bluuebunny/crossref_metadata_2025 huggingface dataset:
Minimally Invasive Transforaminal Lumbar Interbody Fusion Using Banana-Shaped and Straight Cages: Radiological and Clinical Results from a Prospective Randomized Clinical Trial
Authors: Choi Won-Suh , Kim Jin-Sung , Hur Jung-Woo , Seong Ji-Hoon
Published: April 2017

BACKGROUND

In minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF), cage type and position play important roles in fusion achievement and sagittal alignment correction. However, no prospective randomized comparison of the results using different types of cage has been reported to date.

OBJECTIVE

To compare the radiological and clinical outcomes of unilateral MIS-TLIF using 2 types of cage.

METHODS

All candidates for single-level MIS-TLIF were randomized into banana-shaped cage and straight-cage groups. Plain radiographs and computed tomography scans were used for assessment of cage positions, fusion status, disc height, segmental lordotic angle, cage subsidence, and pelvic parameters. Clinical outcome was assessed using visual analog scale and Oswestry Disability Index scores.

RESULTS

Forty-four and 40 consecutive patients were operated on using banana-shaped and straight cages, respectively. Cage position was more anterior and lateral in the straight-cage group and more medial and posterior in the banana-shaped cage group. Solid fusion was achieved in 95.2% and 96.6% of the 2 groups, respectively, at 12 mo. The change in disc height and segmental lordotic angle postoperatively was significantly greater in the banana-shaped cage group. The incidence of subsidence during follow-up was significantly higher in the banana-shaped cage group (P < .04). Clinically, the visual analog scale and Oswestry Disability Index scores decreased significantly after surgery in both groups, with no significant difference between the groups.

CONCLUSION

Our preliminary outcomes suggest that the subsidence rate may be higher using banana-shaped cages in MIS-TLIF, possibly due to their more medial final position.
Aspartame Intake Relates to Coronary Plaque Burden and Inflammatory Indices in Human Immunodeficiency Virus
Authors: Hall Leangelo N. , Sanchez Laura R. , Hubbard Jane , Lee Hang , Looby Sara E. , Srinivasa Suman , Zanni Markella V. , Stanley Takara L. , Lo Janet , Grinspoon Steven K. , Fitch Kathleen V.
Published: April 2017

Background

Dietary sweeteners may contribute to metabolic dysregulation and cardiovascular disease (CVD), but this has not been assessed in human immunodeficiency virus (HIV).

Methods

One hundred twenty-four HIV-infected and 56 non-HIV-infected participants, without history of known coronary artery disease were included. Dietary intake was assessed using a 4-day food record. Coronary plaque was determined using cardiac computed tomography angiography.

Results

Human immunodeficiency virus-infected participants had significantly greater intake of dietary sweeteners, including total sugar (P = .03) and added sugar (P = .009); intake of aspartame (artificial sweetener) was greater among aspartame consumers with HIV versus non-HIV consumers (P = .03). Among HIV-infected participants, aspartame intake was significantly associated with coronary plaque (P = .002) and noncalcified plaque (P = .007) segments, as well as markers of inflammation/immune activation (monocyte chemoattractant protein 1 and lipoprotein-associated phospholipase A2), which may contribute to increased atherogenesis. In multivariable regression modeling, aspartame remained an independent predictor of plaque in HIV. In contrast, among non-HIV-infected participants, no sweetener type was shown to relate to plaque characteristics.

Conclusions

We demonstrate increased intake of dietary sweeteners and a potential novel association between aspartame intake, plaque burden, and inflammation in HIV. Our data suggest that aspartame may contribute to CVD risk in HIV. Further studies should address potential mechanisms by which aspartame may contribute to increased plaque burden and cardiovascular benefits of dietary strategies targeting aspartame intake in HIV.
Epidemiology of Basil Downy Mildew
Authors: Cohen Yigal , Ben Naim Yariv , Falach Lidan , Rubin Avia E.
Published: April 2017

