bluuebunny/crossref_metadata_2025 huggingface dataset:
Deliberative Monetary Valuation
Authors: Bartkowski Bartosz , Lienhoop Nele
Published: January 2018

While economic values of nonmarket ecosystem goods and services are in high demand to inform decision-making processes, economic valuation has also attracted significant criticism. Particularly, its implicit rationality assumptions and value monism gave rise to alternative approaches to economic nonmarket valuation. Deliberative monetary valuation (DMV) originated in the early 2000s and gained particular prominence after 2010, especially in the context of the United Kingdom National Ecosystem Assessment (UK NEA). It constitutes a major methodological development to overcome the limitations of conventional nonmarket valuation methods by incorporating deliberative group elements (information provision, discussion, time to reflect in a group setting) in the valuation process.

DMV approaches range from those that focus on facilitating individual preference formation for complex and unfamiliar environmental changes and stay close to neoclassical economic theory to those that try to go beyond methodological individualism and monetary valuation to include a plurality of different values. The theoretical foundation of DMV comprises a mix of economic welfare theory, on the one hand, and various strands of deliberative democratic theory and discourse ethics, on the other. DMV formats are mostly inspired by deliberative institutions such as citizens’ juries and combine those with stated preference methods such as choice experiments. While the diversity of approaches within this field is large, it has been demonstrated that deliberation can lead to more well-informed and stable preferences as well as facilitate the inclusion of considerations going beyond self-interest. Future research challenges surrounding DMV include the exploration of intergroup power relations and group dynamics as well as the theoretical status and the validity of DMV results.
2. Origins
Authors: Horobin Simon
Published: January 2018

Where does the English language come from? While English is distantly related to both Latin and French, it is principally a Germanic language. ‘Origins’ provides a brief history of the English language, highlighting a number of substantial changes, which have radically altered its structure, vocabulary, pronunciation, and spelling. It begins with Old English (AD 650–1100), then moves on to Middle English (1100–1500), which saw the impact of the French language after the Norman Conquest of 1066. The Early Modern English period (1500–1750) witnessed the biggest impact of Latin upon English, while Late Modern English (1750–1900) resulted in an expansion of specialist vocabulary using Latin and Greek.
3. Authorities
Authors: Horobin Simon
Published: January 2018

‘Authorities’ considers how the rules of usage are established. It first describes the role of dictionaries, frequently held to be the ultimate authority. It then discusses linguistic academies, governing bodies that make pronouncements about correct usage. An alternative source to the dictionary is the usage guide, which tends to adopt a more prescriptive approach and which focuses on a small subset of frequently disputed points of usage. Other ways of determining acceptability is to turn to examples of actual usage, logic, or etymology. Despite the many controversies concerning correct usage and how it should be established, each of the authorities discussed would agree that there is a single authoritative form of the language, known as Standard English.
4. Standards
Authors: Horobin Simon
Published: January 2018

Standard English is a fixed variety, intolerant of variation, and is used throughout the population of English users, irrespective of geography. Where did Standard English come from, how did it come to win such widespread acceptance in the face of so much disagreement, and what is its status today? ‘Standards’ explains that Standard English is a relatively recent phenomenon, which grew out of an eighteenth-century anxiety about the status of English, and which prompted a concern for the codification and ‘ascertaining’, or fixing, of English. Before the eighteenth century, dialect variation was the norm, both in speech and in writing. Spellings, dialects and pronunciation, and good grammar are all discussed.
5. Varieties
Authors: Horobin Simon
Published: January 2018

‘Varieties’ investigates how language varies according to region, discussing regional and social dialects, and how language varies according to use. It considers how Scots, one of several languages spoken in Scotland, differs from both Standard English and Scottish Standard English, although it has much in common. Although pronunciation is the most obvious area of difference, there are many variations between Scots and Standard English grammar and lexicon. Is Scots a dialect of English, or a language in its own right? The linguistic evidence points both ways. The difference between dialects and accents is considered as well as dialect grammars and vocabulary, and emergence of new varieties associated with electronic communication.
7. Why do we care?
Authors: Horobin Simon
Published: January 2018

Why do we care about grammar and spelling to the extent that minor errors trigger paroxysms of despondency and gloom concerning the future of our society and its language? Since most people recognize the inevitability of linguistic change, we might wonder why they are unwilling to allow the language to continue to change today. ‘Why do we care?’ suggests one answer to this question lies in the fact that, as users of English, it is impossible for us to take an external stance from which to observe current usage. Another reason for our concern with such pedantry is bound up with the social cachet that surrounds the concept of ‘good grammar’.
Definitions
Authors: Davis Stephen J.
Published: January 2018

The word ‘monasticism’ derives from the Greek adjectives monos (‘solitary, alone’), or its cognate monachos (‘solitary, deserted’). The first evidence for the use of monachos to refer to a Christian monk comes from an Egyptian papyrus dated to June 324 ce. ‘Definitions’ considers the terms monastic, apotactite, anchorite, cenobite, and ascetic that have been used throughout history, which capture five important characteristics relevant to our understanding of monasticism as it developed in the Greek-speaking world of early Christianity: solitude, the status of being set apart, withdrawal, community, and discipline. It also discusses the history of Buddhist monasticism in India with reference to the Vinaya Piṭaka, part of the Buddhist scriptural canon.
Differences
Authors: Davis Stephen J.
Published: January 2018

