bluuebunny/crossref_metadata_2025 huggingface dataset:
The comparative efficacy and safety of sugammadex and neostigmine in reversing neuromuscular blockade in adults. A Cochrane systematic review with meta‐analysis and trial sequential analysis
Authors: Hristovska A.‐M. , Duch P. , Allingstrup M. , Afshari A.
Published: December 2017

We compared the efficacy and safety of sugammadex and neostigmine in reversing neuromuscular blockade in adults. Our outcomes were: recovery time from second twitch to train‐of‐four ratio > 0.9; recovery time from post‐tetanic count 1–5 to train‐of‐four ratio > 0.9; and risk of composite adverse and serious adverse events. We searched for randomised clinical trials irrespective of publication status and date, blinding status, outcomes reported or language. We included 41 studies with 4206 participants. Time to reversal of neuromuscular blockade from second twitch to a train‐of‐four ratio > 0.9 was 2.0 min with sugammadex 2 mg.kg−1 and 12.9 min with neostigmine 0.05 mg.kg−1, with a mean difference (MD) (95%CI)) of 10.2 (8.5–12.0) (I2 = 84%, 10 studies, n = 835, Grades of Recommendation, Assessment, Development and Evaluation (GRADE): moderate quality). Time to reversal of neuromuscular blockade from a post‐tetanic count of 1–5 to a train‐of‐four ratio > 0.9 was 2.9 min with sugammadex 4 mg.kg−1 and 48.8 min with neostigmine 0.07 mg.kg−1, with a MD (95%CI) of 45.8 (39.4–52.2) (I2 = 0%, 2 studies, n = 114, GRADE: low quality). There were significantly fewer composite adverse events in the sugammadex group compared with neostigmine, with a risk ratio (95%CI) of 0.60 (0.49–0.74) (I2 = 40%, 28 studies, n = 2298, number needed to treat (NNT): 8, GRADE: moderate quality). Specifically, the risk of bradycardia (RR (95%CI) 0.16 (0.07–0.34), n = 1218, NNT: 14, GRADE: moderate quality), postoperative nausea and vomiting (RR (95%CI) 0.52 (0.28–0.97), n = 389, NNT: 16, GRADE: low quality) and overall signs of postoperative residual paralysis (RR (95%CI) 0.40 (0.28–0.57), n = 1474, NNT: 13, GRADE: moderate quality) were all reduced. There was no significant difference regarding the risk of serious adverse events (RR 0.54, 95%CI 0.13–2.25, I2 = 0%, n = 959, GRADE: low quality). Sugammadex reverses neuromuscular blockade more rapidly than neostigmine and is associated with fewer adverse events.
Modification of Aortic Cannula With an Inlet Chamber to Induce Spiral Flow and Improve Outlet Flow
Authors: Darlis Nofrizalidris , Osman Kahar , Padzillah Muhamad Hasbullah , Dillon Jeswant , Md Khudzari Ahmad Zahran
Published: December 2017

Physiologically, blood ejected from the left ventricle in systole exhibited spiral flow characteristics. This spiral flow has been proven to have several advantages such as lateral reduction of directed forces and thrombus formation, while it also appears to be clinically beneficial in suppressing neurological complications. In order to deliver spiral flow characteristics during cardiopulmonary bypass operation, several modifications have been made on an aortic cannula either at the internal or at the outflow tip; these modifications have proven to yield better hemodynamic performances compared to standard cannula. However, there is no modification done at the inlet part of the aortic cannula for inducing spiral flow so far. This study was carried out by attaching a spiral inducer at the inlet of an aortic cannula. Then, the hemodynamic performances of the new cannula were compared with the standard straight tip end‐hole cannula. This is achieved by modeling the cannula and attaching the cannula at a patient‐specific aorta model. Numerical approach was utilized to evaluate the hemodynamic performance, and a water jet impact experiment was used to demonstrate the jet force generated by the cannula. The new spiral flow aortic cannula has shown some improvements by reducing approximately 21% of impinging velocity near to the aortic wall, and more than 58% reduction on total force generated as compared to standard cannula.
Native Bovine and Porcine Pericardia Respond to Load With Additive Recruitment of Collagen Fibers
Authors: Bagno Andrea , Aguiari Paola , Fiorese Michele , Iop Laura , Spina Michele , Gerosa Gino
Published: December 2017

Bovine and porcine pericardia are currently used for manufacturing prosthetic heart valves: their design has become an increasingly important area of investigation in parallel with progressively expanding indications for the transcutaneous approach to heart valves replacement. Before being cut and shaped, pericardial tissues are expected to be properly characterized. Actually, the mechanical assessment of these biomaterials lacks standardized protocols. In particular, the role of preconditioning for achieving a constant mechanical response of tissue samples is still controversial. In the present work, the mechanical response to uniaxial load of native bovine and porcine pericardia, with and without preconditioning was assessed; moreover, the mechanical behavior of pericardia was investigated and explained. It was demonstrated that: (i) pericardial tissue samples hold memory of the loading history but just within the extent of the deformation applied; (ii) the behavior of native bovine and porcine pericardia in response to load is explained by a mechanism based on the additive recruitment of collagen fibers; (iii) the current concept that plasticity is absent in pericardium has to be at least in part reconsidered.
Bacteriological evaluation of composted manure solids prepared from anaerobic digested slurry for hygienic recycled bedding materials for dairy cows
Authors: Okamoto Eiryu , Miyanishi Hiroki , Nakamura Akinobu , Kobayashi Tomoyuki , Kobayashi Norihiko , Terawaki Yoshinori , Nagahata Hajime
Published: December 2017

