bluuebunny/crossref_metadata_2025 huggingface dataset:
In patients with a previous negative prostate biopsy and a suspicious lesion on magnetic resonance imaging, is a 12‐core biopsy still necessary in addition to a targeted biopsy?
Authors: Salami Simpa S. , Ben‐Levi Eran , Yaskiv Oksana , Ryniker Laura , Turkbey Baris , Kavoussi Louis R. , Villani Robert , Rastinehad Ardeshir R.
Published: September 2014

Objectives

To evaluate the performance of multiparametric magnetic resonance imaging (mpMRI) in predicting prostate cancer on repeat biopsy; and to compare the cancer detection rates (CDRs) of MRI/transrectal ultrasonography (TRUS) fusion‐guided biopsy with standard 12‐core biopsy in men with at least one previous negative biopsy.

Patients and Methods

We prospectively enrolled men with elevated or rising PSA levels and/or abnormal digital rectal examination into our MRI/TRUS fusion‐guided prostate biopsy trial. Participants underwent a 3 T mpMRI with an endorectal coil. Three radiologists graded all suspicious lesions on a 5‐point Likert scale. MRI/TRUS fusion‐guided biopsies of suspicious prostate lesions and standard TRUS‐guided 12‐core biopsies were performed. Analysis of 140 eligible men with at least one previous negative biopsy was performed. We calculated CDRs and estimated area under the receiver operating characteristic curves (AUCs) of mpMRI in predicting any cancer and clinically significant prostate cancer.

Results

The overall CDR was 65.0% (91/140). Higher level of suspicion on mpMRI was significantly associated with prostate cancer detection (P < 0.001) with an AUC of 0.744 compared with 0.653 and 0.680 for PSA level and PSA density, respectively. The CDRs of MRI/TRUS fusion‐guided and standard 12‐core biopsy were 52.1% (73/140) and 48.6% (68/140), respectively (P = 0.435). However, fusion biopsy was more likely to detect clinically significant prostate cancer when compared with the 12‐core biopsy (47.9% vs 30.7%; P < 0.001). Of the cancers missed by 12‐core biopsy, 20.9% (19/91) were clinically significant. Most cancers missed by 12‐core biopsy (69.6%) were located in the anterior fibromuscular stroma and transition zone. Using a fusion‐biopsy‐only approach in men with an MRI suspicion score of ≥4 would have missed only 3.5% of clinically significant prostate cancers.

Conclusions

Using mpMRI and subsequent MRI/TRUS fusion‐guided biopsy platform may improve detection of clinically significant prostate cancer in men with previous negative biopsies. Addition of a 12‐core biopsy may be needed to avoid missing some clinically significant prostate cancers.
Sunitinib‐induced hypertension, neutropaenia and thrombocytopaenia as predictors of good prognosis in patients with metastatic renal cell carcinoma
Authors: Rautiola Juhana , Donskov Frede , Peltola Katriina , Joensuu Heikki , Bono Petri
Published: September 2014

Objectives

To evaluate the clinical significance of hypertension (HTN), neutropaenia and thrombocytopaenia as possible new biomarkers of sunitinib efficacy in non‐trial patients with metastatic renal cell carcinoma (mRCC).

Patients and Methods

In all, 181 consecutive patients with mRCC were treated with sunitinib; 39 (22%) received sunitinib 50 mg/day 4 weeks on/2 weeks off, 80 (44%) received 37.5 mg/day continuously and 62 (34%) received 25 mg/day continuously as their starting dose. Treatment‐induced adverse events (AEs) and their impact on outcome were analysed on multiple sunitinib doses.

Results

During sunitinib treatment 60 patients (33%) developed ≥grade 2 HTN, 88 (49%) ≥grade 2 neutropaenia and 135 (75%) ≥grade 1 thrombocytopaenia. These AEs were associated significantly with longer progression‐free survival (PFS; 15.7 vs 6.7; 14.6 vs 6.9; 10.4 vs 4.2 months, respectively; P < 0.001) and overall survival (OS; 37.5 vs 16.2; 33.7 vs 13.2; 22.3 vs 13.2 months, respectively, P ≤ 0.008). Although only neutropaenia was associated with a significantly improved PFS and OS in all sunitinib doses, a similar trend was also seen with HTN and thrombocytopaenia in all sunitinib doses. In multivariate analysis, HTN and neutropaenia were significantly associated with PFS and OS and thrombocytopaenia was significantly associated with PFS. In a 12‐week landmark analysis, HTN and thrombocytopaenia were significantly associated with PFS and OS. Patients who developed all three AEs (a favourable biomarker profile) had significantly better outcome than patients without these AEs (a poor biomarker profile); response rate 47% vs 4%, median PFS 27.1 vs 3.5 months and OS not reached vs 5.3 months (all P < 0.001).

