bluuebunny/crossref_metadata_2025 huggingface dataset:
Youth perspectives on their development in a coding community
Authors: Roque Ricarose , Rusk Natalie
Published: April 2019

Purpose

Many initiatives are seeking to engage children in learning to code. However, few studies have examined how children’s engagement in learning and using coding develops over time. This study aims to seek young people’s perspectives on what they viewed as important in their long-term participation in a coding community.

Design/methodology/approach

This study identified youth with a high level of participation and who demonstrated emergent leadership in the Scratch online community. Using methods from qualitative research on youth development, individual interviews were conducted in which these youth were asked about memorable moments in their participation and how these experiences influenced them.

Findings

While each young person described a unique pathway and perspective, this study identified key experiences that motivated their participation, influenced their development and inspired their emergent leadership. These experiences included opportunities to learn through exploration, to receive feedback from peers, to engage in creative collaboration and to contribute to the community.

Practical implications

This study discussed these findings in light of previous research on youth development, and it suggests that building on practices and principles from research on youth programs can help more young people become engaged in developing broader skills with coding.

Originality/value

Youth highlighted experiences that enabled them to express their ideas, to build relationships, to help others and to see themselves in new ways. Their perspectives expand beyond the predominant focus of coding initiatives on computational thinking and problem-solving skills to also support social, leadership and identity development.
Evaluating the impact resistance of roller compacted concrete containing crumb rubber and nanosilica using response surface methodology and Weibull distribution
Authors: Adamu Musa , Mohammed Bashar S. , Liew Mohd Shahir , Alaloul Wesam Salah
Published: April 2019

Purpose

Roller compacted concrete (RCC) pavement is used in areas subjected to heavy impact loads; therefore, higher impact resistance is a desirable property of consideration. This study aims to investigate the effect of partial replacement of fine aggregate with crumb rubber (CR) and the addition of nanosilica (NS) by weight of cementitious materials on the impact resistance of roller compacted rubbercrete (RCR).

Design/methodology/approach

Four replacement levels of CR (0, 10, 20 and 30 per cent) and four addition levels of NS (0, 1, 2 and 3 per cent) were considered. The impact resistance test was carried out using the drop weight test recommended by ACI 544.

Findings

The results showed that the impact resistance of RCR increases with an increase in both CR and NS addition, though for CR above 20 per cent, sudden drop in impact resistance was observed. However, NS reduces the ductility of RCR by decreasing the post-cracking impact resistance. Response surface methodology was used to develop models for predicting the impact resistance of RCR, and the developed models showed a high degree of correlation. As a result of wide variations in the impact drop test data, two-parameter Weibull distribution function was used for the data analysis, and it was found that the probabilistic distributions of the first crack and ultimate failure impact resistance follow the two-parameter Weibull distribution function.

Originality/value

In this work, the effect of partial replacement of fine aggregate with CR and the addition of NS by weight of cementitious materials on the impact resistance of RCC pavement has been investigated. CR has been used to increase the impact resistance of RCC Pavement.
Favorable response to apremilast in a patient with refractory psoriasis verrucosa
Authors: Okazaki Sari , Osawa Risa , Nakajima Hideki , Nakajima Kimiko , Sano Shigetoshi
Published: April 2019

A 67‐year‐old man, who had been diagnosed with psoriasis 30 years prior, visited our hospital with a complaint of verrucous nodules in the lower legs, which had developed 15 years previously. We diagnosed him as having psoriasis verrucosa of the legs and plaque psoriasis of the torso. Because the lesions were resistant to topical glucocorticoids and vitamin D3, a verrucous lesion in the right leg was treated with surgical ablation, which resulted in the development of generalized pustular psoriasis. After pustular lesions were cleared by systemic glucocorticoids and methotrexate, we treated him with etretinate and cyclosporin, but the verrucous lesions accompanied by chronic bacterial infection persisted over time. One year ago, treatment with recently‐approved apremilast was started. It immediately attenuated the plaques and erythropapular lesions of the trunk. Surprisingly, the verrucous nodules of both legs showed reduction in size in 2 months.
Swift declines predicted following mating system changes driven by an introduced predator
Authors: Wright Timothy F.
Published: April 2019

In Focus: Heinsohn, R., Olah, G., Webb, M., Peakall, R., & Stojanovic, D. (2019). . Journal of Animal Ecology, 88, 502–510.

While the effects of variation in the sex ratio of offspring have been thoroughly explored over the last century, the sex ratio of adults has received far less attention. A paper by Heinsohn and colleagues in this issue shows that changes in the adult sex ratio can have striking effects on mating systems, reproductive success and population viability. These impacts are all the more dramatic because they occur in a critically endangered species, the swift parrot, Lathamus discolor, of Tasmania. This species suffers heavy predation from the introduced sugar glider, Petaurus breviceps, which kills nesting females and their clutches, resulting in strongly male‐biased adult sex ratios. The authors combined demographic and genetic data to show that, at sites with heavier predation, the remaining females were more likely to mate with multiple males. This shift in the mating system also led to lower overall nesting success, with fewer chicks fledged per nest at sites with higher levels of mixed paternity. Population viability models based on these data predicted steep population declines, with models using the highest observed rates of mixed paternity showing the sharpest declines. These results demonstrate that changes in the adult sex ratio can have far‐reaching impacts, including on the fitness of populations themselves.
Nitrogen addition reduced ecosystem stability regardless of its impacts on plant diversity
Authors: Liu Jushan , Li Xiaofei , Ma Quanhui , Zhang Xiang , Chen Ying , Isbell Forest , Wang Deli
Published: April 2019

Global environmental changes are altering ecosystem stability, sometimes by altering biodiversity. For example, by driving grassland plant species loss, nitrogen (N) addition can reduce ecosystem stability. In other cases, however, N addition may alter productivity and ecosystem stability, by increasing the dominance of particularly productive or stable species.