Changes in mastitis‐causing pathogens, pH and water content in composted manure solids (CMS) prepared from digested slurry were evaluated during turning at 2‐day intervals for 8 days (C1–C4). The numbers of streptococci, coagulase‐negative staphylococci and coliforms were 2.6 × 101, 1.7 × 102 and 1.0 × 101 colony‐forming units (cfu)/g in CMS (C4) (summer), and these counts were markedly lower (P < 0.05) than those in CMS (C0 and C1). The bacterial counts ranged from 101 to 1.7 × 102 cfu/g in CMS (C4) (summer) and were within approved levels, <1 × 106 cfu/g, indicating a minimal mastitis risk. The temperatures in CMS (C1–C4) increased to 63°C–74°C in summer and 67°C–70°C in winter. The mean pH values in CMS (C0–C4) were 9.2 in summer and 8.7 in winter, and water contents ranged from 61.7% to 69.6% in summer and 73.2% to 66.2% in winter. The significant decrease of pathogenic bacteria in CMS appears to be closely related to temperature >63°C for 8 days, pH 8.7–9.2, and water content 62% to 73%. This study demonstrates that prepared CMS has value as a recycled material with the potential to alleviate udder health issues in dairy cows.
From applied ethics to empirical ethics to contextual ethics
Authors: Hoffmaster Barry
Published: December 2017

Bioethics became applied ethics when it was assimilated to moral philosophy. Because deduction is the rationality of moral philosophy, subsuming facts under moral principles to deduce conclusions about what ought to be done became the prescribed reasoning of bioethics, and bioethics became a theory comprised of moral principles. Bioethicists now realize that applied ethics is too abstract and spare to apprehend the specificity, particularity, complexity and contingency of real moral issues. Empirical ethics and contextual ethics are needed to incorporate these features into morality, not just bioethics. The relevant facts and features of problems have to be identified, investigated and framed coherently, and potential resolutions have to be constructed and assessed. Moreover, these tasks are pursued and melded within manifold contexts, for example, families, work and health care systems, as well as societal, economic, legal and political backgrounds and encompassing worldviews. This naturalist orientation and both empirical ethics and contextual ethics require judgment, but how can judgment be rational? Rationality, fortunately, is more expansive than deductive reasoning. Judgment is rational when it emanates from a rational process of deliberation, and a process of deliberation is rational when it uses the resources of non‐formal reason: observation, creative construction, formal and informal reasoning methods and systematic critical assessment. Empirical ethics and contextual ethics recognize that finite, fallible human beings live in complex, dynamic, contingent worlds, and they foster creative, critical deliberation and employ non‐formal reason to make rational moral judgments.
Racial disparity and survival outcomes between African‐American and Caucasian American men with penile cancer
Authors: Ritch Chad R. , Soodana‐Prakash Nachiketh , Pavan Nicola , Balise Raymond R. , Velasquez Maria Camila , Alameddine Mahmoud , Adamu Desmond Y. , Punnen Sanoj , Parekh Dipen J. , Gonzalgo Mark L.
Published: December 2017

Objective

To determine whether there is a survival difference for African‐American men (AAM) versus Caucasian American men (CM) with penile squamous cell carcinoma (pSCC), particularly in locally advanced and metastatic cases where disease mortality is highest.

Patients and Methods

Using the Florida Cancer Data System, we identified men with pSCC from 2005 to 2013. We compared age, follow‐up, stage, race, and treatment type between AAM and CM. We performed Kaplan–Meier analysis for overall survival (OS) between AAM and CM for all stages, and for those with locally advanced and metastatic disease. A multivariable model was developed to determine significant predictors of OS.

Results

In all, 653 men (94 AAM and 559 CM) had pSCC and 198 (30%) had locally advanced and/or metastatic disease. A higher proportion of AAM had locally advanced and/or metastatic disease compared to CM (38 [40%] vs 160 [29%], P = 0.03). The median (interquartile range) follow‐up for the entire cohort was 12.6 (5.4–32.0) months. For all stages, AAM had a significantly lower median OS compared to CM (26 vs 36 months, P = 0.03). For locally advanced and metastatic disease, there was a consistent trend toward disparity in median OS between AAM and CM (17 vs 22 months, P = 0.06). After adjusting for age, stage, grade, and treatment type, AAM with pSCC had a greater likelihood of death compared to CM (hazard ratio 1.64, P = 0.014).

Conclusions

AAM have worse OS compared to CM with pSCC and this may partly be due to advanced stage at presentation. Treatment disparity may also contribute to lessened survival in AAM, but we were unable to demonstrate a significant difference in treatment utilisation between the groups.
The soluble guanylate cyclase stimulator IW‐1973 prevents inflammation and fibrosis in experimental non‐alcoholic steatohepatitis
Authors: Flores‐Costa Roger , Alcaraz‐Quiles José , Titos Esther , López‐Vicario Cristina , Casulleras Mireia , Duran‐Güell Marta , Rius Bibiana , Diaz Alba , Hall Katherine , Shea Courtney , Sarno Renee , Currie Mark , Masferrer Jaime L , Clària Joan
Published: December 2017

Background and Purpose

Non‐alcoholic steatohepatitis (NASH) is the hepatic manifestation of metabolic syndrome and is characterized by steatosis, inflammation and fibrosis. Soluble guanylate cyclase (sGC) stimulation reduces inflammation and fibrosis in experimental models of lung, kidney and heart disease. Here, we tested whether sGC stimulation is also effective in experimental NASH.

