bluuebunny/crossref_metadata_2025 huggingface dataset:
Distributed Attention
Authors: Nanay Bence
Published: March 2016

The main claim of this chapter is that the concept of distributed attention plays a crucial role in a number of different aesthetic phenomena. This is illustrated with the help of the (vexed) concept of aesthetic experience and the debate surrounding this concept. The chapter argues that distributed attention is a crucial feature of some paradigmatic examples of aesthetic experiences. The concept of distributed attention is based on the conceptual apparatus of perceptual psychology: it is attention that is focused on one perceptual object but distributed across various properties of this object. This way of attending is unusual and special and it helps us to explain some puzzling features of aesthetic experiences as well as some influential characterizations thereof.
Pictures
Authors: Nanay Bence
Published: March 2016

Theories of picture perception aim to understand our perceptual relation to both the picture surface and the depicted object. I argue that we should talk about not two, but three entities when understanding picture perception: (A) the picture surface, (B) the three-dimensional object the picture surface visually encodes, and (C) the three-dimensional depicted object. As (B) and (C) can come apart, we get a more complex picture of picture perception than normally assumed and one where the notion of twofoldness, which has played an important albeit controversial role in understanding picture perception is replaced by the concept of threefoldness. This framework also allows for a more nuanced account of how our attention can be distributed between various features of A, B, and C when aesthetically appreciating pictures.
The History of Vision
Authors: Nanay Bence
Published: March 2016

One of the most influential ideas of twentieth-century art history and aesthetics is that vision has a history and it is the task of art history to trace how vision has changed. This claim has recently been attacked for both empirical and conceptual reasons. The aim of this chapter is to argue for a new version of the history of vision claim: if visual attention has a history, then vision also has a history. And we have some reason to think that at least in certain contexts (in the context of looking at pictures), visual attention does have a history—more precisely, some forms of distributed attention (namely, twofold attention) is not a human universal but a historically limited phenomenon. Finally, it is argued that empirical findings about cultural variations in the ways people exercise their attention make such historical approaches to attention more justified.
Non-Distributed Attention
Authors: Nanay Bence
Published: March 2016

While the book is about the importance of distributed attention in aesthetics, the aim of this last chapter is to explore those experiences in an aesthetic context where our attention is not at all distributed, but focused. One example for this is what could be labeled as ‘vicarious experience’, where we very much focus our attention to the (potential or actual) actions of a fictional character. This experience can help us describe the mental processes that make it possible for the spectator to identify, or engage, with a fictional character. And the emphasis on vicarious experiences can help us understand some otherwise puzzling features of identification or engagement with a fictional character. The chapter ends with a case study of some artistic uses of the conflict and interplay between distributed and non-distributed attention.
Annelida: Basal Groups And Pleistoannelida
Authors: Purschke Günter
Published: March 2016

Members of the taxon Annelida, the segmented worms, can be found in all marine, limnetic, and terrestrial habitats and as a consequence Annelida constitutes a group of extraordinarily high diversity, among the invertebrates, only comparable to molluscs or arthropods. Recent phylogenomic studies provide a new picture of annelid phylogeny: besides a basal grade comprising taxa such as Chaetopteridae, Oweniidae, and Magelonidae, the vast majority form a clade Pleistoannelida with Errantia and Sedentaria as the highest ranked sistergroups; Clitellata is a polychaete in-group within Sedentaria and taxa formerly regarded as separate phyla are in-groups as well: Sipuncula as part of the basal grade, Myzostoma as part of Errantia, as well as Echiura and Pogonophora as part of Sedentaria. Among annelids the polychaetes display by far the greatest structural variation and degree of development which includes the nervous and sensory system. Especially the errant forms possess rather advanced nervous and sensory systems, exceeding the complexity of basal molluscs and arthropods. This complexity is correlated to their highly developed sensory structures, including isolated or clustered sensory cells, up to complex sensory organs such as apical organs in the larvae, palps, antennae, tentacular, parapodial as well as pygidial cirri, eyes, nuchal organs, lateral organs, dorsal organs, and occasionally statocysts. Irrespective of a large number of more or less recent reviews, a lot of new information has been gathered over past decades and this is been reviewed in the present contribution, which focuses primarily on structure and evolution.
Tardigrada
Authors: Schulze Corinna , Persson Dennis
Published: March 2016

The phylogenetic position of the taxon Tardigrada is still under debate, though increasing evidence places Tardigrada within Panarthropoda. The question that still arises is whether they are the sistergroup of Onychophora, Arthropoda, or Onychophora + Arthropoda. This question may be critically linked to the neuroanatomy of tardigrades and whether or not they possess an unpartitioned, a bipartite, or even a tripartite brain, as well as the organization of the ventral nervous system. The organization of the brain is still under debate but the ventral nervous system clearly shows a rope ladder-like organization, which is in accordance with the organization of the ventral nervous system of Arthropoda, but contrasts with the organization of that of Onychophora. In the brain of both Heterotardigrada and Eutardigrada, often areas can be defined that are linked to the sensory regions of the head. This has led some scientists to interpret the brain as being partitioned in accordance with these sensory areas or segments of the head, whereas other investigations have been interpreted differently.
Growth, mortality, and recruitment signals in age-0 gadids settling in coastal Gulf of Alaska
Authors: Laurel Benjamin J. , Knoth Brian A. , Ryer Clifford H.
Published: March 2016