We examined how N addition affected plant diversity, productivity and the temporal stability of productivity in an 8‐year grassland experiment. We found that N addition enhanced productivity and decreased ecosystem stability throughout the experimental period, even though it reduced species richness in the first 4 years, but increased richness during the subsequent years.

During the early years, N addition decreased ecosystem stability by synchronizing species fluctuations and population stability of the dominant species. During later years, N addition did not increase stability, even though it increased species richness; instead, N addition continued to decrease ecosystem stability by decreasing species dominance and stability of the dominant species, without changing the identity of the dominant species.

Synthesis. Our results indicate that N addition decreased ecosystem stability via mechanisms that were both dependent and independent of plant diversity, and that the mechanisms involved shifted over time. N addition impacted on ecosystem functioning through species richness and the effects on species dominance and the stability of most dominant species, highlighting the join effect of multiple biotic drivers in regulating ecosystem stability.
The power of suggestion: examining the impact of presence or absence of shared first language in the antenatal clinic
Authors: Pilnick Alison , Zayts Olga
Published: April 2019

Healthcare encounters involving participants from diverse linguistic backgrounds are becoming more common due to the globalisation of health care and increasing migration levels. Research suggests that this diversity has a significant impact on health outcomes; however less is known about how it is managed in the actual consultation process. This article presents an analysis of antenatal screening consultations video recorded in Hong Kong, using conversation analysis. We consider how the use of a second or subsequent language impacts on these consultations, and on discussions and decisions about further action. The presence or absence of shared first language did not appear to affect the extent to which particular courses of action were promoted or recommended. Recommendations were a common occurrence across consultations with and without shared first language. However, we argue that the routine use of recommendations can be consequential, as second language speakers may have more limited resources to interrogate or contest these. This finding has implications for the ability for professionals to maximise patient involvement in decision‐making.
Does union membership reduce gender earnings differentials? Evidence from employer–employee matched data in China
Authors: Liu Jing , Xing Chunbing , Ge Yuhao
Published: April 2019

This paper examines whether union membership reduces gender earnings differentials in the Chinese labour market using an employer–employee matched data set. We have three main findings. First, union membership helps reduce the gender differentials in hourly wage and monthly allowance, but not in monthly basic wage and yearly bonus. Second, ensuring that female workers receive overtime pay is one way by which union membership helps reduce the gender earnings differentials. Third, controlling for firm fixed effects reduces the effect of union membership on the gender gap in hourly wage and monthly allowance, which means that the unobserved firm characteristics might impact the effect of union membership on gender earnings differentials.
Health economic analysis of a cluster‐randomised trial (OptiBIRTH) designed to increase rates of vaginal birth after caesarean section
Authors: Fobelets M , Beeckman K , Healy P , Grylka‐Baeschlin S , Nicoletti J , Devane D , Gross MM , Morano S , Daly D , Begley C , Putman K
Published: April 2019

Objective

To perform a health economic analysis of an intervention designed to increase rates of vaginal birth after caesarean, compared with usual care.

Design

Economic analysis alongside the cluster‐randomised OptiBIRTH trial (Optimising childbirth by increasing vaginal birth after caesarean section (VBAC) through enhanced women‐centred care).

Setting

Fifteen maternity units in three European countries – Germany (five), Ireland (five), and Italy (five) – with relatively low VBAC rates.

Population

Pregnant women with a history of one previous lower‐segment caesarean section; sites were randomised (3:2) to intervention or control.

Methods

A cost–utility analysis from both societal and health‐services perspectives, using a decision tree.

Main outcome measures

Costs and resource use per woman and infant were compared between the control and intervention group by country, from pregnancy recognition until 3 months postpartum. Based on the caesarean section rates, and maternal and neonatal morbidities and mortality, the incremental cost–utility ratios were calculated per country.

Results

The mean difference in costs per quality‐adjusted life years (QALYs) gained from a societal perspective between the intervention and the control group, using a probabilistic sensitivity analysis, was: €263 (95% CI €258–268) and 0.008 QALYs (95% CI 0.008–0.009 QALYs) for Germany, €456 (95% CI €448–464) and 0.052 QALYs (95% CI 0.051–0.053 QALYs) for Ireland, and €1174 (95% CI €1170–1178) and 0.006 QALYs (95% CI 0.005–0.007 QALYs) for Italy. The incremental cost–utility ratios were €33,741/QALY for Germany, €8785/QALY for Ireland, and €214,318/QALY for Italy, with a 51% probability of being cost‐effective for Germany, 92% for Ireland, and 15% for Italy.

