bluuebunny/crossref_metadata_2025 huggingface dataset:
Balancing information governance obligations when accessing social care data for collaborative research
Authors: Thiarai Malkiat , Chotvijit Sarunkorn , Jarvis Stephen
Published: February 2019

Purpose

There is significant national interest in tackling issues surrounding the needs of vulnerable children and adults. This paper aims to argue that much value can be gained from the application of new data-analytic approaches to assist with the care provided to vulnerable children. This paper highlights the ethical and information governance issues raised in the development of a research project that sought to access and analyse children’s social care data.

Design/methodology/approach

The paper documents the process involved in identifying, accessing and using data held in Birmingham City Council’s social care system for collaborative research with a partner organisation. This includes identifying the data, its structure and format; understanding the Data Protection Act 1998 and 2018 (DPA) exemptions that are relevant to ensure that legal obligations are met; data security and access management; the ethical and governance approval process.

Findings

The findings will include approaches to understanding the data, its structure and accessibility tasks involved in addressing ethical and legal obligations and requirements of the ethical and governance processes.

Originality/value

The aim of this research is to highlight the potential use of use new data-analytic techniques to examine the flow of children’s social care data from referral, through the assessment process, to the resulting service provision. Data held by Birmingham City Council are used throughout, and this paper highlights key ethical and information governance issues which were addressed in preparing and conducting the research. The findings provide insight for other data-led studies of a similar nature.
3D Seismic survey design using mixed‐radix based algorithm inversion
Authors: Santos Atahebson B. , Porsani Milton J. , Góis Manuelle S.
Published: February 2019

The determination of three‐dimensional geometry and acquisition parameters, the seismic acquisition survey design, is constantly subject of studies in obtaining data with the highest seismic quality, operational efficiency and cost minimization. In this paper, we propose a methodology for inverting geometry parameters of three‐dimensional orthogonal land seismic surveys based on a direct search method using a mixed‐radix based algorithm. In this algorithm, the search space is discretized on a mixed‐radix base, which depends on the extreme values and the search resolution of each parameter. We will show how to reparametrize the orthogonal acquisition geometry elements in order to obtain the independents and integers parameters that are necessary to construct the mixed‐radix base. For the optimization purpose, we define an objective function to contemplate target parameters associated with the elements of the acquisition geometry directly related to the geophysical and operational constraints. Taking in account that the mathematical functions and the objective function we define for the problem have no significant computational cost, all model space parameters are fast and efficiently tested. We applied the algorithm, using as input data, provided by a one‐line roll orthogonal reference geometry, assuming a pair of geological objectives as shallow and deep targets. All selected models that meet both the proposed objectives and the constraints are organized by decreasing order of fitness so that with the mixed‐radix inversion algorithm we found not only the best model, but also a set of suitable models. Likewise, with the best set of geometries, it is possible to establish a direct comparison between them, analysing their adherence to the technical and operational requirements according to the availability and degree of detail of each one. We show the top 10 best results as a table, allowing a direct comparison between all aspects of these geometries, and we summarize the results showing graphically the fitness of all selected geometries and the inverted geometry elements for the 1000 best geometries. These graphical displays provide a direct way to understand how each model behaves as the fitness decreases. The algorithm is very flexible and its application can be extended to any environment and type of acquisition geometry, and in any phase study of an area be it regional, exploratory or development.
Contrasted ecological niches shape fungal and prokaryotic community structure in mangroves sediments
Authors: Luis Patricia , Saint‐Genis Geoffroy , Vallon Laurent , Bourgeois Carine , Bruto Maxime , Marchand Cyril , Record Eric , Hugoni Mylène
Published: February 2019

Mangroves are forest ecosystems located at the interface between land and sea where sediments presented a variety of contrasted environmental conditions (i.e. oxic/anoxic, non‐sulfidic/sulfidic, organic matter content) providing an ideal ecosystem to study microbial communities with niche differentiation and distinct community structures. In this work, prokaryotic and fungal compositions were investigated during both wet and dry seasons in New Caledonian mangrove sediments, from the surface to deeper horizons under the two most common tree species in this region (Avicennia marina and Rhizophora stylosa), using high‐throughput sequencing. Our results showed that Bacteria and Archaea communities were mainly shaped by sediment depth while the fungal community was almost evenly distributed according to sediment depth, vegetation cover and season. A detailed analysis of prokaryotic and fungal phyla showed a dominance of Ascomycota over Basidiomycota whatever the compartment, while there was a clear shift in prokaryotic composition. Some prokaryotic phyla were enriched in surface layers such as Proteobacteria, Euryarchaeota while others were mostly associated with deeper layers as Chloroflexi, Bathyarchaeota, Aminicenantes. Our results highlight the importance of considering fungal and prokaryotic counterparts for a better understanding of the microbial succession involved in plant organic matter decomposition in tropical coastal sediments.
Pedagogy, curriculum and special education: a case study in China
Authors: Cai Li (Lily) , Dearden Jackie , Jin Xiaojing
Published: February 2019