Conclusion

HTN, neutropaenia and thrombocytopaenia were all biomarkers of sunitinib efficacy in patients with mRCC. Our results may help to individualise sunitinib dosing during therapy based on these common sunitinib‐related AEs.
Code clouds: Qualitative geovisualization of geotweets
Authors: Jung Jin‐Kyu
Published: September 2014

The popularity of geotagged social media has provided many research opportunities for geographers and GIScientists in the digital age. This article reviews innovative approaches to studying spatially linked social media, and applies lessons taken from qualitative GIS and geographic visualization to improve these approaches. I introduce the idea of “code clouds” as a potential technique for the qualitative geovisualization of spatial information. Code clouds can depict and visualize analytic codes, or codes identifying key ideas and themes, that are generated through digital qualitative research. Rather than transforming qualitative forms of data into categories or numbers, code clouds attempt to preserve and represent the context of data as a visualized outcome of qualitative analysis. I use examples from an exploratory case study of geotweets in King County, WA, to demonstrate how code clouds can be applied to the production of meanings through qualitative geovisualization.
Can Culture Influence Body‐Specific Associations Between Space and Valence?
Authors: de la Fuente Juanma , Casasanto Daniel , Román Antonio , Santiago Julio
Published: September 2014

People implicitly associate positive ideas with their dominant side of space and negative ideas with their non‐dominant side. Right‐handers tend to associate “good” with “right” and “bad” with “left,” but left‐handers associate “bad” with “right” and “good” with “left.” Whereas right‐handers' implicit associations align with idioms in language and culture that link “good” with “right,” left‐handers' implicit associations go against them. Can cultural conventions modulate the body‐specific association between valence and left‐right space? Here, we compared people from Spanish and Moroccan cultures, which differ in the strength of taboos against the use of the left hand, and therefore in their preference for the right. Results showed stronger explicit associations between space and valence in Moroccan participants than in Spaniards, but they did not show any increased tendency for right‐handed Moroccans to associate “good” with “right” implicitly. Despite differences in cultural conventions between Spaniards and Moroccans, we find no evidence for a cross‐cultural difference in the implicit association between space and valence, which appears to depend on patterns of bodily experience.
Development and validation of a parent‐report measure for detection of cognitive delay in infancy
Authors: Schafer Graham , Genesoni Lucia , Boden Greg , Doll Helen , Jones Rosamond A K , Gray Ron , Adams Eleri , Jefferson Ros
Published: September 2014

Aim

To develop a brief, parent‐completed instrument (ERIC – Early Report by Infant Caregivers) for detection of cognitive delay in 10‐ to 24‐month‐olds born preterm, or of low birthweight, or with perinatal complications, and to establish ERIC's diagnostic properties.

Method

Scores for ERIC were collected from the parents of 317 children meeting ≥inclusion criterion (birthweight <1500g, gestational age <34 completed weeks, 5min Apgar score <7, or presence of hypoxic–ischaemic encephalopathy) and no exclusion criteria. Children were assessed using a criterion score of below 80 on the Bayley Scales of Infant and Toddler Development‐III cognitive scale. Items were retained according to their individual associations with delay. Sensitivity, specificity, and positive and negative predictive values were estimated and a truncated ERIC was developed for use in children <14 months old.

Results

ERIC correctly detected developmental delay in 17 out of 18 children in the sample, with 94.4% sensitivity, 76.9% specificity, 19.8% positive predictive value, 99.6% negative predictive value, 4.09 likelihood ratio positive, and 0.07 likelihood ratio negative.

Interpretation

ERIC has potential value as a quickly administered diagnostic instrument for the absence of early cognitive delay in 10‐ to 24‐month‐old preterm infants and as a screen for cognitive delay.
Fat distribution in children and adolescents with myelomeningocele
Authors: Mueske Nicole M , Ryan Deirdre D , Van Speybroeck Alexander L , Chan Linda S , Wren Tishya AL
Published: September 2014

Aim

To evaluate fat distribution in children and adolescents with myelomeningocele using dual‐energy X‐ray absorptiometry (DXA).

Method

Cross‐sectional DXA measurements of the percentage of fat in the trunk, arms, legs, and whole body were compared between 82 children with myelomeningocele (45 males, 37 females; mean age 9y 8mo, SD 2y 7mo; 22 sacral, 13 low lumbar, 47 mid lumbar and above) and 119 comparison children (65 males, 54 females; mean age 10y 4mo, SD 2y 4mo). Differences in fat distribution between groups were evaluated using univariate and multivariate analyses.

Results

Children with myelomeningocele had higher total body fat (34% vs 31%, p=0.02) and leg fat (42% vs 35%, p<0.001) than comparison children, but no differences in trunk or arm fat after adjustment for anthropometric measures.

Interpretation

Children with myelomeningocele have higher than normal total body and leg fat, but only children with higher level lesions have increased trunk fat, which may be caused by greater obesity in this group. Quantifying segmental fat distribution may aid in better assessment of excess weight and, potentially, the associated health risks.
Inflammatory and bone turnover markers in a cross‐sectional and prospective study of acute Charcot osteoarthropathy
Authors: Petrova N. L. , Dew T. K. , Musto R. L. , Sherwood R. A. , Bates M. , Moniz C. F. , Edmonds M. E.
Published: September 2014

Aims

To assess markers of inflammation and bone turnover at presentation and at resolution of Charcot osteoarthropathy.

Methods

We measured serum inflammatory and bone turnover markers in a cross‐sectional study of 35 people with Charcot osteoarthropathy, together with 34 people with diabetes and 12 people without diabetes. In addition, a prospective study of the subjects with Charcot osteoarthropathy was conducted until clinical resolution.