Conclusion

The OptiBIRTH intervention was likely to be cost‐effective in Ireland and Germany.

Tweetable abstract

The OptiBIRTH intervention (to increase VBAC rates) is likely to be cost‐effective in Germany and Ireland.
Tailored interventions by community pharmacists and general practitioners improve adherence to statins in a Spanish randomized controlled trial
Authors: Oñatibia‐Astibia Ainhoa , Malet‐Larrea Amaia , Larrañaga Belen , Gastelurrutia Miguel Ángel , Calvo Begoña , Ramírez Dulce , Cantero Ignacio , Garay Ángel , Goyenechea Estibaliz
Published: April 2019

Objective

To evaluate the impact of health professionals’ intervention on adherence to statins, the influence on total cholesterol levels, and lifestyle patterns in patients with hypercholesterolemia and analyze the differences according to the center of recruitment.

Study Setting

Forty‐six community pharmacies and 50 primary care centers of Spain.

Study Design

Randomized controlled trial design (n = 746). Patients were assigned into adherent (ADH) or nonadherent group depending on their initial adherence to statins. Nonadherent patients were randomly assigned to intervention (INT) or nonintervention (NOINT) group. Patients enrolled in the INT group received an intervention depending on the cause of nonadherence. Patients in the ADH and NOINT groups received usual care. Intention‐to‐treat (ITT) analysis was performed with multiple imputation to replace the missing data.

Data Collection

Adherence, total cholesterol levels, and lifestyle behaviors.

Findings

The odds of becoming adherent during the 6 months was higher in the INT group compared to the NOINT group (OR = 1,49; 95% CI: 1.30‐1.76; P < 0.001), especially in the community pharmacy group (OR = 2.34; 95% CI: 1.81‐3.03; P < 0.001). Adherent patients showed lower values of total cholesterol compared with nonadherent patients at baseline (ADH: 200.3 mg/dL vs NOADH: 216.7 mg/dL; P < 0.001) and at the endpoint (ADH: 197.3 mg/dL vs NOADH: 212.2 mg/dL; P < 0.001). More patients enrolled in the INT group practices exercise at the end of the study (INT: +26.6 percent; P = 0.002), and a greater number of patients followed a diet to treat hypercholesterolemia (+30.2 percent; P < 0.001).

Conclusions

The intervention performed by health professionals, especially by community pharmacists, improved adherence to statins by hypercholesterolemic patients, and this improvement in adherence was accompanied by a reduction in total cholesterol levels and a healthier lifestyle.
Distribution and Characteristics of Polyphenoloxidase from Pacific White Shrimp (Litopenaeus vannamei)
Authors: Sae‐Leaw Thanasak , Benjakul Soottawat
Published: April 2019

Distribution of polyphenoloxidase (PPO) from different anatomical parts of Pacific white shrimp was examined. Among all parts, cephalothorax possessed the maximal PPO activity (P < 0.05), followed by pereopods, telson, pleopods, carapace, cuticle, and muscle, respectively. The higher PPO activity in cephalothorax was in line with the greater melanosis in this part during chilled storage. According to activity‐staining toward 3,4‐dihydroxy‐ʟ‐phenylalanine (ʟ‐DOPA), PPO exhibited an activity band with a molecular weight (MW) of 210 kDa. When cephalothorax PPO was purified using ammonium sulfate precipitation and a series of chromatographic techniques, involving DEAE–Sepharose anion exchange and Sephadex G‐75 gel filtration columns, homogeneity was obtained. Based on sodium dodecyl sulfate–polyacrylamide gel electrophoresis (SDS–PAGE) and native‐PAGE, the Sephadex G‐75 fraction showed a single band. The MW band on SDS–PAGE and gel filtration was estimated as 210 kDa, suggesting a monomeric molecule. For the inhibitor study, cysteine and 4‐hexylresorcinol showed competitive inhibition toward PPO, while epigallocatechin gallate and kojic acid demonstrated mixed‐type inhibition toward PPO.

Practical Application

Melanosis (black spot formation) triggered by polyphenoloxidase (PPO) drastically reduces the shelf‐life of shrimp. PPO was localized in several anatomical parts of Pacific white shrimp with varying activities. Certain compounds, including cysteine, 4‐hexylresorcinol, epigallocatechin gallate, and kojic acid, showed PPO inhibitory activity with different modes of inhibition. The obtained information provided a promising method for manufacturers to keep the prime eating quality of Pacific white shrimp throughout postmortem transportation and storage using selected PPO inhibitors.
A Multi‐Scale Soil Moisture Monitoring Strategy for California: Design and Validation
Authors: Curtis Jennifer A. , Flint Lorraine E. , Stern Michelle A.
Published: April 2019

