonic resection with primary anastomosis is the gold standard and, if possible, should be performed by laparoscopy, even in emergency cases.
Nostalgia as Affective Landscape: Negotiating Displacement in the “World City”
Authors: Gupta Hemangini , Medappa Kaveri
Published: October 2020

Bangalore, an aspiring “world city”, is rapidly transforming as factories and mills are sold to private developers. As their neighbourhoods now accommodate multi‐million‐dollar gated communities and post‐industrial labour markets, residents experience an in situ displacement, staying in place while landscapes around them dramatically reconfigure. This paper makes sense of how old‐time residents locate themselves within such urban growth through nostalgic invocations of the past. Emplaced within histories and geographies of neighbourhood change, nostalgia creates “affective landscapes” through which residents invoke their closeness to past landscapes of abundance and involvement in community‐making. Such affective landscapes bring together embodied, sensorial, and more‐than‐human fields of action to shape an everyday politics in which residents narrate their marginalization within the world city and articulate their own value here.
Effect of laparoscopic sleeve gastrectomy on vasoactive mediators in obese hypertensive patients: A prospective study
Authors: Salman Ahmed Abdallah , Salman Mohamed Abdalla , Shawkat Mohamed , Hassan Shady A. , Saad Eman H. , Hussein Ahmed Mahmoud , Refaie Osama R. M. , Tourky Mohamed Sabry , Shaaban Hossam El‐Din , Abd Allah Nesrin , El Domiaty Heba Fathy , Elkassar Hesham
Published: October 2020

Introduction

The causal relationship between obesity and high blood pressure is established; however, the detailed pathways for such association are still under research. This work aims to assess the changes in neprilysin, vasoconstrictor and vasodilatory molecules in obese hypertensive patients undergoing laparoscopic sleeve gastrectomy (LSG).

Patients

The present prospective study was done on 59 hypertensive obese patients in whom LGS was performed. Blood pressure, as well as blood samples for neprilysin, angiotensinogen, angiotensin II, renin, endothelin‐1 "ET‐1", aldosterone, atrial natriuretic peptide "ANP" and B‐type natriuretic peptide "BNP", were assessed before and 15 months after surgery. Patients were divided into two groups according to the remission of hypertension (HTN).

Results

After 15 months, remission of hypertension was seen in 42 patients (71%). The declines in the following measurements were significantly higher in patients with remission than those with persistent HTN: aldosterone (p = .029567), angiotensin II (p < .000001), angiotensinogen (p = .000021), neprilysin (p = .000601), renin (p = .000454) and endothelin‐1(p = .000030). There was a significantly higher increment in ANP (p = .000002) and a non‐significant increment in BNP (p = .081740). Angiotensin II 15 months after LSG and Δ ANP % were significant independent predictors of persistent HTN.

Conclusion

In the setting of LSG, aldosterone, angiotensinogen, angiotensin II, renin and neprilysin were significantly lower in patients with remission of HTN after 15 months than those with persistent HTN, and natriuretic peptides were significantly higher. A lower postoperative level of angiotensin II and a larger percentage increment of ANP are independently associated with hypertension remission after LSG.
Seeking ideal clinical guidelines for myasthenia gravis
Authors: Murai Hiroyuki , Utsugisawa Kimiaki , Motomura Masakatsu , Suzuki Shigeaki , Imai Tomihiro
Published: October 2020

A new version of the Japanese clinical guidelines for myasthenia gravis is under development. The current version was published in 2014, in which the top priority in treatment was to maintain patients’ health‐related quality of life. The treatment goal was to achieve a post‐intervention status of minimal manifestations or better (according to the Myasthenia Gravis Foundation of America classification), with an oral prednisolone dose of 5 mg/day or less. The guidelines recommend minimizing the oral prednisolone dose, starting calcineurin inhibitors early in the course of treatment, and effectively treating patients with an early fast‐acting treatment regimen.