Monasticism is a historical and cultural phenomenon found in multiple and varied forms. How are we able to assign this same label convincingly to a variegated field of monastic practices and communities that sometimes seem to stand in tension with each other? ‘Differences’ considers monasticism in terms of two unifying pairs of themes: withdrawal and renunciation (as forms of spatial and bodily differentiation), and regimentation and routinization (as forms of social differentiation). It looks at how Buddhist and Jain monastic movements as well as early Christian monasticism were characterized by ritualized acts of withdrawal and renunciation, and then at different types of monastic settlements, including lavra, cenobitic, Dominican, and Franciscan types.
Rules, social organization, and gender
Authors: Davis Stephen J.
Published: January 2018

‘Rules, social organization, and gender’ considers the social organization of community-based monasticism and the function of rules for the shaping of monastic identity and practice, using both Buddhist and Christian case studies. The study of Buddhist monastic codes draws on different versions of the Vinaya, while the investigation of Christian monastic codes delves into two late ancient Egyptian examples from Upper Egypt. These sources are used to explore how monastic lifestyles and identities replaced conventional civic and familial models, and how gendered forms of monastic life were regulated and sometimes crucially differentiated from each other in practice. Two helpful concepts for understanding how monastic rules function for monks and nuns are ‘resocialization’ and ‘form-of-life’.
Saints and spirituality
Authors: Davis Stephen J.
Published: January 2018

Monastic rules constitute a ‘form-of-life’ for monks and nuns seeking to pursue a life of withdrawal and renunciation. But when it comes to the cultivation of specific virtues—holiness, purity, or perfection—Christian, Jain, and Buddhist monastics have also had other cultural and ethical models to draw on, including charismatic ascetic virtuosi who inspire acts of imitation and veneration. ‘Saints and spirituality’ considers the privileged role that saints and their stories play in the shaping of monastic spirituality. It first defines sainthood in different traditions and then looks at the lives of monastic saints—including Francis of Assisi, Mahāvīra, Gautama Buddha, Anthony, and Milarepa—and the ethics of imitation.
Life support systems
Authors: Vincent Warwick F.
Published: January 2018

There is an astonishing variety and abundance of microscopic life that underpins the ecology of natural waters. The aquatic microbiome—made up of viruses, bacteria, archaea, and microbial eukaryotes—is central to the healthy functioning of lake ecosystems and their responses to environmental change. ‘Life support systems’ describes the key input of energy from the sun and the precarious balance between oxygen gains and losses. It also outlines the key features of the carbon and nitrogen cycles and the important roles that the microbiomes play; and it describes the two different zones of production: the inshore or littoral zone, and the offshore limnetic or pelagic zone.
Food chains to fish
Authors: Vincent Warwick F.
Published: January 2018

‘Food chains to fish’ considers the nature of pelagic and benthic food webs and the coupling between them. Life at the bottom of lakes in the benthic zone is mostly made up of worms, molluscs, and amphipods. In the open lake waters, three groups of zooplankton play a leading role in the transfer of carbon and energy from the base of the food web (phytoplankton and bacteria) to pelagic fish: rotifers, cladocerans, and copepods. Although certain fish species remain within specific zones of the lake, others swim between zones and access multiple habitats. The tracking of elements through the food chain can help understand the impacts of chemical pollution.
1. What the EU is for
Authors: Usherwood Simon , Pinder John
Published: January 2018

‘What the EU is for’ explores the development of the European Community (EC). For France and Germany, finding a way to live together in a durable peace was a fundamental political priority that the EC was designed to serve. As the Second World War recedes into a more distant past, the motive of peace and security remains a powerful influence on governments and politicians of many member states—and peace could only succeed with adequate economic performance. There are two main explanations for the phenomenon of the EC and EU. One emphasizes the role of member states and their intergovernmental dealings; the other gives greater weight to the European institutions.
2. How the EU was made
Authors: Usherwood Simon , Pinder John
Published: January 2018

‘How the EU was made’ examines the combination of interests and events leading to the development of the EC, including the founding treaties. The Single European Act (SEA) provided for completion of the single market by 1992, strengthening the EC’s powers and institutions. It was succeeded by the Maastricht, Amsterdam, Nice, and Lisbon treaties, likewise strengthening both powers and institutions, and responding to similar combinations of pressures. The prospect of the single market helped to revive the economy, and EC institutions gained strength as they dealt with a vast programme of legislation. Recent years have seen the EU grow further, but also Britain’s decision to leave in the 2016 referendum.
5. Agriculture, regions, budget: conflicts over who gets what
Authors: Usherwood Simon , Pinder John
Published: January 2018

‘Agriculture, regions, budget: conflicts over who gets what’ argues that because the single market enhances productivity in the economy, there is benefit for most people. But there will be some who lose from the opening of markets to new competition, and these may demand compensation for agreeing to participate in the new arrangements. Such compensation usually has implications for the EU budget. The size of the budget does constrain what the EU can do, for example in promoting cohesion and balanced development across its member states. Further reforms will be needed if the EU is to remain a relevant actor, both internally and in the wider world.
7. ‘An area of freedom, security and justice’
Authors: Usherwood Simon , Pinder John
Published: January 2018

