bluuebunny/crossref_metadata_2025 huggingface dataset:
The Europeanization of Parliamentary Attention in and out of the European Union
Authors: Sciarini Pascal , Varone Frédéric , Gava Roy , Brouard Sylvain , Navarro Julien , Palau Anna M. , Vliegenthart Rens
Published: March 2019

This chapter adds to the growing literature on the Europeanization of national parliaments by looking at how and to what extent members of parliament (MPs) use parliamentary questions (PQs) on EU-related affairs. Relying on a comparison of three EU member states (France, Spain, and the Netherlands) and Switzerland, we analyze the Europeanization of parliamentary attention from a policy agenda perspective. We formulate expectations regarding variations in the degree of Europeanization across time, countries, and issues, and we test them with descriptive statistics on a rich collection of data covering three decades and including thousands of PQs. Results show that national MPs devote only little attention to EU-related issues, with no increase over time. Issue concentration of PQs is high and has not decreased over time either. Overall, the results tend to underscore the apathy of national MPs on EU matters.
Issue Attention in West European Party Politics
Authors: Green-Pedersen Christoffer
Published: March 2019

The CMP dataset has long been used to study of West European party politics. The consequences of the coding scheme on which the CMP dataset is based has received little attention in discussions. With the development of the CAP data, which includes coding of party manifestos, a comparison of the CMP dataset to CAP coding of identical documents is now possible. The level of attention to various policy issues is relatively similar, but with important exceptions. A similar pattern is identified when looking at the correlation between the two measures on similar issues. The exceptions can be traced to differences in the coding systems in terms of the specific categories included and in terms of the theoretical perspectives behind the coding systems. Using the CMP dataset to measure issue attention requires caution. A major limitation is that attention to a number of issues cannot be identified in the CMP dataset.
The Philosophy of Life as the Field of Immanence
Authors: Flood Gavin
Published: March 2019

The philosophies of life that emphasize life as a plane of immanence, in which there is no outside and no transcendence beyond the world, have expressed a modern non-dualism that is compatible with contemporary developments in neuroscience, social cognition, and evolution. A strong philosophical claim is that the immanence view expresses a truth about life itself, supported by science, against which the history of religions can be measured. A weak claim is that modern articulations of life itself are no more adequate than those of tradition, but the modern view is simply another approximation in expressing the field of immanence. The chapter argues for the weak view.
John the Evangelist
Authors: Behr John
Published: March 2019

Chapter One explores the figure of John and his Gospel from historical testimony given in the second and third century CE and as treated in contemporary scholarship. The John who wrote the Gospel, the chapter argues, was not the son of Zebedee, one of the twelve apostles, but the disciple of the Lord, the Elder who resided in Ephesus. The first part of this chapter also examines, on the basis of the historical evidence, the occasion for the writing of the Gospel, and argues for the unity of the Johannine corpus (including the Apocalypse). The second part of the chapter turns to the description given by Polycrates of Ephesus that John wore the ‘petalon’ in Jerusalem, that is, that he was the high priest of the temple, which, this chapter argues, refers to the fact that, in the Gospel of John, he alone amongst the disciples stood at the foot of the cross as the body of Jesus was lifted up upon the cross as the true Temple. It was, moreover, as this chapter shows, only the followers of John who had an annual celebration of Pascha, held on 14 Nissan, until the mid to late second century, when others began to celebrate this feast on the following Sunday, leading to the Quartodeciman controversy, the association of Sunday with the Resurrection, and the development of the Tridium, the three-day celebration of the Passion.
‘The Temple of His Body’
Authors: Behr John
Published: March 2019

Chapter Three opens Part Two of this work, which looks at what it is that is ‘finished’, as Christ affirms with his last word from the Cross in the Gospel of John. This chapter focuses on Christ as the true Temple, erected when his body is lifted up upon the Cross, Building upon the work of Mary Coloe and others, this chapter explores how Christ is presented in the six feasts which structure the narrative of this Gospel, culminating in the Passion and the appearances of the Risen Christ on the first and eighth day. In addition, this chapter also examines the way in which imagery drawn from the Tabernacle and Temple are used to explain Christ’s flesh (John 1:14 and 6), the relationship of this flesh, his glorified body, to the Eucharist and martyrdom, broadening in this way what is meant by ‘incarnation’.
‘Behold the Human Being’
Authors: Behr John
Published: March 2019

Chapter Four demonstrates how Christ’s word from the Cross, ‘It is Finished’, refers back to the opening verses of Genesis, where, unlike every other aspect of creation, which is brought into existence by an imperative, a divine fiat—‘Let it be!’—the particular project of God is given in the subjunctive, ‘Let us make a human being’: a project only completed when Christ lays down his own life in an act of love, unwitting confirmed by Pilate, ‘behold the human being!’. The first part of the chapter shows how this theme is developed by John over the course of the Gospel, most notably in the ‘woman’ who appears in Cana and at the Cross, and in John 16, where she is in travail until a human being is born into the world. This theme is also traced in the Apocalypse, and in writers following on from John: Ignatius of Antioch writing on his way to martyrdom, Melito of Sardis in his Paschal celebration, and Irenaeus of Lyons as a fundamental feature of his account of the whole economy of God leading, in the end, to the true human being. The second part of this chapter explores how this understanding of the human being informs the enigmatic figure of the Son of Man, as he steps dramatically into view at the beginning of the Gospel and appears frequently thereafter, examining John Ashton’s new proposal for interpreting the Son of Man, as a stage in the composition of the Gospel before the idea of Incarnation came to the fore, but argues instead that the Son of Man is the true human being, uniting heaven and earth, ascending the cross to descend as the flesh he offers to the faithful.
Desired to Do Right
Authors: Newell Quincy D.
Published: March 2019