Results

At presentation, C‐reactive protein (P = 0.007), tumour necrosis factor‐α (P = 0.010) and interleukin‐6 (P = 0.002), but not interleukin‐1β, (P = 0.254) were significantly higher in people with Charcot osteoarthropathy than in people with and without diabetes. Serum C‐terminal telopeptide (P = 0.004), bone alkaline phosphatase (P = 0.006) and osteoprotegerin (P < 0.001), but not tartrate‐resistant acid phosphatase (P = 0.126) and soluble receptor activator of nuclear factor‐κβ ligand (P = 0.915), were significantly higher in people with Charcot osteoarthropathy than in people with and without diabetes.

At follow‐up it was found that tumour necrosis factor‐α (P = 0.012) and interleukin‐6 (P = 0.003), but not C‐reactive protein (P = 0.101), interleukin‐1β (P = 0.457), C‐terminal telopeptide (P = 0.743), bone alkaline phosphatase (P = 0.193), tartrate‐resistant acid phosphatase (P = 0.856), osteoprotegerin (P = 0.372) or soluble receptor activator of nuclear factor‐kβ ligand (P = 0.889), had significantly decreased between presentation and the 3 months of casting therapy time point, and all analytes remained unchanged from 3 months of casting therapy until resolution. In people with Charcot osteoarthropathy, there was a positive correlation between interleukin‐6 and C‐terminal telopeptide (P = 0.028) and tumour necrosis factor‐α and C‐terminal telopeptide (P = 0.013) only at presentation.

Conclusions

At the onset of acute Charcot foot, serum concentrations of tumour necrosis factor‐α and interleukin‐6 were elevated; however, there was a significant reduction in these markers at resolution and these markers may be useful in the assessment of disease activity.
The influence of family history of diabetes on disease prevalence and associated metabolic risk factors among Sri Lankan adults
Authors: Katulanda P. , Ranasinghe P. , Jayawardena R. , Sheriff R. , Matthews D. R.
Published: September 2014

Aims

To describe the influence of family history on diabetes prevalence and associated metabolic risk factors in a nationally representative sample from Sri Lanka.

Methods

A cross sectional national survey was conducted among 5000 adults in Sri Lanka. Family history was evaluated at three levels: (1) parents, (2) grandparents (paternal and maternal) and (3) siblings. A binary‐logistic regression analysis controlling for confounders (age, gender, BMI and physical activity) was performed in all patients with ‘presence of diabetes’ as the dichotomous dependent variable and using family history in father, mother, maternal grandmother/grandfather, paternal grandmother/grandfather, siblings and children as binary independent variables.

Results

The sample size was 4485, mean age was 46.1 ± 15.1 years and 39.5% were males. In all adults, the prevalence of diabetes was significantly higher in patients with a family history (23.0%) than those without (8.2%) (P < 0.001). When family history was present in both parents, the prevalence of diabetes was 32.9%. Presence of a family history significantly increased the risk of diabetes [odds ratio (OR): 3.35, 95% confidence interval (CI): 2.78–4.03], obesity (OR: 2.45, 95% CI: 1.99–2.99), hypertension (OR: 1.25, 95% CI: 1.08–1.45) and metabolic syndrome (OR: 2.28, 95% CI: 1.97–2.63). In all adults, the presence of a family history of diabetes in a father (OR: 1.29, 95% CI: 1.02–1.63), mother (OR: 1.23, 95% CI: 1.11–1.36), paternal grandfather (OR: 1.27, 95% CI: 1.14–1.41), siblings (OR: 4.18, 95% CI: 3.34–5.22) and children (OR: 5.47, 95% CI: 2.93–10.19) was associated with a significantly increased risk of developing diabetes.

Conclusions

Family history and diabetes had a graded association in the Sri Lankan population, because the prevalence increased with the increasing number of generations affected. Family history of diabetes was also associated with the prevalence of obesity, metabolic syndrome and hypertension. Individuals with a family history of diabetes form an easily identifiable group who may benefit from targeted interventions.
What is the potential of spread in invasive bryophytes?
Authors: Mateo Rubén G. , Broennimann Olivier , Petitpierre Blaise , Muñoz Jesús , van Rooy Jacques , Laenen Benjamin , Guisan Antoine , Vanderpoorten Alain
Published: September 2014

Although the number of invasive bryophytes is much lower than that of higher plants, they threaten habitats that are often species rich and of high conservation relevance. Their potential of spread has, however, never been determined. Here, we assess whether the three most invasive bryophyte species shifted their niche during the invasion process and whether the extent of the study area defined to calibrate the model (geographic background, GB) affects model transferability. We then determine whether ecological niche models (ENMs) developed in their native range can be projected in other areas to assess their invasive potential. The macroclimatic niches of Campylopus introflexus, Orthodontium lineare and Lophocolea semiteres were compared in their native range (Southern Hemisphere) and in their invasion range (Northern Hemisphere) using ordination techniques. ENMs from an ensemble model were calibrated in the native range and projected onto the Northern Hemisphere using different GBs. No evidence for niche expansion in the invaded range was found and the species occur in the invaded range under climate conditions that are similar to those in the native range. The performance of the models to predict occurrences in the invaded range increased with the extent of the GB. The potential range of all species included entire regions on continents where they are still absent. The expansion of the investigated species appears to be constrained by climate conditions that are similar to those currently prevailing in their native range, which is consistent with our failure to demonstrate macroclimatic niche shift in the invaded range. The use of large GBs is recommended in such vagile organisms with large, disjunct distributions. The models indicated that invasive bryophyte species might become a threat in central and eastern Europe, North America and eastern Asia if accidentally introduced or naturally dispersed.
Congenital erythropoietic porphyria linked to GATA1‐R216W mutation: challenges for diagnosis
Authors: Di Pierro Elena , Russo Roberta , Karakas Zeynep , Brancaleoni Valentina , Gambale Antonella , Kurt Ismail , Winter S. Stuart , Granata Francesca , Czuchlewski David Rodriguez , Langella Concetta , Iolascon Achille , Cappellini Maria Domenica
Published: September 2014