Age-0 juveniles may be the earliest, reliable indicators of recruitment into commercial marine fisheries, but independent fisheries assessments are usually conducted on older life stages in adult habitats. We used an 8 year juvenile gadid survey along the coast of Kodiak, Alaska to examine annual abundance, growth and mortality in age-0 Pacific cod (Gadus macrocephalus), with comparisons to saffron cod (Eleginus gracilis) and walleye pollock (Gadus chalcogrammus) where possible. Annual abundance of age-0 fish was positively correlated among all three species, suggesting Pacific gadids respond similarly to processes controlling pre-settlement survival and/or delivery to coastal nurseries. In Pacific cod, June temperature was positively correlated with size-at-settlement but post-settlement growth was density- rather than temperature-dependent. Age-0 abundance indices for Pacific and saffron cod predicted the number of age-1 fish the following year (i.e. positive “recruitment signals”), but only in the larger nursery (Anton Larsen Bay) where age-1 gadids were more likely to remain resident after their first year. Recruitment signals for Pacific cod improved with later estimates of age-0 abundance, likely because of high mortality following settlement in July. In contrast, very few age-0 and age-1 walleye pollock were caught across the entire time-series of the survey. Collectively, these data suggest that nearshore surveys may be a tractable means of examining early life history processes and assessing year-class strength in juvenile Pacific and saffron cod, but have relatively low value in understanding the population dynamics of walleye pollock.
Management of One-lung Ventilation
Authors: Blank Randal S. , Colquhoun Douglas A. , Durieux Marcel E. , Kozower Benjamin D. , McMurry Timothy L. , Bender S. Patrick , Naik Bhiken I.
Published: March 2016

AbstractAbstract

Analysis from 1,019 patients undergoing one-lung ventilation indicated that low tidal volume in the presence of low positive end-expiratory pressure is associated with increased pulmonary complications. This suggests that low tidal volume during one-lung ventilation is protective only when accompanied by adequate positive end-expiratory pressure.

Background

The use of lung-protective ventilation (LPV) strategies may minimize iatrogenic lung injury in surgical patients. However, the identification of an ideal LPV strategy, particularly during one-lung ventilation (OLV), remains elusive. This study examines the role of ventilator management during OLV and its impact on clinical outcomes.

Methods

Data were retrospectively collected from the hospital electronic medical record and the Society of Thoracic Surgery database for subjects undergoing thoracic surgery with OLV between 2012 and 2014. Mean tidal volume (VT) during two-lung ventilation and OLV and ventilator driving pressure (ΔP) (plateau pressure − positive end-expiratory pressure [PEEP]) were analyzed for the 1,019 cases that met the inclusion criteria. Associations between ventilator parameters and clinical outcomes were examined by multivariate linear regression.

Results

After the initiation of OLV, 73.3, 43.3, 18.8, and 7.2% of patients received VT greater than 5, 6, 7, and 8 ml/kg predicted body weight, respectively. One hundred and eighty-four primary and 288 secondary outcome events were recorded. In multivariate logistic regression modeling, VT was inversely related to the incidence of respiratory complications (odds ratio, 0.837; 95% CI, 0.729 to 0.958), while ΔP predicted the development of major morbidity when modeled with VT (odds ratio, 1.034; 95% CI, 1.001 to 1.068).

Conclusions

Low VT
per se (i.e., in the absence of sufficient PEEP) has not been unambiguously demonstrated to be beneficial. The authors found that a large proportion of patients continue to receive high VT during OLV and that VT was inversely related to the incidence of respiratory complications and major postoperative morbidity. While low (physiologically appropriate) VT is an important component of an LPV strategy for surgical patients during OLV, current evidence suggests that, without adequate PEEP, low VT does not prevent postoperative respiratory complications. Thus, use of physiologic VT may represent a necessary, but not independently sufficient, component of LPV.
The relationships of the Euparkeriidae and the rise of Archosauria
Authors: Sookias Roland B.
Published: March 2016

For the first time, a phylogenetic analysis including all putative euparkeriid taxa is conducted, using a large data matrix analysed with maximum parsimony and Bayesian analysis. Using parsimony, the putative euparkeriid
Dorosuchus neoetus
from Russia is the sister taxon to Archosauria + Phytosauria.
Euparkeria capensis
is placed one node further from the crown, and forms a euparkeriid clade with the Chinese taxa
Halazhaisuchus qiaoensis
and ‘
Turfanosuchus shageduensis
’ and the Polish taxon
Osmolskina czatkowicensis
. Using Bayesian methods,
Osmolskina
and
Halazhaisuchus
are sister taxa within Euparkeriidae, in turn sister to ‘
Turfanosuchus shageduensis
’ and then
Euparkeria capensis
.
Dorosuchus
is placed in a polytomy with Euparkeriidae and Archosauria + Phytosauria. Although conclusions remain tentative owing to low node support and incompleteness, a broad phylogenetic position close to the base of Archosauria is confirmed for all putative euparkeriids, and the ancestor of Archosauria +Phytosauria is optimized as similar to euparkeriids in its morphology. Ecomorphological characters and traits are optimized onto the maximum parsimony strict consensus phylogeny presented using squared change parsimony. This optimization indicates that the ancestral archosaur was probably similar in many respects to euparkeriids, being relatively small, terrestrial, carnivorous and showing relatively cursorial limb morphology; this
Bauplan
may have underlain the exceptional radiaton and success of crown Archosauria.
Spirals, Scalp Whorls and Skin Biomechanics: Nature’s Own Design For Expansion
Authors: Paul Sharad P.
Published: March 2016

