bluuebunny/crossref_metadata_2025 huggingface dataset:
Developing new SrI2 and β-D-fructopyranose-based metal–organic frameworks with nonlinear optical properties
Authors: Marabello Domenica , Antoniotti Paola , Benzi Paola , Cariati Elena , Lo Presti Leonardo , Canepa Carlo
Published: March 2019

In the context of personalized medicine, there is a growing interest in materials bearing at the same time diagnostic and therapy functions. This article reports a cheap and easily reproducible procedure to obtain materials with a high potential for these applications. Three new strontium iodide–fructose-based metal–organic frameworks with formulae [Sr(C6H12O6)2]I2, [Sr2(C6H12O6)3(H2O)3]I4·0.5H2O and [Sr(C6H12O6)(H2O)3I]I differing in stoichiometry, symmetry and crystal packing, were obtained and characterized by X-ray diffraction. Bulk quantum simulations show that both the ions and the sugar are crucial in determining the predicted nonlinear response; also, the relative arrangement of various functional groups in the unit cell plays a role in the computed optical properties. Small fragments of the three compounds were selected for in vacuo calculations, proving that the reduced dimensions of the particles have a great influence on the nonlinear optical response. Despite the similar chemical composition of the three compounds, second harmonic generation measurements and in crystal and in vacuo theoretical calculations agree that one of the compounds is a much more efficient second harmonic emitter than the other two, and is thus a suitable candidate for bio-sensor applications.
Disaster communication
Authors: Mason Alicia , Flores Lynzee , Liu Pan , Tims Kenzie , Spencer Elizabeth , Gire T. Gabby
Published: March 2019

Purpose

The purpose of this paper is to understand the crisis communication strategies used by the Caribbean medical tourism industry in the 2017 hurricane season, and also evaluate the quality of the disaster communication messages delivered via digital mediums.

Design/methodology/approach

This study includes a comprehensive, qualitative content analysis of 149 risk and crisis messages from 51 healthcare organizations distributed through digital media. The medical tourism providers (MTPs) include hospitals, medical tourism facilitators, practitioners/private physicians, specialty clinics, and dental and cosmetic providers.

Findings

Nearly half of the MTPs included in the data set delivered no post-disaster information to external audiences. The most prominent post-disaster message strategy utilized was conveying operational messages. Furthermore, an unexpected finding was the sheer magnitude of unrelated health-oriented and promotional destination marketing content disseminated before, during and after these events.

Research limitations/implications

This analysis excludes internal organizational channels of communication which may have been used to communicate risk and crisis messages during these events (i.e. employee e-mails, announcements made through intercom systems, etc.). Our analysis does not include content disseminated through medical tourism forums (i.e. Realself.com, Health Traveler’s Forum, FlyerTalk Forum).

Practical implications

Small-scale MTPs can improve on any weaknesses through proactive planning and preparation by creating organizational goals to complete basic crisis communication training courses and in doing so support the applied professional development of disaster and crisis responders in the Caribbean region. Second, MTPs exposed to similar risks of natural disasters may use these findings for comparative analysis purposes to support their own organizational planning. Finally, this study supports the continued utility of the National Center for Food Protection & Defense guidelines for analyzing and evaluating organizational performance.

Originality/value

Currently much of the academic scholarship of applied disaster communication narrowly focuses on the response strategies of one organization, or analyzes one social media platform at a time (i.e. Twitter). A strength of this analysis is the inclusion of an organizational sector (i.e. Caribbean medical tourism providers) and the range of platforms from which the content was captured (e.g. websites, org. blogs and social media networks).
MHD free convection flow of power-law nanofluid film along an inclined surface with viscous dissipation and joule heating
Authors: B. Vasu
Published: March 2019

Purpose

The purpose of this study is to present the magnetohydrodynamic (MHD) flow and heat transfer in an accelerating film of a non-Newtonian pseudo-plastic nanofluid along an inclined surface with viscous dissipation and Joule heating.

Design/methodology/approach

An incompressible and inelastic fluid is assumed to obey the Ostwald-de-Waele power law model and the action of viscous stresses is conﬁned to the developing momentum boundary layer adjacent to the solid surface. Viscous dissipation and Joule heating on the flow of electrically conducting film in the presence of uniform transverse magnetic field is considered for the Carboxyl Methyl Cellulose (CMC) water-based nanofluid. The fluid is the CMC-water-based with concentration (0.1-0.4 per cent) containing three types of nano-solid particles Cu, Al2O3 and TiO2. The modeled boundary layer conservation equations are transformed to dimensionless, coupled and highly non-linear system of differential equations, and then solved numerically by means of a local non-similarity approach with shooting technique. To validate the numerical results, a comparison of the present results is made with the earlier published results and is found to be in good agreement.

Findings

The effects of magnetic parameter, Prandtl number, Eckert number and Biot numbers on the velocity and temperature fields are presented graphically and discussed for various values of thermo-physical parameters. It has been found that magnetic field decelerates the fluid velocity for both cases of Newtonian nanofluid and pseudo-plastic nanofluid because of the generated drag-like Lorentz force. This is of great benefit in magnetic materials processing operations, utilizing static transverse uniform magnetic field, as it allows a strong regulation of the flow field.