Congenital erythropoietic porphyria (CEP) is a rare genetic disease that is characterized by a severe cutaneous photosensitivity causing unrecoverable deformities, chronic hemolytic anemia requiring blood transfusion program, and by fatal systemic complications. A correct and early diagnosis is required to develop a management plan that is appropriate to the patient's needs. Recently only one case of X‐linked CEP had been reported, describing the trans‐acting GATA1‐R216W mutation. Here, we have characterized two novel X‐linked CEP patients, both with misleading hematological phenotypes that include dyserythropoietic anemia, thrombocytopenia, and hereditary persistence of fetal hemoglobin. We compare the previously reported case to ours and propose a diagnostic paradigm for this variant of CEP. Finally, a correlation between phenotype variability and the presence of modifier mutations in loci related to disease‐causing gene is described.
Sensitivity analysis of coexistence in ecological communities: theory and application
Authors: Barabás György , Pásztor Liz , Meszéna Géza , Ostling Annette
Published: September 2014

Sensitivity analysis, the study of how ecological variables of interest respond to changes in external conditions, is a theoretically well‐developed and widely applied approach in population ecology. Though the application of sensitivity analysis to predicting the response of species‐rich communities to disturbances also has a long history, derivation of a mathematical framework for understanding the factors leading to robust coexistence has only been a recent undertaking. Here we suggest that this development opens up a new perspective, providing advances ranging from the applied to the theoretical. First, it yields a framework to be applied in specific cases for assessing the extinction risk of community modules in the face of environmental change. Second, it can be used to determine trait combinations allowing for coexistence that is robust to environmental variation, and limits to diversity in the presence of environmental variation, for specific community types. Third, it offers general insights into the nature of communities that are robust to environmental variation. We apply recent community‐level extensions of mathematical sensitivity analysis to example models for illustration. We discuss the advantages and limitations of the method, and some of the empirical questions the theoretical framework could help answer.
Habitat structure and the evolution of diffusible siderophores in bacteria
Authors: Kümmerli Rolf , Schiessl Konstanze T. , Waldvogel Tuija , McNeill Kristopher , Ackermann Martin
Published: September 2014

Bacteria typically rely on secreted metabolites, potentially shareable at the community level, to scavenge resources from the environment. The evolution of diffusible, shareable metabolites is, however, difficult to explain because molecules can get lost, or be exploited by cheating mutants. A key question is whether natural selection can act on molecule structure to control loss and shareability. We tested this possibility by collating information on diffusivity properties of 189 secreted iron‐scavenging siderophores and the natural habitats occupied by the siderophore‐producing species. In line with evolutionary theory, we found that highly diffusible siderophores have preferentially evolved in species living in structured habitats, such as soil and hosts, because structuring can keep producers and their shareable goods together. Poorly diffusible siderophores, meanwhile, have preferentially evolved in species living in unstructured habitats, such as seawater, indicating that these metabolites are less shareable and more likely provide direct benefits to the producers.
A Simple Equation to Predict a Subscore's Value
Authors: Feinberg Richard A. , Wainer Howard
Published: September 2014

Subscores are often used to indicate test‐takers' relative strengths and weaknesses and so help focus remediation. But a subscore is not worth reporting if it is too unreliable to believe or if it contains no information that is not already contained in the total score. It is possible, through the use of a simple linear equation provided in this note, to determine if a particular subscore adds enough value to be worth reporting.
When Can We Improve Subscores by Making Them Shorter?: The Case Against Subscores with Overlapping Items
Authors: Feinberg Richard A. , Wainer Howard
Published: September 2014

Subscores can be of diagnostic value for tests that cover multiple underlying traits. Some items require knowledge or ability that spans more than a single trait. It is thus natural for such items to be included on more than a single subscore. Subscores only have value if they are reliable enough to justify conclusions drawn from them and if they contain information about the examinee that is distinct from what is in the total test score. In this study we show, for a broad range of conditions of item overlap on subscores, that the value of the subscore is always improved through the removal of such items.
A Meta‐Analysis of Research on the Read Aloud Accommodation
Authors: Buzick Heather , Stone Elizabeth
Published: September 2014