This paper began as an exercise in curiosity – logarithmic spiral designs abound in nature ‐‐ in galaxies, flowers, pinecones and on human scalps as whorls. Why are humans the only primates to have whorls on the scalp? Is the formation of scalp whorls mechanical or genetic? A mechanical theory has long been postulated– the mechanical theory suggests that hair whorl patterning is determined by the tension on the epidermis during rapid expansion of the cranium while the hair follicle is growing downwards – however, this has never before been experimentally proven conclusively. We found, that under certain conditions, we were able to experimentally recreate spirals on the scalp to demonstrate that the basis of scalp whorls is indeed mechanical – and that logarithmic spirals are indeed nature’s own design for rapid expansion of organic tissues. Given our experiments only created whorls when certain conditions were satisfied (and not in others), they have given us great insight into the mechanical formation of skin whorls and the physiology of skin stretch. We believe that these findings will lead to many more advances in understanding skin dynamics and indeed the behavior of any living tissue when confronted by stretch. As a corollary, the application of the results of these studies have led us to the discovery of a new surgical technique for closure of scalp defects using the golden spiral pattern, and this will be the subject of a separate paper.
Attention selectively reshapes the geometry of distributed semantic representation
Authors: Nastase Samuel A. , Connolly Andrew C. , Oosterhof Nikolaas N. , Halchenko Yaroslav O. , Swaroop Guntupalli J. , Oleggio Castello Matteo Visconti di , Gors Jason , Ida Gobbini M. , Haxby James V.
Published: March 2016

Humans prioritize different semantic qualities of a complex stimulus depending on their behavioral goals. These semantic features are encoded in distributed neural populations, yet it is unclear how attention might operate across these distributed representations. To address this, we presented participants with naturalistic video clips of animals behaving in their natural environments while the participants attended to either behavior or taxonomy. We used models of representational geometry to investigate how attentional allocation affects the distributed neural representation of animal behavior and taxonomy. Attending to animal behavior transiently increased the discriminability of distributed population codes for observed actions in anterior intraparietal, pericentral, and ventral temporal cortices. Attending to animal taxonomy while viewing the same stimuli increased the discriminability of distributed animal category representations in ventral temporal cortex. For both tasks, attention selectively enhanced the discriminability of response patterns along behaviorally relevant dimensions. These findings suggest that behavioral goals alter how the brain extracts semantic features from the visual world. Attention effectively disentangles population responses for downstream read-out by sculpting representational geometry in late-stage perceptual areas.
National libraries and regional cooperations: a framework for ECO national libraries
Authors: Najafqolinejad Azam , Hassanzadeh Mohammad
Published: March 2016

Purpose

– The purpose of this paper is to study the cultural integration, the role of national libraries in regional and international cooperation, Economic Cooperation Organization (ECO) national libraries’ barriers of cooperation and drivers of their cooperation and to propose a framework (conceptual and operational) for their cooperation.

Design/methodology/approach

– Data collection tool of this survey was a researcher-made questionnaire, sent to 30 individuals and experts involved in cooperation of ECO National Libraries from eight institutions. The reliability of the questionnaire was calculated using Cronbach’s alpha. It was 0.91. In this study, for awareness of activities between ECO national libraries and extraction of drivers, some documents were studied, and preliminary data were collected by informal interviews with meeting stakeholders and participants.

Findings

– The lack of stability in management positions was one of the major barriers in cooperation of the ECO national libraries. Other major obstacles in this context were lack of continuous communication, lack of common protocols and standards, lack of planning, lack of a central coordinating organization, bureaucracy, etc. Geographical proximity, common history and heritage, common resources, Islamic and cultural factors, importance of information and knowledge, requirements of the international system and political and security requirements were considered as drivers. An information centre was proposed for their active cooperation. Iran is better to host the information centre.

Originality/value

– National libraries as the scientific and cultural memory of nations and heirs of written heritage should cooperate and share their valuable scientific and cultural heritage to the future generations.
An intelligent tracking system based on internet of things for the cold chain
Authors: Luo Heng , Zhu Minjie , Ye Sengang , Hou Hanping , Chen Yong , Bulysheva Larissa
Published: March 2016

Purpose

– Monitoring the real-time temperature, humidity, and physical position status of goods is vital in the cold chain. Diverse logistics technologies and systems have been adopted in the cold chain for monitoring perishable goods. However, these technologies and systems are independent from each other. Data and information in them are not integrated so that information control is not effective. The paper aims to discuss these issues.

