bluuebunny/crossref_metadata_2025 huggingface dataset:
Losing metrics … finding heart
Authors: Day Julia K.
Published: May 2019

Purpose

This paper aims to provide an example of ways in which research plans may shift and how the research team dealt with necessary changes as they unfolded; within this context, the authors encourage the use of qualitative and narrative methods prior to and during the design process to better understand the population for which they are designing. Second, the stories from this case study illustrate the importance of understanding the overall context in design solutions, understanding the value of working with residents during the design process and using design as a tool for advocacy and empathy.

Design/methodology/approach

Initially, a traditional mixed method approach was developed to study the feasibility of tiny homes in homeless populations. Responding to unforeseen circumstances, the research team shifted to more appropriate narrative research methods, capturing a profile of the community. The paper shares narrative accounts from the tiny home village residents.

Findings

Overall, the stories from the Portland visit illustrate the importance of social impact and the understanding of the overall context in design. This study also advocates the use of qualitative interview and narrative methods in design research, especially when used to better understand the “houseless” or other special populations.

Research limitations/implications

There were limitations to the research that likely affected the outcomes and the results. The most apparent limitation was the unanticipated shift in methodology that occurred during the research study, which is also arguably one of the best strengths. Also, because of the qualitative nature of this research, the results are not generalizable to a broader context and only valuable or applicable to special cases.

Practical implications

The true human condition of displaced people is often misrepresented in the minds of those who are unaffected. Designers are uniquely qualified to help solve seemingly unsolvable problems but must do so with caution.

Social implications

For those taking on the challenge of designing for disadvantaged communities, this paper reveals that design research is more than just a problem to solve through habitable boxes. This study brings to light several social, economic and design complications that may arise in this vein of research.

Originality/value

This research methodology was unexpectedly altered when unforeseen events necessitated a shift in the research plan. This process revealed that sensitive social issues can be difficult to navigate and must be treated with utmost respect and flexibility. Issues such as affordable housing, homelessness and sustainability are all examples of wicked problems, which designers are uniquely qualified to help solve but must do so with caution and a true understanding of context. Many lessons were learned through this process.
NHS Inquiries and the Problem of Culture
Authors: Goodwin Dawn
Published: May 2019

If inquiries are about learning the lessons of the past, why do they appear to find the same failings time and again? Bristol, Mid Staffordshire, Morecambe Bay, Liverpool Community Health are all examples of where culture went wrong. The lack of learning from inquiries is a prominent concern and one raised elsewhere in this issue. In this article, I explore why it might be that culture is repeatedly found to be the cause of healthcare failures. I start by reviewing perspectives on what culture is and the degree to which it is possible change it. I examine how culture was described in the Bristol, Mid Staffordshire, Morecambe Bay and Liverpool inquiries and question whether these are the same cultures, with the same problems, or whether they are different. I discuss possible explanations for apparent similarities, describe how cultural change occurs and conclude by drawing out the implications of focussing on culture as a threat to patient safety.
Public Involvement in NHS Inquiries
Authors: Carlyle Ruth
Published: May 2019

Opportunities for engaging the public have changed over the fifty years since the inquiry into the Ely Hospital, Cardiff. NHS inquiries, and inquiries more widely, tend to be called where events have led to public concern and loss of public confidence. Involvement of the public could therefore be assumed to form a part of restoring that public confidence. This paper explores the mechanisms for public involvement in NHS inquiries over the past fifty years, assessing the roles played by the public. It uses the framework outlined by Geoffrey Howe to examine how members of the public have been involved in four NHS inquiries. Findings suggest that the roles and mechanisms have varied, but that understanding the extent of public involvement is a dimension to assessing each of the potential functions of an NHS inquiry.
How migration policies moderate the diffusion of terrorism
Authors: BÖHMELT TOBIAS , BOVE VINCENZO
Published: May 2019

There is an ongoing debate among practitioners and scholars about the security consequences of transnational migration. Yet, existing work has not, so far, fully taken into account the policy instruments states have at their disposal to mitigate these risks, and reliable evidence is lacking for the effectiveness of such measures. This article addresses both shortcomings as whether and to what extent national migration policies affect the diffusion of terrorism via population movements are analysed. Spatial analyses report robust support for a moderating influence of states’ policies: while terrorism can travel from one country to another via larger migration populations, this only applies to target countries with extremely lax regulations and control mechanisms. This research sheds new light on the security implications of population movements, and it crucially adds to our understanding of governments’ instruments for addressing migration challenges as well as their effectiveness.
Disinfectant and Antimicrobial Susceptibility Profiles of Campylobacter coli Isolated in 1998 to 1999 and 2015 from Swine and Commercial Pork Chops
Authors: Beier Ross C. , Harvey Roger B. , Hernandez Charles A. , Andrews Kathleen , Droleskey Robert E. , Hume Michael E. , Davidson Maureen K. , Bodeis‐Jones Sonya , Young Shenia , Anderson Robin C. , Nisbet David J.
Published: May 2019