A multi‐scale soil moisture monitoring strategy for California was designed to inform water resource management. The proposed workflow classifies soil moisture response units (SMRUs) using publicly available datasets that represent soil, vegetation, climate, and hydrology variables, which control soil water storage. The SMRUs were classified, using principal component analysis and unsupervised K‐means clustering within a geographic information system, and validated, using summary statistics derived from measured soil moisture time series. Validation stations, located in the Sierra Nevada, include transect of sites that cross the rain‐to‐snow transition and a cluster of sites located at similar elevations in a snow‐dominated watershed. The SMRUs capture unique responses to varying climate conditions characterized by statistical measures of central tendency, dispersion, and extremes. A topographic position index and landform classification is the final step in the workflow to guide the optimal placement of soil moisture sensors at the local‐scale. The proposed workflow is highly flexible and can be implemented over a range of spatial scales and input datasets can be customized. Our approach captures a range of soil moisture responses to climate across California and can be used to design and optimize soil moisture monitoring strategies to support runoff forecasts for water supply management or to assess landscape conditions for forest and rangeland management.
Association between PTPN22‐1123G/C and susceptibility to rheumatoid arthritis: A systematic review and meta‐analysis
Authors: Wu Xuangao , Yang Hye Jeong , Jung Kim Min , Zhang Ting , Qiu Jing Yi , Park Sunmin
Published: April 2019

Background

The incidence of rheumatoid arthritis (RA) varies greatly among different ethnic groups, suggesting genetic susceptibility. The several genetic variants of protein tyrosine phosphatase, non‐receptor type 22 (PTPN22‐1123G/C, rs2488457) have been widely examined. We systematically evaluated the association of PTPN22‐1123 and RA risk by pooling the related studies conducted in different races.

Methods

Literature was searched using PubMed, EMBASE, Cochrane Library, Korean scientific database, Chinese medical databases, and the Indian medical database to identify eligible studies for determining the association of PTPN22‐1123 and RA risk. The association was assessed in five genetic random effects models including the allelic (AG), recessive (RG), dominant (DG), homozygous (HMG), and heterozygous (HTG) genetic models. Subgroup analyses stratified by ethnicity (Asians and non‐Asians) were assessed.

Results

A total of 10 articles were selected that met the criteria including Hardy‐Weinberg equilibrium. Subjects included 14 186 healthy controls and 5735 with RA. The AG, RG, DG, and HMG genetic models showed no heterogeneity, but the HTG model showed heterogeneity. AG and RG did not exhibit publication bias in any of the studies including Asian and non‐Asian subgroups. The overall effect of PTPN22‐1123 on RA risk in all genetic random models showed significant positive associations (AG: odds ratio [OR]: 1.24; CI: 1.08‐1.42; P = 0.002; RG: OR: 1.35; CI: 1.15‐1.59; P = 0.0003; DG: OR: 1.42; CI: 1.09‐1.85; P = 0.009; HMG: OR: 1.69; CI: 1.22‐2.34; P = 0.002). A significant association when pooling the studies was only revealed in non‐Asians (P < 0.05), but no significant relationship was shown in Asians.

Conclusions

People with C allele in PTPN22‐1123 increased the risk of RA only in non‐Asians.
Nomogram to predict thymoma prognosis: A population‐based study of 1312 cases
Authors: Zhao Mengnan , Yin Jiacheng , Yang Xiaodong , Jiang Tian , Lu Tao , Huang Yiwei , Li Ming , Yang Xinyu , Lin Miao , Niu Hao , Zhan Cheng , Feng Mingxiang , Wang Qun
Published: April 2019

Background

A thymoma is a common cancer within the anterior mediastinum; however, the prognostic characteristics have not been established. The aim of this study was to identify the prognostic factors and develop a nomogram for the prognostic prediction of patients with thymoma based on data from the Surveillance, Epidemiology, and End Results (SEER) database.

Methods

Patients with thymomas diagnosed between 1983 and 2014 were selected. Overall survival (OS) was estimated using the Kaplan–Meier method with the log‐rank test. Univariate and multivariate Cox proportional hazards regression analyses were performed to identify the independent prognostic factors, from which a nomogram for thymomas was created. External validation of the nomogram was performed using data from our center.

Results

A total of 1312 patients with thymomas were enrolled. Age, tumor size, Masaoka–Koga stage, chemotherapy administered, and surgery type were independent prognostic factors for OS. A nomogram for OS was formulated based on the independent prognostic factors and validated using an internal bootstrap resampling approach, which showed that the nomogram exhibited a sufficient level of discrimination according to the C‐index in training (0.713, 95% confidence interval 0.685–0.741) and (0.746, 95% confidence interval 0.625–0.867) validation cohorts.

Conclusion

Several prognostic factors for thymomas were identified. The nomogram developed in this study accurately predicted the 5‐year and 10‐year OS rates of patients with thymomas based on individual characteristics. Risk stratification using the survival nomogram could optimize individual therapy and follow‐up.
Causal analysis in control–impact ecological studies with observational data
Authors: Larsen Ashley E. , Meng Kyle , Kendall Bruce E.
Published: April 2019

Randomized experiments have long been the gold standard in determining causal effects in ecological control–impact studies. However, it may be difficult to address many ecologically and policy‐relevant control–impact questions‐such as the effect of forest fragmentation or protected areas on biodiversity through experimental manipulation due to scale, costs and ethical considerations. Yet, ecologists may still draw causal insights in observational control–impact settings by exploiting research designs that approximate the experimental ideal.