Design/methodology/approach

– By integrating Internet of Things and tracking technologies, this paper proposes an intelligent tracking system, which is designed to achieve effective and fast live monitoring of goods in the cold chain at the lowest cost and with the largest network capacity and simplest protocols.

Findings

– Structure and information platform design mechanism are introduced. The key part of this system is a wireless sensor network built on Zigbee. Wireless sensors located in cold storages or refrigerated trucks are able to collect and transmit live data quickly and efficiently.

Originality/value

– Users of the proposed system can easily monitor goods transported in cold chains. In addition, the system assigns specific servers to save historical data for inquiries.
Developing organisational capabilities to support agility in humanitarian logistics
Authors: L'Hermitte Cécile , Tatham Peter , Bowles Marcus , Brooks Ben
Published: March 2016

Purpose

– The purpose of this paper is to explore the underlying strategic mechanisms of agility in a humanitarian logistics context. Based on the research conducted in business disciplines, the paper empirically examines a set of four strategic dimensions (being purposeful, being action-focused, being collaborative, and being learning-oriented) and identifies an emergent relationship between these capabilities and agile humanitarian logistics operations.

Design/methodology/approach

– Leadership and management actions perceived to support the four capabilities were identified and used as a basis to complete the exploratory research. Specifically, a case study with the United Nations World Food Programme (WFP) was undertaken and, in this context, a qualitative analysis of 29 face-to-face interviews with humanitarian logistics experts working for WFP was conducted.

Findings

– The research corroborates the relevance of the four strategic-level capabilities to the humanitarian logistics context and confirms that these capabilities play a role in the development of agility in humanitarian operations. The work also identifies a set of key strategic decision-making areas that relate to the building of agility.

Research limitations/implications

– Additional research is needed to further investigate and measure the strategic-level capabilities and to quantify their impact on operational agility. Further research should also be undertaken to extend this study to a wider range of humanitarian organisations.

Originality/value

– This paper is the first empirical research that takes a strategic approach to the concept of agility in humanitarian logistics. It highlights that the leaders and managers of humanitarian organisations have a significant role to play in the building of an agile system.
Quantifying communication effects in disaster response logistics
Authors: Diedrichs Danilo R. , Phelps Kaile , Isihara Paul A.
Published: March 2016

Purpose

– Complementing the importance of adequate relief supplies and transportation capacity in the first two weeks of post-disaster logistics, efficient communication, information sharing, and informed decision making play a crucial yet often underestimated role in reducing wasted material resources and loss of human life. The purpose of this paper is to provide a method of quantifying these effects.

Design/methodology/approach

– A mathematical discrete dynamical system is used to model transportation of different commodities from multiple relief suppliers to disaster sites across a network of limited capacity. The physical network is overlaid with the communication network to model information delays and communication breakdowns between agents. The cost in human lives and the monetary cost are measured separately.

Findings

– Simulations results highlight quantitatively how communication deficiencies and indiscriminate shipping of resources result in material convergence and shortage of urgent supplies observed in actual emergencies.

Originality/value

– The model provides an example of a simple, objective, quantitative tool for decision making and training volunteer managers in the importance of a smart response protocol.
Systemic barriers and enablers in humanitarian technology transfer
Authors: Santos Ana Laura R. , Wauben Linda S.G.L. , Goossens Richard , Brezet Han
Published: March 2016

Purpose

– The purpose of this paper is to collect information about barriers and enablers experienced by international experts when transferring medical equipment to countries affected by humanitarian emergencies and to discuss the suitability of the principles of “openness”, “interconnections” and “non-linearity” of systems to understand the nature of the barriers and enablers as described by the international experts.

Design/methodology/approach

– In this study, six semi-structured interviews were conducted with experts from humanitarian organizations. The interviews were based on a simplified model of the transfer of medical equipment adapted from supply chain literature. The model ensured that all the process steps undertaken by humanitarian organizations were considered. Afterwards, the interviews were transcribed and structurally analysed to derive barriers and enablers. Finally, the results were described in light of three theoretical principles of systems thinking.

Findings

– In total, 14 types of barriers and 12 types of enablers were uncovered that illustrate the complexity of transferring medical equipment in humanitarian emergencies. The paper concludes with a proposal for future research to investigate if, and how, an approach guided by systems thinking could help to create a designated space for the formulation of original, synergetic solutions that address the identified barriers.

