bluuebunny/crossref_metadata_2025 huggingface dataset:
‘It depends’: Characterizing speech and language therapy for preschool children with developmental speech and language disorders
Authors: Morgan Lydia , Marshall Julie , Harding Sam , Powell Gaye , Wren Yvonne , Coad Jane , Roulstone Sue
Published: September 2019

Background

Several studies have suggested that practitioners hold speech and language therapy (SLT) practice as tacit and consequently it is difficult for the therapist to describe. The current study uses a range of knowledge elicitation (KE) approaches, a technique not used before in SLT, as a way of accessing this tacit knowledge. There is currently no agreed framework that establishes key factors underpinning practice for preschool children with speech and language disorders. This paper attempts to address that gap.

Aims

To develop a framework of SLTs’ practice when working with preschool children with developmental speech and language disorders (DS&LD).

Methods & Procedures

A mixed‐methods approach was adopted for this study. Data were collected iteratively, from 245 SLTs with experience of working with preschool children with DS&LD across sites in England, by means of focus groups and national events. There were three stages of data collection: local sites, specific‐interest groups and two national events. KE techniques were used to gather data, with initial data being collected in local site focus groups. Findings from groups were taken to subsequent larger groups where a combination of concept mapping, teach‐back and sorting exercises generated a more detailed description of practice, using discussion of consensus and disagreement to stimulate further exploration and definition and provide validatory evidence.

Outcomes & Results

This paper provides a high‐level framework of therapy for preschool children with DS&LD that makes practice explicit in this area. The framework proposes that therapists’ aims for this group of children fall into three categories: addressing children's areas of impairment and skills; achieving functionally meaningful skills and carryover; and supporting adults to provide a supportive communication environment. The exact configuration is shaped by the child's context and needs.

Conclusions & Implications

The framework highlights themes that are well researched in the literature (e.g., speech) and others that have been little studied (e.g., adult understanding), indicating a disconnect between research evidence and practice. The research also highlights the complex nature of interventions for preschool children with DS&LD and the importance therapists attribute to tailoring therapy to individual needs. The framework provides a scaffold upon which SLTs can focus their clinical practice and encourages the profession to understand and explore better the gaps between research evidence and clinical practice for preschool children with DS&LD.
Health States of Exception: unsafe non‐care and the (inadvertent) production of ‘bare life’ in complex care transitions
Authors: Waring Justin , Bishop Simon
Published: September 2019

This paper draws on the work of Giorgio Agamben to understand how the social organisation of care transitions can reduce people to their ‘bare’ life thereby making harmful and degrading treatment seemingly legitimate. The findings of a 2‐year ethnographic study show how some people experience hospital discharge as undignified, inhumane and unsafe process, expressed through their lack of involvement in care planning, delayed discharge from hospital and poorly coordinated care. Our analysis explores how these experiences stem from the way patients are constituted as ‘unknown’ and ‘ineligible’ subjects and, in turn, how professionals become ‘not responsible’ for their care. The result being that the person is reduced to their ‘bare’ life with limited value within the care system. We suggest that the social production of ‘bare life’ is an inadvertent consequence of reconciling and aligning multiple disciplines within a complex care system.
Effects of Spatial and Temporal Data Aggregation on the Performance of the Multi‐Radar Multi‐Sensor System
Authors: Bayabil Haimanote K. , Fares Ali , Sharif Hatim O. , Ghebreyesus Dawit T. , Moreno Hernan A.
Published: September 2019

The objectives of this study were to (1) evaluate the performance of the Multi‐Radar Multi‐Sensor (MRMS) system in capturing precipitation compared to gauge data, and (2) assess the effects of spatial (1–50 km) and temporal (15–120 min) data aggregation scales on the performance of the MRMS system. Point‐to‐grid comparisons were conducted between 215 rain gauges and the MRMS system. The MRMS system at 1 km spatial and 15 min temporal resolutions captured precipitation reasonably well with average R2, root mean square error (RMSE), and percent bias (PBIAS) values of 0.65, 0.5 mm, and 11.9 mm; whereas Threat Score, probability of detection, and false alarm ratio were 0.57, 0.92, and 0.40, respectively. Decreasing temporal resolution from 15 min to two hours resulted in an increase in R2 and a decrease in RMSE, whereas PBIAS was not affected. Reducing spatial resolution from 1 to 50 km resulted in increases in R2 and PBIAS, whereas RMSE was decreased. Increasing spatial aggregation scale from 1 to 50 km resulted in an R2 increase of only 0.08. Similarly, improvement in R2 was only modest (0.17) compared to an eightfold reduction in temporal resolution (from 15 min to two hours). While aggregating data at coarser temporal resolutions resolved some of the under/overestimation issues of the MRMS system, it was apparent even at coarser spatial and temporal resolutions the MRMS system inherently overestimated smaller precipitation events while underestimated bigger events.
Clinical features and risk factors for gout attacks during anti‐tuberculosis treatment: A case‐control study in South Korea
Authors: Ha You‐Jung , Chung Sang Wan , Lee Jae Hyun , Kang Eun Ha , Lee Yun Jong , Song Yeong Wook
Published: September 2019

Aim

This study aimed to investigate the clinical features and risk factors of gout attacks during anti‐tuberculosis (TB) treatment in South Korea.