Experimental Approach

NASH was induced in mice by feeding a choline‐deficient, l‐amino acid‐defined, high‐fat diet. These mice received either placebo or the sGC stimulator IW‐1973 at two different doses (1 and 3 mg·kg−1·day−1) for 9 weeks. IW‐1973 was also tested in high‐fat diet (HFD)‐induced obese mice. Steatosis, inflammation and fibrosis were assessed by Oil Red O, haematoxylin–eosin, Masson's trichrome, Sirius Red, F4/80 and α‐smooth muscle actin staining. mRNA expression was assessed by quantitative PCR. Levels of IW‐1973, cytokines and cGMP were determined by LC‐MS/MS, Luminex and enzyme immunoassay respectively.

Key Results

Mice with NASH showed reduced cGMP levels and sGC expression, increased steatosis, inflammation, fibrosis, TNF‐α and MCP‐1 levels and up‐regulated collagen types I α1 and α2, MMP2, TGF‐β1 and tissue metallopeptidase inhibitor 1 expression. IW‐1973 restored hepatic cGMP levels and sGC expression resulting in a dose‐dependent reduction of hepatic inflammation and fibrosis. IW‐1973 levels were ≈40‐fold higher in liver tissue than in plasma. IW‐1973 also reduced hepatic steatosis and adipocyte hypertrophy secondary to enhanced autophagy in HFD‐induced obese mice.

Conclusions and Implications

Our data indicate that sGC stimulation prevents hepatic steatosis, inflammation and fibrosis in experimental NASH. These findings warrant further evaluation of IW‐1973 in the clinical setting.
The impact of exercise frequency upon microvascular endothelium function and oxidative stress among patients with coronary artery disease
Authors: Borges Juliana P. , Nascimento Alessandro R. , Lopes Gabriella O. , Medeiros‐Lima Daniel J. M. , Coelho Marina P. , Nascimento Pablo M. C. , Kopiler Daniel A. , Matsuura Cristiane , Mediano Mauro Felippe F. , Tibirica Eduardo
Published: December 2017

Purpose

This study compared the effects of low and high weekly exercise frequencies on microvascular endothelium function and oxidative stress among patients with coronary artery disease.

Methods

Thirty‐four male patients completed a 6‐month cardiac rehabilitation programme, from which 23 performed exercise with a high frequency (HF) and 11 with a low frequency (LF). Systemic microvascular blood flow, maximal aerobic capacity, blood lipids, oxidative stress and anthropometric data were assessed prior to and after the cardiac rehabilitation programme. Microvascular blood flow was assessed in the skin of the forearm using laser speckle contrast imaging coupled with iontophoresis of acetylcholine.

Results

Maximal aerobic capacity, biochemical analysis and anthropometric data were similar between groups prior to and after the cardiac rehabilitation programme (P>0·05). However, after 6 months of cardiac rehabilitation performed with HF, there was an increase in the peak response to acetylcholine compared with LF (83·5 ± 58·5 versus 21·8 ± 22·4%; P<0·05). Changes in lipid peroxidation (HF: −5·5 ± 9·4 versus LF: 2·2 ± 12·0 pmol MDA mg−1; P = 0·19), catalase activity (HF: 0·07 ± 0·17 versus LF: 0·04 ± 0·08 U mg−1; P = 0·74) and nitric oxide levels (HF: 1·8 ± 15·3 versus LF: −3·2 ± 12·3 μM; P = 0·36) were similar between groups after cardiac rehabilitation.

Conclusion

Six months of aerobic exercise training performed with high frequency is preferable to low frequency aiming endothelium microvascular function increases in patients with coronary artery disease. The mechanisms involved in this response are unclear and warrant additional research.
Improving the cytological diagnosis of high‐grade serous carcinoma in ascites with a panel of complementary biomarkers in cell blocks
Authors: Zhang X. , Chen L. , Liu Y. , Xu Y. , Zhang X. , Shi Y. , Wang C. , Zhang P. L. , Liu Y.
Published: December 2017

Introduction

Precise cytological diagnosis of pelvic high‐grade serous carcinoma (HGSC) in ascites is important for tumour staging, therapeutic decision‐making and prognostic evaluation. However, it can often be difficult to distinguish metastatic HGSC cells from reactive mesothelial cells based on morphology alone. Immunocytochemical analysis of ascites cell blocks has been used to obtain accurate diagnosis and provide a reliable basis for treatment decisions in the clinic. This study was performed to determine whether a panel of antibodies is necessary to achieve high specificity and sensitivity for the identification of HGSC cells.

Methods

Ascites samples from 70 cases (70/253, 27.7%) of histologically confirmed HGSC were postoperatively collected from 2012 to 2015 and were immunocytochemically analysed.