Originality/value

– This study is the first to explore the specific logistic challenges implicit in the transfer of medical equipment in humanitarian emergencies with a lifecycle perspective. Furthermore, the concept of systems thinking is rather novel in the field of transfer of medical technology.
Relationship among Interpersonal Relationship, Customer Satisfaction and Brand Loyalty in Fashion Retailing Industry
Authors: Hui S.L. , Yee Rachel W.Y.
Published: March 2016

Due to the recent emergence of numerous retail options, the fashion market has become more competitive. Consumers are offered more products choices for their purchase. This has created significant challenges to fashion retailers in attracting new and retaining existing customers. This research proposes that an interpersonal relationship between employees and customers is an effective means for companies to influence the purchase decisions and experiences of customers. We have conducted an empirical study to investigate the impact of interpersonal relationships on customer satisfaction and brand loyalty in the casual wear market. Our findings show that trust in an interpersonal relationship between customer-contact employees and customers has a positive effect on customer satisfaction, which in turn, leads to brand loyalty. We suggest that fashion retailers provide training programs to equip frontline employees with professional skills that deal with issues involved in interpersonal relationships. This is an effective means that help customer-contact employees master the necessary skills to satisfy customer needs and retain customers.
Effect of Cellulase Enzymes and Swelling Agents on Colour Strength and Colourfastness of Handloom Cotton Fabric Dyed with Butea Frondosa
Authors: Dixit Sunita
Published: March 2016

Cellulases and swelling agents are known to be effective in improving the colour strength of cotton. Nowadays, handloom fabrics, such as khadi cotton, are much more preferred due to the development of innovative designs with their use and their comfort in wearing. Also, due to increased environmental awareness, the use of natural dyes are much more preferred in the dyeing of handloom fabrics. However, khadi cotton has some major shortcomings, such as less dyeability. The present study is carried out by keeping in mind that the pretreatment of khadi cotton with cellulases, swelling agents and a combination of cellulases and swelling agents before dyeing improves the colour strength properties. Khadi cotton samples are treated with optimized conditions of the enzymes and swelling agents. The optimum pH, concentration, treatment time and temperature selected for treatment of the samples with acid cellulase enzymes are 5.5, 1.5% (owf), 45 minutes and 50°C, respectively, whereas in the case of neutral cellulase enzymes, 7.5, 2.0% (owf), 70 minutes and 70°C, respectively. The optimum concentration, treatment time and temperature selected for the treatment of the samples with sodium hydroxide, ethylenediamine and zinc chloride are 20% w/v, 60 minutes and 60°C; 80% w/v, 60 minutes and 70°C, and 80% w/v, 60 minutes and 70°C respectively. Butea frondosa dye (5 g) extracted for 75 minutes provides the best results on khadi cotton when dyeing is carried out for 90 minutes. It is observed that out of the various concentrations of mordants used with the Butea frondosa dye, the best shades of colour are obtained by using 0.04 g of alum, 0.01 g of copper sulphate, and 5 g of Babool bark. In terms of optimizing the mordanting, the best results are obtained with Butea frondosa dye when the samples are simultaneously mordanted and dyed with alum, Babool bark and alum. Pre-mordanting is selected for the copper sulphate. It is found that for all the enzyme treated (acid and neutral cellulase) as well as swelling agent treated (sodium hydroxide, ethylenediamine and zinc chloride) samples, the colour strength and colourfastness increase in comparison to the untreated samples.
An explanation of economic impact: why positive impacts can exist for smaller sports
Authors: Agha Nola , Rascher Daniel A.
Published: March 2016

Purpose

– The purpose of this paper is to understand why some sports show a positive economic impact and other sports do not, and to identify a common set of explanatory factors explaining the differences.

Design/methodology/approach

– This explanatory research reviews the economic impact literature to identify the underlying conditions that would theoretically allow any sport, large or small, to generate positive economic effects.

Findings

– Nine conditions are identified that, when present, could allow a community to experience a positive economic impact from a team or stadium. These are then used to explain the discrepancy in known empirical outcomes in major and minor league baseball (MiLB). It appears as if major league teams are more likely to violate the conditions than minor league teams. This research finds theoretical support for previous suggestions that smaller teams and events may be beneficial to local economies. In doing so, it also explains previous empirical results that found some MiLB classifications are associated with positive gains in per capita income.

Practical implications

– Stakeholders can use the nine conditions to understand expected economic impact of their relevant sports. This research provides a comprehensive guide to understanding when economic impact can be positive.

Social implications

– This research helps explain some of the existing controversy regarding economic impact analysis.

Originality/value

– It is the first research to help provide a pre-set of conditions that can help predict whether positive economic impact will occur for specific sports teams or stadium projects.
Comparisons of the utility of researcher‐defined and participant‐defined successful ageing
Authors: Brown Lynsey J. , Bond Malcolm J.
Published: March 2016

Aim

To investigate the impact of different approaches for measuring ‘successful ageing’, four alternative researcher and participant definitions were compared, including a novel measure informed by cluster analysis. Rates of successful ageing were explored, as were their relative associations with age and measures of successful adaptation, to assess construct validity.

Method

Participants, aged over 65, were recruited from community‐based organisations. Questionnaires (assessing successful ageing, lifestyle activities and selective optimisation with compensation) were completed by 317 individuals.

Results

Successful ageing ranged from 11.4% to 87.4%, with higher rates evident from participant definitions. Though dependent upon the definition, successful agers were typically younger, reported greater engagement with lifestyle activities and more frequent optimisation.