Research limitations/implications

The numerical study is valid for two-dimensional, steady, laminar film flow of Ostwald-de-Waele power law non-Newtonian nanofluid along an inclined plate. A uniform transverse magnetic field of strength B0 is applied perpendicular to the wall. Assume that the base fluid and the nano-solid particles are in thermal equilibrium with no slip effects. The interaction of magnetic field with nanofluid has several potential implications and may be used to deal with the problems such as cooling nuclear reactors by liquid sodium and inducting the flow meter which depends on the potential difference in the fluid along the direction perpendicular to the motion and to the magnetic field.

Practical implications

The study has significant applications in magnetic field control of materials processing systems.

Originality/value

The results of the present study may be attentiveness to the engineers and applied mathematicians who are interested in hydrodynamics and heat transfer enhancement associated with film flows.
Location of infantile hemangioma is a predictor of volumetric sequelae after involution
Authors: Chang Shih‐Jen , Yu Wenxin , Gu Yifei , Han Yue , Shang Ying , Chang Lei , Jin Yunbo , Ma Gang , Qiu Yajing , Lin Xiaoxi
Published: March 2019

Although infantile hemangiomas (IH) spontaneously involute, some leave more volumetric sequelae than others. Identifying predictors of such sequelae would provide a management reference for IH lesions and help achieve favorable outcomes. Our objective is to explore the correlation between volumetric residue remaining after IH involution and its location and to identify other potential outcome predictors. All IH patients examined at our hospital from 2008 to 2011 were reviewed, and both the degree of volumetric residue after involution and the quantified degree of sequelae were obtained by comparing follow‐up photographs with photographs of lesions at their maximum size. We discovered that for children with a defined age at the initial visit, lesions of the perifacial area achieved significantly more volumetric regression than lesions of the central facial (P < 0.0001) and chest areas (P = 0.0002). Perifacial lesions had a significantly higher aesthetic score than those on the central facial area (P < 0.0001), chest (P < 0.0001) and trunk/extremities (P = 0.0226) when the age at initial visit and lesion type were consistent. Our study reveals that lesion location and age at initial visit are contributing factors to volumetric sequelae and the aesthetics of the lesion after involution. The results of this study provide a reference to guide treatment decisions with the aim of achieving a favorable outcome.
Why does noise reduce response to alarm calls? Experimental assessment of masking, distraction and greater vigilance in wild birds
Authors: Zhou You , Radford Andrew N. , Magrath Robert D.
Published: March 2019

Environmental noise from anthropogenic and other sources affects many aspects of animal ecology and behaviour, including acoustic communication. Acoustic masking is often assumed in field studies to be the cause of compromised communication in noise, but other mechanisms could have similar effects.

We tested experimentally how background noise disrupted the response to conspecific alarm calls in wild superb fairy‐wrens, Malurus cyaneus, assessing the effects of acoustic masking, distraction and changes in vigilance. We first examined the birds' response to alarm‐call playbacks accompanied by different amplitudes of background noise that overlapped the calls in acoustic frequency. We then scored and videoed their response to alarm calls in two types of background noise, that did or did not overlap call frequency, but were broadcast at a constant amplitude.

Birds were less likely to flee to alarm calls in higher amplitudes of overlapping noise, demonstrating that noise itself compromised communication independently of environmental correlates. Background noise affected the response only if it overlapped in frequency with the alarm calls, implying that the effect was not due to distraction. Further, birds were equally vigilant during background noise of overlapping or non‐overlapping frequency, indicating that the lack of response to alarm calls in overlapping noise was not due to enhanced vigilance and awareness that there was no predator.

We conclude that alarm‐call reception was compromised by masking, a mechanism that is often assumed but rarely tested in an ecological context. Masking compromised reception of high‐frequency “aerial” alarm calls and so could reduce survival in background noise of similar frequency. While anthropogenic noise, which is often of lower frequency, is unlikely to affect communication with these calls, it could affect reception of acoustic cues of danger, or other conspecific or heterospecific alarm calls.

A plain language summary is available for this article.
Natural selection favours a larger eye in response to increased competition in natural populations of a vertebrate
Authors: Beston Shannon M. , Walsh Matthew R.
Published: March 2019

Eye size varies notably across taxa. Much work suggests that this variation is driven by contrasting ecological selective pressures. However, evaluations of the relationship between ecological factors and shifts in eye size have largely occurred at the macroevolutionary scale. Experimental tests in nature are conspicuously absent.

Trinidadian killifish, Rivulus hartii, are found across fish communities that differ in predation intensity. We recently showed that increased predation is associated with the evolution of a smaller eye. Here, we test how divergent predatory regimes alter the trajectory of eye size evolution using comparative mark–recapture experiments in multiple streams.

We found that increases in eye size are associated with enhanced survival, irrespective of predation intensity. More importantly, eye size is associated with enhanced growth in communities that lack predators, while this trend is absent when predators are present.

Such results argue that increased competition for food in sites that lack predators is the key driver of eye size evolution.