Basil downy mildew (BDM) caused by the oomycete Peronospora belbahrii is a destructive disease of sweet basil (Ocimum basilicum) worldwide. It originated in Uganda in the 1930s and recently spread to Europe, the Middle East, Americas, and the Far East. Seed transmission may be responsible for its quick global spread. The pathogen attacks leaf blades, producing chlorotic lesions with ample dark asexual spores on the lower leaf surface. Oospores may form in the mesophyll of infected leaves. The asexual spores germinate on a wet leaf surface within 2 h and penetrate into the epidermis within 4 h. Spore germination and infection occur at a wide range of temperatures from 5 to 28.5°C. Infection intensity depends on the length of dew period, leaf temperature, and inoculum dose. The duration of latent period (from infection to sporulation) extends from 5 to 10 days, depending on temperature and light regime. The shortest is 5 days at 25°C under continuous light. Sporulation requires high humidity but not free leaf wetness. Sporulation occurs at 10 to 26°C. At the optimum temperature of 18°C, the process of sporulation requires 7.5 h at relative humidity ≥ 85%, with 3 h for sporophores emergence from stomata and 4.5 h for spore formation. Sporophores can emerge under light or darkness, but spore formation occurs in the dark only. Limited data are available on spore dispersal. Spores dispersed from sporulating plants contaminate healthy plants within 2 h of exposure. Settled spores may survive on leaf surface of healthy plants for prolonged periods, depending on temperature. Seed transmission of the disease occurs in Europe, but not in Israel or the United States. P. belbahrii in Israel also attacks species belonging to Rosemarinus, Nepeta, Agastache, Micromeria, and Salvia but not Plectranthus (coleus). A Peronospora species that infects coleus does not infect sweet basil. Control of BDM includes chemical, physical, and genetic means. The fungicide mefenoxam was highly effective in controlling the disease but resistant populations were quickly selected for in Israel and Europe rendering it ineffective. A new compound oxathiapiprolin (OSBP inhibitor) is highly effective. Nocturnal illumination of basil crops controls the disease by preventing sporulation. Daytime solar heating suppressed the disease effectively by reducing spore and mycelium viability. The most effective physical means is fanning. Nocturnal fanning prevents or limits dew deposition on leaf surfaces, and as a result, infection and sporulation diminish and epidemics are prevented. Genetic resistance occurs in wild basil and its transfer to sweet basil is under way.
A Novel Needle Structure that Can Avoid Intravascular Injection of Any Filler
Authors: Huang Hsiang , Lin Yu-Shan
Published: April 2017

With increasing use of dermal fillers, more and more adverse effects are reported. The most devastating one is intravascular injection. We propose a novel needle prototype that allows physicians to prevent intravascular injection.
Disability in the Australian workplace: corporate governance or CSR issue?
Authors: Williams Belinda Rachael
Published: April 2017

Purpose

The purpose of this paper is to determine the current state of play for workplace diversity disclosures, specifically disability by investigating the recently revised Australian Securities Exchange (ASX) Corporate Governance Principles and Recommendations.

Design/methodology/approach

Case study methodology using documentary analysis techniques.

Findings

With gender diversity recommendations introduced in 2010 based on the business case perspective, the process of revising the ASX Corporate Governance Principles and Recommendations provided an opportunity for the ASX to expand its diversity focus, with disability diversity specifically identified in the draft third edition. However, the key amendments were subsequently removed when the approved edition was released in 2014 with justification provided on the grounds that disability is a social issue, not a corporate governance issue. Through a widening of the corporate governance lens beyond the business case perspective, this paper calls for a re-imagining of corporate governance to incorporate an ethical viewpoint on diversity.

Social implications

Disability diversity disclosure is merely the first step towards reform in helping to bring about deep change within organisations. Without both administrative reform and institutional reform, any future revisitation of the disability disclosure recommendations may become little more than a “tick the box” approach.

Originality/value

The paper is unique in reviewing the ASX Corporate Governance developmental processes towards workplace disability in its recently revised edition.
Romanian public administration reform 2.0: using innovative foresight methodologies to engage stakeholders and the public
Authors: Zulean Marian , Andreescu Liviu , Gheorghiu Radu , Roescu Andra Maria , Curaj Adrian
Published: April 2017

Purpose

The purpose of this practice-oriented paper is to look at a recent, late-phase development in public administration (PA) reform in Romania, specifically the drafting of the recently adopted national Strategy on Strengthening the Efficiency of Public Administration (2014-2020). In particular, the paper focuses on the opportunities and limits of outsourcing the building of the vision underlying the strategy and the prioritization of strategic objectives. The article’s story is also placed in the broader context of agencification literature and, more specifically, the involvement of executive agencies in policymaking.

Design/methodology/approach

The paper describes the vision-building exercise, developed according to a script already tested in several sectoral strategy-making processes, and the objectives and procedure of the online participatory consultation by using an adapted real-time Delphi format (similarly tested in the recent past).

Findings

The paper reports on the ways in which the output of the visioning process and of online consultations may be used to enhance a strategic process already underway.

Originality/value

PA reform in post-communist countries has been among the most hotly debated, intensely pursued, yet seemingly elusive policy objectives of the transition and post-transition periods. Among pre-accession and then European Union (EU) member states, the need to get in and then to get involved in European policymaking provided some impetus for such reforms and also set substantial constraints, without however always adding much predictability or significantly streamlining the public sector. The paper contributes to this debate by proving an innovative method of devising a reform strategy by outsourcing the strategy-building process to an agency with the necessary know-how and experience.
Does anticipation matter for public administration? The case of the Walloon Region (Belgium)
Authors: Petit Jean Maxime , Brunet Sébastien
Published: April 2017

Purpose

This paper aims at analysing the relationship between anticipation and public administration based on a case study focusing on a specific public agency in charge of knowledge production for policymaking.