Results

The sensitivity and specificity of Ber‐EP4 (a marker of HGSC) for detecting HGSC was 85.7% and 82.1%, respectively, whereas the sensitivity and specificity of HBME‐1 for identifying mesothelial cells was 100% and 68.3%, respectively. To improve the rate of detection further of HGSC, 29 cases of ascites were also stained for E‐cadherin (a marker of HGSC) and calretinin (a marker of mesothelial cells). The combination of Ber‐EP4 and E‐cadherin as markers of adenocarcinoma cells increased the sensitivity and specificity for HGSC detection to 100% and 88.9%, respectively. Meanwhile, the sensitivity and specificity for mesothelial cell identification increased to 100% and 90%, respectively, when HBME‐1 and calretinin were combined.

Conclusion

This panel of complementary biomarkers is valuable and ideal for the differential diagnosis of HGSC based on ascites cytology.
Learning by observation and learning by doing in Down and Williams syndromes
Authors: Foti Francesca , Menghini Deny , Alfieri Paolo , Costanzo Floriana , Mandolesi Laura , Petrosini Laura , Vicari Stefano
Published: December 2017

New skills may be learned by active experience (experiential learning or learning by doing) or by observation of others’ experience (learning by observation). In general, learning by observation reduces the time and the attempts needed to learn complex actions and behaviors. The present research aimed to compare learning by observation and learning by doing in two clinical populations with different etiology of intellectual disability (ID), as individuals with Down syndrome (DS) and individuals with Williams syndrome (WS), with the hypothesis that specific profiles of learning may be found in each syndrome. To this end, we used a mixture of new and existing data to compare the performances of 24 individuals with DS, 24 individuals with WS and 24 typically developing children on computerized tasks of learning by observation or learning by doing. The main result was that the two groups with ID exhibited distinct patterns of learning by observation. Thus, individuals with DS were impaired in reproducing the previously observed visuo‐motor sequence, while they were as efficient as TD children in the experiential learning task. On the other hand, individuals with WS benefited from the observational training while they were severely impaired in detecting the visuo‐motor sequence in the experiential learning task (when presented first). The present findings reinforce the syndrome‐specific hypothesis and the view of ID as a variety of conditions in which some cognitive functions are more disrupted than others because of the differences in genetic profile and brain morphology and functionality. These findings have important implications for clinicians, who should take into account the genetic etiology of ID in developing learning programs for treatment and education.
Beyond the hype? The response to sexual violence in the Democratic Republic of the Congo in 2011 and 2014
Authors: Hilhorst Dorothea , Douma Nynke
Published: December 2017

The Democratic Republic of the Congo (DRC) has witnessed a high prevalence of sexual violence since the wars of the mid‐1990s. The huge response to it commenced around the turn of the century, but turned to ‘hype’ towards 2010. The paper defines ‘hypes’ as phenomena characterised by a media frenzy, eagerness by non‐governmental organisations, and pragmatic local responses. Interviews and analyses conducted in 2011 revealed misuse of services and misrepresentation at different levels. The paper goes on to review medical and legal assistance and to provide evidence of incremental improvements in the response since 2012. It has become better coordinated, with more engagement by the DRC government, more community‐oriented, and has incorporated a broader notion of gender‐based violence. Nonetheless, concern remains about its impact and its continued dependence on international resources. There is apprehension too about social reactions to the problems of corruption and impunity, seemingly adding to the confusion surrounding gender relations in the country.
Resilient patriarchy: public authority and women's (in)security in Karamoja, Uganda
Authors: Hopwood Julian , Porter Holly , Saum Nangiro
Published: December 2017

This paper draws on fieldwork conducted in 2011 and 2016 to explore the differing experiences of Karamojong women following the Government of Uganda's most recent disarmament programme. Besides being deprived of their guns, Karamojong communities have lost most of the cattle on which their livelihoods and way of life were centred. The study assesses whether or not women's experience of patriarchy has changed in these new circumstances, and, if so, how this impacts on their security and control of resources, or the absence of them. It maps, using information primarily supplied by women, public authorities from below, and evaluates if and how they respond to women's protection and survival needs, as well as if current development/humanitarian interventions are of sustainable benefit to Karamojong women. The paper concludes that apparent shifts in gender relations are probably superficial, contingent on continuing food aid, and that economic development and positive social change for women remain elusive.
Relationship between QRS measurements and left ventricular morphology and function in asymptomatic individuals
Authors: Vancheri Federico , Vancheri Sergio , Henein Michael
Published: December 2017

Background and Aim

QRS amplitude and duration are associated with increased left ventricular (LV) volume, mass and dysfunction. However, the diagnostic concordance between QRS measurements and LV morphology and function, as shown by Doppler echocardiography, is not well established. We investigated the relationships of QRS duration and amplitude with echocardiographic measurements of LV morphology and systolic and diastolic function in normal individuals.

Methods

Individuals without signs or symptoms of coronary artery disease or heart failure, who underwent clinical examination as a part of a cross‐sectional survey for the prevalence of coronary risk factors, randomly selected from the population list in Caltanissetta, Italy, were included in the study. QRS duration and amplitude were automatically measured using inbuilt software. LV ejection and filling patterns were studied using Doppler echocardiography.

Results

We studied 184 individuals (96 men and 88 women), mean age 55.9 (11.3). QRS duration increased by 5.4 ms for every 100 g increase in LV mass, and by 4.6 ms for each 10 mm increase in LV end‐diastolic diameter. The amplitude increased by 0.8 mm for every 100 g increase in LV mass. There was no relationship with LV dimensions. A nonlinear correlation was found between QRS amplitude and indexes of global dyssynchrony. The time‐voltage QRS area correlated with LV mass, dimensions and indexes of dyssynchrony. There was no relationship between QRS measurements and ejection fraction.