Read aloud is a testing accommodation that has been studied by many researchers, and its use on K‐12 assessments continues to be debated because of its potential to change the measured construct or unfairly increase test scores. This study is a summary of quantitative research on the read aloud accommodation. Previous studies contributed information to compute average effect sizes for students with disabilities, students without disabilities, and the difference between groups for reading and mathematics using a random effects meta‐analytic approach. Results suggest that (1) effect sizes are larger for reading than for math for both student groups, (2) the read aloud accommodation increases reading test scores for both groups, but more so for students with disabilities, and (3) mathematics scores gains due to the read aloud accommodation are small for both students with and without disabilities, on average. There was some evidence to suggest larger effects in elementary school relative to middle and high school and possible mode effects, but more studies are needed within levels of the moderator variables to conduct statistical tests.
Cerebral cortex involvement in Machado−Joseph disease
Authors: de Rezende T. J. R. , D'Abreu A. , Guimarães R. P. , Lopes T. M. , Lopes‐Cendes I. , Cendes F. , Castellano G. , França M. C.
Published: September 2014

Background and purpose

Machado−Joseph disease (MJD/SCA3) is the most frequent spinocerebellar ataxia, characterized by brainstem, basal ganglia and cerebellar damage. Few magnetic resonance imaging based studies have investigated damage in the cerebral cortex. The objective was to determine whether patients with MJD/SCA3 have cerebral cortex atrophy, to identify regions more susceptible to damage and to look for the clinical and neuropsychological correlates of such lesions.

Methods

Forty‐nine patients with MJD/SCA3 (mean age 47.7 ± 13.0 years, 27 men) and 49 matched healthy controls were enrolled. All subjects underwent magnetic resonance imaging scans in a 3 T device, and three‐dimensional T1 images were used for volumetric analyses. Measurement of cortical thickness and volume was performed using the FreeSurfer software. Groups were compared using ancova with age, gender and estimated intracranial volume as covariates, and a general linear model was used to assess correlations between atrophy and clinical variables.

Results

Mean CAG expansion, Scale for Assessment and Rating of Ataxia (SARA) score and age at onset were 72.1 ± 4.2, 14.7 ± 7.3 and 37.5 ± 12.5 years, respectively. The main findings were (i) bilateral paracentral cortex atrophy, as well as the caudal middle frontal gyrus, superior and transverse temporal gyri, and lateral occipital cortex in the left hemisphere and supramarginal gyrus in the right hemisphere; (ii) volumetric reduction of basal ganglia and hippocampi; (iii) a significant correlation between SARA and brainstem and precentral gyrus atrophy. Furthermore, some of the affected cortical regions showed significant correlations with neuropsychological data.

Conclusions

Patients with MJD/SCA3 have widespread cortical and subcortical atrophy. These structural findings correlate with clinical manifestations of the disease, which support the concept that cognitive/motor impairment and cerebral damage are related in disease.
Genes predict long distance migration and large body size in a migratory fish, Pacific lamprey
Authors: Hess Jon E. , Caudill Christopher C. , Keefer Matthew L. , McIlraith Brian J. , Moser Mary L. , Narum Shawn R.
Published: September 2014

Elucidation of genetic mechanisms underpinning migratory behavior could help predict how changes in genetic diversity may affect future spatiotemporal distribution of a migratory species. This ability would benefit conservation of one such declining species, anadromous Pacific lamprey (Entosphenus tridentatus). Nonphilopatric migration of adult Pacific lamprey has homogenized population‐level neutral variation but has maintained adaptive variation that differentiates groups based on geography, run‐timing and adult body form. To investigate causes for this adaptive divergence, we examined 647 adult lamprey sampled at a fixed location on the Columbia River and radiotracked during their subsequent upstream migration. We tested whether genetic variation [94 neutral and adaptive single nucleotide polymorphisms (SNPs) previously identified from a genomewide association study] was associated with phenotypes of migration distance, migration timing, or morphology. Three adaptive markers were strongly associated with morphology, and one marker also correlated with upstream migration distance and timing. Genes physically linked with these markers plausibly influence differences in body size, which is also consistently associated with migration distance in Pacific lamprey. Pacific lamprey conservation implications include the potential to predict an individual's upstream destination based on its genotype. More broadly, the results suggest a genetic basis for intrapopulation variation in migration distance in migratory species.
Equine post operative ileus: A review of current thinking on pathophysiology and management
Authors: Hudson N. P. H. , Pirie R. S.
Published: September 2014

Equine post operative ileus (POI) is a serious post surgical complication in the horse, with a significant fatality rate. Despite the ongoing debate with regard to both the clinical definition of equinePOIand the optimal management of this condition, there is increasing awareness and acceptance, supported by scientific research, that inflammation plays a key role in its pathophysiology. This review aims to outline the current thinking on the pathophysiology and management of this condition, with reference to the published literature on equine, rodent and humanPOI. Although studies conducted in other species are likely to provide an abundant source of information with potentially useful translational applications for the equine condition, such an approach needs to be cognisant of potential interspecies differences both in the pathogenesis of the condition and in basic gastrointestinal physiology.
Investigation of the response of an aluminium plate subjected to repeated low velocity impact using a continuum damage mechanics approach
Authors: Ghajar R. , Khalili S. M. R. , Yarmohammad Tooski M. , Alderliesten R. C.
Published: September 2014