Jane and Isaac James divorced in 1870. Their reasons for doing so are unknown, but may have been related to Jane’s devotion to the LDS Church and Isaac’s inability to live up to LDS standards of masculinity. Jane reported that Isaac left her for a white fortune teller. After the divorce, Jane moved closer to the center of Salt Lake City; Isaac left Utah. Jane James lost several children and grandchildren to death. The Relief Society, the LDS women’s organization, supported Jane financially and spiritually in this difficult time. She got remarried to Frank Perkins, a black Mormon widower. In 1875, along with several other black Mormons, Jane and Frank Perkins went to the Endowment House—a temporary ritual space used until the LDS temple was completed—to perform baptisms for the dead. The Perkins’s marriage dissolved within two years.
South African Foreign Policy
Authors: Thakur Vineet
Published: March 2019

South Africa’s foreign policy is often accused of being schizophrenic. It often engages in ‘policy summersaults’, as one observer characterizes the wide fluctuations in South Africa’s foreign policy practice. This chapter argues that such conflicted nature of South Africa’s foreign policy practice is indicative of the ambivalent thread that runs through the very idea of South Africa. South Africa is both a rainbow nation and a black country, a country long held to be trekking towards Europe and simultaneously trying to re-turn to Africa. Embodied in the tropes ‘rainbow nation’ and ‘African renaissance’, two different sets of ideas about South African national identity are representative of as well as refracted onto South Africa through its foreign policy practice. The chapter analyses South Africa’s foreign policy practice through debates around South Africa’s national identity.
The Eight Horsemen
Authors: Ravi Chaitanya
Published: March 2019

This chapter examines the period from March 2006–August 2007 and describes the debate over waiver legislation in the US Congress, the Hyde Act that emerged and the debate in India among serving and retired nuclear scientists over the Act’s implications for India’s nuclear programme and its ability to conduct future nuclear tests. The core of the chapter is a description of how the perceived strictures in the Hyde Act on nuclear testing such as the termination clause reignited the simmering debate over the success/failure of India’s lone 1998 thermonuclear test and exposed rifts between the serving scientist (Dr R. Chidambaram) who publicly vouched for its success and a group of retired nuclear weapons scientists who believed otherwise. The chapter ends by detailing how this domestic debate influenced the Indian negotiating position on nuclear testing.
Speaking the Nation
Authors: Bajpai Anandita
Published: March 2019

Untangling the logical, lexical, and semantic patterns of the multiple official speeches of Indian prime ministers, Speaking the Nation gauges how the Indian state has been projected by different governments in different times, in the face of challenges from internal and external actors that put pressure on its leaders to safeguard their status as legitimate elites in power. It analyses how Indian nationhood is consistently reshaped and reaffirmed by invoking its secular ethos and practice, as well as the experience of market liberalization. The book calls for serious engagement with political oratory in India. A close reading of speeches since 1991—from Narasimha Rao to Narendra Modi—it captures how, through these crosscutting topics, the prominent ‘authors of the nation’ and the ‘vanguards of the state’, speak India into being.
Introduction
Authors: Bajpai Anandita
Published: March 2019

The reforms of 1991 marked a paradigm shift from the Nehruvian import substitution economy to market liberalization. How have the Prime Ministers explained this shift to the population and the world and how are these transformations projected as the glossy embodiment of a New emerging India? How have Prime Ministers attempted to rescue state secularism in moments of crisis? The larger framing of the questions posed by the book is: How do nation-states recalibrate and renegotiate their authority as the vanguards of the nation in times when they come to be severely challenged by forces dubbed under the rubric of ‘globalization’? The author explains how the book treats both the cross cutting themes of state secularism and market liberalization not as two distinct themes, marked by separate events, but as intertwined topics through the lens of the same sources. It grounds why it is important to study prime ministerial oratory.
Introduction
Authors: Khanikar Santana
Published: March 2019

How is it that nation-states running on democratic procedures like elections engage simultaneously in extreme forms of violence towards its own citizens? While introducing this question in this chapter, I discuss the institutional, conceptual, and temporal-spatial aspects of the modern state and how it can be studied ethnographically. As a study of the violent dimension of the state, questions of legality, routinesness and the targets of violence are also addressed. The chapter also outlines how the notion of legitimacy is conceived in the work, by examining various competing theorizations, and also by showing how a distinction between the terms hegemony and legitimacy are sustained in the work. At the end, the chapter gives an outline of the rest of the book and how various chapters engage with the issue of state violence in two field-contexts.
Transforming Reforms
Authors: Swain Ashwini K.
Published: March 2019