‘An area of freedom, security and justice’ explains the two main aims of the Schengen Agreements of 1985 and 1990. The first concerned border controls: to eliminate those internal to Schengenland; establish controls round its external frontier; and set rules to deal with asylum, immigration, and the movement or residence of other countries’ nationals within the area. The second was to cooperate in combating crime. While conditions in the EU are, in a general sense, notably free, secure, and just when compared with almost all other parts of the world, the persisting divisions between member states and the EU result in confused lines of control and limited scope for action.
4. Potato soup
Authors: Warner Marina
Published: January 2018

Princes and queens, palaces and castles dominate the foreground of a fairy tale, but through the gold and glitter, the depth of the scene is filled with vivid and familiar circumstances, as the fantastic faculties engage with the world of experience. ‘Potato soup: true stories/real life’ explains that the genre’s themes are real-life themes and the passions real-life passions. The situations in fairy tales also capture deep terrors of occurrences common and, mercifully, uncommon. Despite the historical origins behind stories such as Bluebeard and Snow White, fairy tales, in general, dramatize ordinary circumstances. They are messages of hope arising from desperate yet ordinary situations.
5. Childish things
Authors: Warner Marina
Published: January 2018

Fairy tale hovered as a form of literature between children and adults, but in the Victorian era, the fairy way of writing became a mode of communicating moral values, political dreams, and even scientific knowledge to children. Printing technology made books with pictures one of the most exciting and successful ventures of the nineteenth century, and fairy tales began to be produced deliberately to appeal to an audience of young readers. ‘Childish things: pictures and conversations’ explains that, on the whole, the role of artists who helped create fairy tales has been neglected. It describes the re-writing of fairy tales for this younger audience. Modern fairy tales display a darkening tone.
Epilogue
Authors: Warner Marina
Published: January 2018

A few dissenting voices still consider fairy tales childish and foolish, but on the whole, they have been widely accepted as a most valuable and profound creation of human history and culture. They have come to be treated as scriptures from an authentic inaugural time of imaginative activity, a narrative blueprint when it was all set down, right and true. The Epilogue explains that for these reasons, fairy tales are gradually turning into myths: stories held in common about the deepest dilemmas, no longer aiming at being optimistic or consoling, but rather bearers of wisdom, deep, thought-provoking, and illuminating.
1. Invention in antiquity
Authors: Heilbron J. L.
Published: January 2018

Of the four main schools of ancient philosophy, Aristotle paid greatest attention to physica. Because of his emphasis on physica and because his philosophy dominated during the Middle Ages and beyond, convenience advises taking it as normative. In antiquity, however, it had to compete with Platonic, Epicurean, and Stoic philosophies. ‘Invention in antiquity’ considers the different beliefs of these philosophies before discussing how Romans such as Lucretius, Ovid, and Seneca used these principles in their own work. The applications of Greek physical principles by Archimedes, Vitruvius, Ptolemy, and Pliny are also discussed.
5. Classical physics and its cure
Authors: Heilbron J. L.
Published: January 2018

During the 19th century, physics became a recognized profession and its practitioners ‘physicists’. It and they acquired special training facilities in universities and technical schools that sprang up in Europe and America after 1870. ‘Classical physics and its cure’ shows physicists of the early 20th century admiring, and setting aside, their 19th-century accomplishments as ‘classical’; building a quantum science of atoms and molecules that claimed to contain all of physics and chemistry, ‘in principle’. The work of physicists such as Faraday, Kelvin, Maxwell, Boltzmann, Einstein, Planck, Röntgen, Rutherford, Bohr, and Becquerel is outlined, along with how physics increasingly made good on Bacon’s promise that experimental science would improve the human condition.
6. From old world to new
Authors: Heilbron J. L.
Published: January 2018

‘From old world to new’ looks at the legacies of World War I, and how the discovery of the importance of physics for national defence and industrial development changed the direction of physics. It describes key work on quantum mechanics and the discoveries of radioactivity, nuclear fission, and superconductivity. World War II’s physical science and engineering created radar, leading to microwave technologies and the laser; its atomic bombs brought nuclear power; its V-2 rocket launched the aerospace industry; and it pioneered the electronic computer. High-energy physics was then further developed by Fermilab (in America) and CERN (in Europe). The 1960s onwards saw developments in cosmology, seismology, ionospherics, meteorology, and oceanography.
1. The man made of words
Authors: Teuton Sean
Published: January 2018

‘The man made of words’ describes the history of Native Americans, with a strong focus on the 16th-century European colonization period. To recover from nearly 500 years of conquest and disease that devastated indigenous peoples in North America, Native people had to revisit their history and reimagine themselves through literature. As Native American authors learned to write in English, they also mastered literary forms like the novel, adapting these genres to serve indigenous worldviews, and incorporating oral literatures. Despite numerous challenges and a Native American population decreasing rapidly during colonization, many Native American communities are growing their populations and economies, and are reinvesting in cultural and language revitalization.
4. From artifact to intellectual
Authors: Teuton Sean
Published: January 2018