Conclusions

While the current study suggested an improved classification algorithm using a common research definition, future research should explore how subjective and objective aspects of successful ageing may be combined to derive a measure relevant to policy and practice.
Effect of omalizumab on angioedema in H1‐antihistamine‐resistant chronic spontaneous urticaria patients: results from X‐ACT, a randomized controlled trial
Authors: Staubach P. , Metz M. , Chapman‐Rothe N. , Sieder C. , Bräutigam M. , Canvin J. , Maurer M.
Published: March 2016

Background

Chronic spontaneous urticaria (CSU) severely impacts quality of life (QoL), especially in patients with wheals and angioedema. Omalizumab is approved as add‐on therapy for CSU patients; however, its effect on patients who are double‐positive for wheals and angioedema has not been systematically studied.

Objective

The primary objective was to evaluate the efficacy of omalizumab vs placebo at week 28 using the Chronic Urticaria Quality of Life (CU‐Q2oL) questionnaire. Number of angioedema‐burdened days, time interval between successive angioedema episodes, disease activity, angioedema‐specific and overall QoL impairment were secondary objectives.

Methods

X‐ACT was a phase III, randomized, double‐blind study conducted in 24 centres (Germany), which selectively included CSU patients with angioedema and wheals. Patients were randomized (1 : 1) to omalizumab 300 mg or placebo (every 4 weeks up to week 24) (ClinicalTrials.gov number: NCT01723072).

Results

Of the 91 patients randomized to omalizumab (n = 44) or placebo (n = 47) at baseline, 68 completed the 28‐week treatment phase (omalizumab, 35; placebo, 33). Omalizumab was superior to placebo in improving CU‐Q2oL scores at week 28 (P < 0.001). There was a threefold improvement in angioedema‐burdened days/week with omalizumab (0.3) vs placebo (1.1). The median time to first recurrence of angioedema was 57–63 days with omalizumab and <5 days with placebo. Omalizumab significantly improved angioedema‐specific QoL (P < 0.001). The adverse events reported are in line with the established safety profile of omalizumab.

Conclusion

Omalizumab was an effective treatment option for patients with moderate‐to‐severe CSU symptoms and angioedema unresponsive to high doses of antihistamine treatment.
Value of posterior keratometry in the assessment of surgically induced astigmatic change in cataract surgery
Authors: Klijn Stijn , van der Sommen Charlotte M. , Sicam Victor Arni D. P. , Reus Nicolaas J.
Published: March 2016

Purpose

To investigate the value of posterior keratometry in the assessment of surgically induced astigmatic change (AC) in cataract surgery, with particular emphasis on the influence of test–retest variability.

Methods

Seventy‐seven eyes of 77 cataract patients scheduled for routine cataract surgery were enrolled. All patients received a 2.2‐mm self‐sealing scleral incision (n = 24), single‐plane clear corneal incision (SPCCI; n = 29) or biplanar clear corneal incision (BPCCI; n = 24). Measurements of anterior and posterior corneal astigmatism were performed with a rotating Scheimpflug camera (Pentacam HR) preoperatively and postoperatively. Two repeated readings were taken preoperatively to assess the role of the test–retest effect. Astigmatic change (AC) was analysed according to the polar value method.

Results

On the anterior corneal surface, SPCCIs and BPCCIs caused a statistically significant mean flattening of the incisional meridian of 0.37 and 0.27 dioptres (D), respectively. Scleral incisions on average did not cause AC, although steepening, flattening or torque beyond the test–retest effect was observed in individual cases. On the posterior surface, mean power changes in the incisional meridian were below 0.1 D for all incisions, and these changes were of the same order of magnitude as the test–retest effect.

Conclusion

Surgically induced AC of the posterior corneal surface after cataract surgery is of negligible clinical relevance. Moreover, it is of the same order of magnitude as the test–retest variability of the measurement device and therefore cannot (yet) be reliably assessed.
BRAF mutations in conjunctival melanoma: investigation of incidence, clinicopathological features, prognosis and paired premalignant lesions
Authors: Larsen Ann‐Cathrine , Dahl Christina , Dahmcke Christina M. , Lade‐Keller Johanne , Siersma Volkert D. , Toft Peter B. , Coupland Sarah E. , Prause Jan U. , Guldberg Per , Heegaard Steffen
Published: March 2016

Purpose

To investigate incidence, clinicopathological features and prognosis of BRAF‐mutated conjunctival melanoma in Denmark. Furthermore, to determine BRAF mutations in paired premalignant lesions and evaluate immunohistochemical BRAF V600E oncoprotein detection.

Methods

Data from 139 patients with conjunctival melanoma (1960–2012) were collected. Archived conjunctival melanoma samples and premalignant lesions were analysed for BRAF mutations using droplet digital polymerase chain reaction (PCR). Results were associated with clinicopathological features and compared with BRAF V600E oncoprotein stainings.

Results

The overall incidence of conjunctival melanoma (0.5 cases/1 000 000/year) increased during the study period with 0.13 cases/1 000 000/10 years. The increase comprised a higher proportion of patients aged >65 years, epibulbar tumours and tumours developed from a primary acquired melanosis with atypia. BRAF mutations were identified in 39 of 111 (35%) cases. The rate ratio of BRAF‐mutated versus BRAF‐wild‐type melanoma did not change over time. BRAF mutations were associated with T1 stage (p = 0.007), young age (p = 0.001), male gender (p = 0.02), sun‐exposed location (p = 0.01), mixed/non‐pigmented tumour colour (p = 0.02) and nevus origin (p = 0.005), but did not associate with prognosis. BRAF status in conjunctival melanoma and paired premalignant lesions corresponded in 19 of 20 cases. Immunohistochemistry detected BRAF V600E mutations with a sensitivity of 0.94 and a specificity of 1.00 in newer conjunctival melanoma samples (2000–2012, n = 47).