Here, we review the challenges of making causal inference in non‐experimental control–impact scenarios as well as a suite of statistical tools specifically designed to overcome such challenges. These tools are widely used in fields where experimental research is more limited (i.e., medicine, economics), and could be applied by ecologists across numerous sub‐disciplines.

Using hypothetical examples, we discuss why bias is likely to plague observational control–impact studies in ways that do not surface with experimental manipulations, why bias is generally the barrier to causal inference, and different methods to overcome this bias.

Satellite‐, survey‐ and citizen–science data hold great potential for advancing key questions in ecology that would otherwise be prohibitive to pursue experimentally. However, to harness such data to understand causal impacts of land, environmental and policy changes, we must expand our toolset such that we can improve inference and more confidently advance ecological understanding and science‐informed policy.
Prospective longitudinal comparison study of surgical therapies for peri‐implantitis: 3‐year follow‐up
Authors: Dalago HR , Perrotti V , Torres de Freitas SF , Ferreira CF , Piattelli A , Iaculli F , Bianchini MA
Published: April 2019

Background

The aim of this study was to compare different surgical therapies to treat peri‐implantitis.

Methods

Twenty‐three patients presenting one implant affected by peri‐implantitis were divided into three groups: (i) open flap debridement (OFD) and citric acid decontamination (CAD); (ii) OFD, CAD and subepithelial connective tissue graft (SCTG); (iii) OFD, CAD and implantoplasty. Modified plaque index (MPI), gingival bleeding index (GBI), keratinized mucosa (KM) width, probing depth (PD), bleeding or suppuration on probing (B/SOP), and radiographic crestal bone level were registered 1(T1), 2(T2) and 3(T3) years after treatment.

Results

In Group 1 there was a significant improvement in MPI from baseline to T1, and a significant reduction in PD over time. In Group 2, none of the assessed clinical parameters showed any statistically significant variation over time. In Group 3, there was a significant decrease in PD and B/SOP over time. When comparing the 3 Groups, KM was significanlty greater in Group 2 vs. Group 1 and Group 3 at T1 and T2, and in Group 2 vs. Group 3 at T3.

Conclusion

All therapies were successful in the management of peri‐implantitis; however, SCTG maintained the greatest KM width. Surgical therapies combined with mechanical and chemical decontamination contributed to peri‐implant tissue health.
Behavioural response of green peach aphid Myzus persicae (Sulzer) to volatiles from different rosemary (Rosmarinus officinalis L.) clones
Authors: Dardouri Tarek , Gomez Laurent , Schoeny Alexandra , Costagliola Guy , Gautier Hélène
Published: April 2019

Previous studies have shown that rosemary (Rosmarinus officinalis L.) can serve as a companion plant to control Myzus persicae (Sulzer) because of the repellent effect of certain volatile organic compounds (VOCs) that it emits. In the present study, we investigated which of five clones of rosemary may reveal a repellent effect on M. persicae and aimed to determine the possible VOCs involved.

Analyses of the mixtures of VOCs released by the different clones revealed the presence of 15 main components. However, each clone was characterized by a specific volatile profile showing the existence of marked chemical variability.

By testing the identified VOCs individually, using a dual‐choice olfactometer, we observed that five volatiles had a significant repulsive effect on M. persicae: bornyl acetate, camphor, α‐terpineol, terpinene‐4‐ol and geranyl acetone. In addition, only one clone of rosemary elicited a significant repulsive action.

Nevertheless, all of the tested clones released compounds that are repellent to the aphid when tested individually. Therefore, the emission of individual volatiles by a rosemary plant is not sufficient to elicit a repellent effect.

The concentration, proportion and even the association/synergy of VOCs in the released olfactory bouquets can probably explain these contrasting results and are worthy of additional exploration in future studies.
Assessing the correlation between trichoscopic features in lichen planopilaris and lichen planopilaris activity index
Authors: Lajevardi Vahide , Mahmoudi Hamidreza , Moghanlou Samane , Ansari Mahsa , Teimourpour Amir , Daneshpazhooh Maryam
Published: April 2019

Background/Objectives

Videodermoscopy is a valuable tool for the diagnosis of cicatricial alopecias such as lichen planopilaris. Lichen planopilaris activity index is used for evaluating lichen planopilaris severity. Our aim was to examine the utility of videodermoscopy in the assessment of lichen planopilaris severity.

Methods

One hundred and seventeen histopathologically confirmed lichen planopilaris patients under went videodermoscopy. Lichen planopilaris activity index was calculated according to cicatricial alopecia standardised flowchart. Differences and correlations between trichoscopic features, clinical findings and lichen planopilaris activity index were calculated.

Results

Most trichoscopic features had statistically significant higher prevalence than similar clinical findings. Targetoid pigment pattern, perifollicular scale and milky‐red areas were significantly correlated with lichen planopilaris activity index (P‐value < 0.05). There was statistically significant correlation between targetoid pigment pattern and positive anagen pull test (P‐value < 0.001).