Design/methodology/approach

It is based on a case study methodology: anticipatory practices of a public organisation are critically assessed based on data that originates from public documents and from participant observation within the concerned agency.

Findings

Several dimensions impact the interrelation between anticipation and public administration. First, the organisational set-up is decisive in fostering the development of specific type of anticipatory activities. Second, it confirms a common finding that policymakers are oftentimes more interested in ready-to-use results than in processes of future thinking. And third, it shows that distinctive anticipatory practices can rely on very different networks and, therefore, have different degree of maturity.

Research limitations/implications

The use of a case study, unfortunately, may lead to a lack of generalisability. The authors therefore encourage researchers to test their propositions further.

Originality/value

Nevertheless, the originality of the paper is its central focus on anticipation within public administration – a topic that has not received much attention or study by academics or researchers. Anticipatory practices have been studied at a more general level, but not necessarily in particular public sector environments, which also have their own particular constraints.
Enabling university educators to equip students with inter- and transdisciplinary competencies
Authors: Di Giulio Antonietta , Defila Rico
Published: April 2017

Purpose

Inter- and transdisciplinarity are core concepts in almost all education for sustainable development (ESD) competence frameworks and curricula. To equip students with inter- and transdisciplinary competencies is highly demanding for educators. Educators must not only know how to teach students such competencies, but need to be experienced in inter- and transdisciplinary research and must have some technical knowledge about inter- and transdisciplinarity. This paper aims to show how university educators can be supported in their teaching.

Design/methodology/approach

The paper is a case study based on research and on experiences in interdisciplinary teaching and in supporting educators in their interdisciplinary teaching.

Findings

The paper presents a competence framework of interdisciplinary competencies to guide university teachers that has been developed, implemented and refined in interdisciplinary study programmes belonging to the field of ESD. It shows how the professional development of educators could be addressed referring to the experiences in these programmes. The measures presented consist for one thing of interdisciplinary processes among the educators and of measures directly supporting educators in their teaching for another thing.

Originality/value

The case study the paper refers to is of special value, first, because the experiences are based on long-standing research and on two decades of experiences. Second, because considerable efforts were made to deliver coherent and consistent interdisciplinary teaching in which interdisciplinarity was not only a teaching subject for the students but showed by the educators as well so that the educators involved did not only talk about competencies for inter- and transdisciplinary collaborations but also set an example in their own doings.
Professional development of university educators in ESD: a study from pedagogical styles
Authors: Callejas Restrepo Maria Mercedes , Blanco-Portela Norka , Ladino-Ospina Yolanda , Tuay Sigua Rosa Nidia , Vargas Kenneth Ochoa
Published: April 2017

Purpose

The aim of this paper is to present a vision for university educator professional development, based on self-analysis of pedagogical styles and production of knowledge about the practices that promote education for sustainable development (ESD).

Design/methodology/approach

The “STSE” course is part of the department’s Professional Development Program. The course aims to articulate the relationship between ESD processes and university educator training through reflection on their practices. To accomplish this objective, the course promotes interdisciplinary groups of educators from different backgrounds. These groups are encouraged to introspect regarding their pedagogical styles. A survey is applied to encourage self-analysis of the four pedagogical style dimensions.

Findings

University educators adopt their own pedagogical styles based on the evolution of their practices. This information is useful in generating education, formation and transformation of new professionals in their respective fields. This knowledge also raises questions about ESD, and the construction of processes, values and attitudes to aid this education.

Research limitations/implications

This paper only describes the characterization stage of the university educator pedagogical styles through practice-related self-analysis

Originality/value

This study builds pedagogical knowledge, promotes higher education transformation for sustainable development and strengthens the quality of university education.
Supporting collaborative and continuing professional development in education for sustainability through a communities of practice approach
Authors: Warr Pedersen Kristin
Published: April 2017

Purpose

The purpose of this paper is to consider an expanded vision of professional development for embedding education for sustainability (EfS) in a higher education institution. Through an exploration of a community of practice at the University of Tasmania, this paper examines how collaborative peer learning can sustain and promote continued professional development for staff in higher education who are committed to EfS as an educational paradigm.

Design/methodology/approach

This research was conducted through a mixed methods investigation that involved participant observation and semi-structured interviews and focus groups. Data were analysed and grouped into themes that are discussed in the paper.

Findings

This research reveals that personal values and professional identity were the two driving factors for continued engagement in a collaborative peer learning initiative. Despite institutional challenges and a lack of success of growing membership in the community of practice, participants found a level of job satisfaction and personal connection to the initiative and to each other that has sustained action and impact for this group.