Andhra Pradesh’s electoral politics has frequently provided electricity a starring role, largely due to the way that electoral competition between the state’s two main parties (TDP and Congress), first led to flat rate tariffs in 1982, contributing to financial losses, lack of investments, and deteriorating quality of supply. With World Bank support, the TDP (led by Naidu) embarked on reform and restructuring, but the accompanying steep tariff hike led to mass protest and was interpreted as the reason for the TDP’s electoral loss in 2004. Under Congress rule from 2004–11, when free power to farmers was reinstituted, the sector experienced another bout of shortfalls, losses, and growing subsidy, until 2014, when under Naidu’s TDP again, the government has embarked on a stealthier reform effort, focused on new investments in supply, efforts at energy efficiency, as well as signing up for the UDAY scheme. AP illustrates the constraints on reform efforts compounded by inadequate attention to the challenges of political transition.
Tamil Nadu Power Sector
Authors: Ramakrishnan Hema
Published: March 2019

Tamil Nadu, one of the wealthiest states in India, has achieved almost universal electrification, and also has the highest renewable energy capacity—both wind and solar—in the country. Over the last three decades, two regional parties—DMK and AIADMK—have alternatively governed the state and are locked into a pattern of competitive populism in which electricity subsidies play a big role. Early on, subsidies were well targeted and were also financially covered through cross-subsidies from other consumers and direct support from the government. By the 1980s, concern for financial discipline of the utility was abandoned, power for irrigation was made free, flat-rate meters were introduced, and growing theft was concealed under the carpet of agricultural subsidies, all leading to the deteriorated quality of supply and even more cross subsidies. Reform efforts did little to change the situation, with the state government controlling the electricity regulatory commission to prevent the ailing utility from reforming itself and protecting it from any competition. Ironically, Tamil Nadu is considered to be a power surplus state now due to falling industrial demand. There are few signs of Tamil Nadu climbing out of this spiral.
Conclusion
Authors: Dubashsunila Navroz K. , Kale Sunila S. , Bharvirkar Ranjit
Published: March 2019

The concluding chapter uses the analytic framework of the volume to explain the political economy of electricity. First, social welfare concerns continue to play an important part in shaping Indian electricity; policy making in the sector will need to engage these concerns rather than wish them away. Second, successful states have managed to turn a vicious cycle or low level equilibrium between electoral and electricity outcomes into a virtuous cycle, by delivering on a combination of access, price, and service. Third, past reform efforts reform efforts have failed to seriously engage state-specific political contexts but instead sought to carve out zones of depoliticized decision making. We categorize the state cases based on their relative ability to do so. Finally, the conclusion reflects on how a political mapping of power can help understand the future of Indian electricity as it negotiates a growing turn to renewable electricity.
The Constitution of Free Speech
Authors: Maheshwari Malvika
Published: March 2019

The preliminary chapter outlines the conceptual foundation of India’s free speech regime by focussing on the debates of the Constituent Assembly of India that took place between 1946 and 1949, and traces the development of Article 19 of the Constitution, which guarantees all citizens the right to free speech and expression, albeit with certain ‘reasonable restrictions’ such as public order, decency and morality, and security of the state, among others. While offering a synoptic account of the sundry forms that the right to free speech took as the framers navigated the discrepancies between their imagined ideal and the existent, conflicting reality, the idea is not to uncover some grand master-plan of the Indian democracy from which it has faltered, but to explore how it might lend a fissure to the violent accusations of offending religious, cultural, or national sentiments in contemporary India.
Artists and Their Repertoire of Responses
Authors: Maheshwari Malvika
Published: March 2019

Chapter 7 turns to India’s increasingly angry and insecure but resilient art world, which suggests a range and variety of responses to such an orchestration of violence, contradicting the view of ‘artists as only victims’, as much as it is a reminder of the resilience of democracy in India. Addressing four dominant themes—artists as attackers, unity and collective action, exile and resistance, and fear and self-censorship—it is an exploration of these diverse manifestations. These categories are, of course, only illustrative and not an exhaustive commentary on the assorted ways in which free speech is both understood and modified, when it is increasingly confronted with threatening, violent behaviour.
Representative Women?
Authors: Rai Shirin M. , Spary Carole
Published: March 2019

Building on arguments about differences among women when discussing their representation, the chapter suggests that focusing on the link between descriptive and substantive representation depoliticizes analysis and leads to flawed policy outcomes. The chapter carefully outlines the social profiles of women in the Indian Parliament in terms of their caste, class, religion, and education. It also explores the development of an intersectionality of identities and their mobilization by both autonomous social and regional movements as well as by organized political parties to reflect upon the relationship between the movements and parties and the politics of representation that women members of Parliament mirror in their work in the Parliament.
Sovereignty
Authors: Heathcote Gina
Published: March 2019