Conclusion

Using trichoscopic features in calculating lichen planopilaris activity index with videodermoscope can help in early lichen planopilaris diagnosis and improve post‐treatment follow‐up.
Soil and vegetation differences across ecological boundaries in an arid South African ecosystem
Authors: Osman Rua , Masubelele Mmoto , Khomo Lesego , Chimphango Samson B. M.
Published: April 2019

Boundaries are the most reactive nodes in landscapes and may be hypersensitive to global change in climate and land use. Investigations on how soils govern vegetation boundaries are scant, particularly in arid and semiarid ecosystems. The Tankwa Karoo National Park (TKNP) is a unique arid biodiversity hotspot with an unrivalled aridity gradient from < 100 mm MAP to about 700 mm in < 10 km. We investigated the abruptness of four soil‐vegetation boundaries separating eight communities. Two 50 m transects were established across four boundaries for 24 descending point transects, in which the cover‐abundance of each plant encounter at 1 m intervals was recorded. In addition, three soil samples were collected from the top 5 cm in each of the four boundaries and twelve patches. Soil and vegetation parameters altogether indicated three boundary syndromes that were context dependent: (a) a sharp boundary, (b) a gradual boundary or (c) no boundary exists. Soil respiration recorded here, and perhaps other ecosystem processes, was mediated by the soil‐vegetation boundaries. These nodes should be the focus of ecological studies since they reveal much more than the constituent patches themselves.
Does fentanyl epidural analgesia affect breastfeeding: A prospective cohort study
Authors: Mahomed Kassam , Wild Kellie , Brown Consuela , Green Ann
Published: April 2019

Background

Concerns have been expressed in relation to a possible negative effect of fentanyl epidural analgesia on breastfeeding rates. A 2016 systematic review was inconclusive and suggested cohort studies be performed with control groups to allow for other potential confounding factors.

Aims

To assess the effect of fentanyl epidural analgesia in labour on breastfeeding practices.

Material and Methods

A prospective cohort study, conducted at a metropolitan hospital, Ipswich, Queensland. Eligible women were first‐time mothers, wishing to breastfeed after a vaginal birth at term. Women who had fentanyl epidural only (107) were compared with women who had subcutaneous morphine only (90), and women who had neither subcutaneous morphine nor epidural (107).

Results

Fewer women in the fentanyl epidural analgesia group were fully breastfeeding when leaving hospital (54.2% compared to 69.2% in the no analgesia group and 77.8% in the subcutaneous morphine group; P < 0.05). At 6 weeks postpartum, there was no evidence of difference between the groups (43% for fentanyl epidural analgesia, 52.3% for no analgesia group and 48.9% for subcutaneous morphine group; P = 0.63). Rates of induction of labour, instrumental birth and admission to special care nursery differed significantly between groups and when controlled for these, there was no association between fentanyl epidural analgesia and breastfeeding at discharge (adjusted odds ratio (OR) 0.74; 95% CI 0.39–1.41) or at 6 weeks postpartum (OR 0.75; 95% CI 0.41–1.38).

Conclusion

Our study did not find an association between fentanyl epidural analgesia in labour and rates of fully breastfeeding at discharge and at 6 weeks postpartum.
Development, implementation and evaluation of an advanced practice in continence and women's health physiotherapy model of care
Authors: Brennen Robyn , Sherburn Margaret , Rosamilia Anna
Published: April 2019

Background

With public health facing workforce shortages, increasing costs and increasing demands, innovative patient pathways are vital to meet patient needs. Advanced practice physiotherapy roles are well established in emergency departments and musculoskeletal/orthopaedic services and have begun to emerge in other clinical areas.

Aims

In 2014, the Royal Women's Hospital, Monash Health and Barwon Health received a Victorian Department of Health and Human Services (DHHS) Workforce Innovation grant to develop and implement an advanced practice in continence and women's health physiotherapy assessment model of care.

Material and Methods

A new model of care was developed with an advanced practice physiotherapy‐led assessment clinic integrated into the triage and assessment process of gynaecology, urogynaecology and urology clinics in major public health centres. A clinical competency and credentialing pathway and toolkit were developed to support training and development of advanced practice skills for senior physiotherapists in this clinical area. The initial assessment of the new model of care was undertaken by DHHS and Price‐Waterhouse Coopers, including access to care, cost of assessment and safety.

Results

An advanced practice continence and women's health physiotherapy assessment clinic was implemented safely and contributed to improved access to care as assessed by reduced waiting lists and waiting times for assessment, with high levels of patient satisfaction and no adverse events.

Conclusion

Advanced practice continence and women's health physiotherapy clinics can contribute to streamlined, cost‐efficient triage and assessment processes for patients with urological or gynaecological issues attending tertiary medical clinics.
Decreased total psoas muscle area after neoadjuvant therapy is a predictor of increased mortality in patients undergoing oesophageal cancer resection
Authors: Yassaie Shahed S. , Keane Celia , French Stephen J. H. , Al‐Herz Fadhel A. J. , Young Michael K. , Gordon Alexandra C.
Published: April 2019

Background

Oesophagectomy for locally advanced cancer carries high rates of morbidity and mortality. Patients require a thorough risk assessment alongside preoperative counselling. Total psoas area (TPA) measurements have been used as a surrogate marker of sarcopenia to predict post‐operative complications in oesophageal cancer patients. No studies to date have determined whether there is an association between the proportion of TPA lost during neoadjuvant therapy and post‐operative outcomes.