A plain language summary is available for this article.
Industrial rice farming supports fewer waterbirds than traditional farming on Chongming Island, China
Authors: Xie Hanbin , Zhang Wei , Li Ben , Ma Qiang , Wang Tianhou
Published: March 2019

Natural wetlands in coastal areas have been reclaimed in China and other regions of Asia. The reclaimed lands have been used for large‐scale industrial farming, replacing traditional farming methods, especially in rice fields. To understand the impact of land‐use conversion on biodiversity, particularly of coastal migratory waterbirds, we selected two study sites in Chongming Island, China, representing traditional rice fields versus industrial rice farms. At each site, we carried out waterbird population surveys, measured the environmental factors hypothesized to be important in determining waterbird abundance, and analyzed the effects of the different farming patterns on waterbird populations. Over two annual cycles (from August 2013 to May 2015), 39 waterbird species were observed, with a mean density of 29.3 ± 5.4/ha, on traditional rice fields, compared with 16 species with a mean density of 2.8 ± 0.4/ha on large‐scale industrial rice farms. Our results demonstrated that waterbird diversity was higher on traditional rice fields than on industrial rice farms. Analyses of habitat characteristics and waterbird populations showed that traditional rice fields had more preferred habitats for waterbirds, such as more open‐water cover areas, lower bare mud cover areas, lower rice plant density, no concrete‐covered areas and flooding in the winter. The results suggested that the replacement of traditional rice fields with large‐scale industrial rice farms has had a significantly negative impact on migratory waterbirds using the East Asian–Australasian Flyway; such a change could also have detrimental effects on waterbird conservation efforts in China and other countries along this important migration route.
Emerging from the ice‐fungal communities are diverse and dynamic in earliest soil developmental stages of a receding glacier
Authors: Dresch Philipp , Falbesoner Johannes , Ennemoser Chiara , Hittorf Michaela , Kuhnert Regina , Peintner Ursula
Published: March 2019

We used amplicon sequencing and isolation of fungi from in‐growth mesh bags to identify active fungi in three earliest stages of soil development (SSD) at a glacier forefield (0–3, 9–14, 18–25 years after retreat of glacial ice). Soil organic matter and nutrient concentrations were extremely low, but the fungal diversity was high [220 operational taxonomic units (OTUs)/138 cultivated OTUs]. A clear successional trend was observed along SSDs, and species richness increased with time. Distinct changes in fungal community composition occurred with the advent of vascular plants. Fungal communities of recently deglaciated soil are most distinctive and rather similar to communities typical for cryoconite or ice. This indicates melting water as an important inoculum for native soil. Moreover, distinct seasonal differences were detected in fungal communities. Some fungal taxa, especially of the class Microbotryomycetes, showed a clear preference for winter and early SSD. Our results provide insight into new facets regarding the ecology of fungal taxa, for example, by showing that many fungal taxa might have an alternative, saprobial lifestyle in snow‐covered, as supposed for a few biotrophic plant pathogens of class Pucciniomycetes. The isolated fungi include a high proportion of unknown species, which can be formally described and used for experimental approaches.
PTSD Symptoms Experienced and Coping Tactics Used by Crime Scene Investigators in the United States
Authors: Rosansky Joseph A. , Cook Jeffery , Rosenberg Harold , Sprague Jon E.
Published: March 2019

Few investigations have assessed the prevalence of posttraumatic stress experiences among Crime Scene Investigators (CSIs). We recruited a nationwide sample of 225 CSIs to complete online questionnaires assessing PTSD symptoms, use of specific coping tactics, perceived social support, trait resilience, and demographics. Seven symptoms had been experienced by at least 50% of participants during the previous month, and 9.3% had total checklist scores suggestive of PTSD. A significant regression analysis revealed that higher PTSD scores were associated with drinking alcohol more frequently to deal with stress, admitting more frequently one could not deal with stress and not trying to do so, lower social support, getting angry and letting emotions out more frequently, lower resilience, and finding comfort in one's religious beliefs. Given the proportions of CSIs that experience exposure‐related stress, more should be done to mitigate the prevalence and severity of these symptoms.
Dealing with high uncertainty in qualitative network models using Boolean analysis
Authors: Kristensen Nadiah P. , Chisholm Ryan A. , McDonald‐Madden Eve
Published: March 2019

Models for predicting ecological behaviour typically require large volumes of data for parameterisation, which is a problem because data are scarce. Qualitative modelling (QM) provides an alternative by exploring the entire range of possible parameter values. When a parameter value is completely unknown, QM typically invokes the Principle of Indifference (PoI), for example by sampling the parameter from a uniform prior distribution. However, if PoI is invoked in this probabilistic way, there may be multiple possible methods for defining a parameter space and sampling values from it, and, worryingly, two different but equally defensible methods can lead to different predictions about ecosystem responses.

We investigated how probabilistic PoI can give rise to problems in QM, and developed an alternative method based on Boolean PoI that does not suffer the same limitations. We used a case study that involved predicting the responses of multiple species to the suppression of a pest. The unknown model parameters were interaction strengths between species. For the standard probabilistic method, we drew the parameters randomly from uniform (PoI) and other distributions. For our new Boolean PoI method, we instead simply specified the ranges of “possible” parameter values, and developed a Boolean analysis technique to summarise model predictions.

As expected, invoking probabilistic QM yielded different predictions (species‐response probabilities) for different but equally defensible parameterisation and sampling schemes. Sometimes differences were large enough to impact decision‐making. In contrast, our new Boolean PoI approach simply classifies outcomes (species responses) as certain, possible, or impossible. Encouragingly, some species responses that were not consistently resolved under probabilistic PoI were shown by our method to be in fact governed by simple rules. Our method can also identify key species whose responses determine whole‐system outcomes.