‘From artifact to intellectual’ describes the nineteenth-century Indian Wars and the numerous Native American autobiographies that provide a glimpse into indigenous patterns of living, ways of knowing, and verbal art. These autobiographies also deliver a powerful counter-narrative of US entitlement to indigenous lands during Indian removal. In an era of reform, from around 1890 to 1934, Native and non-Native activists sought legislation to “uplift” the Indian, though reformers’ goals often conflicted. Natives and whites actively collaborated through the Society of American Indians (SAI) to influence federal Indian policy. The SAI helped save Native American writers for the twentieth century, scattering the cultural seeds for later Native literary flourishing.
5. Native American literary studies
Authors: Teuton Sean
Published: January 2018

During the time of the Red Power movement in the late 1960s and 1970s, Native American students brought their visions of justice to college campuses to create what they began to describe as “Native American Studies.” Pressuring universities to accept a more diverse student body, Native scholars demanded that universities allow the production of knowledge by and for Native Americans. To succeed Native American Studies had to tear free of the “salvage anthropology” that shaped the European study of indigenous people from the first moments of contact. Native scholars accomplished an imaginative shift in self-conception: Native Americans are not helpless victims of colonial devastation, but instead the shrewd protectors of indigenous thought.
7. Indigenous futurity
Authors: Teuton Sean
Published: January 2018

‘Indigenous futurity’ considers how indigenous revivals might be viewed as expressions of “futurity,” operating in resistance to those assumptions that consign Native American peoples and lifeways to the past. It discusses a range of Native American poetry and theatre, including the work of Simon Ortiz, Jane Johnston Schoolcraft, John Rollin Ridge, E. Pauline Johnson, Laura Tohe, and Joy Harjo. Whatever the form, contemporary Native poets look to oral literature and its long-held understanding of language as a source of change. Such poetry not only frees Native American voices, but confirms a spiritual awareness of ancestral land and community. Native American writers in all genres express an Indigenous world in all its complexity.
Proteomic-Based Approach to the Proteins Involved in 1-Deoxynojirimycin Accumulation in Silkworm Bombyx mori (Lepidoptera: Bombycidae)
Authors: Chen Hongxia , Liu Yueqin , Wang Wenbing , Olatunji Opeyemi J , Pan Gang , Ouyang Zhen
Published: January 2018

1-Deoxynojirimycin (DNJ) is the most abundant poly-hydroxylated alkaloid in the latex of mulberry leaves and it protects mulberry from insect predation. However, silkworms can survive the poisoning effect of DNJ and accumulate DNJ by consumption of the mulberry leaves. In order to determine the molecular mechanism of DNJ accumulation in silkworm, comparative proteomic analysis was employed to evaluate protein expression in two groups of silkworm bodies (the third instar silkworm bodies had the maximum content of DNJ throughout life, and the newly hatched silkworm bodies had no DNJ). Our results indicated some differentially expressed proteins in the third instar silkworm involved in material metabolism, energy metabolism, oxidation-reduction, detoxification, immune, and transport regulation may correspond to the accumulation of DNJ. Furthermore, the expression levels of five selected differentially expressed protein-encoding genes namely heat shock cognate protein (Hsp 70), glutathione S-transferase sigma 1 (GST), serine protease precursor (Ser), hemolymph protein (30K), and thiol peroxiredoxin (TPx) were investigated by quantitative real-time PCR and the accumulation of DNJ was measured by HPLC. Correlation analysis showed that the expression levels of Hsp70 and Ser were negatively correlated to DNJ accumulation with weak correlation, while 30K, GST, and TPx genes had positive correlation with DNJ accumulation. The findings suggested that these three proteins were probably important in the physiological process of DNJ accumulation in silkworm.
Diurnal heat stress reduces pig intestinal integrity and increases endotoxin translocation
Authors: Gabler Nicholas K , Koltes Dawn , Schaumberger Simone , Murugesan G Raj , Reisinger Nicole
Published: January 2018

Heat stress negatively affects performance and intestinal integrity of pigs. The objective of this study was to characterize the effects of diurnal heat stress (dHS) on nursery-grower pig performance, intestinal integrity, and lipopolysaccharide (LPS) translocation. Forty-eight nursery-grower gilts, individually penned, were randomly assigned to two treatments. Twenty-four pigs were then exposed to dHS for 3 d, 6 h at 38°C and 18 h at 32°C, at 40–60% humidity. The remaining pigs were maintained under thermal neutral (TN) conditions. Changes in pig rectal temperatures (Tr), respiration rates (RR), performance, and blood parameters were evaluated. Additionally, ex vivo ileum integrity was assessed with the Ussing chamber by measuring transepithelial resistance (TER), and 4 kDa fluorescein isothiocyanate (FITC)–dextran (FD4) and FITC–LPS mucosal to serosal flux. As expected, dHS increased pig Tr and RR (P < 0.05) and reduced pig performance (P < 0.05) on the 3-d period. Compared with TN, ileum TER (P = 0.04), FITC–LPS (P < 0.001), and FD4 (P = 0.011) permeability were significantly increased due to dHS. Compared with TN pigs, dHS increased serum endotoxin by 150% (P = 0.031). Altogether, 3-d dHS significantly reduced pig performance and intestinal integrity and increased blood endotoxin concentrations.
Beyond the Double Helix: Reading and Writing the Histone Code
Authors: Allis C. David
Published: January 2018