Susceptibility profiles were determined for 111 Campylobacter coli strains obtained in 1998 to 1999 and 2015 from market age pigs and pork chops against 22 disinfectants and 9 antimicrobials. Resistance to tetracycline (TET) was observed in 44.4% of 1998 to 1999 strains, and the antibiotic resistance profile was TET. But strains obtained in 2015 from swine and retail pork chops had 75% TET resistance and the antibiotic resistance profile was TET, followed by azithromycin‐erythromycin‐TET‐telithromycin‐clindamycin. Antimicrobial resistance increased in 2015 strains. All strains were resistant to triclosan, and 84.1% and 95.8% of strains in 1998 to 1999 and 2015, respectively, were chlorhexidine resistant. All strains were susceptible to benzalkonium chloride. There was a shift toward higher susceptibility to chlorhexidine, triclosan, P‐128, OdoBan, CPB, and CPC in 2015 swine and pork chop strains compared with 1998 to 1999 strains. The disinfectants Tek‐Trol and providone‐iodine, tris(hydroxylmethyl)nitromethane (THN) and formaldehyde demonstrated the highest susceptibilities. Didecyldimethylammonium chloride (C10AC) appeared to be about equally effective as benzyldimethyltetradecylammonium chloride (C14BAC) for inhibiting C. coli, and both were more effective than C8AC and C12BAC, but C16BAC was not efficient at inhibiting C. coli. The BACs, C12BAC and C14BAC, were the most effective ingredients in DC&R. Also, C12BAC and C14BAC, or these two in synergy with C10AC were responsible for inhibition of C. coli at high P‐128 MICs. No cross‐resistance was observed between antibiotics and disinfectants. The continued use of THN and formaldehyde in DC&R should be evaluated since these components are not effective, and their inclusion adds unwanted chemicals in the environment.

Practical Application

Campylobacter species cause diarrheal disease throughout the world. Disinfectants are often used on the farm, in veterinary medicine, by the food processing industry, in restaurants, and in consumer's homes. Limited information is available in the literature showing how disinfectants or disinfectant components may affect the many different foodborne pathogens, and, specifically, Campylobacter coli studied here. The knowledge generated in this study concerning the interactions of a broad array of disinfectants against C. coli may well affect the types of disinfectants and disinfectant formulations allowable for use by medical personnel, producers, food processors, restaurants, and consumers.
Sensory Characterization of Dominant Malawi Peanut Varieties After Roasting
Authors: Gama Aggrey Pemba , Adhikari Koushik
Published: May 2019

Although sensory appeal influences peanut consumption, peanut varieties are mostly selected based on agronomic traits. As a result, the sensory properties of peanut varieties, especially in southern Africa, are not known. Therefore, the primary objective of the study was to determine the sensory properties of the Malawi peanut varieties and the volatile compounds associated with roasted peanut flavor. Six dominant Malawi peanut varieties (Chalimbana, CG7, Nsinjiro, Kakoma, Baka, and Chitala) were evaluated in this study. All peanut samples were shelled and then, roasted in a convection oven to reach medium doneness as indicated by the surface color lightness (L) value of approximately 50. A hybrid descriptive analysis (DA) was done to determine the sensory profile of the roasted peanuts. Volatile compounds were extracted from equilibrated ground peanut sample using headspace‐solid phase microextraction technique and analyzed by GC‐MS. Analysis of Variance (ANOVA) of the DA data showed significant differences (P < 0.05) in the sensory profiles of the peanut varieties. Nsinjiro and Baka had a significantly higher intensity of roasted peanutty aroma and flavor (P < 0.05). The GC‐MS results showed that pyrazines and furans were the dominant volatile compounds but, their respective concentrations, in the evaluated peanut varieties, were significantly different (P < 0.05). Among the pyrazines, 2‐ethyl‐3,5‐dimethyl pyrazine was strongly correlated with roasted peanutty flavor (r = 0.927) just like 2,5 dimethyl pyrazine (r = 0.916). Therefore, 2‐ethyl‐3,5‐dimethyl pyrazine and 2,5‐dimethyl pyrazine production pathways could provide more insights into the origins of roasted peanut flavor.

Practical Application

The findings of this study can help food product developers, who have no access to sensory and analytical analyses, to identify Malawi peanut varieties that are suitable for various food applications. Furthermore, plant breeders could also use the findings to inform new projects aimed at improving the sensory properties of the peanut varieties.
Rare Earth Elements and Yttrium (REY) Geochemistry of Reefal Limestones in the Ordovician, Tarim Basin, NW China and their Paleoenvironment Implications
Authors: MENG Miaomiao , LIU Xinxing , FAN Tailiang , DUNCAN Ian J.
Published: May 2019

This study examines the rare earth elements and yttrium (REY) concentrations of twenty‐five samples from the reef outcrop exposed along the Lianglitage Mountain in the Ordovician, Tarim Basin in China. The concentration analysis provides constraints on the paleoenvironment during reef deposition. Based on the detailed sedimentology and petrographic work, we divide the reef facies into four sub‐facies: the base facies, reef‐core facies, reef‐flank facies, and sealing facies. The geochemical data (such as major and trace elements, carbon and oxygen isotopes, and REYs) are further used to study the coeval seawater characteristics as well as potential diagenesis overprints. The result indicated that the diagenesis has little effect on the REY patterns of the reefal limestones. The REY concentrations of the reefal limestones are overall low (ranging from 3.69 to 19.60 ppm, arithmetic mean=10.22 ppm, SD=5.4). The PAAS‐normalized REY patterns are consistently flat compared to the typical well‐oxidized, shallow marine water patterns. However, the light REE (LREE) depletions, positive La anomalies, negative Ce anomalies and positive Y anomalies, suggest that these reefal limestones are likely an indicative of contemporaneous seawater REY signals. The seawater‐like Y/Ho ratios (average at 37.51) further support that REY signals in these limestones are likely a reflection of seawater with little diagenetic modifications. The low Y/Ho ratios presented only in the reef‐flank facies and sealing facies are likely a suggestion of detrital contamination. Hence, this study confirms that REY patterns of the limestones at the base facies and reef‐core facies can record ancient seawater information, and reefs can be used as a potential geochemical proxy for paleoenvironment studies throughout the Earth's history.
Ultrasound detected changes in joint cartilage thickness in juvenile idiopathic arthritis
Authors: Mitra Sonali , Samui Partha Pratim , Samanta Moumita , Mondal Rakesh Kumar , Hazra Avijit , Mandal Kalyanbrata , Sabui Tapas Kumar
Published: May 2019