This study uses a conceptual framework devised by Norwich and Lewis in the UK in 2007 to examine the education of children with special educational needs and disabilities (SEND) in China. Norwich and Lewis, whose expressed intention was to offer ‘a starting point for setting out a coherent and common framework of teaching that is inclusive’, called for research to further develop their work. In that spirit, this article reports an exploratory case study of pedagogy in a Chinese special school, analysed using Norwich and Lewis’s conceptual framework. The example of practice in China provides a platform for reflection and challenge to existing theories and practices in other contexts, but also a chance to reflect upon the utility of the framework itself. In this regard, the authors suggest that Norwich and Lewis’s conceptual framework provides a helpful lens for analysing inclusive pedagogic practice but that teachers’ self‐knowledge about their own expectations of students needs to feature more centrally.
Fiduciary Duty under the Microscope: Stewardship and the Spectrum of Pension Fund Engagement
Authors: Tilba Anna , Reisberg Arad
Published: February 2019

UK pension fund trustees’ interpretations of their fiduciary duties may shape pension fund approaches to corporate stewardship and engagement envisioned by the UK Stewardship Code. Data from interviews with pension fund trustees, executives, investment intermediaries and pensions experts reveals interpretive pluralism of the concept of fiduciary duty in the area of pension funds. This article develops a model identifying the spectrum of pension fund engagement, linking interpretations of fiduciary duty to intensity and methods of engagement in practice. The findings help disambiguate the concept of ‘Fiduciary Duty’, highlighting the practical challenges of Stewardship Code application. These insights are relevant to the ongoing revisions of the Stewardship Code and policy clarifications of the nature of fiduciary duty by the UK Financial Conduct Authority. The paper encourages trustees, regulators and others to consider what role pension fund trustees should have in stewardship, which may not be directly relevant to their fiduciary duties as trustees.
Evaluation of a simple risk score to predict preterm pre‐eclampsia using maternal characteristics: a prospective cohort study
Authors: Sovio U , Smith GCS
Published: February 2019

Objectives

(1) To derive a simple risk score for preterm pre‐eclampsia based on the model used in the ASPRE trial, and (2) to compare it (i) with the original ASPRE algorithm, (ii) with the NICE Guideline score, and (iii) with and without biochemical and ultrasonic predictors.

Design

Prospective cohort study.

Setting

Cambridge, UK.

Population or Sample

4184 nulliparous women from the Pregnancy Outcome Prediction study.

Methods

Maternal history model coefficients from the ASPRE algorithm were translated into a risk score, preserving the relative weight of each coefficient.

Main outcome measures

Preterm delivery with a diagnosis of pre‐eclampsia.

Results

The area under the ROC curve (AUC) for preterm pre‐eclampsia was 0.846 (95% CI 0.787–0.906) for the risk score and 0.854 (95% CI 0.795–0.914) for the original ASPRE algorithm (P = 0.14). In all, 9.1% of women had a risk score of ≥30 and their risk ratio for preterm pre‐eclampsia was 13.3 (95% CI 6.3–27.8), sensitivity 57.1% (37.5–74.8%), false‐positive rate (1‐specificity) 8.8% (8.0–9.7%), and LR+ 6.5 (4.6–9.1). The score had higher specificity than the NICE Guideline criteria. First trimester levels of PAPP‐A and PlGF were not predictive when included in a model with the risk score. In contrast, mean arterial pressure at booking and 20‐week uterine artery Doppler were independently associated with preterm pre‐eclampsia and the latter modestly increased the AUC (by ~0.02).

Conclusions

A simple risk score derived from the ASPRE screening study predictive model provided clinically useful prediction of the risk of preterm pre‐eclampsia.

Tweetable abstract

A simple risk score derived from the ASPRE screening study provided clinically useful prediction of the risk of preterm pre‐eclampsia.
Marine Mollusks: Food with Benefits
Authors: Khan Bilal Muhammad , Liu Yang
Published: February 2019

The extremely vast biodiversity represented by marine mollusks alongside their widespread utility as a source of food and their high nutritional value has aroused great interest from the scientific community. Furthermore, they can be caught with ease, and their commercial breeding and farming is rampant. This article comprehends the global availability of these organisms, their pretreatment and handling procedures, and their health‐promoting potential with a focus on their antiviral, anti‐inflammatory, and antimicrobial properties. The emphasis herein is on their potential use in the food and nutraceutical industry. In addition, mollusks consumption as part of everyday diet can also be helpful in avoiding many ailments as they are rich in vital nutrients and active secondary metabolites, as well as have the ability to enhance immune response. Moreover, the available literature suggests that normal cooking practices have no notable adverse effects on their nutritional value and they retain certain bioactivities even after the action of digestive enzymes. Though mollusks have been widely studied in relation to the health‐promoting effects reviewed here, there is still more scope for further research in this direction in order to fully utilize this enormous source of food and nutraceuticals.
The Search for “Fred”: An Unusual Vertical Burial Case,
Authors: Wisniewski Kristopher D. , Cooper Nicholas , Heaton Vivienne , Hope Colin , Pirrie Duncan , Mitten Andrew J. , Pringle Jamie K.
Published: February 2019