Method

We investigated the clinical characteristics of 49 patients who suffered from gout attacks while taking anti‐TB medications. Among them, 25 TB patients having newly developed gout attacks without prior history of gout were set to the gout group. Seventy‐five age‐ and sex‐matched TB patients without gout attacks during anti‐TB therapy were randomly selected as the control group. The demographics, clinical features, and laboratory findings between the two groups were compared to establish risk factors of gout attack during anti‐TB treatment.

Results

The gout patients had a mean age of 67.7 ± 13.2 years and 39 patients (79.6%) were male. Approximately half of the patients experienced an attack within 2 months of treatment initiation. The attacks typically involved lower extremity joints (87.8%). The serum uric acid (SUA) levels were significantly elevated at 2 and 6 months after starting anti‐TB medication compared with those at baseline. In the case‐control study, the factors associated with gout attack were higher body mass index (BMI), higher pre‐treatment SUA levels, dyslipidemia, and reduced renal function. In the multivariate model, higher BMI, chronic kidney disease (CKD), and pre‐treatment hyperuricemia (SUA ≥ 6.8 mg/dL) were independent risk factors of gout attack while taking anti‐TB medication.

Conclusions

Patients with high BMI, CKD, and pre‐treatment hyperuricemia are at a higher risk of gout attack during TB treatment.
The IPO corporate social responsibility information disclosure: Does the stock market care?
Authors: Huang Fangliang , Xiang Lijin , Liu Rongbing , Su Shuling , Qiu Hao
Published: September 2019

We create textual information indices using corporate social responsibility (CSR) information extracted from IPO prospectuses in China. We use the indices to measure the issuers’ corporate social performance (CSP) and corporate environmental performance (CEP) and assess how the stock market reacts. We find that CSP disclosure is significantly related to the post‐market performance of the firm. Specifically, better CSP disclosure is correlated with higher post‐IPO listing holding period returns among firms that do not disclose donations or environmental expenditures, although the association does not hold for firms that make donations and environmental expenditures. In addition, institutional investors seem to care more about the CEP information for a firm than the CSP information.
Old World camels in a modern world – a balancing act between conservation and genetic improvement
Authors: Burger P. A. , Ciani E. , Faye B.
Published: September 2019

Old World camels have served humans in cross‐continental caravans, transporting people and goods, connecting different cultures and providing milk, meat, wool and draught since their domestication around 3000–6000 years ago. In a world of modern transport and fast connectivity, these beasts of burden seem to be out‐dated. However, a growing demand for sustainable milk and meat production, especially in countries affected by climate change and increasing desertification, brings dromedaries (Camelus dromedarius) and Bactrian camels (Camelus bactrianus) back onstage and into the focus of animal breeders and scientists. In this review on the molecular genetics of these economically important species we give an overview about the evolutionary history, domestication and dispersal of Old World camels, whereas highlighting the need for conservation of wild two‐humped camels (Camelus ferus) as an evolutionarily unique and highly endangered species. We provide cutting‐edge information on the current molecular resources and on‐going sequencing projects. We cannot emphasise enough the importance of balancing the need for improving camel production traits with maintaining the genetic diversity in two domestic species with specific physiological adaptation to a desert environment.
Homestead tree holdings: Composition, uses and challenges in Checheche Growth Point, South East Lowveld, Zimbabwe
Authors: Thondhlana Gladman , Ruwanza Sheunesu
Published: September 2019

Understanding homestead tree holdings is important for developing local conservation and livelihood strategies. However, relative to urban homesteads, tree holdings in rural African homesteads remain little studied, especially in semi‐arid settings. Using ecological and household surveys, this paper examines homestead tree composition, uses and challenges in Checheche, Zimbabwe. In total, 1,594 trees were encountered across 147 homesteads. Nearly, all homesteads (99%) had trees, and most of them were primarily planted for fruits and shade. Fuelwood, traditional medicines, windbreak and homestead decoration were considered as secondary benefits. Overall, tree density was approximately 112 trees/ha, with an average of 11 ± 7.1 trees per homestead. Homestead tree holdings were explained by age and gender of respondent, homestead ownership and importance attached to and knowledge of trees. Challenges to tree planting mentioned include termites, diseases, livestock damage, high temperatures, water shortages and poor quality soils. Overall, this study shows that homestead tree planting is widespread in semi‐arid rural settings but constraints to tree planting ought to be addressed to optimise the benefits from trees. Further research is needed to fully understand the socioecological context that explains tree survival, as a basis for developing interventions for enabling homestead tree planting.
Prevention of hypotension after spinal anaesthesia for caesarean section: a systematic review and network meta‐analysis of randomised controlled trials
Authors: Fitzgerald J. P. , Fedoruk K. A. , Jadin S. M. , Carvalho B. , Halpern S. H.
Published: September 2019