Aim

The purpose of this study was to investigate the changes in joint cartilage thickness in different subtypes of juvenile idiopathic arthritis (JIA) using ultrasound, comparing them with healthy children and to evaluate the relationship with disease duration and inflammatory markers.

Methods

We conducted a cross‐sectional study comprising of 27 cases of JIA and 54 age‐ and sex‐matched healthy children. Bilateral wrist, knee and ankle joint cartilage thicknesses were measured by ultrasound as per European League Against Rheumatism standard guidelines and compared them between JIA subtypes as well as between cases and control.

Results

Descriptive analysis of the whole cohort revealed the mean age of the study population was 8.3 ± 3.2 years with mean cartilage thicknesses at the wrist, knee and ankle being 1.40 ± 0.89 mm, 1.57 ± 0.78 mm and 1.41 ± 0.85 mm, respectively. The median cartilage thicknesses of wrist, knee and ankle joints of JIA cases (n = 27) and healthy controls (n = 54) were 1.01, 1.35, 1.05 and 1.95, 2.00, 1.95, respectively. The joint cartilage thickness was significantly reduced in JIA in comparison to the healthy cohort (P < 0.01). Diseased boys suffered greater cartilage damage in knee joints compared to girls; the polyarticular variety of cases had thinner knee cartilage in comparison to the oligoarticular subtype. Further, it was found that joint cartilage destruction is independent of inflammatory markers and disease duration.

Conclusion

Significant cartilage thinning in addition was found in JIA children, particularly in the polyarticular subtype, and more in boys than girls, which is independent of disease duration and inflammatory markers, using ultrasound as a primary investigative tool.
Preemptive one lung ventilation enhances lung collapse during thoracoscopic surgery: A randomized controlled trial
Authors: Zhang Yunxiao , Yan Wanpu , Fan Zhiyi , Kang Xiaozheng , Tan Hongyu , Fu Hao , Li Zhendong , Chen Ke‐Neng , Chen Jiheng
Published: May 2019

In routine practice, one lung ventilation (OLV) is initiated upon pleural opening. We conducted a randomized controlled trial to compare lung collapse after preemptive OLV versus conventional OLV in thoracoscopic surgery. A total of 67 patients were enrolled (34 with conventional OLV; 33 with preemptive OLV). Preemptive OLV was conducted by closing the DLT lumen to the non‐ventilated lung immediately upon assuming the lateral position with the distal port closed to the atmosphere until pleural opening (>6 minutes in all cases). Lung collapse was assessed at 1, 5, 10, 20, 30 and 40 minutes after pleural opening using a 10‐point rating scale (10: complete collapse). The primary end point was the duration from pleural opening to satisfactory lung collapse (score of 8). Secondary end points included PaO2 and hypoxemia. The duration from pleural opening to satisfactory lung collapse was shorter in the preemptive OLV group (9.1 ± 1.2 vs. 14.1 ± 4.7 minutes, P < 0.01). PaO2 was comparable between the two groups prior to anesthetic induction (T0), and 20 (T2), 40 minutes (T3) after pleural incision, but was lower in the preemptive OLV group at zero minutes after pleural incision (T1) (457.5 ± 19.0 vs. 483.1 ± 18.1 mmHg, P < 0.01). No patients in either group developed hypoxemia. In summary, preemptive OLV expedites lung collapse during thoracoscopic surgery with minimal safety concern.
Using devitalised seeds in myrmecological research
Authors: O'Hanlon James C , Hill Sarah J , Andrew Nigel R
Published: May 2019

Field studies of myrmecochory (seed dispersal by ants) can benefit from the use of devitalised seeds, particularly where these studies may involve invasive plants or plants outside of their natural range. Here, we test three different methods of seed devitalisation – gamma irradiation (10.6 kGy over 9.1 h at 23.7–25.4 °C), heating (150 °C for 30 min) and freezing (submerged in liquid nitrogen for 10 min) – in three different Australian plants: Acacia longifolia, Acacia melanoxylon and Kennedia rubicunda. We further test their suitability post‐treatment as stimuli for use in field studies of myrmecochory. Gamma radiation and exposure to heat effectively inhibited germination, whereas freezing did not. The devitalisation treatments did not appear to affect the attractiveness of seeds to ants as there was no significant difference in daily collection rate of control seeds compared to devitalised seeds.
The challenge of putting principles into practice: Resource tensions and real‐world constraints in multidisciplinary oncology team meetings
Authors: Lamprell Klay , Arnolda Gaston , Delaney Geoff P. , Liauw Winston , Braithwaite Jeffrey
Published: May 2019