Originality/value

This work contributes an alternative voice to the professional development discussion around EfS. While most professional development activities are aimed at transferring knowledge to individuals and groups that are identified to lack awareness or capacity in a topic, this work highlights the need to include and foster safe learning spaces for continued professional learning. Particular attention is paid to the value of peer learning to support the professional development of sessional staff engaged in EfS.
How to assess professional competencies in Education for Sustainability?
Authors: Garcia Maria Rosa , Junyent Mercè , Fonolleda Marta
Published: April 2017

Purpose

This study aims to contribute to the professional competency approach in Education for Sustainability (ES) from the perspective of complexity and to the assessment of these competencies.

Design/methodology/approach

A qualitative research process was used, which consisted of two main phases: a documentary analysis of the internationally accepted frameworks about professional competencies in ES and complexity and a case study. The context was the Learning Camp of Cistercian Monasteries (Catalonia, Spain), and two educators participated in this camp.

Findings

The main outcomes are: a framework of professional competencies in ES from a complexity perspective, called CESC, and a rubric, as an assessment tool for professional competences in ES.

Originality/value

Based on the results, the author’s can state that this research is a contribution to the ES competency approach and it rectifies the lack of assessment tools in this area. The CESC is a theoretical contribution that facilitates educators’ development of ES competencies based on complexity. The design of the rubric with a high level of applicability and transferability is a methodological contribution which facilitates the assessment of these competencies by educators, as individuals, and educational teams. Related to the case study, several guidelines are proposed regarding the need for educator training to advance in the mobilisation of competencies in ES.
Drivers of contract renewal in international B2B services: a firm-level analysis
Authors: Williams Paul Jeremy , Khan M. Sajid , Semaan Rania , Naumann Earl R. , Ashill Nicholas Jeremy
Published: April 2017

Purpose

A key issue for B2B industrial firms is to better understand the drivers of customer value and contract renewal decisions, due to the long-term supplier-customer relationships. When the B2B firm is operating across national boundaries, there is added complexity to the renewal decision, because the drivers are also influenced by cultural considerations. The purpose of this paper is to examine the main drivers of customer value creation and contract renewal intentions, for a large B2B firm operating in both the USA and Japan and compare the two data sets.

Design/methodology/approach

The company, which provided the data for the study, is a US Fortune 100 firm in the facilities management industry, operating worldwide. Data were collected using a survey questionnaire from a sample of the firm’s customers in two of its largest markets, the USA and Japan. The authors used PLS to analyze the data, and compare and contrast the drivers.

Findings

The findings highlight both similarities and differences across the two countries for the most influential drivers of customer value and contract renewal. Although no differences were found when examining the effect of relational drivers on contract renewal, differences were observed for utilitarian drivers: product quality and price.

Practical implications

The authors expected the relational drivers of contract renewal to be stronger in the high-context culture of Japan, but found that there were no differences with the US market. While relational drivers are important in the decision-making process in both countries, it seems that managers should focus more on price considerations in Japan. In contrast, product quality is relatively more important in the USA, when negotiating contract renewals with customers.

Originality/value

Noticeably absent from the B2B services literature is its application to international markets. In particular, research is lacking on the specific drivers of customer value and contract renewal intentions in the USA and Japan, despite the importance of long-term on-going contractual relationships in these markets. This study has provided additional insights into the complex world of contract renewal between international buyers and sellers of large industrial systems.
The health of India’s older population: do living arrangements matter?
Authors: R. Mahapatro Sandhya , Acharya Arabinda , Singh Pushpendra
Published: April 2017

Purpose

Changing demographic trends in India have resulted in a growing ageing population, and this poses many health challenges for older people. Lack of formal care institutions and social security nets further aggravate the situation. Living arrangements are, thus, expected to play a significant role in determining the healthcare needs of older people. The purpose of this paper is to examine the association of living arrangements with health among older people in India.

Design/methodology/approach

Data for the study were drawn from the Building Knowledge Base on Population Ageing in India (2011). The health status of older people was measured by assessing chronic illness, self-rated health and limitations in activities of daily living. Logistic regression was used to examine the influence of living arrangements on health outcomes. Further, a structural equation model was employed to observe whether poor health preceded co-residence.

Findings

Older people living in co-residential arrangements report more health disadvantages and older people with poor health prefer co-residence with their offspring. Perhaps the support, care and health awareness in co-residential arrangements helps older people obtain the healthcare interventions they require for the various illnesses they have had, and enable them to improve their ongoing health status.

Originality/value

The present study has extended the research on the relationship between health and living arrangements, and has also addressed the case of older people with poor health who prefer to stay in co-residential arrangements which has been taken up by limited studies.
Effects of shoreline armouring and overwater structures on coastal and estuarine fish: opportunities for habitat improvement
Authors: Munsch Stuart H. , Cordell Jeffery R. , Toft Jason D.
Published: April 2017

Nearshore ecosystems are increasingly recognized as critical habitats for fish of cultural, ecological and economic significance. These ecosystems are often densely inhabited by juvenile fish, highly productive and refuges from predation, leading ecologists to characterize them as nurseries. However, nearshore ecosystems are being transformed globally to support demands of growing coastal populations. Many shorelines are modified by armouring (e.g. seawalls, riprap) that minimizes erosion, and overwater structures (e.g. piers, docks) that facilitate waterfront use. These modifications affect the ecology of nearshore systems by restructuring, eliminating and shading shallow waters.