Since the release of the 2014 version, the therapeutic tendencies in myasthenia gravis have been gradually changing in Japan, with an observed increase in the number of patients that achieved the treatment goal. Therefore, it is conceivable that the rationale of the 2014 guidelines was appropriate to treat patients with myasthenia gravis and that it should be taken over by the new guidelines. Meanwhile, the anti‐complement antibody (eculizumab) has been approved, and although off‐label in Japan, the effect of the anti‐CD20 antibody rituximab has been reported repeatedly. Many other agents are currently undergoing clinical trials. In the new guidelines, the treatment strategy should be demonstrated clearly, including these most recent developments.
Intraureteral indocyanine green augments ureteral identification and avoidance during complex robotic‐assisted colorectal surgery
Authors: White Lindsay A. , Joseph Jason P. , Yang David Y. , Kelley Scott R. , Mathis Kellie L. , Behm Kevin , Viers Boyd R.
Published: October 2020

Aim

Up to 10% of patients who undergo nonurological abdominopelvic operations suffer a ureteral injury. While preoperative ureteral stenting to facilitate identification of the ureter is common, it does not reduce the incidence of intraoperative ureteral injury and is not without risk. As we continue to broaden the application of minimally invasive surgical techniques, a new form of ureteral identification and avoidance that does not rely on tactile feedback is needed. We report our initial experience with intraureteral indocyanine green (ICG) for ureteral identification and avoidance during complex robotic‐assisted colorectal surgery.

Method

Patients undergoing adjunctive ureteral identification during robotic‐assisted colorectal surgery were prospectively identified. Each patient underwent intraureteral ICG administration using rigid cystoscopy (22 Fr). A 5‐Fr open‐ended ureteral catheter was inserted up to 20 cm and used to inject 5 ml of 2.5 mg/ml ICG as the catheter was withdrawn to the ureteral orifice. Intraureteral ICG was then detected using near‐infrared laser fluorescence technology (Firefly®).

Results

Successful ICG‐enhanced ureteral identification and avoidance was performed in 15 of 16 (94%) patients undergoing robotic‐assisted colorectal surgery. The median ICG instillation time was 11.5 min (range 4–21 min) and the median operative time with ICG visualization was 489 min (8 h 9 min) [range 268–738 min (4 h 28 min–12 h 18 min)]. No patient experienced intraoperative ureteral injury and there were no adverse sequelae or complications associated with intraureteral ICG administration.

Conclusion

Intraureteral ICG is a safe and effective method of intraoperative ureteral identification and avoidance during complex robotic‐assisted colorectal surgery. Precise and prolonged ureteral visualization was achieved, allowing for long operative times compatible with complex robotic‐assisted operations.
Improving the Pharmacodynamics and In Vivo Activity of ENPP1‐Fc Through Protein and Glycosylation Engineering
Authors: Stabach Paul R. , Zimmerman Kristin , Adame Aaron , Kavanagh Dillon , Saeui Christopher T. , Agatemor Christian , Gray Shawn , Cao Wenxiang , De La Cruz Enrique M. , Yarema Kevin J. , Braddock Demetrios T.
Published: October 2020

Enzyme replacement with ectonucleotide pyrophosphatase phospodiesterase‐1 (ENPP1) eliminates mortality in a murine model of the lethal calcification disorder generalized arterial calcification of infancy. We used protein engineering, glycan optimization, and a novel biomanufacturing platform to enhance potency by using a three‐prong strategy. First, we added new N‐glycans to ENPP1; second, we optimized pH‐dependent cellular recycling by protein engineering of the Fc neonatal receptor; finally, we used a two‐step process to improve sialylation by first producing ENPP1‐Fc in cells stably transfected with human α‐2,6‐sialyltransferase (ST6) and further enhanced terminal sialylation by supplementing production with 1,3,4‐O‐Bu3ManNAc. These steps sequentially increased the half‐life of the parent compound in rodents from 37 hours to ~ 67 hours with an added N‐glycan, to ~ 96 hours with optimized pH‐dependent Fc recycling, to ~ 204 hours when the therapeutic was produced in ST6‐overexpressing cells with 1,3,4‐O‐Bu3ManNAc supplementation. The alterations were demonstrated to increase drug potency by maintaining efficacious levels of plasma phosphoanhydride pyrophosphate in ENPP1‐deficient mice when the optimized biologic was administered at a 10‐fold lower mass dose less frequently than the parent compound—once every 10 days vs. 3 times a week. We believe these improvements represent a general strategy to rationally optimize protein therapeutics.
Trends in diabetic retinopathy screening attendance and associations with vision impairment attributable to diabetes in a large nationwide cohort
Authors: Lawrenson J. G. , Bourmpaki E. , Bunce C. , Stratton I. M. , Gardner P. , Anderson J. ,   EROS Study Group
Published: October 2020

Aims

To investigate diabetic retinopathy screening attendance and trends in certified vision impairment caused by diabetic eye disease.