Methods

Clinical data and imaging of patients who underwent neoadjuvant therapy followed by open two‐stage oesophagectomy between January 2008 and April 2018 were analysed retrospectively. Patients who did not undergo restaging computed tomography scan prior to surgery were excluded from the study. The TPA was measured on two cross‐sectional slices at L4 on computed tomography scans pre‐ and post‐neoadjuvant therapy.

Results

A total of 53 patients who met inclusion criteria were identified. The mean loss of TPA was 7.3%. Patients who had a decrease of TPA of more than 4% had significantly increased 30‐day mortality compared to those who lost 4% or less (24% versus 0%, P = 0.02). Patients aged over 65 years who also had a loss of TPA >4% had significantly increased 30‐day mortality (37% versus 2.9%, odds ratio 19, P = 0.008).

Conclusion

A decrease in TPA of >4% is associated with a significantly higher risk of post‐operative mortality in patients undergoing neoadjuvant therapy followed by oesophagectomy. Measuring the loss of TPA during neoadjuvant treatment could be a novel aid to preoperative risk assessment.
Adverse impact of malnutrition markers on major abdominopelvic cancer surgery
Authors: Sathianathen Niranjan J. , Kwaan Mary , Lawrentschuk Nathan , Weight Christopher J. , Kim Simon P. , Murphy Declan G. , Moon Daniel A. , Konety Badrinath R.
Published: April 2019

Background

Malnutrition has been associated with adverse postoperative outcomes in a range of procedures but none have evaluated the interaction between clinical indicators of malnutrition. We aimed to comparatively evaluate how combinations of nutritional parameters impact postoperative outcomes amongst patients undergoing major cancer operations.

Methods

Major abdominopelvic cancer surgery cases (colectomy, cystectomy, esophagectomy, gastrectomy, hysterectomy, nephrectomy, pancreatectomy, pneumonectomy and prostatectomy) were identified in the American College of Surgeons National Surgical Quality Improvement Program database from 2007–2016. Malnutrition was defined by the presence of the following parameters: body mass index <18.5 kg/m2; preoperative serum albumin <3.0 g/dL or more than 10% weight loss in the last 6 months. Malnourished cases were matched with cases with satisfactory nutritional status using propensity scores. The primary outcome was the incidence of Clavien III–IV complications.

Results

Of the 30 207 cases included, 8.5% had at least one marker of malnutrition. The incidence of Clavien III–IV complications across all cases was 5.8%. In the matched cohort, malnourished cases had a higher rate of complications than those with adequate nutritional status (11.3% versus 9.6%, P = 0.018). A correlation was observed between the number of malnutrition markers possessed and the incidence of Clavien III–V complications. Cases with all three makers had the highest likelihood of experiencing a complication (odds ratio 5.47, 95% confidence interval 1.85–16.17).

Conclusion

Poor nutritional status confers an increased risk of major postoperative complications and being discharged to a facility in non‐upper gastrointestinal cancer patients. There was a correlation between the number of malnutrition parameters and the risk of complications.
Anti‐fibrotic mechanisms of angiotensin AT2‐receptor stimulation
Authors: Sumners Colin , Peluso Antonio Augusto , Haugaard Andreas Houe , Bertelsen Jesper Bork , Steckelings Ulrike Muscha
Published: April 2019

The angiotensin AT2‐receptor is a main receptor of the protective arm of the renin‐angiotensin system. Understanding of this unconventional G‐protein coupled receptor has significantly advanced during the past decade, largely because of the availability of a selective non‐peptide AT2‐receptor agonist, which allowed the conduct of a multitude of studies in animal disease models. This article reviews such preclinical studies that in their entirety provide strong evidence for an anti‐fibrotic effect mediated by activation of the AT2‐receptor. Prevention of the development of fibrosis by AT2‐receptor stimulation has been demonstrated in lungs, heart, blood vessels, kidney, pancreas and skin. In lungs, AT2‐receptor stimulation was even able to reverse existing fibrosis. The article further discusses intracellular signalling mechanisms mediating the AT2‐receptor‐coupled anti‐fibrotic effect, including activation of phosphatases and subsequent interference with pro‐fibrotic signalling pathways, induction of matrix‐metalloproteinases and hetero‐dimerization with the AT1‐receptor, the TGF‐βRII‐receptor or the RXFP1‐receptor for relaxin. Knowledge of the anti‐fibrotic effects of the AT2‐receptor is of particular relevance because drugs targeting this receptor have entered clinical development for indications involving fibrotic diseases.
“Which door should I go through?” (In)visible intersections of race and disability in the academy
Authors: Bhakta Amita
Published: April 2019

Institutional inclusivity and diversity have been an increasing focus of debate within the academy. For the discipline of geography and universities more broadly to become fully inclusive, greater attention is warranted within these debates on the intersection of race and disability. An existing lack of discussion on relations between race and disability in the academy draws attention to the invisibility of disabled academics of black and minority ethnic backgrounds. Drawing on examples of spaces of (mis)recognition and of indifference inside and outside the space of the British academy, this paper calls for greater attentiveness in geography and beyond to the socio‐cultural and spatial issues faced by ethnic minority disabled members of the university community that are otherwise hidden. A focus on these hidden issues in research agendas, institutional practices, and the academy more broadly is warranted to enable the university to strive towards greater inclusivity.
Child Protection in Voluntary Sports Clubs in Germany — Factors Fostering Engagement in the Prevention of Sexual Violence
Authors: Rulofs Bettina , Feiler Svenja , Rossi Lea , Hartmann‐Tews Ilse , Breuer Christoph
Published: April 2019