Here, we review literature examining effects of armouring and overwater structures on coastal and estuarine fishes, and discuss how research and management can coordinate to minimize negative effects.

Along armoured shorelines, fish assemblages differed from unarmoured sites, fish consumed less epibenthic and terrestrial prey, beach spawning was less successful and fish were larger. Under large overwater structures, visually oriented fish were less abundant and they fed less. Shade from overwater structures also interrupted localized movements of migratory fish. Thus, shoreline modifications impaired habitats by limiting feeding, reproduction, ontogenetic habitat shifts from shallow to deeper waters and connectivity.

Research suggests that restoring shallow waters and substrate complexity, and minimizing shading underneath overwater structures, can rehabilitate habitats compromised by shoreline modifications.

Synthesis and applications. Shoreline armouring and overwater structures often compromise fish habitats. These threats to nearshore fish habitats will become more severe as growing coastal populations and rising sea levels increase demands for shoreline infrastructure. Our ability to assess and rehabilitate nearshore fish habitats along modified shorelines will be enhanced by: focusing research attention on metrics that directly indicate fish habitat quality; implementing and evaluating shoreline features that repair compromised habitat functions within human‐use constraints; collating natural history knowledge of nearshore ecosystems; and embracing the socio‐ecological nature of habitat improvements by educating the public about conservation efforts and fostering appreciation of local nearshore ecosystems. Actions to reduce impacts of shoreline modifications on fish are particularly feasible when they align with societal goals, such as improving flood protection and providing spaces that facilitate recreation, education, and connections between people and nature.
The role of changing climate in driving the shift from perennial grasses to annual succulents in a Mediterranean saltmarsh
Authors: Strain Elisabeth M. A. , van Belzen Jim , Comandini Paolo , Wong Joanne , Bouma Tjeerd J. , Airoldi Laura
Published: April 2017

Changing climate threatens the structure and function of saltmarshes, which are often severely degraded by other human perturbations. Along the Mediterranean coastline, increasing temperature and decreasing rainfall have been hypothesised to trigger habitat shifts from perennial grasses to annual succulents in fragile saltmarsh ecosystems, such as those fringing the North Adriatic coastline.

We used manipulative field experiments to investigate the effects of increased temperature, decreased precipitation and increased inundation period associated with rising sea levels on the dominant species in the lower marsh, the perennial grass Spartina spp. and the annual succulent Salicornia veneta.

At ambient inundation, the combined effects of increased temperature and decreased precipitation enhanced soil temperature and decreased soil moisture, resulting in an increased number of plants, height and live biomass of S. veneta, as well as greater dead biomass of Spartina spp. compared with current conditions. Increased inundation reduced the soil redox potential, and resulted in losses of both Spartina spp. and S. veneta, but these negative effects were much more pronounced for S. veneta. An inundation tolerance test confirmed that S. veneta is significantly more vulnerable to rapid increases in inundation than Spartina spp.

We conclude that at current inundation, the increasing drought conditions in the North Adriatic Sea are favouring the spread of the annual succulent S. veneta. The increasing spread of these succulents could reduce the future capability of the system to respond to projected increasing sea levels, as S. veneta is highly vulnerable to increased inundation.

Synthesis. Our results highlight the complex interactions between different components of changing climate. Management strategies for saltmarshes in the Mediterranean and other microtidal locations facing similar changes in climate should focus on maintaining the freshwater and coastal channels free from blockages to ameliorate the effects of episodic drought/heatwave conditions and increasing the sediment supply and preventing coastal squeeze to enhance the resilience of the system to the continuous threat of sea level rise.
Application of MALDI‐TOF MS for Estimating the Postmortem Interval in Rat Muscle Samples
Authors: Li Chengzhi , Ma Dong , Deng Kaifei , Chen Yijiu , Huang Ping , Wang Zhenyuan
Published: April 2017

Estimating the postmortem interval (PMI) is very important in the forensic sciences. Although many approaches have been used for estimating the PMI, accurate PMI calculations are still difficult. In this study, four Sprague Dawley (SD) rats were sacrificed by suffocation, and muscle samples were collected by dissection at various time intervals (0, 48, 96, and 144 h) after death. All samples were probed using matrix‐assisted laser desorption/ionization time‐of‐flight mass spectrometry (MALDI‐TOFMS) to obtain molecular images and data for principal component analysis (PCA). The results showed that the peaks at m/z 1511, 1543, 1564, 1586 clearly decreased in intensity from 0 to 144 h postmortem and that the time groups were separated from each other on the PCA score plot. The prediction model showed high recognition capability (95.93%) and cross‐validation (83.72%). Our work suggests that MALDI‐TOF MS can be used to determine the PMI.
Relationship between endobronchial ultrasound‐guided (EBUS)‐transbronchial needle aspiration utility and computed tomography staging, node size at EBUS, and positron emission tomography scan node standard uptake values: A retrospective analysis
Authors: Marchand Clare , Medford Andrew R.L.
Published: April 2017