Spinal anaesthesia for caesarean section commonly causes maternal hypotension. This systematic review and network meta‐analysis compared methods to prevent hypotension in women receiving spinal anaesthesia for caesarean section. We selected randomised controlled trials that compared an intervention to prevent hypotension with another intervention or inactive control by searching MEDLINE and Embase, Web of Science to December 2018. There was no language restriction. Two reviewers extracted data on trial characteristics, methods and outcomes. We assessed risk of bias for individual trials (Cochrane tool) and quality of evidence (GRADE checklist). We assessed 109 trials (8561 women) and 12 different methods that resulted in 30 direct comparisons. Methods ranked by OR (95%CI) from most effective to least effective were: metaraminol 0.11 (0.04–0.26); norepinephrine 0.13 (0.06–0.28); phenylephrine 0.18 (0.11–0.29); leg compression 0.25 (0.14–0.43); ephedrine 0.28 (0.18–0.43); colloid given before induction of anaesthesia 0.38 (0.24–0.61); angiotensin 2, 0.12 (0.02–0.75); colloid given after induction of anaesthesia 0.52 (0.30–0.90); mephentermine 0.09 (0.01–1.30); crystalloid given after induction of anaesthesia 0.78 (0.46–1.31); and crystalloid given before induction of anaesthesia 1.16 (0.76–1.79). Phenylephrine caused maternal bradycardia compared with control, OR (95%CI) 0.23 (0.07–0.79). Ephedrine lowered umbilical artery pH more than phenylephrine, standardised mean difference (95%CI) 0.78 (0.47–1.49). We conclude that vasopressors should be given to healthy women to prevent hypotension during caesarean section with spinal anaesthesia.
Graph analysis of DTI‐based connectome: decreased local efficiency of subcortical regions in PE patients with high sympathetic activity
Authors: Chen J. , Huang X. , Lu C. , Liu T. , Dai Y. , Yao Z. , Chen Y.
Published: September 2019

Introduction

Hyperactivity of the sympathetic nervous system was considered as one of the factors involved in the pathological mechanisms of premature ejaculation (PE). Sympathetic skin response of the penis (PSSR) was used to evaluate the activity of sympathetic innervations in the penis, which was controlled by the central nervous system (brain). Shorter PSSR was found in PE patients; however, little was known regarding the central neural mechanisms of PE patients with high sympathetic activity.

Methods

PSSR of PE patients was evaluated, and diffusion tensor images of participants were collected. Graph theoretical analysis was employed to examine the differences of the topological properties of structural brain connectome between PE patients with high sympathetic activity and healthy controls (HCs). Moreover, the relationships between topological characteristics and clinical features in PE patients were also explored.

Results

Decreased local efficacy was found in the left amygdala, right pallidum and thalamus in the white matter brain networks of PE when compared with HC (survived false discovery rate (FDR) correction). In addition, PE patients showed decreased global efficacy in the left amygdala and right rolandic operculum, supramarginal gyrus, heschl gyrus, inferior temporal gyrus, pallidum and thalamus; however, these results did not survive FDR correction. Finally, the local efficacy of right thalamus had a positive correlation with the premature ejaculation diagnostic tool (PEDT) scores, while the local efficacy of left amygdala was negatively associated with the state score of the state‐trait anxiety inventory (STAI) and penile shaft sensory threshold.

Conclusion

The results highlighted the abnormal topological properties of structural brain connectome in PE with high sympathetic activity. We also suggested that the clinical features of PE were related to the abnormality of several brain regions involved in the central control of ejaculation and emotion. This study provided new insights into the central neural mechanisms of PE, which might offer biological markers for understanding the physiopathology of PE.
Sarcopenic obesity and post‐operative morbidity after pancreatic surgery: a cohort study
Authors: Ratnayake Chathura B. B. , Wells Cameron , Olsson Magda , Windsor John A. , Pandanaboyana Sanjay
Published: September 2019

Background

Several indices of sarcopenia (SARC) exist in the literature, however, there is no consensus as to the best SARC index to predict post‐operative morbidity following pancreatic surgery.

Methods

A prospectively collected database was reviewed in a single institution including a total of 89 consecutive patients who had undergone pancreatic resection between 2015 and 2018.

Results

A total of 89 patients comprised the cohort. Seventy‐one percent (63/89) underwent pancreaticoduodenectomy. SARC was identified in 49 patients (55%) using psoas muscle index, 44 patients (49%) using the skeletal muscle index and 25 patients (28%) using the skeletal muscle attenuation. Post‐operative morbidity did not differ between SARC and non‐SARC (NSARC) patients using all three preoperative computed tomography measures (skeletal muscle index SARC 64%, 28/44, NSARC 64%, 29/45, P = 1.000; psoas muscle index SARC 63%, 31/49, NSARC 65%, 26/40, P = 0.810; skeletal muscle attenuation SARC 17/25, NSARC 40/64, P = 0.247). However, sarcopenic obesity was a significant independent risk factor for overall post‐operative morbidity on multivariate analysis (odds ratio 1.241 (SE 0.608), P = 0.041) with the highest specificity (81%).

Conclusion

Preoperative sarcopenic obesity can be an important independent predictor of post‐operative morbidity following pancreatic resection. There remains a need for standardization of SARC indices.
Early fluid overload was associated with prolonged mechanical ventilation and more aggressive parameters in critically ill paediatric patients
Authors: Laroque Sinott Lopes Clarice , Unchalo Eckert Guilherme , Sica da Rocha Taís , Fontela Patrícia S. , Pedro Piva Jefferson
Published: September 2019

Aim

We evaluated the influence of early fluid overload on critically ill children admitted to a paediatric intensive care unit by examining mechanical ventilation (MV), mortality, length of stay and renal replacement therapy.

Methods

This retrospective cohort study covered January 2015 to December 2016 and focused on all episodes of MV support that exceeded 24 hours. The fluid overload percentage (FO%) was calculated daily for the first 72 hours and we estimated its effect on outcomes.