Our non‐probabilistic representation of uncertainty circumvents the philosophical problems in standard implementations of PoI for QM. Our Boolean analysis method summarises results in a way that is interpretable and potentially useful to conservation decision makers. A priority for future research is to increase the efficiency of our Boolean approach to allow it to deal with problems of higher complexity (more interactions).
Moral hazard: the effect of insurance on risk and efficiency
Authors: Roll Kristin H.
Published: March 2019

While there is a large body of literature investigating the effect of crop and livestock insurance on input and yield, limited attention has been paid to the effect of insurance on efficiency. This article investigates how insurance affects technical efficiency and whether insurance alters the utilized input quantity to a riskier bundle using the Norwegian salmon farming industry as a case. The results illustrate that insurance has an enhancing effect on production and efficiency and changes the utilized input mix—a well‐insured farmer uses more feed and less capital and labor than a less‐insured farmer. When linking this to each input's risk profile, the results indicate that insurance will induce the use of the risk‐increasing factor (feed) and reduce the use of the risk‐decreasing factors (labor and capital)—thereby increasing production risk and indicating moral hazard.
The Disclosure Dilemma: Nuclear Intelligence and International Organizations
Authors: Carnegie Allison , Carson Austin
Published: March 2019

Scholars have long argued that international organizations solve information problems through increased transparency. This article introduces a distinct problem that instead requires such institutions to keep information secret. We argue that states often seek to reveal intelligence about other states' violations of international rules and laws but are deterred by concerns about revealing the sources and methods used to collect it. Properly equipped international organizations, however, can mitigate these dilemmas by analyzing and acting on sensitive information while protecting it from wide dissemination. Using new data on intelligence disclosures to the International Atomic Energy Agency and an analysis of the full universe of nuclear proliferation cases, we demonstrate that strengthening the agency's intelligence protection capabilities led to greater intelligence sharing and fewer suspected nuclear facilities. However, our theory suggests that this solution gives informed states a subtle form of influence and is in tension with the normative goal of international transparency.
Protease/antiprotease network in allergy: The role of Staphylococcus aureus protease‐like proteins
Authors: Krysko Olga , Teufelberger Andrea , Van Nevel Sharon , Krysko Dmitri V. , Bachert Claus
Published: March 2019

Staphylococcus aureus is being recognized as a major cofactor in atopic diseases such as atopic dermatitis, chronic rhinosinusitis with nasal polyps, and asthma. The understanding of the relationship between S aureus virulence factors and the immune system is continuously improving. Although the precise mechanism of the host's immune response adaptation to the variable secretion profile of S aureus strains continues to be a matter of debate, an increasing number of studies have reported on central effects of S aureus secretome in allergy. In this review, we discuss how colonization of S aureus modulates the innate and adaptive immune response, thereby predisposing the organism to allergic sensitization and disrupting immune tolerance in the airways of patients with asthma and chronic rhinosinusitis with nasal polyps. Next, we provide a critical overview of novel concepts dealing with S aureus in the initiation and persistence of chronic rhinosinusitis with nasal polyps and asthma. The role of the S aureus serine protease‐like proteins in the initiation of a type 2 response and the contribution of the IL‐33/ST2 signaling axis in allergic responses induced by bacterial allergens are discussed.
Allergens in dog extracts: Implication for diagnosis and treatment
Authors: Wintersand Anna , Asplund Klara , Binnmyr Jonas , Holmgren Erik , Nilsson Ola B. , Gafvelin Guro , Grönlund Hans
Published: March 2019

Background

Five to ten percent of the population in affluent countries are allergic to dog. Diagnosis and treatment is based on allergen extracts from natural sources where composition and concentration are poorly defined.

Objective

We aimed to quantify six dog allergens (Can f 1‐6) in commercial skin prick test (SPT) solutions and to determine individual allergen profiles in dogs.

Method

The allergen content of SPT solutions from five vendors and allergen source material from three anatomical sites were analyzed. Fur and saliva samples were collected from a mixed population of 120 dogs. Can f 1‐6 were quantified by inhibition ELISA using purified recombinant or natural allergens and polyclonal or monoclonal antibodies. Allergenicity was analyzed by basophil activation test.

Results

Extensive variation in allergen composition was observed in commercial SPT vials resulting in a patient‐dependent ability to activate basophils. Extract heterogeneity depended on collection site and allergen composition in individual dogs and source materials. Can f 2 and Can f 6 exhibited low levels in fur and SPT solutions, whereas Can f 4, which was the dominating allergen in fur samples, did not display similar high proportions in SPT solutions. Can f 3 varied most among SPT solutions.