Experimental investigation of repeated impacts on aluminium plates is performed using drop weights impacting from either constant or variable heights. In repeated impacts of constant and variable heights, the effect of plasticity is noticeable on the specimens in the very first impact. The effect of strain hardening is observed at higher impact numbers. Stiffness of plates is decreased by initiation and propagation of cracks in the specimens. Finally, perforation and penetration occur at the ultimate consecutive impacts. Numerical simulations of repeated impacts are also conducted using continuum damage mechanics by Abaqus software. Lemaitre's model is used as the damage model, and the code is written in Vumat subroutine. The effect of initial uniaxial and biaxial tensile stress on the plates is considered in repeated impacts, and it is concluded that plates with initial tensile uniaxial stress at transverse edges have maximum values of contact force and absorbed energy.
Can biological traits of stream invertebrates help disentangle the effects of multiple stressors in an agricultural catchment?
Authors: Lange Katharina , Townsend Colin R. , Matthaei Christoph D.
Published: September 2014

Biological traits, which may give insights into the mechanisms driving the distribution of organisms along gradients of stressor intensities, have been proposed as a tool for disentangling the effects of multiple stressors acting simultaneously on scales ranging from climatic region to river basins, valleys, reaches and microhabitats. However, the combined effects of farming intensity and flow reduction on biological traits of stream invertebrates remain to be studied.

We assessed the benthic invertebrate community and physicochemistry at 43 stream sites along gradients of farming intensity (0–95% of the catchment in intensively managed grassland) and water abstraction (0–92% streamflow reduction). Using general linear models and an information‐theoretic approach, we studied individual and combined effects of agricultural stressors on invertebrate traits and community composition.

Traits often followed predictable patterns along stressor gradients, and non‐additive interactions between paired stressors were common. Farming intensity was more frequently related to life‐history, resistance and resilience traits, whereas water abstraction was correlated more often with general biological traits such as feeding habits, dietary preference and respiration. Further, traits and traditional measures of community structure, such as taxon relative abundances and community indices, offered a similar level of distinction along the gradients of stressor intensities.

Our findings indicate that invertebrate traits can differentiate the effects of multiple stressors and provide insights into potential mechanisms. At the landscape scale, farming intensity exerted stronger effects via invertebrate habitat quality and water abstraction via food availability. At the reach scale, both fine sediment and nutrients affected habitat quality, whereas nutrients showed more marked effects via food availability. Finally, we propose a suite of traits that may provide the strongest differentiation of stressor intensities.
Niche expansion in a resilient endemic species following introduction of a novel top predator
Authors: Sharpe Diana M. T. , Chapman Lauren J.
Published: September 2014

Introduced species can have profound direct ecological impacts on native species, yet their potential indirect effects remain relatively unexplored. For instance, introduced predators may directly affect some native species via predation, which may in turn have indirect consequences for other species that are released from competition.

We explore this possibility in East Africa's Lake Victoria basin, where the introduction of the predatory Nile perch, Lates niloticus, in the 1950s and 60s contributed to the overall or local extinction of hundreds of native fish by the 1980s. We ask whether this dramatic change in assemblage composition has led to competitive release and niche expansion in Rastrineobola argentea, a resilient native cyprinid that has thrived in this highly perturbed ecosystem.

To address this question, we compare the trophic ecology of R. argentea before (1966) and after (2011) the introduction of the Nile perch in Lake Victoria; and across eight satellite lakes that differ in their history of Nile perch invasion. Using this combination of spatial and temporal comparisons, we test for increases in dietary niche breadth (niche expansion) and changes in the level of individual specialisation of R. argentea in invaded versus uninvaded contexts.

In our historical comparison, we find good evidence for dietary niche expansion and an increase in interindividual diet variation in R. argentea over time. Across lakes, however, strong bottom‐up effects (i.e. variation in prey availability) appear to obscure any potential top‐down effects of the Nile perch introduction on the trophic ecology of R. argentea.

Overall, we find substantial temporal and spatial variation in the diet and niche breadth of R. argentea, but the underlying drivers remain uncertain, given the complexity of both anthropogenic and natural ecological changes in Lake Victoria over the past century. Understanding both the direct and indirect impacts of introduced species is challenging, but important for successful long‐term management of human‐altered ecosystems.
High secondary production in a Coastal Plain river is dominated by snag invertebrates and fuelled mainly by amorphous detritus
Authors: Benke Arthur C. , Bruce Wallace J.
Published: September 2014

The 2‐years production dynamics of major taxa (family/order) and functional feeding groups was synthesised from detailed production analyses previously published for all major invertebrate species/genera (retained by a 100 μm sieve) found on snags (submerged wood) in a sixth‐order south‐eastern U.S. Coastal Plain river.

The trophic basis of this production and annual consumption of six food types were quantified. Invertebrate production (148 and 203 g dry mass m−2 year−1 of snag surfaces for the 2 years) was among the highest ever measured for a specific habitat in non‐polluted or unregulated rivers and was still relatively high when converted to overall area of the river bed (48 and 70 g m−2 year−1). Snag production constituted 73% of total main‐channel production (production from snag and river bed combined). Chironomidae (40–44% over the 2 years), Ephemeroptera (14–21%) and Trichoptera (25–31%) together represented the majority (88–93%) of the putative production of primary consumers on snags.

Functional group analysis showed that fine filterers (26–36% over the 2 years), gatherers (36–44%) and macro‐filterers (21–25%) represented the majority of total invertebrate production. Production of predaceous insects (mostly Plecoptera, Odonata and Megaloptera) represented only 5–7% of the total.