Multidisciplinary oncology team meetings are crucial hubs for integrated, patient‐centered diagnosis and treatment planning. Team meetings are designed to enact the best practice principles of multidisciplinary care. Yet surveys of clinicians and allied health providers who are members of multidisciplinary teams (MDTs) identify real‐world constraints on putting principles into practice. We review the guidelines for multidisciplinary care set out by Cancer Australia and scope the real‐world constraints in enacting each of these guidelines, focusing on the crucial MDT meeting component of multidisciplinary care. We discuss resources and strategies required for compliance.
Pediatric patients requiring extracorporeal membrane oxygenation in heart failure: 30‐day outcomes; mid‐ and long‐term survival. A single center experience
Authors: Merkle Julia , Azizov Farid , Sabashnikov Anton , Weixler Viktoria , Weber Carolyn , Djordjevic Ilija , Eghbalzadeh Kaveh , Kröner Axel , Zeriouh Mohamed , Wahlers Thorsten , Bennink Gerardus
Published: May 2019

Nowadays, an increasing number of neonatal and pediatric patients with severe heart failure benefits from extracorporeal membrane oxygenation (ECMO) support. A total of 39 pediatric patients needed venoarterial ECMO (vaECMO) support in our department between January 2008 and December 2016. Patients were retrospectively divided in two groups: 30‐day survivor group (17 patients) and 30‐day nonsurvivor group (22 patients). Outcome and factors predictive for 30‐day mortality and mid‐ as well as long‐term survival up to 7‐year follow‐up were analyzed by univariate analysis and Kaplan‐Meier survival estimation. Basic demographics and preoperative characteristics did not differ between groups (P > 0.05). 67% of patients were successfully weaned off ECMO and 44% survived 30‐day after ECMO application. After 7‐year follow‐up 28% of pediatric patients were alive. Thirty‐day survivors were significantly more likely to undergo elective cardiac surgery (P = 0.001), whereas significantly more 30‐day nonsurvivors underwent urgent surgery (P = 0.004). Odds of incidence of catecholamine refractory circulatory failure, failed myocardial recovery, and cerebral edema was significantly higher in 30‐day nonsurvivor group (41.6‐fold, 16‐fold, and 2.5‐fold, respectively). Kaplan‐Meier survival estimation analysis revealed significant differences in terms of mid‐ and long‐term survival among neonates, infants, toddlers, and preadolescents (Breslow P = 0.037 and Log‐Rank P = 0.028, respectively). vaECMO provides an efficient therapy option for life‐threatening heart disorders in neonates and pediatric patients being at high risk for myocardial failure leading to circulatory arrest. Urgency of surgery effected on higher mortality, but there was no difference in terms of mortality in 30‐day survivor group in comparison to 30‐day nonsurvivor group among neonates, infants, toddlers, and preadolescents.
Effect of hepatic impairment on the pharmacokinetics of vilaprisan: An open‐label, single‐dose, parallel‐group study
Authors: Chattopadhyay Niladri , Riecke Kai , Ligges Sandra , Zimmermann Torsten , Halabi Atef , Schultze‐Mosgau Marcus‐Hillert
Published: May 2019

Aims

The study objective was to evaluate the pharmacokinetics of the selective progesterone receptor modulator vilaprisan in participants with hepatic impairment. Additionally, the safety and tolerability of vilaprisan were investigated.

Methods

In this phase 1, open‐label, nonrandomised, parallel‐group, pharmacokinetic study, men and women with mild or moderate hepatic impairment (Child–Pugh grade A or B) and control participants with normal hepatic function matched by age, weight and sex received a single oral 2 mg dose of vilaprisan. Key pharmacokinetic parameters, relationships between parameters and safety outcomes were measured.

Results

Thirty‐six participants completed the study: 9 with mild hepatic impairment, 9 with moderate hepatic impairment and 18 matched control participants with normal hepatic function. Vilaprisan reached maximum plasma concentrations after 1–2 hours. Unbound vilaprisan exposure was 1.44‐fold higher for participants with mild hepatic impairment vs controls (90% confidence interval: 0.91–2.26), and 1.74‐fold higher for participants with moderate impairment vs controls (90% confidence interval: 1.09–2.78). The maximum observed unbound peak concentrations were similar for participants with hepatic impairment and matched controls. Vilaprisan 2 mg was well tolerated and the incidence of treatment‐emergent adverse events was similar across cohorts.

Conclusion

Only mild increases of <1.75‐fold in exposure were observed in participants with mild or moderate hepatic impairment compared with control participants. No safety concern was identified. These data, alongside the excellent safety profile observed in phase 1 and 2 studies, do not indicate that a dose adjustment would be required in patients with mild or moderate hepatic impairment.
Characterisation of P2Y2 receptors in human vascular endothelial cells using AR‐C118925XX, a competitive and selective P2Y2 antagonist
Authors: Muoboghare Markie O. , Drummond Robert M. , Kennedy Charles
Published: May 2019

Background and Purpose

There is a lack of potent, selective antagonists at most subtypes of P2Y receptor. The aims of this study were to characterise the pharmacological properties of the proposed P2Y2 receptor antagonist, AR‐C118925XX, and then to use it to determine the role of P2Y2 receptors in the action of the P2Y2 agonist, UTP, in human vascular endothelial cells.