Background

Endobronchial ultrasound‐guided transbronchial needle aspiration (EBUS‐TBNA) diagnoses and stages mediastinal lymph node pathology. This retrospective study determined the relationship between EBUS‐TBNA utility and non‐small cell lung cancer (NSCLC) stage, lymph node size, and positron emission tomography (PET) standard uptake values (SUV), and the utility of neck ultrasound in bulky mediastinal disease.

Methods

Data of 284 consecutive patients who had undergone EBUS‐TBNA was collected. Two hundred patients had suspected NSCLC, with 148 confirmed NSCLC cases. The diagnostic utility of EBUS‐TBNA was determined according to NSCLC stage, EBUS lymph node size, PET SUV, use in distal metastases, and mutation testing. The utility of neck ultrasound for N3 disease was calculated in patients with bulky mediastinal disease.

Results

EBUS‐TBNA was well tolerated with 97% sensitivity in distant metastatic disease, avoiding the need for distal metastases biopsy in 81% of cases. It had equivalent diagnostic accuracy in all NSCLC stages and in lymph nodes <10 mm, <20 mm or >20 mm (sensitivity >92% in all cases), with no mutation testing failures. EBUS‐TBNA had 33% sensitivity in PET indolent (SUV < 4) nodes and 79% sensitivity in PET active nodes (SUV > 4). EBUS‐TBNA diagnosed 12 cases of lymphoma without flow cytometry.

Conclusions

The use of EBUS‐TBNA meant that distant metastatic biopsy was avoided in 81% of cases, performing well irrespective of cancer stage, node size, and facilitating mutation testing. Neck ultrasound failed to detect N3 disease in patients with bulky mediastinal disease. EBUS‐TBNA had a sensitivity of 33% for metastases in PET negative nodes, highlighting PET limitations.
Spatio‐temporal connectivity: assessing the amount of reachable habitat in dynamic landscapes
Authors: Martensen Alexandre Camargo , Saura Santiago , Fortin Marie‐Josee
Published: April 2017

Landscape heterogeneity and habitat connectivity affect species movements, playing an important role in determining the likelihood of species persistence. However, landscape connectivity is usually evaluated using static snap‐shots, which do not account for the sequential interactions among habitat patches through time.

We developed a network‐based model of landscape dynamics, and corresponding connectivity metrics, to account for the reachable habitat across space and time. We illustrate the behaviour of these metrics, using fragmented forested landscapes in the Atlantic Forest of Brazil. We parametrized the models using the dispersal capacities of selected bird and small mammal species.

We found that when considering spatio‐temporal links, connectivity is estimated to be on average 30% higher (with a maximum of 150% higher) than what is estimated from purely spatial models. This higher degree of spatio‐temporal connectivity arises due to connections through temporal stepping‐stone patches that appear (habitat gain) and disappear (habitat loss) over time. Species with short dispersal distances (<1000 m) particularly benefited from the spatio‐temporal connections. The contribution of spatio‐temporal connectivity to habitat reachability increased with higher habitat loss rates. Moreover, it depended on the amount of habitat in the landscape, being higher at intermediate habitat amounts (∼30%).

We showed that accounting for spatio‐temporal connectivity is critical for understanding ecological patterns and processes in dynamic landscapes, and that a series of purely spatial connectivity metrics underestimates the actual connectivity patterns across time. The proposed spatio‐temporal connectivity approach and metrics can be applied to evaluate the effective connectivity patterns and trends in a variety of dynamic landscapes, avoiding the potential overestimates of population isolation and extinction probabilities that may result from widely used purely spatial connectivity models.
Dentists’ restorative decision‐making and implications for an ‘amalgamless’ profession. Part 4: clinical factor
Authors: Alexander G , Hopcraft MS , Tyas MJ , Wong RHK
Published: April 2017

Background

The Minamata Convention embodies a worldwide reduction in the production and use of mercury and mercury‐containing products and processes, including a phase‐down of dental amalgam. This will change the approach to the use of direct restorative materials in the near future. There is little research as to the influence of clinical factors on dentists’ decision‐making which may be of use when determining the impact of any change.

Methods

An online survey relating to aspects of and attitudes to the use of direct restorative materials was distributed to all dentists who were members of the Australian Dental Association and/or members or fellows of the Royal Australasian College of Dental Surgeons. Data were statistically analysed.