Results

We included 186 MV episodes in 154 patients. The median age was 13.8 months, with an interquartile range (IQR) of 3.8‐34.0 months, and the mortality rate was 12.4%. The median FO% in the first 72 hours was 8.0% (IQR 3.6%‐11.2%). An FO% of ≥10% was associated with higher ventilatory parameters, namely peak inspiratory pressure (P = .023) and positive end expiratory pressure (P = .003), and renal replacement therapy (P = .02) and higher mortality (8.8% vs 19.7%). In a multivariate Cox regression model, FO ≥ 10% at 72 hours was independently associated with longer MV support, but not mortality (P = .001).

Conclusion

In a heterogeneous paediatric population given MV, an early cumulative FO of ≥10% was associated with more aggressive ventilatory parameters and prolonged length of MV, but not mortality.
Editorial: the problem of supragastric belching needs to be heard
Authors: Halland Magnus , Katzka David A.
Published: September 2019

LINKED CONTENT

This article is linked to Sawada et al paper. To view this article, visit https://doi.org/10.1111/apt.15417.
Letter: hepatocellular carcinoma surveillance determines survival in patients at risk
Authors: Zhu Shao‐Liang , Li Yuan‐Qi , Hu Hui , Ma Liang
Published: September 2019

LINKED CONTENT

This article is linked to Kim et al paper. To view this article, visit https://doi.org/10.1111/apt.14623.
Editorial: understanding differences in patient response to ondansetron in irritable bowel syndrome with diarrhoea—are we any closer? Authors' reply
Authors: Gunn David , Garsed Klara , Lam Ching , Singh Gulzar , Lingaya Melanie , Wahl Verena , Niesler Beate , Henry Amanda , Hall Ian , Whorwell Peter , Spiller Robin
Published: September 2019

LINKED CONTENT

This article is linked to Gunn et al and Black et al papers. To view these articles, visit https://doi.org/10.1111/apt.15420 and https://doi.org/10.1111/apt.15455.
Letter: predictors of survival in patients undergoing transjugular intrahepatic portosystemic shunt—what should we assess by ultrasound?
Authors: Yuan Shuai , Yang Xiaomin , Chen Jin , Zhao Shenggang , Xu Jianjiang , Liang Chun
Published: September 2019

LINKED CONTENT

This article is linked to Armstrong et al paper. To view this article, visit https://doi.org/10.1111/apt.15164.
Letter: metformin reduces the risk of hepatocellular carcinoma in diabetic patients. Authors' reply
Authors: Vilar‐Gomez Eduardo , Chalasani Naga
Published: September 2019

LINKED CONTENT

This article is linked to Vilar‐Gomez et al and Huo et al papers. To view these articles, visit https://doi.org/10.1111/apt.15331 and https://doi.org/10.1111/apt.15467.
Letter: metformin treatment and hepatocellular carcinoma risk in non‐alcoholic fatty liver disease. Authors’ reply
Authors: Vilar‐Gomez Eduardo , Chalasani Naga
Published: September 2019

LINKED CONTENT

This article is linked to Vilar‐Gomez and et al and Dogru et al papers. To view these articles, visit https://doi.org/10.1111/apt.15331 and https://doi.org/10.1111/apt.15462.
The responsibilities of the engaged bioethicist: Scholar, advocate, activist
Authors: Scully Jackie Leach
Published: September 2019

The work of a bioethicist carries distinctive responsibilities. Alongside those of any worker, there are responsibilities associated with giving guidance to practitioners, policy makers and the public. In addition, bioethicists are professionally exposed to and required to identify situations of moral trouble, and as a result may find themselves choosing to work as advocates or activists, with responsibilities that are distinct from those generally acknowledged within academia. The requirement for bioethics to make normative judgements entails taking a stance, which means there cannot be a sharp line between ‘academic’ or ‘objective’ bioethics, and advocacy/activism, but a continuum of bioethicists’ engagement and an associated continuum of responsibilities.
From data to personal user models for life‐long, life‐wide learners
Authors: Kay Judy , Kummerfeld Bob
Published: September 2019

As technology has become ubiquitous in learning contexts, there has been an explosion in the amount of learning data. This creates opportunities to draw on the decades of learner modelling research from Artificial Intelligence in Education and more recent research on Personal Informatics. We use these bodies of research to introduce a conceptual model for a Personal User Model for Life‐long, Life‐wide Learners (PUMLs). We use this to define a core set of system competency questions. A successful PUML and its interface must enable a learner to answer these by scrutinising their PUML, aided by its scaffolding interfaces. We aim to give learners both control over their own learning data and the means to harness that data for the important metacognitive processes of self‐monitoring, reflection and planning. We conclude with a set of design guidelines for creating PUMLs. Our core contribution is a way to think about the design and evaluation of learning data and applications so that they give learner control and agency beyond simple data access and algorithmic transparency.

Practitioner Notes

What is already known about this topic

There is decades of Artificial Intelligence in Education (AIED) research on learner modelling, personalisation and Open Learner Models (OLMs).

There is a growing body of work on Personal Informatics.

What this paper adds

Drawing on the above research, we present a conceptual model showing how learning applications and data repositories relate to a Personal User Model for Life‐long, Life‐wide Learners (PUMLs).

A set of competency questions to inform design and evaluation of PUMLs.

Guidelines for designing interfaces that enable learners to scrutinise and control their learning data and models.

Implications for practice and/or policy

As universities create institutional repositories of learning data, our work takes a complementary, learner‐centred perspective of learning data, applications and repositories.

PUMLs offer a mechanism to support student’s meta‐cognitive processes.