Conclusion

The incidence of conjunctival melanoma increased in Denmark over 50 years. The proportion of BRAF‐mutated conjunctival melanoma was constant. BRAF mutations were identified as early events in conjunctival melanoma, associated with a distinct clinicopathological profile, similar to BRAF‐mutated cutaneous melanoma. Immunohistochemical detection of BRAF can be used to assess BRAF V600E mutations.
The prognostic value of retinal vessel analysis in primary open‐angle glaucoma
Authors: Waldmann Nicolas Philipp , Kochkorov Asan , Polunina Anna , Orgül Selim , Gugleta Konstantin
Published: March 2016

Purpose

To analyse a prognostic value of initial retinal vessel flicker response for the 3‐year development of functional (visual field) and morphological (nerve fibre layer thickness) damage progression in primary open‐angle glaucoma patients.

Patients and methods

Initially, 70 patients were recruited, and flicker response was measured by standardized procedure with the retinal vessel analyser (RVA). Ocular coherence tomography of retinal nerve fibre layer (OCT RNFL) and a visual field testing were performed at beginning and every 6 months for 3 years; 56 patients completed the study.

Results

No correlation was found between the progression of visual field (VF) mean defect and retinal nerve fibre layer (RNFL) thinning over 3 years on one and the maximal flicker reaction in arteries and veins on the other side (all p > 0.1). However, the calculated difference of examined parameters in the superior versus inferior retinal halves correlated significantly between the RNFL thinning and the initial maximal flicker response for arteries (p = 0.01) and veins (p = 0.003).

Conclusion

This longitudinal study did not find a general correlation between initial retinal vessel response to flicker light and the glaucoma damage progression measured by OCT and VF, hence limiting the relevance of the RVA device as a predictor of future glaucomatous damage.
What made you wait so long? Delays in presentation of retinal detachment: knowledge is related to an attached macula
Authors: Eijk Eva S. V. , Busschbach Jan J. V. , Timman Reinier , Monteban Helma C. , Vissers Jan M. H. , van Meurs Jan C.
Published: March 2016

Purpose

In rhegmatogenous retinal detachment, the time between first symptoms and reattachment surgery is critical to prevent macular detachment. We explored which determinants discriminate between ‘macula‐ON’ and ‘macula‐OFF’ retinal detachments to improve timely treatment.

Methods

Eight‐hundred patients with rhegmatogenous retinal detachment admitted for surgery at the Rotterdam Eye Hospital in the Netherlands were eligible to complete a questionnaire to explore the following determinants: (i) patient's delay and doctor's delay; (ii) patient‐reported causes for delay; (iii) symptoms as early warning signals; (iv) patient's prior knowledge about retinal detachment; and (v) trait anxiety.

Results

Five hundred and twenty‐one questionnaires (65%) were analysed. Median interval between first symptoms and surgery was 14 days. Macula‐ON/OFF ratio was 46/54. Patient's delay in macula‐ON patients (median 3 days) was shorter than in macula‐OFF (5 days, p = 0.026). No difference was found in doctor's delay except for ‘waiting time for surgery’: macula‐ON patients were operated on faster (median 1 day) than macula‐OFF (median 5 days, p < 0.001). Macula‐ON patients more often attributed symptoms to retinal problems. Except floaters, no symptoms were determined as early warning signals for macula‐ON. Macula‐ON patients more often reported knowing that prognosis would be worse when treated later, even when controlled for previous experience with retinal detachment.

Conclusion

Macula‐ON patients seem to self‐refer faster to a healthcare provider, seem more sensitive to floaters and seem more informed. This suggests that increasing awareness, especially about floaters, might increase the proportion of patients with macula still on at the moment of referral to the ophthalmologist.
A Regional Drug and Therapeutics Committee‐led Intervention to Reduce the Hospital Costs of Expensive HIV Drugs
Authors: Mikkelsen Camilla Munk , Andersen Stig Ejdrup
Published: March 2016

In 2009, the regional Drug and Therapeutics Committee (DTC) began a series of meetings with lead specialists in infectious diseases. The role of the DTC was to engage clinicians and ensure commitment to prescribing the least expensive drugs among the clinically equivalent HAARTs (highly active antiretroviral therapy). DTC also led implementation of a national guideline. This study analyses the impact of this process on HAART consumption and expenditure. The HAART consumption and expenditure (2009–2013) was compared to forecasts produced by exponential smoothing (2004–2009). Abrupt switches between drug regimens coincided with the DTC‐led meetings. Overall, HAART consumption rose 16%, while price per defined daily dose (DDD) fell 11% and the 2013 expenditure decreased 23%. The consumption of drugs addressed by the guideline rose 48%. Still, the 2013 expenditure was 41.5 million DKK (5.5 million €) (27%) lower than expected, reflecting a fall in price per DDD that coincided with the intervention. The consumption of drugs not addressed by the guideline rose 8.3%, while price per DDD fell 8.5% and the 2013 expenditure was 26.8 million DKK (3.6 million €) (19%) lower than expected. Despite a steadily increasing consumption, significant cost savings followed this DTC‐led intervention. This multifaceted approach might be applicable to changing the prescribing of other expensive drug classes.
Demographic and genetic connectivity: the role and consequences of reproduction, dispersal and recruitment in seagrasses
Authors: Kendrick Gary A. , Orth Robert J. , Statton John , Hovey Renae , Ruiz Montoya Leonardo , Lowe Ryan J. , Krauss Siegfried L. , Sinclair Elizabeth A.
Published: March 2016