Conclusion

There is a great variation of dog allergens in natural extracts raising questions of source, sampling, processing and ultimately of standardization and minimum allergen levels for accurate diagnosis and treatment.
A 2:1 atrioventricular block presenting paradoxical ventriculophasic response
Authors: Nakashima Takashi , Suzuki Keita , Ido Takahisa , Yamaura Makoto , Takahashi Shigekiyo , Aoyama Takuma
Published: March 2019

Ventriculophasic response (VR) is defined as the shortening of the sinus cycle length in the setting of greater than second‐degree atrioventricular (AV) block. Typically, the PP intervals interposing a QRS complex are shorter than those without a QRS complex. Paradoxical VR is a rare clinical entity. We report about an 80‐year‐old man presenting with a 2:1 AV block, in whom typical and paradoxical VRs were observed.
Inside Checkpoint 300: Checkpoint Regimes as Spatial Political Technologies in the Occupied Palestinian Territories
Authors: Rijke Alexandra , Minca Claudio
Published: March 2019

As a part of the architecture of the Israeli occupation of the Palestinian Territories, the Israeli government introduced in 2005 a series of so‐called terminal checkpoints as “neutral border crossings”, to minimise the impact of these barriers on Palestinian lives through a different design and the use of several machines, such as turnstiles and metal detectors. In this article, we analyse terminal Checkpoint 300 in Bethlehem, framing it as a spatial political technology aimed at controlling the movement of Palestinians. More specifically, we investigate the interactions between Palestinian commuters, Israeli soldiers/security guards and the machines operating inside Checkpoint 300. We conclude by suggesting that Checkpoint 300 is a porous barrier whose regime is produced, reproduced but also challenged by such interactions, and that, despite the new “neutral design”, Checkpoint 300 is a place still filled with tension and violence, often exercised by the machines and their “decisions”.
Early combined immunosuppression may be effective and safe in older patients with Crohn’s disease: post hoc analysis of REACT
Authors: Singh Siddharth , Stitt Larry W. , Zou Guangyong , Khanna Reena , Dulai Parambir S. , Sandborn William J. , Feagan Brian G. , Jairath Vipul
Published: March 2019

Background

Physicians may be reluctant to prescribe combined immunosuppression in older patients with Crohn's disease due to perceived risk of treatment‐related complications.

Aim

To evaluate the impact of age on risk of Crohn's disease‐related complications in patients treated with early combined immunosuppression vs conventional management in a post hoc analysis of the randomised evaluation of an algorithm for Crohn's treatment (REACT), a cluster‐randomised trial.

Methods

We compared efficacy (time to major adverse outcome of Crohn's disease‐related surgery, hospitalisation or serious complications; corticosteroid‐free clinical remission) and safety outcomes at 24 months, between patients aged <60 vs ≥60 years randomised to early combined immunosuppression or conventional management, using Cox proportional hazard analysis or modified Poisson model. In the early combined immunosuppression arm, patients with failure to achieve clinical remission within 4‐12 weeks of corticosteroids were treated with a combination of tumour necrosis factor‐α antagonist plus anti‐metabolite and sequentially escalated in a stepwise algorithm.

Results

Of 1981 patients, 311 were ≥60 years (15.7%; 173 randomised to early combined immunosuppression and 138 to conventional management). Over 24 months, 10% of older patients developed Crohn's disease‐related complications (early combined immunosuppression vs conventional management: 6.4% vs 14.5%) and 14 patients died (3.5% vs 5.8%). There was no difference between younger and older patients in risk of achieving corticosteroid‐free clinical remission (<60 years, early combined immunosuppression (72.6%) vs conventional management (64.4%): relative risk [RR], 1.06 [95% CI, 0.98‐1.15] vs ≥60 years, early combined immunosuppression (74.8%) vs conventional management (63.0%): RR, 1.09 [0.90‐1.33], P‐interaction = 0.78) or time to major adverse outcome (<60 years: hazard ratio [HR], 0.71 [0.53‐0.96] vs ≥60 years: HR, 0.69 [0.31‐1.51], P‐interaction = 0.92) with early combined immunosuppression vs conventional management.

Conclusions

We observed no difference in efficacy and safety of early combined immunosuppression compared to conventional management in older and younger patients. Early combined immunosuppression may be considered as a treatment option in selected older patients with Crohn's disease with suboptimal disease control. Clinical Trial Identifier: NCT01030809.
Representing the Milan metropolitan region from a public policy perspective
Authors: Del Fabbro Matteo
Published: March 2019

The present paper proposes a three‐axis method for identifying metropolitan regions in a European context that was developed from a public policy perspective within the field of regional geography. Drawing on a harmonised definition of functional urban area and a case‐specific literature review, the proposed method can be applied to urban regions characterised by multiple territorial development patterns. This paper focuses on the metropolitan node of Milan within the urban network of northern Italy. First, the concept of functional territorial scale is used to assess the city‐regional scale of Milan. Then, based on available geographical descriptions of metropolitan Milan, the metropolitan region is defined as a set of labour market areas, rather than as a single metropolitan area. Finally, some demographic and employment trends that have characterised the Milan metropolitan region and its emerging territorial imbalances over time are highlighted. Having identified a metropolitan territorial unit of Milan, the paper outlines some linkages between city‐regional development and metropolitan institutional policy.
ATP1A3 mosaicism in families with alternating hemiplegia of childhood
Authors: Yang Xiaoling , Yang Xiaoxu , Chen Jiaoyang , Li Shupin , Zeng Qi , Huang August Y. , Ye Adam Y. , Yu Zhe , Wang Sheng , Jiang Yuwu , Wu Xiru , Wu Qixi , Wei Liping , Zhang Yuehua
Published: March 2019