Conclusions

QRS prolongation and increase in amplitude are strongly influenced by LV increased mass and volume, as well as by dyssynchrony, independently of ejection fraction.
Government size and economic growth in an endogenous growth model with rent‐seeking
Authors: Wadho Waqar , Ayaz Umair
Published: December 2017

We explore the relationship between government size and economic growth in an endogenous growth model with human capital and an unproductive capital which facilitates rent‐seeking. With exogenous as well as endogenous time discounting, we find a non‐monotonic relationship between the size of government and economic growth. We find that with very high (low) discounting, there is a unique low (high) growth equilibrium, regardless of the size of government. For the intermediate range of discounting, there are multiple equilibria and the growth outcome depends on the size of government. With endogenous time discounting, the growth outcome is path dependent and depends on the level of inherited human capital. However, there is only one stable growth regime and the economy endogenously switches to it. When the institutional constraints on rent‐seeking are not extremely high, the stable regime is the one in which there is a high‐growth equilibrium for a smaller size of the government and for larger size, both the high‐growth and the low‐growth equilibrium coexist. When the institutional constraints on rent‐seeking are extremely high, there exists only a unique high‐growth equilibrium irrespective of the size of government. Furthermore, economies with bigger size of the government and/or with poor quality institutions will take longer to endogenously switch to this stable growth regime.
Sleep spindles and slow waves in schizophrenia and related disorders: main findings, challenges and future perspectives
Authors: Castelnovo Anna , Graziano Bianca , Ferrarelli Fabio , D'Agostino Armando
Published: December 2017

Sleep abnormalities have recently gained renewed attention in patients diagnosed with schizophrenia. Disrupted thalamocortical brain oscillations hold promise as putative biomarkers or endophenotypes of the disorder. Despite an increase in studies related to sleep spindle and slow‐wave activity, findings remain in part contradictory. Although sleep spindle deficits have been confirmed in several groups of patients with chronic, medicated schizophrenia, data on the early stages of the disorder and in unmedicated subjects are still insufficient. Findings on slow‐wave abnormalities are largely inconclusive, possibly due to the different criteria employed to define the phenomenon and to the influence of atypical antipsychotics. In this review, we aim to address the methodological and practical issues that may have limited the consistency of findings across research groups and different patient populations. Given the neurobiological relevance of these oscillations, which reflect the integrity of thalamocortical and cortico‐cortical function, research in this domain should be encouraged. To promote widespread consensus over the scientific and clinical implications of these sleep‐related phenomena, we advocate uniform and sound methodological approaches. These should encompass electroencephalographic recording and analysis techniques but also selection criteria and characterization of clinical populations.
Integrating community assembly and biodiversity to better understand ecosystem function: the Community Assembly and the Functioning of Ecosystems (CAFE) approach
Authors: Bannar‐Martin Katherine H. , Kremer Colin T. , Ernest S.K. Morgan , Leibold Mathew A. , Auge Harald , Chase Jonathan , Declerck Steven A.J. , Eisenhauer Nico , Harpole Stanley , Hillebrand Helmut , Isbell Forest , Koffel Thomas , Larsen Stefano , Narwani Anita , Petermann Jana S. , Roscher Christiane , Cabral Juliano Sarmento , Supp Sarah R.
Published: December 2017

The research of a generation of ecologists was catalysed by the recognition that the number and identity of species in communities influences the functioning of ecosystems. The relationship between biodiversity and ecosystem functioning (BEF) is most often examined by controlling species richness and randomising community composition. In natural systems, biodiversity changes are often part of a bigger community assembly dynamic. Therefore, focusing on community assembly and the functioning of ecosystems (CAFE), by integrating both species richness and composition through species gains, losses and changes in abundance, will better reveal how community changes affect ecosystem function. We synthesise theBEFandCAFEperspectives using an ecological application of the Price equation, which partitions the contributions of richness and composition to function. Using empirical examples, we show how theCAFEapproach reveals important contributions of composition to function. These examples show how changes in species richness and composition driven by environmental perturbations can work in concert or antagonistically to influence ecosystem function. Considering how communities change in an integrative fashion, rather than focusing on one axis of community structure at a time, will improve our ability to anticipate and predict changes in ecosystem function.
The idiopathic normal‐pressure hydrocephalus Radscale: a radiological scale for structured evaluation
Authors: Kockum K. , Lilja‐Lund O. , Larsson E.‐M. , Rosell M. , Söderström L. , Virhammar J. , Laurell K.
Published: December 2017

Background and purpose

Despite the important role of imaging in diagnosing idiopathic normal‐pressure hydrocephalus (iNPH), a structured overall assessment of radiological signs is still lacking. The purpose of this study was to construct a radiological scale, composed of morphological signs of iNPH, and compare it with clinical symptoms.

Methods

In this prospective, population‐based study of iNPH, 168 individuals (93 females) [mean age 75 (range 66–92) years] underwent computed tomography of the brain and a neurological examination with assessment of clinical symptoms according to Hellström's iNPH scale. Two radiologists, blinded to clinical data, independently evaluated and measured eight radiological parameters, i.e. Evans’ index, callosal angle, size of temporal horns, narrow high‐convexity sulci, dilated Sylvian fissures, focally dilated sulci, peri‐ventricular hypodensities and bulging of the lateral ventricular roof.