Experimental Approach

Cell lines expressing native or recombinant P2Y receptors were superfused constantly, and agonist‐induced changes in intracellular Ca2+ levels monitored using the Ca2+‐sensitive fluorescent indicator, Cal‐520. This set‐up enabled full agonist concentration–response curves to be constructed on a single population of cells.

Key Results

UTP evoked a concentration‐dependent rise in intracellular Ca2+ in 1321N1‐hP2Y2 cells. AR‐C118925XX (10 nM to 1 μM) had no effect per se on intracellular Ca2+ but shifted the UTP concentration–response curve progressively rightwards, with no change in maximum. The inhibition was fully reversible on washout. AR‐C118925XX (1 μM) had no effect at native or recombinant hP2Y1, hP2Y4, rP2Y6, or hP2Y11 receptors. Finally, in EAhy926 immortalised human vascular endothelial cells, AR‐C118925XX (30 nM) shifted the UTP concentration–response curve rightwards, with no decrease in maximum.

Conclusions and Implications

AR‐C118925XX is a potent, selective and reversible, competitive P2Y2 receptor antagonist, which inhibited responses mediated by endogenous P2Y2 receptors in human vascular endothelial cells. As the only P2Y2‐selective antagonist currently available, it will greatly enhance our ability to identify the functions of native P2Y2 receptors and their contribution to disease and dysfunction.
A study of 51 subtypes of peripheral blood immune cells in newly diagnosed young type 1 diabetes patients
Authors: Oras A , Peet A , Giese T , Tillmann V , Uibo R
Published: May 2019

Type 1 diabetes (T1D) results from autoimmune destruction of insulin-producing beta cells in pancreatic islets. Various immune cell populations are involved in disease development and natural course. However, to our knowledge, so far there are no comprehensive comparative investigations of all main immune cell populations and their most important subsets at the onset of disease. Therefore, in the current study, we analyzed 51 peripheral blood immune cell populations in 22 young T1D patients and in 25 age-matched controls using a comprehensive polychromatic flow cytometry panel developed for whole blood by the COST Action no. BM0907 ENTIRE (European Network for Translational Immunology Research and Education: From Immunomonitoring to Personalized Immunotherapy) consortium. We found that in T1D patients, frequencies and absolute counts of natural killer (NK) cells, dendritic cells (DC) and T cells, as well as their respective subsets, were significantly altered compared to controls. Further, we observed that changes in several cell populations (e.g. CD14+CD16+ non-classical monocytes, plasmablasts) were dependent on the age of the patient. In addition to age-related changes, we also found that alterations in immune cell patterns were associated with parameters such as the presence of ketoacidosis and C-peptide serum levels. Our study provides a foundation for future studies investigating different cell lineages and their role in T1D and illustrates the value of polychromatic flow cytometry for evaluating all main peripheral immune cells and their subsets in whole blood samples.
Floppy eyelid syndrome “plasty” procedure: Employment of a periosteal transposition flap for surgery of floppy eyelid syndrome
Authors: Waldie Anna M. , Francis Ian C. , Coroneo Minas T. , Wilcsek Geoffrey
Published: May 2019

Importance

Floppy eyelid syndrome “plasty” (FESplasty) is a surgical technique that addresses underlying superior tarsal plate and lateral canthal instability in floppy eyelid syndrome (FES) and aims to restore normal anatomical and physiological function to the upper eyelid.

Background

To describe the use of FESplasty in the surgical management of FES, and to report outcomes in an initial patient cohort.

Design

Retrospective study.

Participants

Seven patients (nine eyelids) with FES undergoing FESplasty.

Methods

A single surgeon (G.W.) performed all procedures. FESplasty utilizes a periosteal flap based at the inferolateral orbital rim, and applied to the anterior surface of the upper tarsal plate. It is combined with a titrated shortening procedure of the upper eyelid. Patient demographics, comorbidities and ocular symptoms and signs were recorded preoperatively. Pre‐ and postoperative upper eyelid distractibility were graded and documented.

Main Outcome Measures

Postoperative improvement in upper eyelid distractibility and symptomatology, operative complications and FES recurrence.

Results

FES symptoms and upper eyelid laxity improved at last follow‐up (average 24 weeks) in all patients, with no FES recurrences after a maximum follow‐up of 36 weeks. One patient, in whom FESplasty exacerbated his pre‐existing aponeurotic ptosis, required definitive ptosis surgery subsequently. There was one case of postoperative wound infection. Obstructive sleep apnoea was present in four of the seven patients. The remaining three patients were awaiting assessment.

Conclusions and Relevance

FESplasty is likely to confer long‐term effective stabilization of the lateral canthal tendon, lateral commissure and superior tarsal plate. Anatomical and functional results appeared to have been successfully achieved.
Going Easy and Going After: Building Inspections and the Selective Allocation of Code Violations
Authors: Bartram Robin
Published: May 2019

Sociologists have demonstrated how public and private actors reproduce economic and racial inequality, by protecting the values of lucrative real estate, enforcing the tastes of elite and middle–class populations, and unfavorably sorting low–income and minority residents. Building inspections and code violations affect each of these processes. Yet, we know remarkably little about how decisions about building code violations are made. Drawing on fieldwork with building inspectors and statistical analysis of data on building violations in Chicago, I find that building inspectors allocate code violations in surprising ways: They go easy on low– and moderate–income property owners and go after professional landlords and wealthy homeowners. I join others in urging sociologists to look beyond assumptions about the unified logic of the growth machine and fully unpack the relationship—in terms of potential and parameters—between frontline agents of the state and inequality.
S2k‐Leitlinie Merkelzellkarzinom (MZK, MCC, neuroendokrines Karzinom der Haut) – Update 2018
Authors: Becker Jürgen C. , Eigentler Thomas , Frerich Bernhard , Gambichler Thilo , Grabbe Stephan , Höller Ulrike , Klumpp Bernhard , Loquai Carmen , Krause‐Bergmann Albrecht , Müller‐Richter Urs , Pföhler Claudia , Schneider‐Burrus Sylke , Stang Andreas , Terheyden Patrick , Ugurel Selma , Veith Johannes , Mauch Cornelia
Published: May 2019