PUMLs go beyond simplistic views of data access and transparency of algorithmic processes—empowering learners to scrutinise their long‐term data and its use.
Failure of abdominal wall closure after intestinal transplantation: Identifying high‐risk recipients
Authors: Cloonan Madeline R. , Fortina Chaeli A. , Mercer David F. , Vargas Luciano M. , Grant Wendy J. , Langnas Alan N. , Merani Shaheed
Published: September 2019

Open abdomen and fascial dehiscence after intestinal transplantation increase morbidity. This study aims to identify recipient and donor factors associated with failure to achieve sustained primary closure (failed‐SPC) of the abdomen after intestinal transplant. We conducted a single‐center retrospective study of 96 intestinal transplants between 2013 and 2018. Thirty‐eight (40%) were adult patients, and 58 were pediatric patients. Median age at transplantation was 36.0 and 5.8 years, respectively. Failed‐SPC occurred in 31 (32%) patients. Identified risk factors of failed‐SPC included preexisting enterocutaneous fistula (OR: 6.8, CI: 2.4‐19.6, P = .0003), isolated intestinal graft (OR: 3.4, CI: 1.24‐9.47, P = .02), male sex in adults (OR: 3.93, CI: 1.43‐10.8, P = .009), and age over four years (OR: 6.22, CI: 1.7‐22.7, P = .004). There was no association with primary diagnosis and prior transplant with failed‐SPC. Donor‐to‐recipient size ratios did not predict failed‐SPC. There was an association between failed‐SPC and extended median hospital stay (100 vs 57 days, P = .007) and increased time to enteral autonomy in pediatric patients. There is a relationship between failed‐SPC and a higher rate of laparotomy (OR: 21.4, CI: 2.78‐178.2, P = .0003) and fistula formation posttransplant (OR: 11.4, CI: 2.83‐45.84, P = .0005) in pediatric patients. Given inferior outcomes with failed‐SPC, high‐risk recipients require careful evaluation.
Insights into the potential host range ofPhytophthora foliorum
Authors: Harris Anna R. , Webber Joan F.
Published: September 2019

During a survey forPhytophthora ramorumundertaken in north‐west Scotland in early 2016,Phytophthora foliorumwas found infecting foliage of the invasive shrubRhododendron ponticum. Prior to this,P. foliorumhad only been reported from foliage of hybrid azaleas in nurseries in California and Tennessee and from azalea plants in an ornamental nursery in Spain. No other hosts were known, and much of the behaviour ofP. foliorumremained enigmatic. The species is classified inPhytophthoraClade 8c, with closest relatives,P. ramorumandPhytophthora lateralis, both of which are highly damaging tree pathogens. To explore the threat thatP. foliorummight pose to trees, its growth–temperature responses on agar media and ability to cause lesions in the living bark of various hosts were contrasted with the behaviours ofP. ramorumandP. lateralis.Phytophthora foliorumproved faster growing and more tolerant of temperature extremes than the otherPhytophthoraspecies. Comparisons of bark colonization initially focussed onR. ponticumand larch speciesLarix deciduaandLarix kaempferias all three are significant hosts ofP. ramorumin the UK. Further experiments included anotherP. ramorumhost,Fagus sylvatica(European beech), and the main host ofP. lateralis,Chamaecyparis lawsoniana(Lawson cypress). Findings suggested that as well as being a significant pathogen ofR. ponticum, damage caused byP. foliorumto both species of larch and beech was very similar to that of the EU1 lineage ofP. ramorum, although growth in host tissue was also influenced by season.
Clinical, imaging and follow‐up study of optic neuritis associated with myelin oligodendrocyte glycoprotein antibody: a multicentre study of 62 adult patients
Authors: Shor N. , Aboab J. , Maillart E. , Lecler A. , Bensa C. , Le Guern G. , Grunbaum S. , Marignier R. , Papeix C. , Heron E. , Gout O. , Savatovsky J. , Galanaud D. , Vignal C. , Touitou V. , Deschamps R.
Published: September 2019

Background and purpose

There are few clinico‐radiological data on optic neuritis (ON) with myelin oligodendrocyte glycoprotein antibody (MOG‐IgG). The objective was to characterize the clinico‐radiological phenotype and outcome of patients with MOG‐IgG‐related ON.

Methods

The records of all adult patients admitted in three medical centres with MOG‐IgG‐associated ON who underwent orbital and brain magnetic resonance imaging (MRI) at the acute phase were reviewed. Spinal cord MRI within 1 month from the ON and all of the follow‐up MRI were reviewed.

Results

Of 62 patients, 41.9% had bilateral ON and 66.2% optic disc swelling. On initial MRI, lesions were anterior (92%), extensive (63%) and associated with optic perineuritis (46.6%). Silent brain lesions were found in 51.8% of patients but were mainly non‐specific (81%). Of 39 individuals with spinal MRI at onset, nine had abnormal findings (four were asymptomatic). Two symptomatic patients had longitudinally extensive myelitis with concurrent H‐sign. At last follow‐up, 5% of patients had visual acuity ≤0.1. Brain MRI remained unchanged in 41 patients (87%).