Police witness intelligence stated a murdered adult male “Fred” had been vertically buried in wooded hilly terrain 30 years ago in the Midlands, U.K. Conventional search methods were unsuccessful; therefore, the police requested a geophysical investigation to be undertaken to determine whether “Fred” could be detected. A multiphased geophysical approach was conducted, using bulk ground conductivity and metal detectors, then follow‐up magnetics and ground penetrating radar (GPR) survey profiles on electromagnetic (EM) anomalous areas. A tight grid pattern was used to account for the reduced target size. Relatively high‐resolution EM and GPR techniques were determined optimal for this terrain and sandy soil. Geophysical anomalies were identified and the most promising intrusively investigated, and this was found to be a large boulder and tree roots. Study implications suggest careful multiphase geophysical surveys are best practice and give confidence in cold case searches. This study yielded a no‐body result, effectively saving police time and costs from further investigations.
Relevance of using length of stay as a key indicator to monitor emergency department performance: Case study from a rural hospital in Thailand
Authors: Suriyawongpaisal Paibul , Kamlungkuea Threebhorn , Chiawchantanakit Natchaya , Charoenpipatsin Norramon , Sriturawanit Phun , Kreesang Pattraporn , Thongtan Thanita
Published: February 2019

Objective

The present study explores factors related to length of stay (LOS) in a rural public hospital in Thailand and assesses the feasibility of using LOS as an ED key performance indicator.

Methods

Using a mixed‐methods approach, qualitative methods (in‐depth interviews, patients’ chart review and participatory observations) were used to guide and elaborate findings from quantitative analysis of 555 electronic ED records.

Results

Multivariate analysis revealed that age, Emergency Severity Index score and number of laboratory tests were significantly associated with LOS. The qualitative approach provided contradicting evidence on the linkage between LOS and patient outcomes. On the one hand, considering the 4 h rule, a child with asthma was referred to a tertiary care hospital because of deterioration after 4 h of ED care. On the other hand, a woman with sepsis was hospitalised with improved condition despite 7 h of ED care. Interviews revealed the waiting time to see doctors was probably the top priority issue for patients.

Conclusions

Factors related to LOS in a rural hospital in Thailand are similar and in contrast to those of a previous study in a medical school setting. Reasons for the discrepancy of findings and implications for improving ED services were discussed. Our data support the notion of controversy in using LOS as a key indicator of ED performance in this rural hospital setting. Thus, it is imperative to not rely on any single throughput or process indicators to monitor ED performance, but to take into account a set of indicators including patient outcomes.
Dietary enrichment of edible insects with omega 3 fatty acids
Authors: Oonincx Dennis G.A.B. , Laurent Sophie , Veenenbos Margot E. , van Loon Joop J.A.
Published: February 2019

Edible insects are advocated as sustainable and healthy food and feed. However, commercially produced insects are often low in n‐3 fatty acids and have suboptimal n‐6/n‐3 ratios. A certain amount and proportion of these FAs is required to optimize human health. Flaxseed oil consists primarily (57%) out of alpha‐linolenic acid. An experiment was conducted to quantify the effect of flaxseed oil provision on fatty acid composition and to determine the quantity needed to attain a beneficial n‐6/n‐3 ratio. Three species were used in the experiment: house crickets (Acheta domesticus [L.]), lesser mealworms (Alphitobius diaperinus [Pfanzer]) and black soldier flies (Hermetia illucens [L.]). These were provided with either a control diet or a diet enriched with 1%, 2%, or 4% flaxseed oil during their larval/nymphal stage. Fatty acid profiles of diets and insects were determined via GC‐MS. The three species had distinct fatty acid profiles on all four diets, but responded similarly to flaxseed oil addition. For each percent added to the diet, the alpha‐linolenic acid content of the insects increased by 2.3%–2.7%. Four percent addition increased the n‐3 fatty acid content 10–20 fold in the three species and thereby strongly decreased n‐6/n‐3 ratios from 18–36 to 0.8–2.4. A ratio below 5 is considered optimal for human health and was achieved by 2% flaxseed oil inclusion for house crickets and lesser mealworms, and at 1% inclusion for black soldier flies. Adding a source of n‐3 fatty acids to insect diets can thus improve the nutritional quality of insects.
Preventive skin analgesia with lidocaine patch for management of post‐thoracotomy pain: Results of a randomized, double blind, placebo controlled study
Authors: Fiorelli Alfonso , Pace Caterina , Cascone Roberto , Carlucci Annalisa , De Ruberto Emanuele , Izzo Anna Cecilia , Passavanti Beatrice , Chiodini Paolo , Pota Vincenzo , Aurilio Caterina , Santini Mario , Sansone Pasquale
Published: February 2019

Background

To evaluate whether pre‐emptive skin analgesia using a lidocaine patch 5% would improve the effects of systemic morphine analgesia for controlling acute post‐thoracotomy pain.

Methods

This was a double‐blind, placebo controlled, prospective study. Patients were randomly assigned to receive lidocaine 5% patch (lidocaine group) or a placebo (placebo group) three days before thoracotomy. Postoperative analgesia was induced in all cases with intravenous morphine analgesia. The intergroup differences were assessed in order to evaluate whether the lidocaine patch 5% would have effects on pain intensity when at rest and after coughing (primary end‐point) on morphine consumption, on the recovery of respiratory function, and on peripheral painful pathways measured with N2 and P2 laser‐evoked potential (secondary end‐points).