Das Merkelzellkarzinom (MCC, ICD‐O M8247/3) ist ein seltener, maligner, primärer Hauttumor mit epithelialer und neuroendokriner Differenzierung. Die Tumorzellen teilen viele morphologische, immunhistochemische und ultrastrukturelle Eigenschaften mit den Merkelzellen der Haut.

Die Diagnose MCC wird selten klinisch gestellt. Erst histologisch und immunhistochemisch wird der Verdacht auf ein MCC bestätigt. Nachdem eine Fernmetastasierung durch Bildgebung mit Schnittbildverfahren ausgeschlossen worden ist, sollte aufgrund der hohen Zahl von okkulten Lymphknotenmetastasen eine Schildwächterlymphknotenbiopsie erfolgen. Bei Primärtumoren ohne Hinweise auf das Vorliegen von Organmetastasen soll eine vollständige chirurgische Exzision mit Sicherheitsabstand erfolgen. Die strahlentherapeutische Behandlung sollte in allen Stadien der Tumorerkrankung in Betracht gezogen werden.

Für das fortgeschrittene, operative oder strahlentherapeutische nicht mehr kurativ behandelbare MCC gibt es bisher keine etablierte systemische Therapie, für die in einer prospektiv‐randomisierten Studie eine Verbesserung des rezidivfreien Überlebens oder des Gesamtüberlebens demonstriert werden konnte. Eine Immuntherapie mittels PD‐1/PD‐L1‐Blockade erscheint aber einer Chemotherapie überlegen zu sein.

Aufgrund seiner Aggressivität, der in der Regel gegebenen Indikation zur Schildwächterlymphknotenbiopsie bei gleichzeitig häufiger Lokalisation im Kopf‐Hals‐Bereich, der zu evaluierenden Indikation einer adjuvanten Radiotherapie sowie der Komplexität der notwendigen Diagnostik zur korrekten Prognoseabschätzung soll das Vorgehen im Rahmen einer interdisziplinären Zusammenarbeit (interdisziplinäres Tumorboard) festgelegt werden.
Ethical principles for promoting health research data sharing with sub‐Saharan Africa
Authors: Anane‐Sarpong Evelyn , Wangmo Tenzin , Tanner Marcel
Published: May 2019

A powerful feature of global health research is data‐sharing with regions which bear the heaviest burden of disease. It offers novel opportunities for aggregating data to address critical global health challenges in ways higher than relying on individual studies. Yet there exist important stratifiers of the capacity to share data, particularly across the Global North‐South divide. Systemic challenges that characterize sub‐Saharan Africa and disadvantage the region's scientific productivity threaten the burgeoning data‐sharing culture too. Like all endeavors requiring equal commitments under unequal circumstances, a strong ethical impetus is needed to help reduce inequities and imbalances to encourage adherence. This article discusses mandatory data‐sharing in relation to peculiar challenges faced by sub‐Saharan African scientists to suggest ethical principles for rethinking and reframing solutions. We propose six principles which mirror guidelines from the Institute of Medicine and encapsulate principles from the Emanuel Framework, Nairobi Data Sharing Principles, and the COHRED guidelines.
Cognitive impairment in children with CACNA1A mutations
Authors: Humbertclaude Veronique , Riant Florence , Krams Benjamin , Zimmermann Valerie , Nagot Nicolas , Annequin Daniel , Echenne Bernard , Tournier‐Lasserve Elisabeth , Roubertie Agathe ,   Episodic Syndrome Consortium
Published: May 2019

Aim

To describe the clinico‐radiological phenotype of children with a CACNA1A mutation and to precisely evaluate their learning ability and cognitive status.

Method

Children between the ages of 3 and 18 years harboring a pathogenic CACNA1A mutation associated with episodic ataxia, hemiplegic migraine, benign paroxysmal torticollis, benign paroxysmal vertigo, or benign paroxysmal tonic upgaze, were enrolled in this cross‐sectional study. Data concerning psychomotor development, academic performance, educational management, clinical examination at inclusion, and brain imaging were collected. Cognitive assessment was performed using age‐standardized scales.

Results

Eighteen patients (nine males, nine females; mean age at inclusion: 11y 7mo [SD 4y 5mo; range 3y–17y 11mo]) from 14 families were enrolled. Eleven patients displayed the coexistence or consecutive occurrence of more than one type of episodic event. Nine patients exhibited abnormal neurological examination at inclusion. Brain magnetic resonance imaging (MRI) showed cerebellar atrophy in five patients. Psychomotor development was delayed in nine patients and academic difficulties were reported by the parents in 15 patients; nine patients were in special education. Impairment of intellectual function was assessed in six of the 12 patients with interpretable Full‐scale IQ scores and was more frequent when cerebellar atrophy was present on MRI.