Production of the three major taxa and three major functional groups was remarkably consistent over 2 years of monthly sampling, despite strong seasonal variation in discharge/light/temperature and production of individual genera and families.

Seventy‐nine per cent of production by primary consumers was supported by microbially enriched amorphous detritus, the major component of seston originating primarily from floodplain forests. Invertebrates consumed ˜357 g AFDM m−2 (river bed) year−1 of seston, 325 g m−2 year−1 of amorphous detritus and 20 g m−2 year−1 of diatoms. Dividing seston consumption by seston transport indicated that ˜67% of seston was consumed over 100 km of river length.

Consumption was higher than autochthonous net primary production, supporting other evidence that terrestrially derived dissolved organic matter, incorporated via the microbial loop, is the main trophic basis of this riverine food web. Macro‐filtering hydropsychid caddisflies were omnivorous with > half their production from carnivory. Snag predators, including hydropsychids, consumed ˜60% (29 g m−2 year−1 of river bed) of invertebrate production (assumed to be from snags), leaving the remainder for emergence, downstream transport and consumption by fish.
Comprehensive analysis of phenotypes and genetics in 21 Chinese families with haemophilia B: characterization of five novel mutations
Authors: Guo Z.‐P. , Yang L.‐H. , Qin X.‐Y. , Liu X.‐E. , Chen J.‐F. , Zhang Y.‐F.
Published: September 2014

Molecular characterization of haemophilia B (HB) at the factor IX gene (F9) is essential to establish diagnosis, confirm genotype‐phenotype correlations and to advise in genetic counselling. This study aimed to identify the causative mutations in 21 Chinese families with HB and to analyse the association of these mutations with clinical phenotype. Phenotypic analyses were performed using one‐stage assay for factor IX (FIX) activity (FIX: C) and enzyme‐linked immunosorbent assay for FIX antigen (FIX: Ag). Direct sequencing of the F9 gene was carried out. For those suspected to have a large deletion, multiplex ligation‐dependent probe amplification (MLPA) was performed. Predicting the causal impact of new changes was studied by bioinformatics approaches. We also assessed the effect of the F9 mutations on the FIX protein structure and function. Causative mutations were detected in all study patients. There were 14 point mutations, three small deletions, one large deletion and one small in‐frame duplication that together comprised a total of 19 unique variants, of which five were novel. The structural and functional defects of novel missense and in‐frame deletion/duplication mutations were demonstrated by bioinformatics approaches. The 12 missense mutations include five purely quantitative mutations, five predominantly qualitative abnormalities and two combined defects. Our data confirmed the genetic heterogeneity of the F9 mutations. Quantitative missense mutations were found to be in different regions of precursor FIX compared with qualitative and combined ones.
Prognostic significance of 25‐hydroxivitamin D entirely explained by a higher comorbidity burden: Experience from a South‐Eastern European Dialysis Cohort
Authors: Schiller Adalbert , Apetrii Mugurel , Onofriescu Mihai , Siriopol Dimitrie , Veisa Gabriel , Schiller Oana , Bob Flaviu , Timar Romulus , Mihaescu Adelina , Kanbay Mehmet , Covic Adrian
Published: September 2014

Vitamin D deficiency is still a common problem particularly in the elderly and in individuals with various degrees of renal impairment. The present study aimed to evaluate the association between plasma concentrations of 25(OH)D and death in a large cohort of prevalent patients on hemodialysis (HD) from south‐east Romania, a typical Balkan region. This is an observational prospective study that included a total of 570 patients on maintenance HD. Study patients were classified into three groups by baseline 25(OH)D levels: (1) sufficient 25(OH)D—i.e., >30 ng/mL; (2) insufficient 25(OH)D—i.e., between 10 and 29 ng/mL; and (3) deficient 25(OH)D—i.e., <10 ng/mL. During the follow‐up period of 14 months, 68 patients (11.9%) died, the Kaplan–Meier analysis showing significant differences in all‐cause mortality for chronic kidney disease patients in different 25(OH)D groups (P = 0.002). Unadjusted Cox regression analysis also showed significant differences in survival. The multivariate Cox regression model showed no significant differences in survival according to vitamin D levels. Hazard ratio for death in the “<10 ng/mL” group was 1.619 (P = 0.190) and in the “10–30 ng/mL” group was 0.837 (P = 0.609). In our dialysis population with a high comorbidity burden, low 25(OH)D concentration was not associated with mortality in the adjusted Cox model, suggesting that vitamin D deficiency could represent only a non‐specific marker for a poor health status, with less impact on mortality.
Disability and Sexual Inclusion
Authors: De Boer Tracy
Published: September 2014

Many disabled people face some form of exclusion or discrimination. One of the most damaging, yet pervasive, types of exclusion is sexual exclusion. Various factors hinder sexual opportunities for disabled persons, such as social attitudes around body image, gender, and sexuality. In this paper, I engage with Sheila Jeffreys's paper, “Disability and the Male Sex Right,” wherein she argues that discourse around sexual rights for disabled people is a veiled way of promoting male dominance over women. Though Jeffreys raises many pertinent issues, she assumes that when a disabled man seeks commercial sex, he does so as an act of domination or violence. I argue that when a disabled man seeks commercial sex, he is seeking the goods of sex, such as connection, intimacy, and pleasure.
Philosophical Inclusive Design: Intellectual Disability and the Limits of Individual Autonomy in Moral and Political Theory
Authors: Davy Laura
Published: September 2014