Results

A total of 90 patients were randomized, of whom 45 were allocated to the lidocaine group and 45 to the placebo group. Lidocaine compared with the placebo group showed a significant reduction in pain intensity both at rest (P = 0.013) and after coughing (P = 0.015), and in total morphine consumption (P = 0.001); and also showed a better recovery of flow expiratory volume in one second (P = 0.025) and of forced vital capacity (P = 0.037). The placebo group compared with the lidocaine group presented a reduction in amplitude of N2 (P = 0.001) and P2 (P = 0.03), and an increase in the latency of N2 (P = 0.023) and P2 (P = 0.025) laser‐evoked potential.

Conclusions

The preventive skin analgesia with lidocaine patch 5% seems to be a valid adjunct to intravenous morphine analgesia for controlling post‐thoracotomy pain. However, our initial results should be corroborated/confirmed by larger studies.
Gender Differences in Use of Alcohol Treatment Services and Reasons for Nonuse in a National Sample
Authors: Gilbert Paul A. , Pro George , Zemore Sarah E. , Mulia Nina , Brown Grant
Published: February 2019

Background

The majority of adults with alcohol use disorders do not obtain help, and women are less likely to utilize alcohol services than men. We sought to quantify gender differences in alcohol services utilization, overall and by type, using national longitudinal data and to explore potential gender differences in perceived need for help and reasons for not seeking help.

Methods

We analyzed data from the National Epidemiologic Survey on Alcohol and Related Conditions from White, African American, and Hispanic adults (n = 2,592) who met DSM‐IV criteria for alcohol abuse or dependence at Wave 1 (2000 to 2001). We tested gender differences in Wave 2 (2004 to 2005) services utilization, perceived need for help, and treatment barriers using Rao‐Scott chi‐square tests and assessed predictors of outcomes in multivariable logistic regression, adjusting for problem severity, co‐occurring disorders, and demographics.

Results

Women had much lower odds than men of utilizing any alcohol service (adjusted odds ratio [aOR] 0.53; 95% confidence interval [95% CI]: 0.33, 0.86), specialty services (aOR 0.41; 95% CI 0.19, 0.87), and 12‐step groups (aOR 0.39; 95% CI 0.21, 0.71). Perceived need for help among those who had not used any services was very low (5%), with no gender difference. Further, men and women reported equivalent numbers of treatment barriers and the same rank order for the most frequently endorsed barriers. However, women were twice as likely as men to think a problem would get better by itself—the most frequent reason for not seeking help (47% vs. 24%, p < 0.001), and men were more likely than women to report unsuccessful past help‐seeking and not thinking anyone could help (19% vs. 3%, p < 0.001 and 17% vs. 5%, p = 0.001, respectively).

Conclusions

Consistent with previous studies, women were less likely to utilize alcohol services than men. Future interventions should address low problem recognition, and tailoring to gender‐specific barriers may help close the disparity in services utilization.
Exploring the Use of Smartphone Geofencing to Study Characteristics of Alcohol Drinking Locations in High‐Risk Gay and Bisexual Men
Authors: Wray Tyler B. , Pérez Ashley E. , Celio Mark A. , Carr Daniel J. , Adia Alexander C. , Monti Peter M.
Published: February 2019

Background

Geofencing offers new opportunities to study how specific environments affect alcohol use and related behavior. In this study, we examined the feasibility of using geofencing to examine social/environmental factors related to alcohol use and sexual perceptions in a sample of gay and bisexual men (GBM) who engage in heavy drinking and high‐risk sex.

Methods

HIV‐negative GBM (N = 76) completed ecological momentary assessments for 30 days via a smartphone application and were prompted to complete surveys when inside general geofences set around popular bars and clubs. A subset (N = 45) were also asked to complete surveys when inside personal geofences, which participants set themselves by identifying locations where they typically drank heavily.

Results

Approximately 49% of participants received a survey prompted by a general geofence. Among those who identified at least 1 personal drinking location, 62.2% received a personal geofence‐prompted survey. Of the 175 total location‐based surveys, 40.2% occurred when participants were not at the location that was intended to be captured. Participants reported being most able to openly express themselves at gay bars/clubs and private residences, but these locations were also more “sexualized” than general bars/clubs. Participants did not drink more heavily at gay bars/clubs, but did when in locations with more intoxicated patrons or guests.

Conclusions

Geofencing has the potential to improve the validity of studies exploring environmental influences on drinking. However, the high number of “false‐positive” prompts we observed suggests that geofences should be used carefully until improvements in precision are more widely available.
Effects of alien pine plantations on small mammal community structure in a southern African biodiversity hotspot
Authors: Rebelo Alanna J. , Rebelo Anthony G. , Rebelo Alexander D. , Bronner Gary N.
Published: February 2019

Commercial plantations and alien tree invasions often have substantial negative impacts on local biodiversity. The effect of plantations on faunal communities in the fire‐adapted fynbos vegetation of the Cape Floristic Region biodiversity hotspot is not yet well quantified. We studied small mammal community structure in alien Pinus radiata plantations and adjacent fynbos regenerating after clear‐felling of plantations on the Cape Peninsula, South Africa. Small mammal sampling over 1,800 trap‐nights resulted in 480 captures of 345 individuals (excluding recaptures) representing six species. Significantly more species, individuals (12 X) and biomasses (29 X) of small mammals occurred on recovering fynbos sites compared to plantations. This was commensurate with a higher diversity of plant growth forms, vegetation densities and live vegetation biomass. Only one small mammal species, the pygmy mouse (Mus minutoides), was consistently trapped within plantations. Fynbos sites were dominated by three small mammal species that are ecological generalists and early successional pioneer species, rendering the recovering fynbos slightly depauperate in terms of species richness and evenness relative to other studies done in pristine fynbos. We make three recommendations for forestry that would facilitate the restoration of more diverse natural plant communities and progressively more diverse and dynamic small mammal assemblages in a key biodiversity hotspot.
Reversal of defunctioning stoma following rectal cancer surgery: are we getting better? A population‐based single centre experience
Authors: Gadan Soran , Lindgren Rickard , Floodeen Hannah , Matthiessen Peter
Published: February 2019