Results

In a linear regression model, all parameters except ventricular roof bulging were significantly associated with clinical iNPH symptoms. The seven remaining parameters were summarized into a total iNPH Radscale score ranging from 0 to 12. There was a significant correlation (r = 0.55, P < 0.001) between the total iNPH Radscale score and clinical symptoms. The inter‐rater agreement for the included radiological parameters was high (intraclass correlation, 0.74–0.97).

Conclusion

The iNPH Radscale may become a valuable diagnostic screening tool, allowing a structured radiological assessment. A high iNPH Radscale score together with clinical symptoms should raise suspicion of iNPH, motivating further evaluation for shunt surgery.
UVA1 impairs the repair of UVB‐induced DNA damage in normal human melanocytes
Authors: Kimeswenger Susanne , Dingelmaier‐Hovorka Ruth , Foedinger Dagmar , Jantschitsch Christian
Published: December 2017

The exact correlation between melanoma and sun‐light is still a controversially debated issue. Although natural sunlight contains various ratios of UVA and UVB, most investigators so far focused on the effects of single solar wavebands and neglected possible interactions. Therefore, in this study primary human melanocytes of three donors were simultaneously exposed to physiologic doses of UVA1 and UVB. Effects on apoptosis were analysed using annexin V assays and cell death ELISAs, and effects on DNA damage were investigated using southwestern slot blots. While UVA1 did not influence UVB‐induced apoptosis, UVA1 impaired the repair of UVB‐induced cyclobutane pyrimidine dimers (CPD) as the amount of CPD was 1.8 times higher in UVA1 + UVB than in UVB only exposed melanocytes six hours after irradiation. We conclude that UVA1 might contribute to melanomagenesis as it partially inhibits the repair of UVB‐induced CPD in human melanocytes while it does not affect UVB‐mediated apoptosis.
Brief Interventions for Couples: An Integrative Review
Authors: Kanter Jeremy B. , Schramm David G.
Published: December 2017

Objective

To review brief couple interventions (BCIs), with a focus on contributions to theory, development, and implications for practice.

Background

For decades, scholars have observed the individual and societal costs of relationship instability. Due to these costs, state and federal agencies have invested millions of dollars in relationship and marriage education programs with the hope of promoting the positive effects associated with healthy relationships. However, the plausibility of many of these interventions has been challenged, suggesting a need for renewed focus on different approaches to promote relationship quality and stability throughout the life course.

Method

We searched numerous databases to review brief interventions used in multiple disciplines. This review resulted in 12 studies ranging from samples of young adults to established couples.

Results

We found several interventions using distinct delivery methods and theoretical frameworks. These interventions targeted numerous individual and relational processes, such as self‐esteem, distress related to conflict, and gratitude that promoted healthy relationship functioning.

Conclusion

We provide evidence that brief interventions influence individual and relational processes by targeting factors relevant to couples across the life course. We ultimately find support for the utility of the vulnerability–stress–adaptation model when developing interventions for couples.

Implications

On the basis of our review, we end with numerous practical suggestions for clinicians to adopt when developing programs to promote healthy relationships.
Experience and Brokerage in Asset Markets: Evidence from Art Auctions
Authors: Bruno Brunella , Garcia‐Appendini Emilia , Nocera Giacomo
Published: December 2017

Focusing on the art market, where auction houses act as brokers between art sellers and buyers, we investigate whether more experienced brokers achieve better performance as information providers and matchmakers. We find that houses with artist‐specific experience are more likely to achieve a sale and provide more precise pre‐sale estimates. These findings suggest that experience in a specific market segment plays an important role for brokers to reduce illiquidity and opacity in markets with asymmetric information. Our analysis also shows that specific experience matters above and beyond other house‐specific factors, including reputation and market power.
Patterns and magnitude of flow alteration in California, USA
Authors: Zimmerman Julie K. H. , Carlisle Daren M. , May Jason T. , Klausmeyer Kirk R. , Grantham Theodore E. , Brown Larry R. , Howard Jeanette K.
Published: December 2017

Quantifying the natural flow regime is essential for management of water resources and conservation of aquatic ecosystems. Understanding the degree to which anthropogenic activities have altered flows is critical for developing effective conservation strategies. Assessing flow alteration requires estimates of flows expected in the absence of human influence and under current land use and water management.

There are several techniques to predict flows in streams and rivers; however, none have been applied to make predictions of natural flow conditions over large regions and time periods. We utilised machine learning statistical models to predict natural monthly flows (natural streamflows without the influence of water management or anthropogenic land use) in California from 1950 to 2015, using time‐dependent and fixed watershed variables from reference stream gages. These models were then used to make estimates of mean, maximum and minimum monthly flows in all streams in the state.

We compared observed flows measured at 540 stream gages across the state with expected natural flows at the same locations, to quantify the type, frequency and magnitude of flow alteration over the past 20 years (1996–2015). A gage was considered altered if an observed flow metric (monthly mean, annual maximum, annual minimum) fell outside the 80% prediction interval of the modelled flow estimate.