Chapter 4 analyses the gendering of state sovereignty, via a focus on legal subjectivity articulated without assertion of traditional male models of personhood. Building on intersectionality and the articulation of plural subjectivities in the previous chapters, chapter 4 contemplates a model of split subjectivity as a useful redescription of how state sovereignty functions within global governance. The chapter considers the importance of gendered experiences and histories of law as informing legal knowledge while rejecting a feminist message centred on woman as subject. The chapter develops the split subject as a relational understanding of legal subjects that incorporates the temporal and territorial implications of inter-, cross-, and regional-state relations and analyses the responsibility to protect and secession via the split subject. The split subject is intended to engage international law at its foundations and to displace the masculine subjects implied in mainstream conceptions of state sovereignty.
Introduction
Authors: Neuwirth Angelika
Published: March 2019

The introduction first sketches the general approach followed in the volume, which is to trace the historical emergence of the text of the Qur’an against the historical background of the period. It situates this approach within the context of often conflicting discourses and political issues of knowledge production between Europe and the Islamic world and clarifies the way in which the study of the Qur’an can bridge hermeneutic polarities between East and West. Following this, the thirteen chapters that follow are described in brief, and an overview of the methodology and conclusions of the work are given.
How the Qur’an Has Been Read So Far
Authors: Neuwirth Angelika
Published: March 2019

A sketch of the previous research on the Qur’an is provided in detail. The overview of approaches and results in Western research goes back to the nineteenth century, following the story of Qur’an research first up to the Wissenschaft des Judentums (science of Judaism) school of the early twentieth century. Following this, more recent trends in Qur’an research, including the more source-critical and skeptical methods of recent decades, are described. Finally, a sketch of the diversity of current approaches is given, situating the approach of this volume within its relevant scholarly context.
Stages of Communal Formation in the Early Meccan Period
Authors: Neuwirth Angelika
Published: March 2019

This chapter reviews the “communal development” that occurred over the course of the early Meccan period of the Qur’an’s proclamation. This proceeds from an early “psalmic” piety based largely around the vigil and the Prophet-biographical elements of the early suras to proclamations more focused on “warning” and reflections on writing and signs of creation.
Qur’an and Bible
Authors: Neuwirth Angelika
Published: March 2019

In this chapter the general issues of interpretation involving the differences and similarities between the Qur’an and the Old and New Testaments are critically discussed. Allegory and typology are discussed as overall hermeneutic categories and as ways of describing and approaching the Bible and the Qur’an. Reflections are offered here on the nature of the “Prophetic discourse” represented in the Qur’an, and questions of genre and contemporary approaches to scriptural reading are put forward. The appellatory nature of Prophetic speech in the Qur’an offers some of the clearest points of comparison and contrast with biblical texts, along with narrative passages and their relation to history.
An epidemiologic overview of a tertiary referral practice for male paediatric lichen sclerosus
Authors: Hoare Dylan Thomas , Metcalfe Peter
Published: March 2019

Within the paediatric population, changing patterns of circumcisions have confounded the epidemiology and presentation of lichen sclerosus (LS). We sought to evaluate the incidence, demographics, and clinical features of patients presenting to a single Albertan paediatric urologist with LS. This retrospective descriptive analysis evaluated all paediatric patients referred for phimosis to a single paediatric urologist in Edmonton, Alberta. Chief complaints/symptoms, date of birth, and date of circumcision were identified. The primary outcome of interest was the proportion of circumcisions with pathologically confirmed LS. From July 2006 to March 2016, 4,163 patients were seen for phimosis of the approximate 12,000 new referrals. Hundred phimosis patients had clinically suspected LS. Of those adequately reported, 81 (81/83) were microscopically confirmed to be LS with a mean age of 9.6 years and median age of 8.9 years (range 4.1 to 16.1 years). This cohort represented 2.0% of phimosis referrals and approximately 0.7% of all referrals to our paediatric urologist. When compared to physiologic phimosis, these patients had higher rates of dysuria (n=28, 34.6% versus n=1, 1.0%, P<0.0001) and urinary retention (n=18, 22.2% versus n=1, 1.0%, P<0.0001) as presenting complaints. LS of the paediatric male genitalia is an uncommon, albeit clinically significant disease entity. The clinical diagnosis for the trained practitioner is very accurate.
Spatial clusters of chronic preventable hospitalizations (ambulatory care sensitive conditions) and access to primary care
Authors: Mazumdar Soumya , Chong Shanley , Arnold Luke , Jalaludin Bin
Published: March 2019

Background

Potentially preventable hospitalizations (PPHs) or ambulatory care sensitive conditions (ACSCs) represent hospitalizations that could be successfully managed in a primary care setting. Research from the USA and elsewhere on the role of primary care provider (PCP) access as a PPH driver has been conflicting. We investigated the role of PCP access in the creation of areas with persistently significant high rates of PPHs over time or PPH hotspots/spatial clusters.

Methods

Using a detailed dataset of PCPs and a dataset of 106 334 chronic PPH hospitalizations from South Western Sydney, Australia, we identified hotspots of chronic PPHs. We contrasted how hotspot PPHs were different from other PPHs on a range of factors including PCP access.