Background

The aim was to assess factors influencing the timing of defunctioning stoma (DS) reversal following low anterior resection of rectum for cancer (LAR).

Methods

All patients operated with LAR and a primary DS during a 9‐year period were included. Reversal later than 120 days after LAR was considered as delayed. A DS not reversed within 2 years was considered as permanent.

Results

In the present study, median age at LAR was 67 years, 45% were females, median body mass index was 25, 87% had American Society of Anesthesiologists class I or II, 64% had pre‐operative radiotherapy, and 3% had cancer stage IV. A total of 79% (92/116) underwent stoma reversal, whereof 25% (23/92) were reversed within 120 days. The most common health‐related reasons for delayed stoma reversal were adjuvant chemotherapy in 38%, symptomatic anastomotic leakage in 16% and other post‐operative adverse events in 13%. In 35% delayed stoma reversal was because of low priority within the healthcare system. A total of 18% (20/110) never had their DS reversed (n = 11) or had their DS converted to a permanent end colostomy (n = 9). Major risk factors for permanent stoma were stage IV cancer in 55%, and symptomatic anastomotic leakage in 30%.

Conclusion

One fourth of the patients had their defunctioning stoma reversed within 120 days. The most common identifiable medical reasons for delayed stoma reversal were adjuvant chemotherapy and symptomatic anastomotic leakage, while in one out of three patients it was because of low priority by the healthcare provider.
Iatrogenic and non‐iatrogenic causes of female fertility loss that may indicate fertility preservation
Authors: Spath Marian A. , Braat Didi D.M.
Published: February 2019

Due to advances in fertility preservation options and improvements in life expectancy, there is growing need for fertility preservation counseling for women at risk for premature ovarian insufficiency. The aim of this review is to provide an overview of various causes of female fertility loss and to raise awareness for counseling women about their options for fertility preservation. Furthermore, for counseling of women not only at the time of gonadotoxic treatment but also post‐treatment and also of women with other benign causes of increased risk for impaired fertility or premature ovarian insufficiency.
Device‐induced platelet dysfunction in mechanically assisted circulation increases the risks of thrombosis and bleeding
Authors: Chen Zengsheng , Zhang Jiafeng , Kareem Kafayat , Tran Douglas , Conway Robert G. , Arias Katherin , Griffith Bartley P. , Wu Zhongjun J.
Published: February 2019

Thrombotic and bleeding complications are the major obstacles for expanding mechanical circulatory support (MCS) beyond the current use. While providing the needed hemodynamic support, those devices can induce damage to blood, particularly to platelets. In this study, we investigated device‐induced alteration of three major platelet surface receptors, von Willebrand factor (VWF) and associated hemostatic functions relevant to thrombosis and bleeding. Fresh human whole blood was circulated in an extracorporeal circuit with a clinical rotary blood pump (CentriMag, Abbott, Chicago, IL, USA) under the clinically relevant operating condition for 4 hours. Blood samples were examined every hour for glycoprotein (GP) IIb/IIIa activation and receptor loss of GPVI and GPIbα on the platelet surface with flow cytometry. Soluble P‐selectin in hourly collected blood samples was measured by enzyme linked immunosorbent assay to characterize platelet activation. Adhesion of device‐injured platelets to fibrinogen, collagen, and VWF was quantified with fluorescent microscopy. Device‐induced damage to VWF was characterized with western blotting. The CentriMag blood pump induced progressive platelet activation with blood circulating time. Particularly, GPIIb/IIIa activation increased from 1.1% (Base) to 11% (4 hours) and soluble P‐selectin concentration increased from 14.1 ng/mL (Base) to 26.5 ng/mL (4 hours). Those device‐activated platelets exhibited increased adhesion capacity to fibrinogen. Concurrently, the CentriMag blood pump caused progressive platelet receptor loss (GPVI and GPIbα) with blood circulating time. Specifically, MFI of the GPVI and GPIbα receptors decreased by 17.2% and 16.1% for the 4‐hours sample compared to the baseline samples, respectively. The device‐injured platelets exhibited reduced adhesion capacities to collagen and VWF. The high molecular weight multimers (HMWM) of VWF in the blood disappeared within the first hour of the circulation. Thereafter the multimeric patterns of VWF were stable. The change in the VWF multimeric pattern was different from the progressive structural and functional changes of platelets with the circulation time. This study suggested that the CentriMag blood pump could induce two opposite effects on platelets and associated hemostatic functions under a clinically relevant operating condition. The device‐altered hemostatic function may contribute to thrombosis and bleeding simultaneously as occurring in patients supported by a rotary blood pump. Device‐induced damage of platelets may be an important cause for bleeding in patients supported with rotary blood pump MCS systems relative to device‐induced loss of HMWM‐VWF.
Does eye examination order for standard automated perimetry matter?
Authors: Kelly Stephen R. , Bryan Susan R. , Crabb David P.
Published: February 2019

Purpose

In spite of faster examination procedures, visual field (VF) results are potentially influenced by fatigue. We use large‐scale VF data collected from clinics to test the hypothesis that perimetric fatigue effects are greater in the eye examined second.