Interpretation

Cognitive impairment is commonly associated with CACNA1A mutations. We suggest that CACNA1A‐associated phenotype should be considered a neurodevelopmental disorder.

What this paper adds

Cognitive disabilities and academic difficulties are common in children with CACNA1A mutations associated with episodic syndromes.

Cognitive function ranges from normal to moderate intellectual disorder in wheelchair‐dependent children.

Patients with vermian atrophy are at a higher risk of cognitive impairment.
Assessment of fetal modified myocardial performance index in early‐onset and late‐onset fetal growth restriction
Authors: Zhang Lina , Han Jijing , Zhang Na , Li Zhen , Wang Jingjing , Xuan Yinghua , Kagan Karl Oliver , Wu Qingqing , Sun Lijuan
Published: May 2019

Aim

To investigate the changes of modified myocardial performance index (Mod‐MPI) in early‐onset and late‐onset fetal growth restriction (FGR) cases, and its association with adverse perinatal outcome.

Methods

This was a prospective study on 77 early‐onset and 100 late‐onset FGR cases. Hundred normal fetuses were matched as control groups for early‐onset and late‐onset FGR groups, respectively. Mod‐MPI and vessel Doppler parameters including umbilical artery (UA), ductus venosus (DV), and middle cerebral artery (MCA) were measured. Perinatal outcomes were followed up. Mod‐MPI of FGR cases were compared in normal Doppler, abnormal Doppler, and control groups. The association of Mod‐MPI and perinatal outcome was investigated, and further efficacy of Mod‐MPI predicting adverse outcome was studied.

Results

Compared with control groups, both abnormal and normal Doppler groups showed increased Mod‐MPI in early‐onset and late‐onset FGR, respectively. Mod‐MPI had no significant difference between abnormal and normal Doppler groups. Mod‐MPI was associated with adverse outcome in early‐onset FGR (OR = 3.307) and late‐onset FGR (OR = 3.412). The sensitivity and specificity of Mod‐MPI predicting adverse outcome were 60% and 80% when cutoff value was 0.47 in early‐onset FGR. And they were 65% and 70% when cutoff value was 0.50 in late‐onset FGR.

Conclusion

Fetal growth restriction fetuses had increased Mod‐MPI. Mod‐MPI could be used to predict adverse perinatal outcome of FGR fetuses. Mod‐MPI was an effective parameter to supplement vessels’ Doppler parameters in monitoring FGR.
Aortopulmonary window in adults: A rare entity leading to Eisenmenger syndrome
Authors: El Dick Joud , El‐Rassi Issam , Tayeh Christelle , Bitar Fadi , Arabi Mariam
Published: May 2019

An aortopulmonary window (APW) is a rare congenital heart defect involving an abnormal communication between the ascending aorta and the pulmonary trunk with separate aortic and pulmonary valves. This defect accounts for 0.2% of all congenital cardiac anomalies and if left untreated can lead to Eisenmenger syndrome, severe pulmonary hypertension, heart failure, and poor survival. The authors herein present a case of APW type III with Eisenmenger syndrome in an adult patient whose initial complaint was cyanosis, and provide a thorough review of the literature of cases of APW with Eisenmenger syndrome that have survived into adulthood.
Intertemporal sustainability of current account imbalances: New evidence from the OECD countries
Authors: Singh Tarlok
Published: May 2019

This study estimates the intertemporal model for the relationship between exports and imports and examines the sustainability of current account deficits (CADs) and the validity of intertemporal budget constraint for 24 Organisation for Economic Co‐operation and Development countries. The standard ordinary least squares (OLS)‐based two‐step Engle and Granger test, the cointegration regression Durbin–Watson (CRDW) test, and the Stock–Watson test performed on the one‐regime model with time‐invariant parameters and no structural break provide mixed support for the presence of cointegration between exports and imports. The recursive least squares‐based cumulative sum of recursive residuals (CUSUM) and the cumulative sum of squares of recursive residuals (CUSUMSQ) tests and the OLS‐based Andrews‐Quandt (AQ) and Andrews – Ploberger (AP) tests suggest the presence of structural breaks in the long‐run relationship between exports and imports for a number of countries. The end‐of‐sample new cointegration breakdown tests performed on the OLS, fully modified OLS, and full‐information maximum‐likelihood estimates of the model suggest the presence of cointegration between exports and imports for most countries. The dominant support for cointegration between trade flows points toward the sustainability of CADs and the validity of intertemporal budget constraint. The macroeconomic stabilization policies seem to have been effective in correcting the market failures and maintaining the steady‐state equilibrium relationship between trade flows in the sample countries. The findings of this study have important implications for empirical research. The structural breaks in the cointegrating vector could occur even over the short time periods and at any point in time. It is essentially important to assess the sustainability of the external position in the presence of long‐period as well as short‐period breaks in the cointegrating vector.
Can Item Response Times Provide Insight Into Students’ Motivation and Self‐Efficacy in Math? An Initial Application of Test Metadata to Understand Students’ Social–Emotional Needs
Authors: Soland James
Published: May 2019