Drawing on the built environment concept of “inclusive design” and its emphasis on creating accessible environments for all persons regardless of ability, I suggest that a central task for feminist disability theory is to redesign foundational philosophical concepts to present opportunities rather than barriers to inclusion for people with disability. Accounts of autonomy within liberal philosophy stress self‐determination and the dignity of all individual persons, but have excluded people with intellectual disability from moral and political theories by denying their capacity for individual autonomy, seen as a chief marker of moral personhood. This paper modifies and extends feminist theories of relational autonomy by arguing for the need to view autonomy as a feature of persons that is manifested only through relations of support, advocacy, and enablement. An “inclusively designed,” relational account negotiates the tensions encountered in attempts to apply autonomy to people with high support needs, and politicizes the concept as an advocacy tool for people with intellectual disability and their allies.
Democratizing Disability: Achieving Inclusion (without Assimilation) through “Participatory Parity”
Authors: Knight Amber
Published: September 2014

More than two decades after the passage of the Americans with Disabilities Act (1990), people with disabilities continue to live at the margins of American democracy and capitalist society. This persistent exclusion poses a conundrum to political theorists committed to disability rights, multiculturalism, and social justice. Drawing from feminist insights, specifically the work of Nancy Fraser, among others, I examine the necessary conditions for meaningful inclusion to be realized within a deliberative democracy. Using Fraser's concept of “participatory parity” as a proxy for inclusion, I strategize how to overcome informal barriers—economic inequality and misrecognition—that persist even after disabled people are granted the legal right to participate. The analysis concludes that a truly inclusionary and multicultural democracy requires the redistribution of wealth and a more expansive model of political deliberation, one that can recognize unconventional (even nonverbal) modes of communication through practices of translation.
World Stroke Organization Global Stroke Services Guidelines and Action Plan
Authors: Lindsay Patrice , Furie Karen L. , Davis Stephen M. , Donnan Geoffrey A. , Norrving Bo
Published: September 2014

Every two seconds, someone across the globe suffers a symptomatic stroke. ‘Silent’ cerebrovascular disease insidiously contributes to worldwide disability by causing cognitive impairment in the elderly. The risk of cerebrovascular disease is disproportionately higher in low to middle income countries where there may be barriers to stroke care. The last two decades have seen a major transformation in the stroke field with the emergence of evidence-based approaches to stroke prevention, acute stroke management, and stroke recovery. The current challenge lies in implementing these interventions, particularly in regions with high incidences of stroke and limited healthcare resources. The Global Stroke Services Action Plan was conceived as a tool to identifying key elements in stroke care across a continuum of health models.

At the minimal level of resource availability, stroke care delivery is based at a local clinic staffed predominantly by non-physicians. In this environment, laboratory tests and diagnostic studies are scarce, and much of the emphasis is placed on bedside clinical skills, teaching, and prevention. The essential services level offers access to a CT scan, physicians, and the potential for acute thrombolytic therapy, however stroke expertise may still be difficult to access. At the advanced stroke services level, multidisciplinary stroke expertise, multimodal imaging, and comprehensive therapies are available. A national plan for stroke care should incorporate local and regional strengths and build upon them.

This clinical practice guideline is a synopsis of the core recommendations and quality indicators adapted from ten high quality multinational stroke guidelines. It can be used to establish the current level of stroke services, target goals for expanding stroke resources, and ensuring that all stages of stroke care are being adequately addressed, even at the advanced stroke services level. This document is a start, but there is more to be done, particularly in the realm of primary prevention.

Despite differences in resource availability, the message we wish to convey is that stroke awareness, education, prevention, and treatment should always be feasible. Communities and institutions should set goals to continuously expand their stroke service capabilities. This document is intended to augment stroke advocacy efforts throughout the world, providing a strategic plan for optimizing stroke outcomes.
Perioperative use of bispectral (BIS) monitor for a pressure ulcer patient with locked‐in syndrome (LIS)
Authors: Yoo Christine , Ayello Elizabeth A , Robins Bryan , Salamanca Victor R , Bloom Marc J , Linton Patrick , Brem Harold , O’Neill Daniel K
Published: September 2014

The bispectral (BIS) monitor uses brain electroencephalographic data to measure the depth of sedation and pharmacological response during anaesthetic procedures. In this case, the BIS monitor was used for another purpose, to demonstrate postoperatively to the nursing staff that a patient with history of locked‐in syndrome (LIS), who underwent pressure ulcer debridement, had periods of wakefulness and apparent sensation, even with his eyes closed. Furthermore, as patients with LIS can feel pain, despite being unable to move, local block or general anaesthesia should be provided for sharp surgical debridement and other painful procedures. This use of the BIS has shown that as a general rule, the staff should treat the patient as though he might be awake and sensate even if he does not open his eyes or move his limbs. The goal of this study was to continuously monitor pain level and communicate these findings to the entire wound team, i.e. anaesthesiologists, surgeons and nurses.