We found that 95% of the 540 stream gages in California had at least 1 month of altered flows over the past 20 years, and 11% of gages were frequently altered (over two‐thirds of the months recorded had evidence of altered flows). The type of alteration varied across the state with flows being either depleted, inflated or a mix of both at different times of the year. Most altered gages (68%) exhibited both depletion and inflation in monthly flows over the time period. Inflation of monthly mean flows was most prevalent during the summer months, while depletion of monthly flows was evident throughout the year.

Type, frequency and magnitude of flow alteration varied by region. Flow depletion was present at >80% of gages in the North Coast and Central Coast, flow inflation was measured at >80% of gages in the South Coast and San Francisco Bay and both depletion and inflation were evident at >80% of gages in the Sacramento River and San Joaquin and Tulare regions. Annual maximum flows were consistently depleted and annual minimum flows were commonly inflated in the Sierra Nevada and Central Valley (Sacramento River and San Joaquin and Tulare regions). This is the first study to comprehensively assess flow alteration at stream gages across California. Understanding the patterns and degree of alteration can aid in prioritising streams for environmental flow assessment and developing conservation strategies for native freshwater biota.
A patient decision aid for risk‐reducing surgery in premenopausal BRCA1/2 mutation carriers: Development process and pilot testing
Authors: Harmsen Marline G. , Steenbeek Miranda P. , Hoogerbrugge Nicoline , van Doorn Helena C. , Gaarenstroom Katja N. , Vos M. Caroline , Massuger Leon F.A.G. , de Hullu Joanne A. , Hermens Rosella P.M.G.
Published: December 2017

Background

BRCA1/2 mutation carriers’ choice between risk‐reducing salpingo‐oophorectomy (RRSO) and salpingectomy with delayed oophorectomy is very complex. Aim was to develop a patient decision aid that combines evidence with patient preferences to facilitate decision making.

Design

Systematic development of a patient decision aid in an iterative process of prototype development, alpha testing by patients and clinicians and revisions using International Patient Decision Aid Standards (IPDAS) quality criteria. Information was based on the available literature and current guidelines. A multidisciplinary steering group supervised the process.

Setting and participants

Pre‐menopausal BRCA1/2 mutation carriers choosing between RRSO and salpingectomy with delayed oophorectomy in Family Cancer Clinics in the Netherlands.

Main outcome measures

IPDAS quality criteria, relevance, usability, clarity.

Results

The patient decision aid underwent four rounds of alpha testing and revisions. Finally, two paper decision aids were developed: one for BRCA1 and one for BRCA2. They both contained a general introduction, three chapters and a step‐by‐step plan containing a personal value clarification worksheet. During alpha testing, risk communication and information about premature menopause and hormone therapy were the most revised items. The patient decision aids fulfil 37 of 43 (86%) IPDAS criteria for content and development process.

Discussion and conclusions

Both BRCA1/2 mutation carriers and professionals are willing to use or offer the developed patient decision aids for risk‐reducing surgery. The patient decision aids have been found clear, balanced and comprehensible. Future testing among patients facing the decision should point out its effectiveness in improving decision making.
Apparent resilience of a declining Afro‐Palaearctic migrant to forest loss on the wintering grounds
Authors: Mallord John W. , Orsman Christopher J. , Roberts Japheth T. , Boafo Kwame , Skeen Roger Q. , Sheehan Danaë K. , Vickery Juliet A.
Published: December 2017

Populations of long‐distance migrant birds are declining but it is unknown what role land cover change in non‐breeding areas may be playing in this process. Using compositional analysis, we assessed habitat selection by one such migrant, the Wood WarblerPhylloscopus sibilatrix, at a wintering site in the forest–savannah transition zone in Eastern Region, Ghana. There was a preference for forest, a habitat that is in marked decline at this site. Annual habitat mapping revealed that the area of forest declined by 26% between 2011/12 and 2013/14, mainly through clearance for conversion to arable land. Numbers of birds changed throughout the season, but despite the reduction in the preferred forest habitat, there was no change in the total number of birds recorded at the site over the study period. The number of birds recorded at a point was positively related to the proportion of cleared land, plantation and, to a lesser extent, dense forest within 100 m. Investigation of the fine‐scale habitat preferences of radiotagged Wood Warblers suggested that there was an optimum number of trees, around 66–143 per hectare, at which estimated probability of occupancy was 0.5, falling to a probability of 0.2 at 25 trees per hectare. We suggest that Wood Warblers may be buffered against the loss of forest habitat by their ability to utilize degraded habitats, such as well‐wooded farmland, that still retain a substantial number of trees. However, the continued loss of trees, from both forest and farmland is ultimately likely to have a negative impact on wintering Wood Warblers in the long‐term.
Pre‐employment risk screening: Comparability of integrity assessment technology platforms
Authors: Dages Kelly D. , Zimmer Seth , Jones John W.
Published: December 2017

The prevalence of mobile devices (e.g., smartphones and tablets) has led to job applicants increasingly choosing to use these mobile devices to complete online pre‐employment assessments in the application process. This study identifies increasing mobile device usage trends for applicants completing an unproctored integrity assessment across 13 quarterly time periods. Further, the comparability of the integrity assessment results when completed on mobile devices compared to when it is completed on computers was examined. Results revealed that the integrity assessment had comparable mean scores, number of admissions, reliability estimates, and validity coefficients across mobile devices and computers. Pass rates for the assessment across the delivery modes showed small differences though some were statistically significant. Applicants using smartphones to complete the assessment took significantly more time than applicants using computers or tablets.
Resident intestinal eosinophils constitutively express antigen presentation markers and include two phenotypically distinct subsets of eosinophils
Authors: Xenakis Jason J. , Howard Emily D. , Smith Kalmia M. , Olbrich Courtney L. , Huang Yanjun , Anketell Dilanjan , Maldonado Samuel , Cornwell Evangeline W. , Spencer Lisa A.
Published: December 2017