Methods

Series of six Humphrey Swedish Interactive Testing Algorithm (SITA) VFs from 6901 patients were retrospectively extracted from a VF database from four different glaucoma clinics. Mean deviation (MD) was compared between first and second tested eyes. A surrogate measure of longitudinal MD variability over time was estimated from errors using linear regression of MD against time then compared between first and second tested eye.

Results

Right eye VF was tested consistently first throughout in 6320 (91.6%) patients. Median (interquartile range; IQR) MD in the first tested (right) eye and second tested (left) eye was −2.57 (−6.15, −0.58) dB and −2.70 (−6.34, −0.80) dB respectively (median reduction VF sensitivity of 0.13 dB; p < 0.001). Median (IQR) increase in our surrogate measure of longitudinal MD variability in the second eye tested was 3% (−43%, 50%); this effect was not associated with patient age or rest time between examinations.

Conclusion

Statistically significant perimetric fatigue effects manifest on average in the second eye tested in routine clinics using Humphrey Field Analyzer SITA examinations. However, the average effects were very small and there was enormous variation among patients. We recommend starting with a right eye examination so that any perimetric fatigue effects, if they exist in an individual, will be as constant as possible from visit to visit.
Urinary mitochondrial DNA copy number identifies renal mitochondrial injury in renovascular hypertensive patients undergoing renal revascularization: A Pilot Study
Authors: Eirin A. , Herrmann S. M. , Saad A. , Abumoawad A. , Tang H. , Lerman A. , Textor S. C. , Lerman L. O.
Published: February 2019

Aims

Patients with renovascular hypertension (RVH) exhibit elevated urinary mtDNA copy numbers, considered to constitute surrogate markers of renal mitochondrial injury. The modest success of percutaneous transluminal renal angioplasty (PTRA) in restoring renal function in RVH has been postulated to be partly attributable to acute reperfusion injury. We hypothesized that mitoprotection during revascularization would ameliorate PTRA–induced renal mitochondrial injury, reflected in elevated urinary mtDNA copy numbers and improve blood pressure and functional outcomes 3 months later.

Methods

We prospectively measured urinary copy number of the mtDNA genes COX3 and ND1 using qPCR in RVH patients before and 24 hrs after PTRA, performed during IV infusion of vehicle (n = 8) or the mitoprotective drug elamipretide (ELAM, 0.05 mg/kg/h, n = 6). Five healthy volunteers (HV) served as controls. Urinary mtDNA levels were also assessed in RVH and normal pigs (n = 7 each), in which renal mitochondrial structure and density were studied ex‐vivo.

Results

Baseline urinary mtDNA levels were elevated in all RVH patients vs HV and directly correlated with serum creatinine levels. An increase in urinary mtDNA 24 hours after PTRA was blunted in PTRA+ELAM vs PTRA+Placebo. Furthermore, 3‐months after PTRA, systolic blood pressure decreased and estimated glomerular filtration rate increased only in ELAM–treated subjects. In RVH pigs, mitochondrial damage was observed using electron microscopy in tubular cells and elevated urinary mtDNA levels correlated inversely with renal mitochondrial density.

Conclusions

PTRA leads to an acute rise in urinary mtDNA, reflecting renal mitochondrial injury that in turn inhibits renal recovery. Mitoprotection might minimize PTRA–associated mitochondrial injury and improve renal outcomes after revascularization.
PTEN immunohistochemistry in endometrial hyperplasia: which are the optimal criteria for the diagnosis of precancer?
Authors: Travaglino Antonio , Raffone Antonio , Saccone Gabriele , Mascolo Massimo , Pignatiello Sara , Mollo Antonio , De Placido Giuseppe , Insabato Luigi , Zullo Fulvio
Published: February 2019