The human genome is estimated to contain 30,000 – 40,000 unique genes; the DNA sequence and chromosomal location of all these genes are becoming widely known. A central challenge facing the biomedical community is how to derive medically‐valuable knowledge about the function of these genes from the now‐available DNA sequence data. Though every gene exists within every cell in the human body, only a small percentage of genes are activated in any given cell. To manage this genetic information efficiently, nature has evolved a sophisticated system that facilitates access to specific genes. This system relies on a DNA‐histone protein complex called chromatin to efficiently package the genetic information that exists within each cell. This packaging system makes certain genes more readily accessible to transcription factors and other machinery that must engage our genetic template. Chromatin modifications, and the regulation of the enzymes responsible for adding or subtracting them, are poised to take center stage in the study of cancer in the current post‐genomic or epigenomic era. Moreover, the implications of chromatin and its modification are beginning to gain appreciation in clinical oncology. The identification of altered DNA methylation and histone acetylase activity in a range of human cancers, coupled with the use of HDAC inhibitors in the treatment of leukemia, make a compelling argument. It is clear that the regulatory signals provided by chromatin modifications will revolutionize our view of cancer as new models of “epigenetic carcinogenesis” are advanced. We favor the view that there exists an epigenetic indexing system for our genome, or a “histone or epigenetic code,” that represents a fundamental regulatory mechanism that acts outside of the DNA itself. We predict that this “code” impacts on most, if not all, chromatin‐templated processes with far‐reaching consequences for cell fate decisions and for normal and pathological development.

Most of our current research is centered on chromatin and its regulation though post‐translational modification of histone (and non‐histone) proteins. That said, other mechanisms such as the existence of DNA methylation and of small non‐coding RNAs are also likely, if not certainly, involved. How epigenetic states, “ON” or “OFF”, are inherited from one generation to the next is a central question that we, and others, are currently addressing.
Making and Breaking Ubiquitin
Authors: Muir Thomas W , McGinty Robert , Pratt Matt , Chatterjee Champak , Schwartz Edmund
Published: January 2018

A complex interplay between DNA, histones, and chromatin associated proteins coordinates the structure and function of the eukaryotic genome. To help accomplish this task, extensive posttranslational modifications of the core histone proteins have evolved. One of the less elucidated modifications, monoubiquitylation of H2B (uH2B), has been implicated in transcription elongation and histone methylation of H3 K4 and K79. Characterization of the role of uH2B in these processes requires the isolation or generation of homogenously ubiquitylated H2B. To this end, we have developed a traceless semisynthetic strategy to generate uH2B. We employ two expressed protein ligation (EPL) reactions and two methods for ligation site removal to synthesize native uH2B. The resulting uH2B was reconstituted into core histone octamers and nucleosome arrays were then generated for biochemical characterization.

Controlling protein function through posttranslational manipulations has emerged as an attractive complimentary technology to existing genetic systems. We have developed a new posttranslational, small molecule‐mediated, technology for the manipulation of protein function. This system, termed SURF (Split‐Ubiquitin for the Rescue of Function), places the complementation of ubiquitin under the control of a small molecule. Before complementation a protein of interest is targeted for destruction by the proteasome through the introduction of an N‐terminal degron. Small molecule induced dimerization results in ubiquitin complementation and folding followed by cleavage of the protein of interest, thereby releasing it from the degron and rescuing its function. This system has been successfully applied to activate several classes of proteins in living cells. This general strategy should allow for inducible rescue of a variety of proteins in such a way that their native structure and function are maintained.
Long-term Outcome of Small, Incidentally Detected Rectal Neuroendocrine Tumors Removed by Simple Excisional Biopsy Compared With the Advanced Endoscopic Resection During Screening Colonoscopy
Authors: Kwak Min-Sun , Chung Su Jin , Yang Jong In , Im Jong Pil , Park Min Jung , Lee Cheol , Kim Joo Sung
Published: January 2018

BACKGROUND:

Incidental, small rectal neuroendocrine tumors during colonoscopy screening are sometimes removed using biopsy forceps. Few studies have examined the clinical course of rectal neuroendocrine tumors removed by simple excisional biopsy.

OBJECTIVE:

We investigated the long-term outcome of rectal neuroendocrine tumors removed by simple excisional biopsy compared with standard endoscopic resection.

DESIGN:

This was a cohort study.

SETTINGS:

This study was performed at a healthcare center in Korea.

PATIENTS:

We enrolled patients with rectal neuroendocrine tumors detected during a screening colonoscopy between 2003 and 2015.

MAIN OUTCOME MEASURES:

The clinical characteristics and long-term outcomes (overall survival and disease-free survival) of small neuroendocrine tumors <10 mm were compared between the simple excisional biopsy group and advanced endoscopic resection group.