Alternating hemiplegia of childhood (AHC) is a rare and severe neurodevelopmental disorder characterized by recurrent hemiplegic episodes. Most AHC cases are sporadic and caused by de novo ATP1A3 pathogenic variants. In this study, the aim was to identify the origin of ATP1A3 pathogenic variants in a Chinese cohort. In 105 probands including 101 sporadic and 4 familial cases, 98 patients with ATP1A3 pathogenic variants were identified, and 96.8% were confirmed as de novo. Micro‐droplet digital polymerase chain reaction was applied for detecting ATP1A3 mosaicism in 80 available families. In blood samples, four asymptomatic parents, including two paternal and two maternal, and one proband with a milder phenotype were identified as mosaicism. Six (7.5%) parental mosaicisms were identified in multiple tissues, including four previously identified in blood and two additional cases identified from paternal sperms. Mosaicism was identified in multiple tissues with varied mutant allele fractions (MAFs, 0.03%‐33.03%). The results suggested that MAF of mosaicism may be related to phenotype severity. This is the first systematic report of ATP1A3 mosaicism in AHC and showed mosaicism as an unrecognized source of previously considered “de novo” AHC. Identifying ATP1A3 mosaicism provides more evidence for estimating recurrence risk and has implications in genetic counseling of AHC.
Feasibility and outcomes of fibreoptic endoscopic evaluation of swallowing following prophylactic swallowing rehabilitation in head and neck cancer
Authors: Patterson Joanne , Toft Kate , McAuley Fiona , King Emma , McLachlan Kirsty , Roe Justin W. G. , Wells Mary
Published: March 2019

Objectives

Investigate the feasibility and outcomes of fibreoptic endoscopic evaluation of swallowing (FEES) following a programme of prophylactic swallowing exercises in head and neck cancer (HNC) patients treated with radiotherapy.

Design

Prospective, single cohort, feasibility study.

Setting

Three head and neck cancer centres in Scotland.

Participants

Pre‐radiotherapy HNC patients who consented to participate in a prophylactic swallowing intervention.

Outcome measures

Fibreoptic endoscopic evaluation of swallowing recruitment and retention rates, assessment acceptability and compliance, qualitative process evaluation.

Results

Higher rates of recruitment and retention were achieved in centres where FEES equipment was available on‐site. Travel and anticipated discomfort were barriers to recruitment. Data completion was high for all rating scales, with good reliability. Following radiotherapy, swallowing safety significantly deteriorated for liquid boluses (P = 0.005‐0.03); pharyngeal residue increased for liquid and semi‐solid boluses. Pharyngo‐laryngeal oedema was present pre‐treatment and significantly increased post‐radiotherapy (P = 0.001). Patients generally reported positive experience of FEES for their own learning and establishing a baseline.

Conclusions

Fibreoptic endoscopic evaluation of swallowing is an acceptable method of assessing patients for a prophylactic swallowing intervention and offers some additional information missing from VF. Barriers have been identified and should be taken into account in order to maximise recruitment for future trials.
Turkish validation of the Sino‐Nasal Outcome Test‐22
Authors: Cakir Cetin Asli , Kumus Ozgur , Keskinoglu Pembe , Sutay Semih , Ecevit Mustafa Cenk
Published: March 2019

Objectives

The Sino‐Nasal Outcome Test (SNOT)‐22 is a widely used health‐related quality of life questionnaire. This study aimed to conduct a translation and validation study of the SNOT‐22 in the Turkish language.

Design

We achieved a convenient translation and cultural adaptation process to translate the original SNOT‐22 into the Turkish language (observational prospective cohort study).

Setting

This study was conducted in a single tertiary‐level university hospital.

Participants

We performed reliability, validity and responsiveness analyses in 313 participants. One hundred eighty‐nine of the participants were the chronic rhinosinusitis (CRS) group, and 79 healthy volunteers enrolled in the control group. Twenty‐nine participants who underwent endoscopic sinus surgery for CRS were evaluated for pre‐postoperative responsiveness analysis.

Main Outcome Measures

Reliability (internal consistency and test‐retest reproducibility), validity, responsiveness, sensitivity and specificity.

Results

The internal consistency coefficient (Cronbach's alpha) was 0.909 in the CRS test group, 0.955 in the CRS retest group, and 0.916 in the control group. The reliability value (Pearson correlation coefficient) of the test‐retest group was 0.901. The validity was assessed by the independent sample t‐test between the CRS and control groups and resulted in a significant difference (P < 0.001). Responsiveness was interpreted using the paired t‐test between pre‐ and post‐medical and pre‐ and post‐surgical treatment groups; statistical analysis found significance in both groups (P < 0.001). When using the SNOT‐22 cut‐off value of 33.5, the sensitivity and specificity of the Turkish version of the SNOT‐22 was 54.5% and 75.9%, respectively (95% CI, area under the curve (AUC): 0.69, range 0.624â€“0.756, P = 0.000).

Conclusions

The authors suggest that the Turkish SNOT‐22 is a valid, reliable, reproducible and responsive questionnaire.
Allergic contact dermatitis caused by synthetic rubber gloves in healthcare workers: Sensitization to 1,3‐diphenylguanidine is common
Authors: Dejonckheere Guillaume , Herman Anne , Baeck Marie
Published: March 2019

Background

The frequency of allergic contact dermatitis has significantly increased in healthcare workers since the transition from latex to synthetic rubber gloves, with 1,3‐diphenylguanidine being identified as the most frequently implicated allergen.