Accurate estimation of connectivity among populations is fundamental for determining the drivers of population resilience, genetic diversity, adaptation and speciation. However the separation and quantification of contemporary versus historical connectivity remains a major challenge. This review focuses on marine angiosperms, seagrasses, that are fundamental to the health and productivity of temperate and tropical coastal marine environments globally. Our objective is to understand better the role of sexual reproduction and recruitment in influencing demographic and genetic connectivity among seagrass populations through an integrated multidisciplinary assessment of our present ecological, genetic, and demographic understanding, with hydrodynamic modelling of transport. We investigate (i) the demographic consequences of sexual reproduction, dispersal and recruitment in seagrasses, (ii) contemporary transport of seagrass pollen, fruits and seed, and vegetative fragments with a focus on hydrodynamic and particle transport models, and (iii) contemporary genetic connectivity among seagrass meadows as inferred through the application of genetic markers. New approaches are reviewed, followed by a summary outlining future directions for research: integrating seascape genetic approaches; incorporating hydrodynamic modelling for dispersal of pollen, seeds and vegetative fragments; integrating studies across broader geographic ranges; and incorporating non‐equilibrium modelling. These approaches will lead to a more integrated understanding of the role of contemporary dispersal and recruitment in the persistence and evolution of seagrasses.
Clinical approaches towards asthma and chronic obstructive pulmonary disease based on the heterogeneity of disease pathogenesis
Authors: Hizawa N.
Published: March 2016

Asthma and chronic obstructive pulmonary disease (COPD) are each heterogeneous disease classifications that include several clinical and pathophysiological phenotypes. This heterogeneity complicates characterization of each disease and, in some cases, hinders the selection of appropriate treatment. Therefore, in recent years, emphasis has been placed on improving our understanding of the various phenotypes of asthma and of COPD and identifying biomarkers for each phenotype. Likewise, the concept of the endotype has been gaining acceptance; an endotype is a disease subtype that is defined by unique or distinctive functional or pathophysiological mechanisms. Endotypes of asthma or COPD may be primarily characterized by increased susceptibility to type 2 inflammation, increased susceptibility to viral infections, bacterial colonization or impaired lung development. The ‘Dutch hypothesis’ is as follows: gene variants underlying particular endotypes interact with detrimental environmental stimuli (e.g. smoking, viral infection and air pollution) and contribute to the ultimate development of asthma, COPD or both. Novel approaches that involve multidimensional assessment should facilitate identification and management of the components that generate this heterogeneity. Ultimately, patients with chronic inflammatory lung diseases may be treated based on these endotypes as determined by the respective biomarkers that correspond to individual endotypes instead of on disease labels such as asthma, COPD or even asthma–COPD overlap syndrome (ACOS).
Multicenter evaluation of the utilization of endoscopic ultrasound
Authors: D’Souza Sharlene L. , Holub Jennifer L. , Pavic Brian T. , Rodriguez Sarah A.
Published: March 2016

Background and Aim

There are currently no data regarding the number and type of endoscopic ultrasound (EUS) procedures being carried out in the USA. The aims of the present study are to: (i) estimate the annual number of EUS procedures being carried out in a nationwide database; (ii) describe the indications and types of EUS carried out; and (iii) examine short‐term trends in volume.

Methods

Retrospective analysis from the Clinical Outcomes Research Initiative (CORI) of EUS procedures carried out on patients >18 years of age from 1 January 2010 through 31 December 2013.

Results

EUS cases (n = 7614) were carried out by 68 endoscopists at 18 sites over the study period, representing 1.7% of the total number of endoscopic procedures. The most common indications were evaluation of a pancreatic mass (14.7%), diagnostic sampling with fine‐needle aspiration (14.1%), and evaluation of a pancreatic cyst (14.0%). The number of EUS examinations and cases undergoing same‐day endoscopic retrograde cholangiopancreatography (ERCP) increased over the study period (P < 0.0001). Use of general anesthesia or deep sedation increased markedly from 37.8% to 82.8% of procedures (P < 0.0001).

Conclusions

This is the largest survey of EUS practice in the USA. Evaluation of the pancreas accounts for approximately 40% of the indications for EUS. Use of EUS increased over the study period, and the proportion carried out with deep sedation or general anesthesia also increased. These data may have implications regarding the number of endosonographers who should be trained, as well as cost issues pertaining to increasing use of anesthesia providers and same‐day ERCP.