RESULTS:

In total, 166 patients were diagnosed with rectal neuroendocrine tumors (≤5 mm, n = 100; 6–9 mm, n = 50; 10–19 mm, n = 15; ≥20 mm, n = 1). Among the 150 patients with neuroendocrine tumors <10 mm, follow-up endoscopy was performed on 99 (59.6%). All of the tumors were confined to the mucosa or submucosa. Thirty-one and 68 patients were included in the simple excisional biopsy and advanced endoscopic resection groups. The overall follow-up duration was 6.5 years (range, 1.0–12.8 y). Neither overall nor disease-related death occurred. Two patients exhibited local recurrence (6.5%, at 8 and 11 y) in the simple excisional biopsy group and 1 patient (1.5%, at 7 y) in the advanced endoscopic resection group, resulting in no significant difference (p = 0.37). All of the recurrences were diagnosed >5 years from initial diagnosis and successfully treated endoscopically.

LIMITATIONS:

More long-term data should be warranted.

CONCLUSIONS:

The long-term outcome of small rectal neuroendocrine tumors <10 mm removed by simple excisional biopsy was excellent. Neither overall survival nor disease-free survival significantly differed between the simple excisional biopsy group and the advanced endoscopic resection group. Thus, simple excisional biopsy and long-term follow-up can be cautiously applied for small rectal neuroendocrine tumors in clinical practice. See Video Abstract at http://links.lww.com/DCR/A406.
Incidence and Long-term Implications of Prepouch Ileitis: An Observational Study
Authors: Segal Jonathan P. , McLaughlin Simon D. , Faiz Omar D. , Hart Ailsa L. , Clark Susan K.
Published: January 2018

BACKGROUND:

Restorative proctocolectomy is the procedure of choice in patients with ulcerative colitis refractory to medical therapy. Prepouch ileitis is characterized by mucosal inflammation immediately proximal to the pouch. Prepouch ileitis is uncommon, and long-term follow-up data are lacking.

OBJECTIVE:

The aim of this study is to report the long-term outcomes of prepouch ileitis.

DESIGN:

We followed up a cohort of patients with prepouch ileitis that was originally described in 2009. Patients were followed up until the last recorded clinic attendance or at the point of pouch failure. Follow-up data collected included stool frequency, endoscopic findings, treatment, and overall pouch function.

SETTING:

We accessed a prospectively maintained database at our institution between January 2009 and January 2017.

PATIENTS:

Three of the 34 patients originally described in 2009 were lost to follow-up; we reanalyzed data on the remaining 31.

MAIN OUTCOME MEASURE:

The rate of pouch failure was defined as the need for ileostomy or pouch revision.

RESULTS:

All 31 patients had coexisting pouchitis at index diagnosis of prepouch ileitis. The median length of follow-up from the index pouchoscopy was 98 (range, 27–143) months. Seven (23%) patients who had an index pouchoscopy with prepouch ileitis went on to pouch failure, which is significantly higher than expected (p = 0.03). Five (71%) of these patients had chronic pouchitis, and 2 (29%) had small-bowel obstruction due to prepouch stricture. Two patients had evidence that would support possible Crohn’s disease at long-term follow-up.

LIMITATIONS:

This was a retrospective analysis. Because of the nature of the study, there was some missing information that may have influenced the results. Our study is further limited by small patient numbers.

CONCLUSIONS:

Prepouch ileitis is associated with a significantly increased risk of pouch failure compared with the overall reported literature for restorative proctocolectomy. Prepouch ileitis does not appear to be strongly predictive of Crohn’s disease at long-term follow-up. See Video Abstract at http://links.lww.com/DCR/A480.
Grade Experience of Online Nurse Practitioner Students
Authors: Morgan Phyllis D. , Stone Jennifer , Moussa Mahaman , Fogel Joshua , Steele Linda
Published: January 2018

This study examined the grade experience for online nurse practitioner students (N = 3760) who took more than 1 clinical course per academic term as compared with those who did not. Students who had more than 1 clinical course per term had a greater percentage of clinical course failures than other students (2.1% vs 0.8%, P = .001). Nurse practitioner programs should develop clear policies and guidelines for students taking more than 1 clinical course at a time.
Food for Thought
Authors: Cohen Deborah A.
Published: January 2018

The ability of people to adhere to nutritional advice is frequently undermined by restaurants that serve foods with more calories than consumers need to maintain energy balance and retail outlets that aggressively market low-nutrient foods. Multiple studies have shown that how food is presented, served, and marketed strongly influences what and how much people consume and that most people have a limited capacity to avoid these influences. Yet, there is still a strong misperception that individuals should be able to control what they eat, regardless of what they face in restaurants and food markets. As a consequence, there are no serious efforts to regulate restaurants or food markets in a manner similar to the regulation of other consumer products, where consumers are generally protected from harm. Standards and regulations on portion sizes, bundled meals, and impulse marketing strategies could be created to protect consumers from business practices designed to foster the overconsumption of foods that underlie multiple chronic diseases, including type 2 diabetes, heart diseases, and cancer. Dietitians should become involved in the development of standards for the service and marketing of food away from home, which currently creates a substantial burden that most people cannot avoid, ignore, or easily overcome on their own.
Identifying Glaucomatous Damage to the Macula
Authors: Alluwimi Muhammed S. , Swanson William H. , King Brett J.
Published: January 2018

SIGNIFICANCE

Measurements of the macula have been increasingly used to diagnose and manage patients with glaucoma. Asymmetry analysis was clinically introduced to assess damage to the macular ganglion cells in patients with glaucoma, but its effectiveness is limited by high normal between-subject variability.