Objectives

To highlight the role of 1,3‐diphenylguanidine as the culprit allergen in contact allergies to synthetic rubber gloves, to propose recommendations for patch testing, and to discuss alternatives for sensitized subjects.

Materials and methods

Patch test data from healthcare workers who developed hand dermatitis after wearing rubber gloves and who reacted positively to glove samples and rubber additives were collected from September 2010 to December 2017 in a Belgian hospital.

Results

A total of 44 caregivers were included in this study. Patch tests showed that: (a) 84% of the study population reacted positively to carba mix; (b) 86% reacted positively to 1,3‐diphenylguanidine; and (c) 13 (30%) reacted positively to thiuram mix. Half of the subjects reacted positively to gloves containing 1,3‐diphenylguanidine, whereas none reacted to accelerator‐free gloves.

Conclusion

The most commonly identified allergen was 1,3‐diphenylguanidine, far ahead of thiurams, which were previously described as the most sensitizing accelerators. The use of 1,3‐diphenylguanidine‐free gloves is recommended. No subject reacted to gloves without accelerators, thus confirming their efficiency among accelerator‐sensitized patients. We recommend that 1,3‐diphenylguanidine be added to the European baseline series.
The dynamics of proclaimed privately protected areas in South Africa over 83 years
Authors: De Vos Alta , Clements Hayley S. , Biggs Duan , Cumming Graeme S.
Published: March 2019

Views that protected area (PA) expansion relies predominantly on land purchased by government are increasingly being challenged. The inclusion of privately owned PAs (PPAs) in national conservation strategies is now commonplace, but little is known about their long‐term persistence and how it compares to that of state‐owned PAs. We undertook the first long‐term assessment of the dynamics of a national system of terrestrial PPAs, assessing its growth, as well as its resilience to downgrading, downsizing, and degazettement (PADDD). Between 1926 and 2018, 6.2% of all private nature reserves established in South Africa were degazetted, compared to 2.2% of state‐owned nature reserves. Privately owned PA growth exceeded that of state‐owned PAs. Trends in PA establishment differed between privately owned and state‐owned PAs, reflecting different legislative, political, and economic events. Our findings highlight the value of enabling legislative environments to facilitate PPA establishment, and demonstrate the potential of PPAs as a long‐term conservation strategy.
Single‐center, real‐world experience with granulocyte colony‐stimulating factor for management of leukopenia following kidney transplantation
Authors: Hamel Stephanie , Kuo Vicky , Sawinski Deirdre , Johnson David , Bloom Roy D. , Bleicher Melissa , Goral Simin , Lim Mary Ann , Trofe‐Clark Jennifer
Published: March 2019

Background

Leukopenia is a frequent complication following kidney transplantation. Granulocyte colony‐stimulating factor (G‐CSF) has been used to accelerate white blood cell (WBC) count recovery; however, published experience in kidney transplantation is limited.

Methods

We retrospectively reviewed our kidney transplant recipients from January 2012 to September 2016 with a G‐CSF order to evaluate leukopenia management (defined as WBC <3000 cells/μL).

Results

Thirty‐six recipients were included. On average, G‐CSF treatment began at 98 ± 38 days. At G‐CSF initiation, mean WBC count was 1240 ± 420 cells/μL and absolute neutrophil count (ANC) was 653 ± 368 cells/μL. Mean G‐CSF dose was 4.6 ± 1.2 mcg/kg/dose (total 11.8 ± 9.0 mcg/kg), 77.8% of recipients were prescribed G‐CSF as outpatients, and overall, median time to WBC count recovery was 9 (IQR 4‐14) days. Changes in immunosuppression and prophylaxis regimens for leukopenia were also common. Within 1 month following leukopenia onset, no patients experienced acute rejection and 5 (14%) developed infection requiring hospitalization or opportunistic infection.

Conclusion

In kidney recipients with leukopenia, G‐CSF may be helpful to achieve WBC count recovery in addition to changes in immunosuppression and prophylaxis medications. Prospective, randomized data are still needed to determine optimal G‐CSF dosing in this population.
The impact of intraoperative fluid management during laparoscopic donor nephrectomy on donor and recipient outcomes
Authors: Williams Aaron M. , Kumar Sathish S. , Bhatti Umar F. , Biesterveld Ben E. , Kathawate Ranganath G. , Sung Randall S. , Woodside Kenneth J. , Englesbe Michael J. , Alameddine Mitchell B. , Waits Seth A.
Published: March 2019

Background

Intraoperative fluid management during laparoscopic donor nephrectomy (LDN) may have a significant effect on donor and recipient outcomes. We sought to quantify variability in fluid management and investigate its impact on donor and recipient outcomes.

Methods

A retrospective review of patients who underwent LDN from July 2011 to January 2016 with paired kidney recipients at a single center was performed. Patients were divided into tertiles of intraoperative fluid management (standard, high, and aggressive). Donor and recipient demographics, intraoperative data, and postoperative outcomes were analyzed.

Results

Overall, 413 paired kidney donors and recipients were identified. Intraoperative fluid management (mL/h) was highly variable with no correlation to donor weight (kg) (R = 0.017). The aggressive fluid management group had significantly lower recipient creatinine levels on postoperative day 1. However, no significant differences were noted in creatinine levels out to 6 months between groups. No significant differences were noted in recipient postoperative complications, graft loss, and death. There was a significant increase (P < 0.01) in the number of total donor complications in the aggressive fluid management group.