Results

There were 408 respondents to the survey. Eighty‐seven per cent of respondents (strongly) disagreed that amalgam was a technically more difficult material to place compared with resin composite, 82% (strongly) disagreed that placement time for amalgam was longer than that for resin composite and 69% (strongly) disagreed that amalgam was more difficult to finish than resin composite. Eighty‐three per cent of respondents stated they were confident in their ability to place amalgam restorations. Where physical properties were of importance, indirect restorations were preferred (e.g. parafunction) 54%. The factors considered most important when choosing a direct restorative material included moisture control and aesthetics; least important factors were cost and time to place.

Conclusions

There is consensus that amalgam is not more technically difficult to use, place or finish than resin composite and vice versa. There is recognition that both amalgam and resin composite have limitations in terms of physical properties. When choosing a direct restorative material, clinical factors considered to be of greatest importance are moisture control, aesthetics and the need to apply minimally invasive approaches. There is little difference in the opinions of users and non‐users of amalgam with respect to these findings.
Real‐world experience of the feasibility and tolerability of the 2/1 dosing schedule with sunitinib in the treatment of patients with advanced renal cell carcinoma in Australia
Authors: Crumbaker Megan , Guminski Alexander , Gurney Howard , Sabanathan Dhanusha , Wong Shirley , Pavlakis Nick
Published: April 2017

Aim

Sunitinib is a first‐line treatment option for metastatic renal cell carcinoma (mRCC) funded by the Australian Pharmaceutical Benefits Scheme. Toxicities are common with the standard schedule leading to alternative dosing schedules to be suggested. We reviewed Australian treatment practices to evaluate the safety and outcomes of patients on a 2 weeks on, 1 week off treatment schedule (2/1).

Methods

We performed a retrospective review of 63 patients with mRCC treated with first‐line sunitinib on a 2/1 schedule at four Australian centers.

Results

Forty‐six patients (73%) initiated sunitinib on the 2/1 schedule whereas 17 (27%) switched from the 4/2 schedule due to toxicity. Three progressing on a 4/2 schedule tolerated up‐titration of their dose with a clinical and radiological response on the 2/1 schedule. The median duration of treatment was 31.9 months; median duration of treatment on the 2/1 schedule in patients changing from 4/2 was 11.5 months. Few (6.3%) ceased due to toxicity. Median overall survival was 37.2 months.

Conclusion

In this retrospective review of the 2/1 sunitinib schedule, time on treatment with clinical benefit exceeded the overall survival times seen in the phase III trials utilizing the 4/2 schedule. Overall survival also exceeded that seen in these trials. Few patients ceased due to toxicity. The 2/1 schedule appears to be an acceptable schedule to use in selected patients with mRCC both at initiation of first‐line treatment and in those intolerant to the 4/2 schedule.
Automated T‐wave analysis can differentiate acquired QT prolongation from congenital long QT syndrome
Authors: Sugrue Alan , Noseworthy Peter A. , Kremen Vaclav , Bos J. Martijn , Qiang Bo , Rohatgi Ram K. , Sapir Yehu , Attia Zachi I. , Brady Peter , Caraballo Pedro J. , Asirvatham Samuel J. , Friedman Paul A. , Ackerman Michael J.
Published: April 2017

Background

Prolongation of the QT on the surface electrocardiogram can be due to either genetic or acquired causes. Distinguishing congenital long QT syndrome (LQTS) from acquired QT prolongation has important prognostic and management implications. We aimed to investigate if quantitative T‐wave analysis could provide a tool for the physician to differentiate between congenital and acquired QT prolongation.

Methods

Patients were identified through an institution‐wide computer‐based QT screening system which alerts the physician if the QTc ≥ 500 ms. ECGs were retrospectively analyzed with an automated T‐wave analysis program. Congenital LQTS was compared in a 1:3 ratio to those with an identified acquired etiology for QT prolongation (electrolyte abnormality and/or prescription of known QT prolongation medications). Linear discriminant analysis was performed using 10‐fold cross‐validation to statistically test the selected features.

Results

The 12‐lead ECG of 38 patients with congenital LQTS and 114 patients with drug‐induced and/or electrolyte‐mediated QT prolongation were analyzed. In lead V5, patients with acquired QT prolongation had a shallower T wave right slope (−2,322 vs. −3,593 mV/s), greater T‐peak‐Tend interval (109 vs. 92 ms), and smaller T wave center of gravity on the x axis (290 ms vs. 310 ms; p < .001). These features could distinguish congenital from acquired causes in 77% of cases (sensitivity 90%, specificity 58%).