PURPOSE

We aimed to reduce the high normal between-subject variability and improve the potential of asymmetry analysis to identify glaucomatous damage to the macula.

METHODS

Twenty patients with glaucoma (aged 57 to 85 years) and 30 age-similar control subjects (aged 53 to 89 years) were recruited from a longitudinal glaucoma study. Participants were imaged with the Spectralis OCT using the posterior pole protocol; measurements of the averaged retinal thickness and ganglion cell layer (GCL) thickness were obtained. We established three zones per hemifield within the central ±9°, based on the lowest between-subject variability that we previously found and the course of retinal nerve fiber layer projections. The criteria for flagging abnormality were at least two contiguous zones when P < 5% or one zone when P < 1% with two-tailed tests.

RESULTS

Between-subject variability of the asymmetry analysis for both retinal and GCL thicknesses remained lower than that of the average thickness across each zone in control subjects (F > 2.52, P < .01). Asymmetry analysis of retinal and GCL thicknesses flagged 16 and 18 of 20 patients, respectively.

CONCLUSIONS

Between-subject variability was reduced in control subjects using the three zones; our criteria identified glaucomatous damage to the macula in most of the patients. We used high-density B-scans to confirm the patterns of the glaucomatous damage we found in this study.
Results for Water-drinking Test, before and after Laser Iridotomy, in Primary Angle-closure Suspects
Authors: Razeghinejad M. Reza , Karampour Parisa , Masoumpour Masoumeh Beigom , Tajbakhsh Zahra , Nowroozzadeh M. Hossein
Published: January 2018

SIGNIFICANCE

Intraocular pressure and ocular biometric changes were similar before and after laser iridotomy in response to the water-drinking test in a cohort of patients at risk of angle closure. The water-drinking test does not seem to be a good provocative test to determine which eyes would benefit from a laser iridotomy. Our data call into question the preoperative predictive value of this test.

PURPOSE

The aim of this study was to evaluate the effect of water-drinking test on intraocular pressure and ocular biometric parameters, before and after laser peripheral iridotomy, in patients with an occludable angle.

METHODS

Twenty-seven patients, who met the inclusion criteria and had at least 180 degrees of iridotrabecular apposition, underwent a complete eye examination followed by the measurement of ocular biometric (using LenStar LS-900; Haag-Streit AG, Koeniz, Switzerland) and anterior chamber parameters (using Pentacam HR; Oculus Optikgerate GmbH, Wetzlar, Germany). All the measurements were repeated 30 minutes after the water-drinking test. Two weeks after laser peripheral iridotomy, all the measurements were repeated both before and after the water-drinking test.

RESULTS

The mean ± SD of the age of the participants was 57 ± 9 years, and 23 (85.2%) were male. Intraocular pressure increased after the water-drinking test in both pre–laser peripheral iridotomy (17.0 vs. 19.3 mmHg, P < .001) and post–laser peripheral iridotomy (15.6 vs. 18.6 mmHg, P < .001) conditions. The thickness values of central cornea increased slightly after the water-drinking test in pre–laser peripheral iridotomy (535 vs. 538 μm, P = .001) compared with post–laser peripheral iridotomy (532 vs. 536 μm, P = .003). The water-drinking test had no significant effect on other biometric or anterior chamber parameters, before or after laser peripheral iridotomy.

CONCLUSIONS

The water-drinking test increased intraocular pressure, both before and after laser peripheral iridotomy. Laser peripheral iridotomy had no significant effect on the amount of intraocular pressure change after the water-drinking test. The water-drinking test has no effect on other biometric or anterior chamber parameters.
Comparison of Scleral Tono-Pen Intraocular Pressure Measurements with Goldmann Applanation Tonometry
Authors: Badakere Swathi Vallabh , Choudhari Nikhil S. , Rao Harsha L. , Chary C. Raghava , Garudadri Chandra Sekhar , Senthil Sirisha
Published: January 2018

SIGNIFICANCE

Measuring the intraocular pressure (IOP) on the sclera can be an alternative to conventional corneal measurement in eyes with scarred corneas. However, these measurements have to be evaluated prior in normal eyes. Our study aimed to evaluate scleral IOP using Tono-Pen and compared it with corneal Goldmann applanation measurements.

PURPOSE

The aim of this study was to evaluate the ability of limbal and scleral Tono-Pen IOP readings to predict central corneal Goldmann applanation tonometry (GAT) readings in eyes with normal corneas.

METHODS

In a cross-sectional study, 115 eyes of 115 patients attending a tertiary eye care center underwent GAT on the central cornea followed by Tono-Pen readings at the central cornea, at the limbus, and at the sclera. Bland-Altman plots were used to determine the agreement between different methods of IOP measurement.