Results and conclusions

Six spatially contiguous areas comprising of eight postcodes were identified as hotspots with risks ranging from 1.6 to 2.9. The hotspots were found to be more disadvantaged and had better PCP access than other areas. Socioeconomic disadvantage explained the most variation (8%) in clustering while PCP access explained only a small fraction though using detailed PCP access measures helped. Nevertheless a large proportion of the variation remained unexplained (86.5%) underscoring the importance of individual level behaviours and other factors in driving chronic PPH clustering.
Development and validation of a questionnaire to measure research impact
Authors: Solans-Domènech Maite , MV Pons Joan , Adam Paula , Grau Josep , Aymerich Marta
Published: March 2019

Although questionnaires are widely used in research impact assessment, their metric properties are not well known. Our aim is to test the internal consistency and content validity of an instrument designed to measure the perceived impacts of a wide range of research projects. To do so, we designed a questionnaire to be completed by principal investigators in a variety of disciplines (arts and humanities, social sciences, health sciences, and information and communication technologies). The impacts perceived and their associated characteristics were also assessed. This easy-to-use questionnaire demonstrated good internal consistency and acceptable content validity. However, its metric properties were more powerful in areas such as knowledge production, capacity building and informing policy and practice, in which the researchers had a degree of control and influence. In general, the research projects represented an stimulus for the production of knowledge and the development of research skills. Behavioural aspects such as engagement with potential users or mission-oriented projects (targeted to practical applications) were associated with higher social benefits. Considering the difficulties in assessing a wide array of research topics, and potential differences in the understanding of the concept of ‘research impact’, an analysis of the context can help to focus on research needs. Analyzing the metric properties of questionnaires can open up new possibilities for validating instruments used to measure research impact. Further to the methodological utility of the current exercise, we see a practical applicability to specific contexts where multiple discipline research impact is requires.
The influence of spectral composition on spring and autumn phenology in trees
Authors: Brelsford Craig C , Nybakken Line , Kotilainen Titta K , Robson T Matthew
Published: March 2019

Several recent reviews highlight the molecular mechanisms that underpin phenological responses to temperature and photoperiod; however, these have mostly overlooked the influence of solar radiation and its spectral composition on these processes. For instance, solar radiation in the blue and ultraviolet (UV) regions of the spectrum, as well as the red/far-red (R:FR) ratio, can influence spring and autumn phenology. Solar radiation reaching the Earth changes diurnally and seasonally; however, rising global temperatures, latitudinal range shifts and light pollution are likely to produce novel combinations of phenological cues for tree species. Here, we review the literature on phenological responses to spectral composition. Our objective was to explore the natural variation in spectral composition using radiative transfer models and to reveal any species-specific or ecotype-specific responses relating to latitudinal origin. These responses are likely to be most pronounced at high latitudes where spectral composition varies most throughout the year. For instance, trees from high latitudes tend to be more sensitive to changes in R:FR than those from low latitudes. The effects of blue light and UV radiation on phenology have not been studied as much as those of R:FR, but the limited results available suggest both could be candidate cues affecting autumn leaf colouration and senescence. Failure of more–southern species and ecotypes to adapt and use spectral cues during northwards range shifts could result in mistimed phenology, potentially resulting in frost damage, reduced fitness and limited range expansion. Future areas for research should look to establish how consistently different functional types of tree respond to spectral cues and identify photoreceptor-mediated mechanisms that allow plants to combine information from multiple light cues to coordinate the timing of phenological events. It should then be feasible to consider the synchronous or sequential action of light cues within a hierarchy of environmental factors regulating phenology.
Effects of phloem on canopy dieback, tested with manipulations and a canker pathogen in the Corylus avellana/Anisogramma anomala host/pathogen system
Authors: Lachenbruch B , Zhao Jia-Ping
Published: March 2019

Canker pathogens cause necrosis of the phloem, but in many host/pathogen systems, they also cause canopy dieback, which implicates xylem, not phloem dysfunction. We hypothesize that this dieback distal to the canker is caused by water stress resulting from the lack of a phloem-to-xylem connection, which in a healthy plant would allow delivery of nonstructural carbohydrates (NSCs) and water inward to aid in xylem embolism refilling. We tested several components of this hypothesis in the host/pathogen system Corylus avellana L./Anisogramma anomala (Peck) E. Müll (Eastern filbert blight). Cankers were non-girdling and usually ≥0.1 m long. As expected, healthy controls had higher specific conductivity (Ks) than diseased stems, but unexpectedly, had similar moisture content (m.c.), showing that the lower Ks did not result from more embolisms in the diseased stems. Moreover, manipulations that removed cambium and phloem to simulate a canker, or that shaded stems to lower NSCs, did not result in lower Ks or m.c. than controls. The outer millimeter of xylem adjacent to a canker had infrequent tyloses and/or fungal hyphae in many but not all samples, and dye studies showed little xylem water transport in that region, but the incidence of these blockages was insufficient to cause the observed 19% decrease in Ks. Healthy stems had higher m.c. than diseased stems above the canker (or analogous) location and were longer for the same leaf weight, suggestive of water stress in the upper portion of diseased stems. These results suggest that dieback distal to cankers in this system results from the bottleneck in water transport in the region adjacent to a canker, but did not find evidence to support the requirement of a phloem-to-xylem connection for continued water transport.
Defoliation constrains xylem and phloem functionality
Authors: Hillabrand Rachel M , Hacke Uwe G , Lieffers Victor J
Published: March 2019