As computer‐based tests become more common, there is a growing wealth of metadata related to examinees’ response processes, which include solution strategies, concentration, and operating speed. One common type of metadata is item response time. While response times have been used extensively to improve estimates of achievement, little work considers whether these metadata may provide useful information on social–emotional constructs. This study uses an analytic example to explore whether metadata might help illuminate such constructs. Specifically, analyses examine whether the amount of time students spend on test items (after accounting for item difficulty and estimates of true achievement), and difficult items in particular, tell us anything about the student's academic motivation and self‐efficacy. While results do not indicate a strong relationship between mean item durations and these constructs in general, the amount of time students spend on very difficult items is highly correlated with motivation and self‐efficacy. The implications of these findings for using response process metadata to gain information on social–emotional constructs are discussed.
Science and Practice in NRM: Insights from connectivity restoration in the south west slopes of NSW
Authors: Durant Kylie , Knight Alexandra R.
Published: May 2019

Interactions between landholders, practitioners and research scientists have greatly influenced landscape restoration activities in South‐eastern Australia. Vegetation connectivity projects undertaken by Holbrook Landcare Network in the Slopes to Summit (S2S) region of South‐eastern Australia have benefitted from the input of both scientists and practitioners. This paper explores what factors support an evidence‐informed restoration outcome, what constrains this and what we can learn from this case.
Corrosion fatigue behaviour and microstructural characterisation of G20Mn5QT cast steel in 3.5‐wt% NaCl solution
Authors: Han Qinghua , Wang Xin , Lu Yan
Published: May 2019

Corrosion fatigue behaviour and microstructural characterisation of G20Mn5QT cast steel are investigated in simulated seawater. Fractography is performed by using scanning electron microscopy (SEM). The macroscale fracture surface and microstructure of the failed specimen are acquired including the crack initiation, crack propagation, and pitting evolution. The maximum cyclic stress (S) versus number of cycles to failure (N) curves is derived by three‐parameter fatigue curve method. Fatigue life is predominantly controlled by the corrosion pitting‐induced crack initiation when tested in simulated seawater at lower stress levels. As the maximum cyclic stress is less than 185 MPa, the chloride ion erosion is the main influence factor, which affects the fatigue failure of the G20Mn5QT cast steel in simulated seawater.
Soil & Water Assessment Tool (SWAT) simulated hydrological impacts of land use change from temperate grassland to energy crops: A case study in western UK
Authors: Holder Amanda J. , Rowe Rebecca , McNamara Niall P. , Donnison Iain S. , McCalmont Jon P.
Published: May 2019

When considering the large‐scale deployment of bioenergy crops, it is important to understand the implication for ecosystem hydrological processes and the influences of crop type and location. Based on the potential for future land use change (LUC), the 10,280 km2 West Wales Water Framework Directive River Basin District (UK) was selected as a typical grassland dominated district, and the Soil & Water Assessment Tool (SWAT) hydrology model with a geographic information systems interface was used to investigate implications for different bioenergy deployment scenarios. The study area was delineated into 855 sub‐basins and 7,108 hydrological response units based on rivers, soil type, land use, and slope. Changes in hydrological components for two bioenergy crops (Miscanthus and short rotation coppice, SRC) planted on 50% (2,192 km2) or 25% (1,096 km2) of existing improved pasture are quantified. Across the study area as a whole, only surface run‐off with SRC planted at the 50% level was significantly impacted, where it was reduced by up to 23% (during April). However, results varied spatially and a comparison of annual means for each sub‐basin and scenario revealed surface run‐off was significantly decreased and baseflow significantly increased (by a maximum of 40%) with both Miscanthus and SRC. Evapotranspiration was significantly increased with SRC (at both planting levels) and water yield was significantly reduced with SRC (at the 50% level) by up to 5%. Effects on streamflow were limited, varying between −5% and +5% change (compared to baseline) in the majority of sub‐basins. The results suggest that for mesic temperate grasslands, adverse effects from the drying of soil and alterations to streamflow may not arise, and with surface run‐off reduced and baseflow increased, there could, depending on crop location, be potential benefits for flood and erosion mitigation.
Dry‐matter losses and changes in nutrient concentrations in grass and maize silages stored in bunker silos
Authors: Köhler Brigitte , Taube Friedhelm , Ostertag Johannes , Thurner Stefan , Kluß Christof , Spiekers Hubert
Published: May 2019

To reduce losses and improve forage use efficiency in dairy farming systems, mass and nutrient flows during silage production have to be measured from the field to feed bunk. However, data on these losses at the farm scale are scarce. Thus, we examined dry‐matter (DM) losses and changes in nutrient concentrations (proximate constituents, nitrogen [N], phosphorus [P]) and energy values (net energy for lactation [NEL]) of silages on three experimental farms from ensiling to feed‐out. The investigated material included forages from permanent grassland and whole‐crop maize that were stored in 64 side‐walled bunker silos. To determine DM losses, the total‐in versus total‐out method was applied. Additionally, the changes in the nutrient concentrations were measured by comparing the concentrations before and after ensiling. Data analyses were carried out by using ANOVA, and the means across groups were compared via multiple contrast tests. On average, the farms had good silage production management. Average values showed a trend towards higher DM losses during the ensiling process with grass (9%) than maize (7%). The N and P concentrations of the silages remained mainly unchanged during the ensiling process, suggesting that the total losses of N and P were also low (<10%). Regarding the fibre fractions, ensiling resulted in a significant reduction in the concentration of amylase‐treated ash‐excluded neutral detergent fibre (aNDFom) for grass (11%) and maize (15%), while ash‐excluded acid detergent fibre (ADFom) was not affected by the ensiling process. These changes resulted in slightly improved energy values in the silages.