Conclusions

Our study supports a mostly benign ophthalmological course of MOG‐IgG‐associated ON, despite initially longitudinally extensive lesions and development of optic nerve atrophy on orbital MRI. Spinal MRI could be of interest in detecting silent suggestive lesions.
Population structure, life cycle, and trophic niche of the glacial relict amphipod, Gammaracanthus lacustris, in a large boreal lake
Authors: Salonen Jouni K. , Hiltunen Minna , Figueiredo Kaisa , Paavilainen Pinja , Sinisalo Tuula , Strandberg Ursula , Kankaala Paula , Taskinen Jouni
Published: September 2019

Ecology of the glacial relict macrocrustacean Gammaracanthus lacustris, a rare inhabitant of deep Fennoscandian lakes, is poorly understood. We studied the life cycle and trophic position of this cold‐stenothermic amphipod in Lake Paasivesi, eastern Finland. The study is based on intensive sampling and analyses of fatty acid composition as well as stable carbon (δ13C) and nitrogen (δ15N) isotope ratios.

Both day and night, the G. lacustris population occurred at depths below 25 m at temperatures <8°C, and the density increased towards the bottom of the lake, where it was 0.4–0.6 individuals/m3.

Gammaracanthus lacustris was observed to reach a length of >40 mm and live up to 4 years. The oldest and the largest individuals and females seemed to favour the deepest zones.

In October, almost 100% of females with length at least 25 mm (i.e. females presumably at least 1‐year‐old) had an embryo sack with 20–200 eggs or embryos—the larger the female, the more young it had.

The developing eggs of G. lacustris had a very high fatty acid content, indicating that the females invest heavily on provisioning their young. Furthermore, the fatty acid composition differed among life stages, and in particular the eggs had a higher proportion of eicosapentaenoic acid than juveniles or adults.

The stable δ13C and δ15N isotope ratios and fatty acid biomarkers of the food web, together with visual observations, indicate that G. lacustris is a carnivore that feeds mainly on zooplankton and other relict macrocrustaceans.

Due to its high content of essential polyunsaturated fatty acids, G. lacustris is a valuable prey for fish and other predators in the food web. However, as a glacial relict with strict habitat requirements the species is vulnerable to global warming and local environmental changes. These facts should be considered in the management of lakes and their catchments.
Trait‐based climate vulnerability assessments in data‐rich systems: An application to eastern Bering Sea fish and invertebrate stocks
Authors: Spencer Paul D. , Hollowed Anne B. , Sigler Michael F. , Hermann Albert J. , Nelson Mark W.
Published: September 2019

Trait‐based climate vulnerability assessments based on expert evaluation have emerged as a rapid tool to assess biological vulnerability when detailed correlative or mechanistic studies are not feasible. Trait‐based assessments typically view vulnerability as a combination of sensitivity and exposure to climate change. However, in some locations, a substantial amount of information may exist on system productivity and environmental conditions (both current and projected), with potential disparities in the information available for data‐rich and data‐poor stocks. Incorporating this level of detailed information poses challenges when conducting, and communicating uncertainty from, rapid vulnerability assessments. We applied a trait‐based vulnerability assessment to 36 fish and invertebrate stocks in the eastern Bering Sea (EBS), a data‐rich ecosystem. In recent years, the living marine resources of the EBS and Aleutian Islands have supported fisheries worth more than US $1 billion of annual ex‐vessel value. Our vulnerability assessment uses projections (to 2039) from three downscaled climate models, and graphically characterizes the variation in climate projections between climate models and between seasons. Bootstrapping was used to characterize uncertainty in specific biological traits and environmental variables, and in the scores for sensitivity, exposure, and vulnerability. The sensitivity of EBS stocks to climate change ranged from “low” to “high,” but vulnerability ranged between “low” and “moderate” due to limited exposure to climate change. Comparison with more detailed studies reveals that water temperature is an important variable for projecting climate impacts on stocks such as walleye pollock (Gadus chalcogrammus), and sensitivity analyses revealed that modifying the rule for determining vulnerability increased the vulnerability scores. This study demonstrates the importance of considering several uncertainties (e.g., climate projections, biological, and model structure) when conducting climate vulnerability assessments, and can be extended in future research to consider the vulnerability of user groups dependent on these stocks.
A global estimate of terrestrial net secondary production of primary consumers
Authors: Street Garrett M. , McNickle Gordon G.
Published: September 2019

Aim

Net secondary production (NSP) emerges from the consumption of net primary production (NPP) by all heterotrophic organisms. There has been sporadic interest in the importance of NSP, but no global estimates have been produced. Here, we examine NSP and attempt a global estimate using contemporary NPP data combined with modern metabolic scaling theory for consumption rates. We distinguish between potential NSP, as the amount of secondary production that could be supported by NPP, and realized NSP, as the amount remaining after anthropogenic habitat disruption.

Location

Global.

Time period

2000–2014.

Methods

We present a metabolic model of NSP, implementing a type II functional response for consumption rates, wherein search efficiency and handling time are calculated based on consumer mass and ambient temperature. We solve this model for each 0.05‐decimal‐degree pixel in the global terrestrial biosphere, using as data inputs NPP (MOD17A3) and land‐surface temperature (MOD11C3). We aggregate estimates within global land‐cover classifications (MCD12C1) to obtain cover‐specific and global estimates of NSP. We also correct our estimates based on declines in consumer abundance reported in Living planet report 2014.

Results

We estimate that potential NSP is 4.74 Pg C/year globally (95% CI: 3.75–5.75). When we correct for global consumer population declines, realized NSP is estimated at 2.37 Pg C/year (95% CI: 1.86–2.89), a loss of 50% in the rate of carbon flux through secondary consumers.