Based on the theoretical framework of organisational capacity and using data from an online survey of 8571 sports clubs in Germany, this study investigates clubs’ engagement towards child protection and the prevention of sexual violence. Only half of the clubs indicate that the prevention of sexual violence is a relevant topic for them, and on average, the clubs have implemented between two and three prevention measures. Pertaining to organisational capacity, human resource capacity (e.g. share of volunteers, share of women on the board) and structural capacity (e.g. club culture) exhibit significant effects on clubs’ activation towards child protection.
‘Occupation Children’ in Germany after World War II — Problems and Coping Strategies
Authors: Kleinau Elke , Schmid Rafaela
Published: April 2019

The article focuses on the autobiographical memories of people born in Germany after the Second World War, whose mothers were local women and whose fathers were members of the allied forces. Based on the analysis of narrative interviews, we ask how these people experienced their growing up and their sociocultural environment in the post‐war era, and what kind of coping strategies they developed to deal with adverse living conditions.
Influence of subsidies and promotional strategies on outcomes in a beneficiary‐based commercial weight‐loss programme
Authors: Gudzune Kimberly A. , Alexander Eleanore , Tseng Eva , Durkin Nowella , Jerome Gerald J. , Dalcin Arlene , Appel Lawrence J. , Clark Jeanne M.
Published: April 2019

To determine whether initial engagement, continued participation, and weight loss vary by subsidy and promotional strategies in a beneficiary‐based, commercial weight‐loss programme. We conducted a retrospective analysis of data from 2013 to 2016. Our dependent variables included initial engagement (≥1 calls; ≥2 weights), coach calls and weight change. Our independent variables were subsidy strategy (total subsidy (n = 9) vs cost sharing (n = 3)) and combination of promotional‐subsidy strategies (mixed campaign + total subsidy (n = 6) vs mass media + total subsidy (n = 3)). We used logistic and linear regression analyses adjusted for beneficiary factors and clustering by organization. From 12 participating organizations, 26 068 beneficiaries registered of which 6215 initially engaged. Cost sharing was associated with significantly greater initial engagement as compared to total subsidy (OR 3.73, P < 0.001); however, no significant between‐group differences existed in calls or weight change. Mass media + total subsidy group had significantly greater calls and weight loss at 12 months compared to mixed campaign + total subsidy (−2.6% vs −1.8%, P = 0.04). Cost sharing may promote greater initial engagement, although does not contribute to better participation or weight loss relative to total subsidy. If organizations elect total subsidy, then pairing this strategy with a mass media campaign may promote greater participation and weight loss among beneficiaries.
Effects of publication bias on conservation planning
Authors: Hickisch R. , Hodgetts T. , Johnson P. J. , Sillero‐Zubiri C. , Tockner K. , Macdonald D.W.
Published: April 2019

Conservation planners need reliable information on spatial patterns of biodiversity. However, existing data sets are skewed because some ecosystems, taxa, and locations are underrepresented. We determined how many articles have been published in recent decades on the biodiversity of different countries and their constituent provinces. We searched the Web of Science catalogues Science Citation Index (SCI) and Social Science Citation Index (SSCI) for biodiversity‐related articles published from 1993 to 2016 that included country and province names. We combined data on research publication frequency with other provincial‐scale factors hypothesized to affect the likelihood of research activity (i.e., economic development, human presence, infrastructure, and remoteness). Areas that appeared understudied relative to the biodiversity expected based on site climate likely have been inaccessible to researchers for reasons, notably armed conflict. Geographic publication bias is of most concern in the most remote areas of sub‐Saharan Africa and South America. Our provincial‐scale model may help compensate for publication biases in conservation planning by revealing the spatial extent of research needs and the low cost of redoing this analysis annually.
Lymphomatoid papulosis type E with a CD56+ immunophenotype presenting with purpura‐like lesions
Authors: Ba Wei , Yin Guang , Yang Jingrun , Zhang Ziyan , Wang Wenjuan , Zhao Zigang , Chen Hongxiao , Li Chengxin
Published: April 2019

Lymphomatoid papulosis (LyP) type E is a recently described variant characterized by the occurrence of large necrotic eschar‐like lesions displaying microscopically angioinvasive and angiodestructive infiltrates of CD30+ lymphocytes, frequently coexpressing CD8. Rare cases of LyP type E with a CD56+ immunophenotype have been described. Herein, we describe a 36‐year‐old woman with LyP type E, characterized by purpura‐like lesions on her left ankle. Initially, she presented with left ankle swelling, petechiae and ecchymosis, and rapidly developing necrotic papules, all of which resolved spontaneously over a period of a few months without intentional therapy. Biopsy revealed CD30 and CD56 positive atypical cell infiltrates with marked angiocentricity and angiodestruction. Awareness of this rare LyP variant and its correct recognition, even if the clinical presentation is unusual, is important to avoid aggressive treatment.