Methods

This was a retrospective study of attendance in three urban UK diabetic eye screening programmes in England. A survival analysis was performed to investigate time from diagnosis to first screen by age and sex. Logistic regression analysis of factors influencing screening attendance during a 15‐month reporting period was conducted, as well as analysis of new vision impairment certifications (Certificate of Vision Impairment) in England and Wales from 2009 to 2019.

Results

Of those newly registered in the Routine Digital Screening pathway (n = 97 048), 80% attended screening within the first 12 months and 88% by 36 months. Time from registration to first eye screening was longer for people aged 18–34 years, and 20% were unscreened after 3 years. Delay in first screen was associated with increased risk of referable retinopathy. Although 95% of participants (n = 291 296) attended during the 15‐month reporting period, uptake varied considerably. Younger age, social deprivation, ethnicity and duration of diabetes were independent predictors of non‐attendance and referable retinopathy. Although the last 10 years has seen an overall reduction in vision impairment certification attributable to diabetic eye disease, the incidence of vision impairment in those aged <35 years was unchanged.

Conclusions

Whilst the majority of participants are screened in a timely manner, there is considerable variation in uptake. Young adults, have sub‐optimal attendance, and levels of vision impairment in this population have not changed over the last 10 years. There is an urgent need to explore barriers to/enablers of attendance in this group to inform policy initiatives and tailored interventions to address this issue.
Depression and antecedent medication adherence in a cohort of new metformin users
Authors: Niaz Diva , Necyk Candace , Simpson Scot H.
Published: October 2020

Aims

The association between depression and poor medication adherence is based on cross‐sectional studies and cohort studies that measure adherence rates after depression status is determined. However, depressive symptoms occur well before diagnosis. This study examined adherence patterns in the year before a depressive episode.

Methods

This retrospective cohort study followed new metformin users identified in Alberta Health's administrative data between 2008 and 2018. Depressive episodes starting ≥1 year after metformin initiation were identified using a validated case definition. Controls were randomly assigned a pseudo depression date. Adherence to oral antihyperglycemic medications was estimated using proportion of days covered (PDC) and group‐based trajectory models to explore the association between depression and poor adherence (PDC<0.8).

Results

A depressive episode occurred in 17,418 (10.6%) of 165,056 new metformin users. Individuals with depression were more likely to have poor adherence compared to controls (adjusted odds ratio 1.21; 95% CI 1.17, 1.26). Five trajectories were identified: nearly perfect adherence (PDC >0.95 [34.8% of cohort]), discontinued (PDC=0 [18.3% of cohort], poor initial adherence (PDC 0.75) that declined either rapidly (9.2% of cohort) or gradually (30.1% of cohort), and poor initial adherence (PDC 0.26) that increased gradually (7.6% of cohort). Individuals with depression were more likely to be in one of the four trajectories of poor adherence compared to controls (adjusted odds ratio 1.24; 95% CI 1.19‐1.29).

Conclusions

Poor medication adherence occurs in the year before a depressive episode; therefore, poor medication use patterns could be used as an early warning sign for depression.
Development and validation of the Epilepsy Surgery Satisfaction Questionnaire (ESSQ‐19)
Authors: Wiebe Samuel , Wahby Sandra , Lawal Oluwaseyi A. , Sajobi Tolulope T. , Keezer Mark R. , Nguyen Dang K. , Malmgren Kristina , Tellez‐Zenteno Jose , Atkinson Mark J. , Hader Walter J. , Josephson Colin B. , Macrodimitris Sophia , Patten Scott B. , Pillay Neelan , Sharma Ruby , Singh Shaily , Starreveld Yves
Published: October 2020

Objective

No validated tools exist to assess satisfaction with epilepsy surgery. We aimed to develop and validate a new measure of patient satisfaction with epilepsy surgery, the 19‐item Epilepsy Surgery Satisfaction Questionnaire (ESSQ‐19).

Methods

An initial 31‐item measure was developed based on literature review, patient focus groups, thematic analysis, and Delphi panels. The questionnaire was administered twice, 4‐6 weeks apart, to 229 adults (≥18 years old) who underwent epilepsy surgery ≥1 year earlier, at three centers in Canada and one in Sweden. Participants also completed seven validated questionnaires to assess construct validity. Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) assessed the factorial structure of the questionnaire. Cronbach alpha and intraclass correlation coefficients (ICCs) assessed the internal consistency and test‐retest reliability of the ESSQ‐19. Spearman and polyserial correlations assessed construct validity.