Main conclusions

Our estimates should not be viewed as the last word on NSP but are sufficient to suggest that the flux of carbon through consumers is of a similar magnitude to many other fluxes crucial to the global carbon cycle. We view this as a hypothesis to be tested that suggests NSP deserves significantly more attention in Earth systems, macroecology and biogeochemical research.
Determinants of blood telomere length in antiretroviral treatment‐naïve HIV‐positive participants enrolled in the NEAT 001/ANRS 143 clinical trial
Authors: Alejos B , Stella‐Ascariz N , Montejano R , Rodriguez‐Centeno J , Schwimmer C , Bernardino JI , Rodes B , Esser S , Goujard C , Sarmento‐Castro R , De Miguel R , Esteban‐Cantos A , Wallet C , Raffi F , Arribas JR ,   the NEAT 001/ANRS 143 Study Group
Published: September 2019

Objectives

Our aim was to investigate factors associated with baseline blood telomere length in participants enrolled in NEAT 001/ANRS 143, a randomized, open‐label trial comparing ritonavir‐boosted darunavir (DRV/r) plus raltegravir (RAL) with DRV/r plus tenofovir disoproxil fumarate/emtricitabine (TDF/FTC) in antiretroviral therapy (ART)‐naïve HIV‐positive adults.

Methods

A cross‐sectional study of 201 randomly selected participants who had stored samples available was carried out. We measured telomere length (i.e. the relative telomere length, calculated as the telomere to single copy gene ratio) at baseline with monochrome quantitative multiplex polymerase chain reaction (PCR). We used multivariable predictive linear regression to calculate mean differences and 95% confidence intervals (CIs) for the association between baseline telomere length and baseline characteristics.

Results

The baseline characteristics of the 201 participants did not differ from those of the 805 participants in the parent trial population: 89% were male, the mean age was 39 years, 83.6% were Caucasian, 93% acquired HIV infection via sexual transmission, the mean estimated time since HIV diagnosis was 2.1 years, the mean HIV‐1 RNA load was 4.7 log10 HIV‐1 RNA copies/mL, the mean nadir and baseline CD4 counts were 301 and 324 cells/μL, respectively, and the mean CD4:CD8 ratio was 0.4. In the univariate analysis, shorter telomere length was associated with older age (per 10 years) (P < 0.001), HIV‐1 RNA ≥ 100 000 copies/mL (P = 0.001), CD4 count < 200 cells/μL (P = 0.037), lower CD4:CD8 ratio (P = 0.018), statin treatment (P = 0.004), and current alcohol consumption (P = 0.035). In the multivariable analysis, older age (P < 0.001) and HIV RNA ≥ 100 000 copies/mL (P = 0.054) were independently associated with shorter telomere length.

Conclusions

Both age and HIV RNA viral load correlated with shorter blood telomere length in untreated persons living with HIV. These results suggest that HIV infection and age have synergistic and independent impacts upon immunosenescence.
Shopping with the resale value in mind: A study on second‐hand luxury consumers
Authors: Turunen Linda Lisa Maria , Pöyry Essi
Published: September 2019

The market for second‐hand luxury products is growing and the variety of available sales channels has increased; consumers can buy second‐hand luxury goods not only from brick‐and‐mortar stores but also from a myriad of both global and local online channels. Arguably, the increase in available sales channels has changed consumers’ purchasing behaviour as the roles between sellers and buyers are alternating as one can act as a buyer one day and a seller the next. However, prior research on luxury consumption has mainly focused on brand‐new luxury goods, largely neglecting the consumption of previously‐used luxury products and has not accounted for the multi‐channel shopping environment. The purpose of this paper is to understand how consumers mentally approach the purchase of second‐hand luxury products and what kinds of decision‐making styles they use. The empirical interview data of 22 consumers was analysed by the means of shopping style dimensions that account for both consumer characteristics and external shopping conditions. The interviewees were members of a Facebook buy and sell ‐group focused on luxury products and had recently bought a second‐hand luxury product. All the existing dimensions were evident in the data but an additional dimension was also identified: resale value consciousness. The new dimension emphasizes an investment‐led and price‐quality conscious shopping style but was also found to relate to impulse buying and brand consciousness. The emergence of the dimension is argued to be due to the increase in viable online sales channels for second‐hand luxury products.
Pharmacists' perceived responsibility for patient care when there is a risk of misadventure: a qualitative study
Authors: Bennett Georgia , Taing Meng-Wong , Hattingh H Laetitia , La Caze Adam
Published: September 2019

Objective

To investigate how community pharmacists view their responsibility for patient care in a scenario involving opioid use with significant risk of toxicity or misadventure.

Methods

A case scenario was developed based on an Australian coronial inquiry involving a patient suffering fatal toxicity following misuse of opioids. Community pharmacists working in Brisbane, Queensland, were invited to take part in face-to-face semi-structured interviews at their place of work. Participants were asked how they would respond to the scenario in practice and their perceived responsibilities.

Key findings

Twenty-one pharmacists were interviewed. Participants identified similar actions in response to the case, and potential barriers and enablers. Participants differed with regard to how they described their perceived scope of practice and degree of responsibility in response to the case. Most participants described their scope of practice in terms of medication management with a focus on patient outcomes. Some participants described a narrower scope of practice that focused on either medicine supply or legal aspects. Participants who described a medication management focus differed in their views regarding their responsibility for patient outcomes in the case.