RESULTS

The median IOP (interquartile range) by GAT performed on the central cornea was 18 (16, 24) mmHg, and the IOP ranged from 10 to 54 mmHg. The median IOPs (interquartile range) by Tono-Pen obtained at central cornea, limbus, and sclera were 16 (13, 23), 23 (17, 28), and 33 (27, 44) mmHg, respectively. The Pearson correlation coefficient and the 95% limits of agreement between GAT readings and Tono-Pen readings at the central cornea were 0.9 (P< .001) and −4.9 to 8.74 mmHg, respectively. The correlation coefficient between GAT readings and Tono-Pen readings at the limbus and GAT readings and Tono-Pen readings at the sclera was 0.46 (P< .001) and 0.23 (P= .01), respectively. The 95% limits of agreement between these pairs of readings were −20.55 to 13.66 and −44.02 to 13.37 mmHg, respectively.

CONCLUSIONS

This study showed limited ability of Tono-Pen readings obtained at the limbus and sclera to predict the central corneal GAT IOP readings in eyes with normal corneas at various IOP ranges.
Direct-to-Implant Breast Reconstruction in Women Older than 65 Years: A Retrospective Analysis of Complication Rate and Overall Outcomes
Authors: Knackstedt Rebecca , Gatherwright James , Moreira Andrea
Published: January 2018

Background:

Half of all cancers occur in women older than 65 years, yet only 4 to 14 percent of these women undergo reconstruction. Most studies on reconstruction in the elderly have focused on tissue expander/implant or autologous reconstruction. A direct-to-implant approach theoretically reduces the number of operations and postoperative visits, but has yet to be investigated in the elderly.

Methods:

Institutional review board approval was granted for a retrospective chart review for patients who underwent direct-to-implant reconstruction from 2012 to 2015 with any staff in the authors’ department. A control cohort of patients who underwent tissue expander/implant-based reconstruction from the same period was analyzed.

Results:

Direct-to-implant reconstruction was performed in 24 breasts in 19 patients with at least 30-day follow-up and in 17 breasts in 14 patients with at least 1-year follow-up. A control group analysis of tissue expander/implant patients was performed for 109 breasts in 88 patients. The tissue expander/implant group was significantly younger (p = 0.001), with a lower body mass index (p = 0.004). There was no difference in the rate of seroma, hematoma, infection, necrosis, or failed reconstruction. Direct-to-implant patients had significantly reduced numbers of drain days (p < 0.001), length of stay (p = 0.05 and p = 0.039), readmissions (p = 0.03 and 0.03), extra hospital days (p = 0.05 and p = 0.045), and postoperative visits (p < 0.001).

Conclusions:

Direct-to-implant breast reconstruction in the elderly yields similar complication and failure rates compared to tissue expander/implant reconstruction. However, direct-to-implant reconstruction patients had a reduced number of drain days and fewer readmissions, hospital stays, and postoperative visits. Direct-to-implant reconstruction is a powerful tool to use in elderly women with appropriate breast shape and ptosis.

CLINICAL QUESTION/LEVEL OF EVIDENCE:

Therapeutic, III.
The Comparison of Strattice and SurgiMend in Acellular Dermal Matrix–Assisted, Implant-Based Immediate Breast Reconstruction
Authors: Mazari Fayyaz A. K. , Wattoo Ghulam M. , Kazzazi Nazar H. , Kolar Kadappa M. , Olubowale Olumuyiwa O. , Rogers Clare E. , Azmy Iman A.
Published: January 2018

Background:

Strattice (porcine derivative) and SurgiMend (bovine derivative) are the two most common acellular dermal matrices used in breast reconstruction in the United Kingdom. This retrospective study compared clinical outcomes in immediate implant-based breast reconstruction patients.

Methods:

The study, conducted across three hospitals, included all patients who underwent immediate implant-based breast reconstruction using Strattice and SurgiMend. The primary outcome measure was implant loss rate. Secondary outcome measures included acellular dermal matrix loss rate, seroma formation, and minor and major complication rates. Intergroup comparison was performed.

Results:

Eighty-two patients (Strattice, n = 45; SurgiMend, n = 37) underwent 97 immediate implant-based breast reconstructions (Strattice, n = 54; SurgiMend, n = 43). There were no differences between groups for age, comorbidities, specimen weight, or implant volume. Drains were used in all Strattice and 36 (84 percent) SurgiMend cases. The implant loss rate was higher for Strattice (n = 10, 20 percent) compared with SurgiMend (n = 3, 7 percent) but failed to reach statistical significance (chi-square test, p = 0.077). The acellular dermal matrix loss rate was significantly higher (Fisher’s exact test, p = 0.014) in the Strattice group (n = 7, 14 percent), with no acellular dermal matrix loss with SurgiMend. The reoperation rate was also significantly higher (chi-square test, p = 0.002) in the Strattice group (n = 17, 33 percent, versus n = 3, 7 percent). The incidence of red breast was significantly higher (chi-square test, p = 0.022) in the SurgiMend group (n = 9, 21 percent, versus n = 3, 6 percent). Seroma, wound problems, and infection rates were similar.

Conclusions:

Clinical outcomes, including implant loss, acellular dermal matrix loss, and reoperation rates, are significantly better when using SurgiMend in immediate implant-based breast reconstruction compared with Strattice. An appropriately powered randomized trial is needed to provide further information.

CLINICAL QUESTION/LEVEL OF EVIDENCE:

Therapeutic, III.