Conclusion

T‐wave morphological analysis on lead V5 of the surface ECG could successfully differentiate congenital from acquired causes of QT prolongation.
Introduction: Critical Agrarian Studies in Theory and Practice
Authors: Edelman Marc , Wolford Wendy
Published: April 2017

In this introductory article we argue for renewed attention to life and labor on and of the land—or what we call the field of Critical Agrarian Studies. Empirically rich and theoretically rigorous studies of humanity's relationship to “soil” remain essential not just for historical analysis but for understanding urgent contemporary crises, including widespread food insecurity, climate change, the proliferation of environmental refugees, growing corporate power and threats to biodiversity. The article introduces an innovative and varied collection of works in Critical Agrarian Studies and also examines the intellectual and political history of this broader field.
High intensity focused ultrasound for the treatment of adenomyosis: selection criteria, efficacy, safety and fertility
Authors: Zhang Lian , Rao Fangwen , Setzen Raymond
Published: April 2017

Adenomyosis is a disorder of uterus in which endometrial glands and stroma are present within the uterine musculature. The main clinical manifestations are dysmenorrhea and menorrhagia. Adenomyosis has a great impact on both the quality of life and fertility of women. The treatment of adenomyosis remains an immense challenge. Relevant articles were searched through MEDLINE and PubMed between 2000 and March 2017. The search terms of adenomyosis, magnetic resonance imaging (MRI) features of adenomyosis, high intensity focused ultrasound (HIFU), ultrasound‐guided HIFU and MRgFUS were used. There were no language restrictions. HIFU is a non‐invasive local thermal ablation technique which has been used in the treatment of both focal and diffuse adenomyosis. Several case studies have demonstrated that HIFU presents low rate of minor and/or major complications and, at the same time, a long symptom‐relief period. Multiple factors such as the enhancement type of the adenomyotic lesion, volume of the adenomyotic lesions, number of hyperintense foci on T2WI, location of the uterus, location of adenomyotic lesions, thickness of the abdominal wall and distance from the skin to the adenomyotic lesions contribute to the efficacy of HIFU. Consequently, based on these contributing factors, specific and strict selection criteria have been used to achieve higher efficacy. Thus, patients with pelvic endometriosis, adhesions between the bowel and the uterus, or an abdominal surgical scar wider than 10 mm, are not suitable for HIFU treatment. Moreover, HIFU‐treated patients with adenomyosis, who wished to conceive, showed high conception and live birth rates. HIFU is a new and promising treatment option for patients with adenomyosis, but its efficacy, safety, cost‐effectiveness and fertility outcome must be evaluated by randomized controlled trials.
The Effect of Ultimate Ownership on the Disclosure of Environmental Information
Authors: Wang Peng , Wang Fangjun , Hu Nan
Published: April 2017

This study empirically examines whether environmental information disclosure (EID) is influenced by the characteristics of a firm's ultimate owners. Based on the EID of publicly listed firms in China, we qualitatively measure the quality of EID of each firm and link those quality scores to firm characteristics to understand the determinants of EID. We further link the EID scores to market valuation of the firm through the Ohlson valuation model to understand whether the market appreciates EID. Our results show that EID is more likely for government‐controlled firms, firms with less hierarchy in their ultimate ownership and firms with more discrepancy between voting rights and cash flow rights. Our results also indicate that the stock market appreciates environmental issues and that EID itself, as well as disclosure quality, is associated with a higher market valuation. Our results still hold with the endogeneity issue controlled.
Fair Value Measurement and Mandated Accounting Changes: The Case of the Victorian Rail Track Corporation
Authors: Abbott Malcolm , Tan‐Kantor Angela
Published: April 2017

VicTrack in the State of Victoria in Australia began using fair value to value its assets in 2011. In doing this the company encountered the difficulties normally associated with valuing long‐lived assets that are specific to their use. In this paper, a case study is presented centred on VicTrack in order to provide information on the basic difficulties of determining the fair value of assets that are long‐lived, specific‐to‐use and in markets that are incomplete; and to better understand some of the implications of the switch from historical costs to fair value.
The Public Accountability Value of a Triple Bottom Line Approach to Performance Reporting in the Water Sector
Authors: Tan Lai Ken , Egan Matthew
Published: April 2017

Global water resources are subject to increasing supply constraints. We respond by exploring how novel public sector performance reporting can service public accountability. Here our focus is an exploration of the drivers and utility of a unique ‘sustainability’‐focused, publicly disclosed, performance reporting initiative undertaken by a water agency in Australia. Semi‐structured interviews were conducted with a range of individuals from 2013 to 2014. A disclosure index was also constructed to assess the quality of the disclosures. While the key purpose of the reports was to provide managerial accountability with intra‐governmental stakeholders, they were also drawn on to serve a secondary public accountability purpose with external stakeholders. We argue that the prioritisation of internal stakeholders could threaten utility for public accountability purposes. However, in this case, the reports were also found to be largely relevant to the general public. The study demonstrates that reporting developed for managerial accountability purposes can be designed and targeted also to contribute usefully to ancillary public accountability objectives. Our engagement with the public sector to explore the role and effectiveness of novel reporting strategies in support of sustainability and accountability objectives is topical, and contributes to understanding potential solutions in other contexts.