Conclusion

Pharmacists in this study varied in terms of their perceived scope of practice and responsibility to patient outcomes in response to a case involving a patient at risk of opioid-related harm. Further work on pharmacist responsibility may reduce this variability.
Comparative analysis on the effect of low‐thermal plasma dissection device (PEAK PlasmaBlade) vs conventional electrosurgery in post‐bariatric abdominoplasty: A retrospective randomised clinical study
Authors: Schlosshauer Torsten , Kiehlmann Marcus , Riener Marc‐Oliver , Sader Robert , Rieger Ulrich M.
Published: September 2019

Post‐bariatric patients undergoing abdominoplasty have a relatively high risk of complications due to residual obesity and major comorbidities. Also, conventional electrosurgery and the associated thermal tissue damage may compromise outcomes. This retrospective randomised clinical study evaluated the effect of low‐thermal plasma dissection device (PEAK [pulsed electron avalanche knife] PlasmaBlade) in comparison with conventional electrosurgery. A total of 52 post‐bariatric patients undergoing abdominoplasty were randomised to PEAK PlasmaBlade (n = 26) and to monopolar electrosurgery (n = 26). Wounds of 20 patients per group were examined histologically for acute thermal injury depth. In PEAK PlasmaBlade incisions, acute thermal damage was significantly reduced compared with standard of care (40% vs 75%; P = .035). Also, acute thermal injury depth from PEAK PlasmaBlade was less than that from electrosurgery (2780 μm vs 4090 μm). Significantly less total complication rate (30.8% vs 69.2%; P = .012) was found by PEAK PlasmaBlade compared with electrosurgery. Moreover, the PEAK PlasmaBlade showed less than half as many wound healing problems (19.2% vs 46.2%; P = .075), far fewer secondary bleeding (7.7% vs 30.8%; P = .075), and no seroma compared with four seroma with the standard of care (0% vs 15.4%; P = .11). PEAK PlasmaBlade appears to be superior to traditional monopolar electrosurgery for post‐bariatric abdominoplasty, because it demonstrated significantly less tissue damage, less total complication rate, and fewer postoperative seroma resulting in faster wound healing.
Feasibility and safety of image‐guided vacuum‐assisted breast biopsy: A PRISMA‐compliant systematic review and meta‐analysis of 20 000 population from 36 longitudinal studies
Authors: Fang Ming , Liu Guilin , Luo Guoliang , Wu Tianyu
Published: September 2019

Breast cancer is a serious disease in women. We estimated the global technical success rate and complication rates of percutaneous vacuum‐assisted breast biopsy (VABB). PubMed, Embase, Web of Science, and Scopus databases were retrieved up to July 2018 to find studies in which technical success rate and complication rates of VABB were available. Pooled rates were calculated according to location mode (ultrasonography [US] or mammography) and needle type (8‐ or 11‐gauge Mammotome probes). Of the 36 articles with 20 868 cases, we found the pooled technical success rate 0.9999(0.9997, 1.0000) (I2 = 17.1%, P = .187) and low complication risks including haematoma 0.1092(0.0748, 0.1437) (I2 = 98.3%, P < .001), pain 0.0738(0.0334, 0.1141) (I2 = 95.9%, P < .001), vasovagal reflex 0.0281(0.0035, 0.0527) (I2 = 92.5%, P < .001), and infection 0.0027(−0.0019, 0.0073) (I2 = 49.8%, P = .113). In this systematic review and meta‐analysis, the pooled data suggested that VABB with US or mammography could be promising for diagnosis and treatment of breast disease. Further studies were necessary to identify strategies for these findings.
Insight into cations substitution on structural and electrochemical properties of nanostructured Li2FeSiO4/C cathodes
Authors: Sivaraj Pazhaniswamy , Abhilash Karuthedath Parameswaran , Nalini Balakrishnan , Selvin Paneerselvam Christopher , Goel Sunkulp , Yadav Sudheer Kumar
Published: September 2019

Structural instability is the major obstacle in the Li2FeSiO4/C cathode during charge and discharge process, which can be improved by the substitution of cations in the host cage. In this study, the transition metal ions with different valence (Ag1+, Zn2+, Cr3+, and Ti4+) have been substituted in Li2FeSiO4/C via modified sol‐gel method and the impact on the structural, electrical, and electrochemical performances has been systematically explored. The Rietveld‐refined XRD pattern and HR‐TEM (SAED) result reveal that all the prepared samples maintain orthorhombic structure (S.G‐ Pmn21). The FE‐SEM and TEM micrographs of bare and doped Li2FeSiO4/C display nanoparticle formation with 20‐40 nm size. Among different cation‐substituted silicates, Li2Fe0.9Ti0.1SiO4/C sample exhibits an excellent total conductivity of 1.20 × 10−4 S cm−1 which is one order of magnitude higher than the bare Li2FeSiO4/C sample. The galvanostatic charge‐discharge curves and cyclic voltammetric analysis reveal that the Li2Fe0.9Ti0.1SiO4/C material provides an excellent initial specific capacity of 242 mAh g−1 and maintains a capacity of 226 mAh g−1 after 50 cycles with capacity retention of 93.38%. The Ti doping is a promising strategy to overcome the capacity fading issues, by preventing the structural collapse during Li‐ion intercalation/de‐intercalation processes in the Li2FeSiO4/C electrode through the strong hybridization between the 3d and 4s orbitals in titanium and 2p orbital in oxygen.