Insect defoliation contributes to tree mortality under drought conditions. Defoliation-induced alterations to the vascular transport structure may increase tree vulnerability to drought; however, this has been rarely studied. To evaluate the response of tree vascular function following defoliation, 2-year-old balsam poplar were manually defoliated, and both physiological and anatomical measurements were made after allowing for re-foliation. Hydraulic conductivity measurements showed that defoliated trees had both increased vulnerability to embolism and decreased water transport efficiency, likely due to misshapen xylem vessels. Anatomical measurements revealed novel insights into defoliation-induced alterations to the phloem. Phloem sieve tube diameter was reduced in the stems of defoliated trees, suggesting reduced transport capability. In addition, phloem fibers were absent, or reduced in number, in stems, shoot tips and petioles of new leaves, potentially reducing the stability of the vascular tissue. Results from this study suggest that the defoliation leads to trees with increased risk for vascular dysfunction and drought-induced mortality through alterations in the vascular structure, and highlights a route through which carbon limitation can influence hydraulic dysfunction.
The Burden of Brain Hypoxia and Optimal Mean Arterial Pressure in Patients With Hypoxic Ischemic Brain Injury After Cardiac Arrest*
Authors: Sekhon Mypinder S. , Gooderham Peter , Menon David K. , Brasher Penelope M. A. , Foster Denise , Cardim Danilo , Czosnyka Marek , Smielewski Peter , Gupta Arun K. , Ainslie Philip N. , Griesdale Donald E. G.
Published: March 2019

Objectives:

In patients at risk of hypoxic ischemic brain injury following cardiac arrest, we sought to: 1) characterize brain oxygenation and determine the prevalence of brain hypoxia, 2) characterize autoregulation using the pressure reactivity index and identify the optimal mean arterial pressure, and 3) assess the relationship between optimal mean arterial pressure and brain tissue oxygenation.

Design:

Prospective interventional study.

Setting:

Quaternary ICU.

Patients:

Adult patients with return of spontaneous circulation greater than 10 minutes and a postresuscitation Glasgow Coma Scale score under 9 within 72 hours of cardiac arrest.

Interventions:

All patients underwent multimodal neuromonitoring which included: 1) brain tissue oxygenation, 2) intracranial pressure, 3) jugular venous continuous oximetry, 4) regional saturation of oxygen using near-infrared spectroscopy, and 5) pressure reactivity index–based determination of optimal mean arterial pressure, lower and upper limit of autoregulation. We additionally collected mean arterial pressure, end-tidal CO2, and temperature. All data were captured at 300 Hz using ICM+ (Cambridge Enterprise, Cambridge, United Kingdom) brain monitoring software.

Measurements and Main Results:

Ten patients (7 males) were included with a median age 47 (range 20–71) and return to spontaneous circulation 22 minutes (12–36 min). The median duration of monitoring was 47 hours (15–88 hr), and median duration from cardiac arrest to inclusion was 15 hours (6–44 hr). The mean brain tissue oxygenation was 23 mm Hg (sd 8 mm Hg), and the mean percentage of time with a brain tissue oxygenation below 20 mm Hg was 38% (6–100%). The mean pressure reactivity index was 0.23 (0.27), and the percentage of time with a pressure reactivity index greater than 0.3 was 50% (12–91%). The mean optimal mean arterial pressure, lower and upper of autoregulation were 89 mm Hg (11), 82 mm Hg (8), and 96 mm Hg (9), respectively. There was marked between-patient variability in the relationship between mean arterial pressure and indices of brain oxygenation. As the patients’ actual mean arterial pressure approached optimal mean arterial pressure, brain tissue oxygenation increased (p < 0.001). This positive relationship did not persist when the actual mean arterial pressure was above optimal mean arterial pressure.

Conclusions:

Episodes of brain hypoxia in hypoxic ischemic brain injury are frequent, and perfusion within proximity of optimal mean arterial pressure is associated with increased brain tissue oxygenation. Pressure reactivity index can yield optimal mean arterial pressure, lower and upper limit of autoregulation in patients following cardiac arrest.
Corneal Cross-Linking: The Science Beyond the Myths and Misconceptions
Authors: Rubinfeld Roy S. , Caruso Ciro , Ostacolo Carmine
Published: March 2019

Purpose:

There has been a recent explosion in the variety of techniques used to accomplish corneal cross-linking (CXL) for the treatment of ectatic corneal diseases. To understand the success or failure of various techniques, we review the physicochemical basis of corneal CXL and re-evaluate the current principles and long-standing conventional wisdom in the light of recent, compelling, and sometimes contradictory research.