Intestinal eosinophils are implicated in homeostatic and disease‐associated processes, yet the phenotype of intestinal tissue‐dwelling eosinophils is poorly defined and their roles in intestinal health or disease remain enigmatic. Here we probed the phenotype and localization of eosinophils constitutively homed to the small intestine of naive mice at baseline, and of antigen‐sensitized mice following intestinal challenge. Eosinophils homed to the intestinal lamina propria of naive mice were phenotypically distinguished from autologous blood eosinophils, and constitutively expressed antigen‐presenting cell markers, suggesting that intestinal eosinophils, unlike blood eosinophils, may be primed for antigen presentation. We further identified a previously unrecognized resident population of CD11chi eosinophils that are recovered with intraepithelial leucocytes, and that are phenotypically distinct from both lamina propria and blood eosinophils. To better visualize intestinal eosinophils in situ, we generated eosinophil reporter mice wherein green fluorescent protein expression is targeted to both granule‐delimiting and plasma membranes. Analyses of deconvolved fluorescent z‐section image stacks of intestinal tissue sections from eosinophil reporter mice revealed eosinophils within intestinal villi exhibited dendritic morphologies with cellular extensions that often contacted the basement membrane. Using an in vivo model of antigen acquisition in antigen‐sensitized mice, we demonstrate that both lamina propria‐associated and intraepithelium‐associated eosinophils encounter, and are competent to acquire, lumen‐derived antigen. Taken together these data provide new foundational insights into the organization and functional potential of intestinal tissue‐dwelling eosinophils, including the recognition of different subsets of resident intestinal eosinophils, and constitutive expression of antigen‐presenting cell markers.
Mechanical activation and cement formation of trimagnesium phosphate
Authors: Brückner Theresa , Hurle Katrin , Stengele Anja , Groll Jürgen , Gbureck Uwe
Published: December 2017

Magnesium phosphate cements have attracted an increasing attention for biomedical applications in the past years due to their high mechanical performance and fast in vivo degradation at bony implantation sites. Cements are usually multicomponent mixtures of cement raw powders and setting regulators, whereas the latter may have a detrimental effect on the biocompatibility. Here, we demonstrate that following prolonged grinding of trimagnesium phosphate (Mg3(PO4)2, farringtonite), a mechanically induced disordering reaction strongly altered farringtonite reactivity such that self‐setting cements without further components were formed with a compressive strength of up to 11 MPa. Time‐resolved X‐ray diffraction analysis revealed that the formation of a nanocrystalline magnesium phosphate phase during grinding was responsible for cement setting to the highly hydrated magnesium phosphate mineral cattiite (Mg3[(PO4)2∙22H2O), whereas crystalline farringtonite showed practically no setting reaction.
Differing phylogeographic patterns within the Indo‐West Pacific mangrove genus Xylocarpus (Meliaceae)
Authors: Guo Zixiao , Guo Wuxia , Wu Haidan , Fang Xiaoting , Ng Wei Lun , Shi Xianggang , Liu Ying , Huang Zhicheng , Li Weixi , Gan Lu , He Sining , Zhong Cairong , Jian Shuguang , Gong Xun , Shi Suhua , Huang Yelin
Published: December 2017

Aim

The genus Xylocarpus contains two mangrove species, X. granatum and X. moluccensis, and a rare non‐mangrove, X. rumphii. The two mangrove species are ideal models to study the biogeography of coastal plants with a unique dispersal ability, that is via buoyant propagules. We constructed the phylogeny of Xylocarpus and its relatives and determined the population structures of the two mangrove species. We aimed to elucidate the roles of continental drift and long‐distance dispersal (LDD) in shaping the present‐day distribution of Xylocarpus and to determine the factors affecting the patterns of population differentiation.

Location

The Indo‐West Pacific (IWP) region.

Methods

Thirty populations of X. granatum, 15 of X. moluccensis and four of X. rumphii were sampled across the IWP region. Five chloroplast DNA intergenic spacers were sequenced for Xylocarpus and outgroup species to determine divergence times. The genetic diversity, divergence and structure of the two mangrove species were further analysed using five nuclear and two chloroplast DNA loci. Migrations between oceanic regions were estimated.

Results

The genus Xylocarpus diverged from its sister genus Carapa approximately 19.4 Ma. The populations of X. granatum differentiated into three groups, with genetic breaks present across the Malay Peninsula and Wallacea, whereas X. moluccensis populations differentiated into two groups, with a genetic break present only across the Malay Peninsula. Migration was also observed between populations of the Southeast Asian and Australasian regions in X. moluccensis but not in X. granatum.

Main conclusion

Since Xylocarpus originated after the breakup of Gondwana and subsequent plate motions, its current distribution range should have been facilitated by present‐day LDD instead of past continental drift. Despite the capacity of LDD, the presence of differing population structures across land barriers (the Sunda and Sahul Shelves) and ocean currents indicated differential limitations in the dispersal capabilities of X. granatum and X. moluccensis.