Guidelines recommend protein phosphatase and tensin homolog (PTEN) immunohistochemistry for differentiating between benign endometrial hyperplasia (BEH) and atypical endometrial hyperplasia/endometrioid intraepithelial neoplasia (AEH/EIN). However, it is unclear when PTEN expression should be defined as ‘lost’ and thus suggestive of AEH/EIN. We aimed to determine the optimal immunohistochemical criteria to define PTEN loss in endometrial hyperplasia, through a systematic review and meta‐analysis of diagnostic accuracy. Electronic databases were searched for studies assessing immunohistochemical expression of PTEN in both BEH and AEH/EIN specimens. PTEN status (‘loss’ or ‘presence’) was the index test; histological diagnosis (‘AEH/EIN’ or ‘BEH’) was the reference standard. Accuracy was quantified based on the area under the curve (AUC) on summary receiver operating characteristic (SROC) curves, for several different thresholds of PTEN expression. Eighteen studies with 1362 hyperplasias were included. Six different criteria to define PTEN loss were assessed. Low diagnostic accuracy was found for complete loss of expression (AUC = 0.71), presence of any null gland (AUC = 0.63), positive cells <10% (AUC = 0.64), positive cells <50% (AUC = 0.71) and moderate‐to‐null intensity (AUC = 0.64). Barely moderate diagnostic accuracy was only found for the subjective criterion ‘weak‐to‐null intensity’ (AUC = 0.78). Therefore, the clinical usefulness of PTEN immunohistochemistry in this field should be further investigated.
Antimicrobial resistance, prevalence of resistance genes, and molecular characterization in intestinal Bacteroides fragilis group isolates
Authors: Kouhsari Ebrahim , Mohammadzadeh Nima , Kashanizadeh Mohammad Ghasem , Saghafi Mohammad Mehdi , Hallajzadeh Masoumeh , Fattahi Azam , Ahmadi Alireza , Niknejad Farhad , Ghafouri Zahra , Asadi Arezoo , Boujary Nasrabadi Mohammad Reza
Published: February 2019

Since the level of antimicrobial resistance in Bacteroides fragilis has increased, monitoring the antimicrobial susceptibility could be necessary. The objectives of this study were to (i) investigate the prevalence of species, the occurrence of reduced antimicrobial susceptibility (E‐test method), and antibiotic resistance genes in the B. fragilis group and (ii) evaluate the prevalence of enterotoxigenic B. fragilis and the distribution of bft gene subtypes in hospitalized patients. As many as 475 isolates out of 250 stool samples were detected to be B. fragilis group by using conventional biochemical tests (API‐32A system) and multiplex‐PCR. In addition, 48.2%, 13.9%, 76.6%, and 1.2% of B. fragilis group isolates were resistant (according to EUCAST breakpoint) to piperacillin‐tazobactam, meropenem, clindamycin, and metronidazole, respectively. Six metronidazole‐resistant strains were isolated; B. fragilis (n: 3), B. thetaiotaomicron, B. vulgates, and B. ovatus. The presence of the cfiA, cepA, ermF, and nim genes was observed in 3.8%, 15.9%, 34.1%, and 0.7% of the B. fragilis isolates, respectively. One hundred thirty‐two B. fragilis isolates (27.8%)and 21 B  fragilis isolates (15.9%) turned out to be bft gene positive by multiplex‐PCR; eleven isolates (52.4%) harbored bft‐1, eight isolates (38%) harbored bft‐2 isotypes, and two isolates (9.5%) harbored bft‐3 isotype (16.66%). These bacteria harbor antimicrobial resistance genes that could be transferred to other susceptible intestinal strains. Further investigations on lineage analysis are needed for a better understanding of these bacteria in Iran.
IL‐2/IL‐6 ratio correlates with liver function and recovery in acute liver injury patients
Authors: Sun Yu , Gu Jian , Liu Rui , Zhou Haoming , Lu Ling , Dai Xinzheng , Qian Xiaofeng
Published: February 2019

Acute liver injury can result from a number of different diseases. Inflammatory cytokines are known to be involved in the development of this condition; however, their precise roles and effects on liver function remain unclear. The goal of this study was to determine the relationship between serum cytokine levels and both the severity of liver damage and recovery in acute liver injury. We enrolled 100 patients with acute liver injury caused by drug application who were hospitalized from September 2012 to September 2017 and measured serum levels of alanine aminotransferase (ALT), aspartate aminotransferase (AST), and the cytokines, interleukin (IL)‐2 and IL‐6, before and after clinical therapy. Our results indicate that IL‐2 and IL‐6 levels are altered significantly following clinical therapy. However, with the exception of an association between IL‐2 and ALT, we found no correlation between the differences in cytokine levels pre‐ and post‐therapy and recovery of liver function. In contrast, we observed that pre‐ vs post‐treatment difference in the IL‐2/IL‐6 ratio negatively correlates with the pre‐ vs post‐treatment difference in ALT and AST values, and positively correlates with ALT and AST at 1‐month post‐discharge. Thus, our data suggest that IL‐2/IL‐6 ratio may represent a novel predictor for the prognosis of liver injury.
Transgenerational effects of obesogens
Authors: Lee Michelle Kira , Blumberg Bruce
Published: February 2019

Obesity and associated disorders are now a global pandemic. The prevailing clinical model for obesity is overconsumption of calorie‐dense food and diminished physical activity (the calories in—calories out model). However, this explanation does not account for numerous recent research findings demonstrating that a variety of environmental factors can be superimposed on diet and exercise to influence the development of obesity. The environmental obesogen model proposes that exposure to chemical obesogens during in utero and/or early life can strongly influence later predisposition to obesity. Obesogens are chemicals that inappropriately stimulate adipogenesis and fat storage, in vivo either directly or indirectly. Numerous obesogens have been identified in recent years and some of these elicit transgenerational effects on obesity as well as a variety of health end‐points after exposure of pregnant F0 females. Prenatal exposure to environmental obesogens can produce lasting effects on the exposed animals and their offspring to at least the F4 generation. Recent results show that some of these transgenerational effects of obesogen exposure can be carried across the generations via alterations in chromatin structure and accessibility. That some chemicals can have permanent effects on the offspring of exposed animals suggests increased caution in the debate about whether and to what extent exposure to endocrine‐disrupting chemicals and obesogens should be regulated.
Feedback modes matter: Comparing student perceptions of digital and non‐digital feedback modes in higher education
Authors: Ryan Tracii , Henderson Michael , Phillips Michael
Published: February 2019