Methods:

Two clinicians and a medicinal chemist developed a list of current key topics, controversies, and questions in the field of corneal CXL based on information from current literature, medical conferences, and discussions with international practitioners of CXL.

Results:

Standard corneal CXL with removal of the corneal epithelium is a safe and efficacious procedure for the treatment of corneal ectasias. However, the necessity of epithelium removal is painful for patients, involves risk and requires significant recovery time. Attempts to move to transepithelial corneal CXL have been hindered by the lack of a coherent understanding of the physicochemistry of corneal CXL. Misconceptions about the applicability of the Bunsen–Roscoe law of reciprocity and the Lambert–Beer law in CXL hamper the ability to predict the effect of ultraviolet A energy during CXL. Improved understanding of CXL may also expand the treatment group for corneal ectasia to those with thinner corneas. Finally, it is essential to understand the role of oxygen in successful CXL.

Conclusions:

Improved understanding of the complex interactions of riboflavin, ultraviolet A energy and oxygen in corneal CXL may provide a successful route to transepithelial corneal CXL.
Blood Vessels and Lymphatic Vessels in the Cornea and Iris After Penetrating Keratoplasty
Authors: Li Suxia , Li Lin , Zhou Qingjun , Gao Hua , Liu Mingna , Shi Weiyun
Published: March 2019

Purpose:

To detect early growth of blood and lymphatic vessels in the mouse cornea and iris after penetrating keratoplasty.

Methods:

Penetrating keratoplasty was performed with C57BL/6 mice as donors and BALB/c mice as recipients. Graft transparency and neovascularization were examined by slit-lamp microscopy. Whole mounts of the cornea and iris were processed for detection of the outgrowth of blood and lymph vessels.

Results:

On day 3 after surgery, all corneal grafts were slightly edematous, and blood vessels in the corneoscleral limbus dilated. LYVE-1+ lymphatic vessels and CD31+ blood vessels were distributed in the peripheral cornea. In the iris, the density of blood vessels increased, and LYVE-1+ cells nearly vanished. On day 7, the grafts became opaque, and blood vessels grew into the recipient bed. A great quantity of lymph vessels invaded the cornea. LYVE-1+ arborescent cells were found around the lymphatic vessels. In the iris, blood vessels became bulky and stiff, and arborescent LYVE-1+ cells increased in number. On day 14, corneal neovascular regression and graft clarity were found. Lymphatic vessels regressed more slowly than blood vessels in the cornea. In the iris, blood vessels remained coarse. Increasing arborescent LYVE-1+ cells were also noted in the ciliary body.

Conclusions:

Our findings suggest that the iris–ciliary body could amplify immune signals and in part promote initiation of immune rejection after keratoplasty by providing a pathway for macrophages, which might participate in corneal lymphangiogenesis.
Outcomes of a Modified Technique for Successful Pneumatic Dissection in Pediatric Eyes With Corneal Scars
Authors: Mattioli Leila , Weiss Jayne S. , Spena Rossella , Leon Pia , Myerscough James , Bovone Cristina , Busin Massimo
Published: March 2019

Purpose:

To report the outcomes of a modified deep anterior lamellar keratoplasty (DALK) procedure for the treatment of scarred corneas in otherwise healthy pediatric eyes.

Methods:

All pediatric eyes undergoing DALK by the same surgeon (M.B.) between July 2013 and June 2017 were enrolled. The standard DALK procedure was modified by including a large (9 mm) and deep (150 μm from the thinnest pachymetric measurement) trephination, a minimal cannula advancement from the base of the trephination, and a clearing of a central 6 mm optical zone. The success rates of pneumatic dissection, visual and refractive outcomes, and complications were reported. A complete ophthalmologic examination was performed preoperatively and a few days after suture removal (6-months post-DALK) for all patients as well as 12, 24, and 36 months postoperatively for available patients.

Results:

Fourteen eyes of 13 patients with various indications were included in this study. The mean age at the time of surgery was 11.7 ± 2.5 years. Pneumatic dissection succeeded in all but one case (13/14 eyes = 92.8%), which was completed by hand dissection. All sutures were removed within 6 months of surgery. With a minimum postoperative follow-up of 6 months, best spectacle-corrected visual acuity improved from ≤20/50 to ≥20/40 in all but one eye, which was known to be amblyopic.

Conclusions:

Despite impaired corneal transparency and increased tissue consistency, a modified DALK technique allows successful pneumatic dissection in an extremely high percentage of scarred pediatric eyes. Visual results compare favorably with those obtained in children after penetrating keratoplasty, while vision threatening complications are minimized.
Long-term management and outcomes of tracheobronchial stent by flexible bronchoscopy in infants <5 kg: A 13-year single-center experience
Authors: Hsieh Kao-Hsian , Chou Ya-Ling , Soong Wen-Jue , Lee Yu-Sheng , Tsao Pei-Chen
Published: March 2019

Background:

Tracheobronchial (TB) lumen narrowing may require prolonged positive-pressure ventilation, endotracheal tube intubation or even surgical interventions. Therapeutic flexible bronchoscopy (TFB) of balloon-expandable metallic stent (BEMS) placement and subsequent forceps, laser and balloon dilatation management might be less invasive and helpful. This study aimed to analyse the placement, follow-up management with TFB and long-term outcomes in small infants with BEMS.