Conclusions

Aggressive fluid management during LDN does not improve recipient outcomes and may worsen donor outcomes compared to standard fluid management.
Motivation of Parent–Child Co‐residence Behavior: Evidence from the China Health and Retirement Longitudinal Study
Authors: Wang Yijie , Sun Wenkai , Wang Xianghong
Published: March 2019

This paper examines the motivations of parent‐child co‐residence behavior in China using data from the China Health and Retirement Longitudinal Study. We test three possible motives: social norms, self‐interest and altruism. We find that social norms play an important role in household co‐residence behavior, showing that the belief that “sons take care of parents” is strong, and children in different birth orders take different responsibilities. Taking the one‐child policy as a natural experiment, we compared co‐residence behavior between only‐child and multi‐child families. This allowed us to test whether children in multi‐child families with wealthier parents more often co‐reside in order to compete for a bequest. We find that parents' wealth is more appealing to children in multi‐child families. The results support the life cycle theory that co‐residence decisions are motivated by self‐interest. We also find some evidence of altruism when parents and children make co‐residence decisions. These findings provide some insights for designing future elder‐support policies in China.
Associations of physical activity levels and screen time with oral glucose tolerance test profiles in Singaporean women of reproductive age actively trying to conceive: the S‐PRESTO study
Authors: Bernard J. Y. , Ng S. , Natarajan P. , Loy S. L. , Aris I. M. , Tint M. T. , Chong Y.‐S. , Shek L. , Chan J. , Godfrey K. M. , Khoo C. M. , Leow M. K.‐S. , Müller‐Riemenschneider F. , Chan S.‐Y.
Published: March 2019

Aim

To examine the associations of physical activity and screen time, a proxy for sedentary behaviour, with fasting and post‐load glucose levels in Singaporean women enrolled in a multi‐ethnic Asian preconception study.

Methods

Moderate and vigorous physical activity and screen time (television and other electronic devices) were self‐reported by women enrolled in the S‐PRESTO cohort. Fasting, 30‐min and 120‐min glucose levels before and during a 75‐g oral glucose tolerance test were measured. Associations of physical activity and screen time with glucose levels were analysed using multivariable linear marginal regression.

Results

A total of 946 women aged 31.4±3.7 years were examined, of whom 72% were of Chinese, 15.5% were of Malay, 9.3% were of Indian and 3.2% were of mixed ethnicity. A total of 32% of women reported being active, 36% watched television ≥2 h/day and 26% used electronic devices ≥3 h/day. In adjusted models, vigorous, but not moderate, physical activity was associated with lower overall glucose levels, and was associated more strongly with post‐challenge than fasting glucose levels. Compared to women not engaging in vigorous physical activity, those engaging in physical activity ≥75 min/week had lower mean fasting [–0.14 (95% CI –0.28, –0.01) mmol/l], 30‐min [0.35 (95% CI –0.68, –0.02) mmol/l] and 120‐min [–0.53 (95% CI –0.16, –0.90) mmol/l] glucose levels (overall P value=0.05). We found no associations of screen time with glucose levels.

Conclusions

Independently of the time spent in non‐vigorous physical activity and using screens, engaging in vigorous physical activity may be a modifiable factor to improve glucose regulation in women of Asian ethnicity who are attempting to conceive.
Prevalence of diabetes in Poland: a combined analysis of national databases
Authors: Topor‐Madry R. , Wojtyniak B. , Strojek K. , Rutkowski D. , Bogusławski S. , Ignaszewska‐Wyrzykowska A. , Jarosz‐Chobot P. , Czech M. , Kozierkiewicz A. , Chlebus K. , Jędrzejczyk T. , Mysliwiec M. , Polanska J. , Wysocki M.J. , Zdrojewski T.
Published: March 2019

Aims

To assess the number of people with diabetes in Poland using combined national sources and to evaluate the usefulness of data from an insurance system for epidemiological purposes.

Methods

The data were collected from four sources: 1) 2013 all‐billing records of the national insurance system comprising people of all age groups undergoing procedures or receiving services in primary healthcare, specialist practices and hospitals and also those receiving drugs; 2) an epidemiological study, NATPOL, that involved the assessment of people with undiagnosed diabetes; 3) the RECEPTOmetr Sequence study on prescriptions; and 4) regional child diabetes registries.

Results

In 2013, 1.76 million people (0.98 million women and 0.79 million men) had medical consultations (coded E10‐E14) and 2.13 million people (1.19 million women and 0.94 million men) purchased drugs or strip tests for diabetes. A total of 0.04 million people who used medical services did not buy drugs. In total, the number of people with diabetes in the insurance system was 2.16 million (1.21 million women and 0.95 million men), which corresponds to 6.1% (95% CI 6.11–6.14) of women and 5.1% (95% CI 5.12–5.14) of men. Including undiagnosed cases, the total number of people with diabetes in Poland was 2.68 million in 2013.

Conclusion

The estimated prevalence of diabetes (diagnosed and undiagnosed cases) in Poland is 6.97%. Data from the national insurance system with full coverage of the population can be treated as a reliable source of information on diseases with well‐defined diagnosis and treatment methods, combined with an assessment of the number of undiagnosed individuals.