Assessment feedback is increasingly being provided in digital modes, from electronic annotations to digital recordings. Digitally recorded feedback is generally considered to be more detailed than text‐based feedback. However, few studies have compared digital recordings with other common feedback modes, including non‐digital forms such as face‐to‐face conversations. It is also unclear whether providing multiple feedback modes is better than a single mode. To explore these possibilities, an online survey asked 4514 Australian university students to rate the level of detail, personalisation and usability of the feedback comments they had most recently received. Of the students who received a single feedback mode only, electronic annotations and digital recordings were rated most highly on the three quality indicators. Students who received multiple modes were more likely to agree with all three indicators than those who received a single mode. Finally, students who received multiple modes were more likely to agree that the comments were detailed and usable when one of those modes was a digital recording. These findings enhance our understanding of feedback design, indicating that it is important to consider the strengths and weaknesses of particular modes, and the value of offering multiple modes.
Flexible representations in visual working memory and interactions with long‐term learning: Commentary on the special issue
Authors: Rhodes Stephen , Cowan Nelson
Published: February 2019

This special issue of the British Journal of Psychology brings together cutting edge research on a range of topics in visual working memory (VWM). In this commentary, we attempt to summarize common themes in current VWM research exemplified in this issue. The articles include several reviews of important topics as well as empirical papers covering three main themes. The first concerns the nature of mental representations of memoranda in the commonly used delayed estimation task, where both fine‐grained and broad categorical details appear to be represented, and their susceptibility to interference. The second concerns interactions between VWM representations, both those that produce individuation of representations and those that create an overarching ensemble structure. Finally, the third main topic concerns the use of VWM during visual search and in the learning of repeated configurations in search displays. The work presented here, and other work in the field, points to a rich interplay between representations in VWM but also between VWM and information in long‐term memory. Opportunities for further investigation are highlighted throughout.
Total anatomical reconstruction during robot‐assisted radical prostatectomy: focus on urinary continence recovery and related complications after 1000 procedures
Authors: Manfredi Matteo , Checcucci Enrico , Fiori Cristian , Garrou Diletta , Aimar Roberta , Amparore Daniele , De Luca Stefano , Bombaci Sabrina , Stura Ilaria , Migliaretti Giuseppe , Porpiglia Francesco
Published: February 2019

Objectives

To present the functional and oncological outcomes after ≥1 year of follow‐up, following an experience of >1000 robot‐assisted radical prostatectomies (RARPs) with our standardised total anatomical reconstruction (TAR) technique. To evaluate which factors influence postoperative continence recovery in order to obtain a nomogram to predict the risk of postoperative urinary incontinence (UI).

Patients and Methods

The enrolment phase began in June 2013 and ended in May 2017. Patients were prospectively included in the study with the following inclusion criteria: (i) localised prostate cancer (clinical stages cT1–3, cN0, cM0); (ii) indication for RP; and (iii) preoperative multiparametric prostate magnetic resonance imaging. All patients underwent RARP with the TAR technique done at the end of the demolitive phase. The continence rates were assessed at 24 h, and 1, 4, 12, 24 and 48 weeks after catheter removal. Patients were defined as continent if they answered ‘zero pad’ or ‘one safety pad’ per day. A logistic regression model was used to evaluate the potential impact of some pre‐ and intraoperative factors on postoperative urinary continence recovery. Model discrimination was assessed using an area under (AUC) the receiver operating characteristic (ROC) curve. A nomogram to predict the risk of postoperative UI after RARP with the TAR technique was generated based on the logistic model.

Results

In all, 1008 patients were enrolled in our study. At 24 h, and 1, 4, 12, 24 and 48 weeks after catheter removal, 621 (61.61%), 594 (58.93%), 803 (79.66%), 912 (90.48%), 950 (94.25%) and 956 (94.84%) patients were continent, respectively. In the logistic regression model, the variables analysed had a higher impact on continence recovery at 4 and 12 weeks. At 4 weeks, the postoperative odds of urinary continence recovery increased with the absence of diabetes [odds ratio (OR) 2.76, 95% confidence interval (CI) 1.41–5.41] and D'Amico low vs high risk (OR 2.01, 95% CI 1.01–3.99). At 12 weeks, urinary continence increased with the absence of diabetes (OR 3.01, 95% CI 1.23–7.35), D'Amico low vs high risk (OR 4.04, 95% CI 1.56–10.47), and D'Amico intermediate vs high risk (OR 3.33, 95% CI 1.66–6.70). ROC curves were drawn and an AUC value of 61.9% (95% CI 57.49–66.36) at 4 weeks and 63.8% (95% CI 58.03–69.65) at 12 weeks were computed. Based on these parameters, two nomograms (at 4 and 12 weeks postoperatively) were generated.

Conclusion

The TAR technique conferred excellent results in the early recovery of urinary continence. Two nomograms were created, to predict preoperatively the postoperative odds of urinary continence recovery at 4 and 12 weeks after RARP by integrating the presence of diabetes and D'Amico risk classification.