Methods:

This retrospective study reviewed the medical records and associated TFB videos of infants with a maximum body weight (BW) of 5.0 kg who had TB BEMS placement from January 2005 to December 2017 at our institution. All TFB procedures were supported with a novel noninvasive ventilation, nasopharyngeal oxygen with intermittent nose closure and abdominal compression.

Results:

Forty-one BEMSs were placed in 24 infants. The mean BW and mean age were 4.0 ± 0.7 kg and 4.9 ± 2.4 months, respectively. There were 20, 8 and 13 stents located in trachea, carina and main-stem bronchi, respectively. Seven infants with 13 stents died without obvious stent-related mortality. Seven stents in five infants were successfully retrieved by rigid endoscopy (RE). At placement, the diameters of 28 tracheal and 21 bronchial stents were 7.5 ± 1.1 (4-10) and 5.4 ± 0.9 (4-8) mm, respectively. These implanted BEMSs could be gradually and significantly (p < 0.01) expanded. At the end of the follow-up period, all the remaining 21 stents in 12 infants were functional. The diameters of the 14 remaining tracheal and 13 remaining bronchial stents were 9.6 ± 2.0 (8-14) and 7.2 ± 1.4 (4-10) mm, respectively.

Conclusion:

BEMSs are practical and effective in selected small infants with benign TB narrowing and can be safely implanted and managed with TFB, and finally retrieved by RE.
Panel-based NGS reveals disease-causing mutations in hearing loss patients using BGISEQ-500 platform
Authors: Sun Yan , Yuan Jing , Wu Limin , Li Min , Cui Xiaoli , Yan Chengbin , Du Lique , Mao Liangwei , Man Jianfen , Li Wei , Kristiansen Karsten , Wu Xuan , Pan Weijun , Yang Yun
Published: March 2019

Hearing loss is a highly heterogeneous disease presented with various phenotypes. Genetic testing of disease-causing mutations plays an important role in precise diagnosis and fertility guidance of heredity hearing loss. Here we reported an effective method employing target enrichment and BGISEQ-500 platform to detect clinically relevant alterations for heredity hearing patients in a single assay.

In this study, we designed an array based chip, containing 127 genes related to hearing loss. Then we conducted targeted next-generation sequencing toward 58 patients to make a precise diagnosis using BGISEQ-500 platform.

We successfully detected disease-causing mutations in 77.59% (45/58) of the patients with hearing loss. Finally, a total of 62 disease-causing mutations were identified, including 31 missense, 17 Indel, 11 splicing, 2 synonymous, and 1 copy number variant. 58.06% (36/62) of which has never been reported before.

To our knowledge, this is the first report using BGISEQ-500 platform to investigate both syndromic and nonsyndromic hearing loss in the Chinese population. The results showed that this method can greatly assist and enhance hearing loss diagnosis and improve molecular diagnostics outcome.
The relationship between smoking and stroke
Authors: Pan Biqi , Jin Xiao , Jun Liu , Qiu Shaohong , Zheng Qiuping , Pan Mingwo
Published: March 2019

Background:

Stroke is one of the leading causes of death and disability for adult men and women worldwide, and a number of studies have explored the influences of smoking on stroke. However, few studies have discussed the relationship between stroke and smoking with consideration of the following factors: sex, the number of cigarettes smoked per day, stroke subtype, and the follow-up duration. Consequently, we aimed to extend previous work by using a systematic review to explore the relationship between stroke and cigarette smoking in reference to the above factors.

Methods:

A systematic review was conducted using the PubMed, Embase, and Cochrane Central Register databases and the following search criteria: [“stroke” (MeSH) and “smoking” (MeSH)]. All analyses were conducted with Stata, and funnel plots and Egger regression asymmetry tests were used to assess publication bias.

Results:

The meta-analysis included 14 studies involving 303134 subjects. According to the meta-analysis, smokers had an overall increased risk of stroke compared with nonsmokers, with a pooled odds ratio (OR) of 1.61 (95% confidence interval [CI]: 1.34–1.93, P < .001). A subgroup analysis conducted based on smoking status revealed ORs of 1.92 (95% CI: 1.49–2.48) for current smokers and 1.30 (95% CI: 0.93–1.81) for former smokers. In addition, the relationship between stroke of any type and smoking status was also statistically significant; current smokers had an increased risk of stoke compared with nonsmokers (OR: 1.46, 95% CI: 1.04–2.07, P < .001), which was influenced by sex (men: OR: 1.54, 95% CI: 1.11–2.13, P = .002; women: OR: 1.88, 95% CI: 1.45–2.44, P < .023). From the analysis, we also observed that passive smoking increased the overall risk of stroke by 45% (OR: 1.45, 95% CI: 1.0–2.11, P < .05). Based on the dose-response meta-analysis, the risk of stroke increased by 12% for each increment of 5 cigarettes per day.