Results

Median age of participants and time since surgery were 42 years (interquartile range [IQR] = 32‐54) and 5 years (IQR = 2‐8.75), respectively. EFA and CFA yielded 18 items that segregated into four domains (mean score [SD]), namely, seizure control (76.4 [25]), psychosocial functioning (67.3 [26]), surgical complications (84 [22]), and recovery from surgery (73 [24]), one global satisfaction item, and a summary global score (74 [21]). The domain and summary scores demonstrated good to excellent internal reliability (Cronbach ⍺ range = .84‐.95) and test‐retest reliability (ICC range = 0.71‐0.85). Construct validity was supported by predicted correlations with other instruments.

Significance

The ESSQ‐19 is a new, valid, and reliable measure of patient satisfaction with epilepsy surgery that can be used in clinical and research settings.
Circadian/multidien Molecular Oscillations and Rhythmicity of Epilepsy (MORE)
Authors: Bernard Christophe
Published: October 2020

The occurrence of seizures at specific times of the day has been consistently observed for centuries in individuals with epilepsy. Electrophysiological recordings provide evidence that seizures have a higher probability of occurring at a given time during the night and day cycle in individuals with epilepsy here referred to as the seizure rush hour. Which mechanisms underlie such circadian rhythmicity of seizures? Why don't they occur every day at the same time? Which mechanisms may underlie their occurrence outside the rush hour? In this commentary, I present a hypothesis: MORE – Molecular Oscillations and Rhythmicity of Epilepsy, a conceptual framework to study and understand the mechanisms underlying the circadian rhythmicity of seizures and their probabilistic nature. The core of the hypothesis is the existence of ~24‐hour oscillations of gene and protein expression throughout the body in different cells and organs. The orchestrated molecular oscillations control the rhythmicity of numerous body events, such as feeding and sleep. The concept developed here is that molecular oscillations may favor seizure genesis at preferred times, generating the condition for a seizure rush hour. However, the condition is not sufficient, as other factors are necessary for a seizure to occur. Studying these molecular oscillations may help us understand seizure genesis mechanisms and find new therapeutic targets and predictive biomarkers. The MORE hypothesis can be generalized to comorbidities and the slower multidien (week/month period) rhythmicity of seizures, a phenomenon addressed in another article in this issue of Epilepsia.
Validation of a model to predict electroencephalographic seizures in critically ill children
Authors: Fung France W. , Parikh Darshana S. , Jacobwitz Marin , Vala Lisa , Donnelly Maureen , Wang Zi , Xiao Rui , Topjian Alexis A. , Abend Nicholas S.
Published: October 2020

Objective

Electroencephalographic seizures (ESs) are common in encephalopathic critically ill children, but identification requires extensive resources for continuous electroencephalographic monitoring (CEEG). In a previous study, we developed a clinical prediction rule using three clinical variables (age, acute encephalopathy category, clinically evident seizure[s] prior to CEEG initiation) and two electroencephalographic (EEG) variables (EEG background category and interictal discharges within the first 30 minutes of EEG) to identify patients at high risk for ESs for whom CEEG might be essential. In the current study, we aimed to validate the ES prediction model using an independent cohort.

Methods

The prospectively acquired validation cohort consisted of 314 consecutive critically ill children treated in the Pediatric Intensive Care Unit of a quaternary care referral hospital with acute encephalopathy undergoing clinically indicated CEEG. We calculated test characteristics using the previously developed prediction model in the validation cohort. As in the generation cohort study, we selected a 0.10 cutpoint to emphasize sensitivity.

Results

The incidence of ESs in the validation cohort was 22%. The generation and validation cohorts were alike in most clinical and EEG characteristics. The ES prediction model was well calibrated and well discriminating in the validation cohort. The model had a sensitivity of 90%, specificity of 37%, positive predictive value of 28%, and negative predictive value of 93%. If applied, the model would limit 31% of patients from undergoing CEEG while failing to identify 10% of patients with ESs. The model had similar performance characteristics in the generation and validation cohorts.

Significance

A model employing five readily available clinical and EEG variables performed well when validated in a new consecutive cohort. Implementation would substantially reduce CEEG utilization, although some patients with ESs would not be identified. This model may serve a critical role in targeting limited CEEG resources to critically ill children at highest risk for ESs.