bluuebunny/crossref_metadata_2025 huggingface dataset:
The roles of acclimation and behaviour in buffering climate change impacts along elevational gradients
Authors: Enriquez‐Urzelai Urtzi , Tingley Reid , Kearney Michael R. , Sacco Martina , Palacio Antonio S. , Tejedo Miguel , Nicieza Alfredo G.
Published: March 2020

The vulnerability of species to climate change is jointly influenced by geographic phenotypic variation, acclimation and behavioural thermoregulation. The importance of interactions between these factors, however, remains poorly understood.

We demonstrate how advances in mechanistic niche modelling can be used to integrate and assess the influence of these sources of uncertainty in forecasts of climate change impacts.

We explored geographic variation in thermal tolerance (i.e. maximum and minimum thermal limits) and its potential for acclimation in juvenile European common frogs Rana temporaria along elevational gradients. Furthermore, we employed a mechanistic niche model (NicheMapR) to assess the relative contributions of phenotypic variation, acclimation and thermoregulation in determining the impacts of climate change on thermal safety margins and activity windows.

Our analyses revealed that high-elevation populations had slightly wider tolerance ranges driven by increases in heat tolerance but lower potential for acclimation. Plausibly, wider thermal fluctuations at high elevations favour more tolerant but less plastic phenotypes, thus reducing the risk of encountering stressful temperatures during unpredictable extreme events. Biophysical models of thermal exposure indicated that observed phenotypic and plastic differences provide limited protection from changing climates. Indeed, the risk of reaching body temperatures beyond the species' thermal tolerance range was similar across elevations. In contrast, the ability to seek cooler retreat sites through behavioural adjustments played an essential role in buffering populations from thermal extremes predicted under climate change. Predicted climate change also altered current activity windows, but high‐elevation populations were predicted to remain more temporally constrained than lowland populations.

Our results demonstrate that elevational variation in thermal tolerances and acclimation capacity might be insufficient to buffer temperate amphibians from predicted climate change; instead, behavioural thermoregulation may be the only effective mechanism to avoid thermal stress under future climates.
The Role of Framing Mechanisms in Explaining System‐Wide Change: The Case of the Northern Ireland Conflict and Peace Process
Authors: Murphy Joanne , Denyer David , Pettigrew Andrew
Published: March 2020

System‐wide change is often challenging to achieve due to complex and fragmented institutions, dispersed and diffused power structures, confidence‐sapping histories of failure and the influence of multiple and overlapping fields. This study examines how a large complex system‐wide problem such as the Northern Ireland Conflict and Peace Process was paradoxically opened up and made more receptive to change by widening of the way the problem was framed. We demonstrate how and why the framing enables the mobilization of cooperation and the delivery of contextually appropriate collective action critical to the achievement of outcomes in system‐wide change processes. More specifically, we examine how and why such complex and precarious processes emerge over extended timescales through four mechanisms: frame contesting, reframing, frame reproduction and frame defending. Each of these mechanisms is agentic, dynamic, purposive and politically charged. The time‐series analysis of these interlinked mechanisms is a crucial and innovative feature of the study. We encourage management and organizational scholars to elevate their gaze to the system‐wide changes so emblematic of contemporary society and offer an outline agenda for research.
Practice and perspectives of Australian dietitians in management of patients on pancreatic enzyme replacement therapy
Authors: Delaney Caitlin , Vo Ruth , Beck Eleanor
Published: March 2020

Prescribing pathways for Australian dietitians are limited in comparison to dietitians practising in New Zealand and the United Kingdom. Therefore where medication dose may be titrated relative to dietary intake, such as in pancreatic exocrine insufficiency, dietitians in Australia are unable to initiate therapy or adjust dosage.

Aim

To explore current practice roles of Australian dietitians working with patients requiring pancreatic enzyme replacement therapy (PERT), and opinions and influences on these practices.

Methods

An online survey and telephone interviews with self‐nominated dietitians who identified with extended scope of practice with patients on PERT. Thematic analysis was undertaken through an inductive approach to better understand the contexts and reasoning around a dietitian's extended scope of practice.

Results

The majority of participants in the online survey (74/81) described roles beyond traditional scope of practice with patients requiring PERT, especially in a multidisciplinary team environment. Most respondents (97%) believed PERT prescribing for dietitians would be beneficial. Nine semi‐structured telephone interviews with experienced dietitians revealed perceived benefits of current advanced and informal extended scope of practice for dietitians including greater efficiency; improved patient care; increased job satisfaction and enhanced inter‐professional communication. Dietitians believe they are adequately equipped to prescribe medication where dose is largely dependent upon diet.

Conclusions

In Australia, it is common for dietitians in care of patients prescribed PERT to engage in informal, extended scope of practice. Further research is required to determine the framework to achieve formal extended scope of practice related to PERT and potentially other medications.
Sonocrystallization as a tool to reduce oil migration by changing physical properties of a palm kernel fat
Authors: da Silva Thais Lomonaco Teodoro , Marsh Melissa , Gibon Veronique , Martini Silvana
Published: March 2020

Oil migration (OM) has been an immense issue in fat‐based foods such as peanut butter and chocolate fillings. The objective of this study was to evaluate the effect of high‐intensity ultrasound (HIU) on OM in a palm kernel oil‐based fat used in chocolate fillings, coatings, and confectionery applications. The sample was crystallized at 30 °C for 90 min and stored for 48 hr at 25 °C. HIU was applied after 20 min at 30 °C using a 3.2‐mm diameter tip operating at an amplitude of 216 µm (90 W) for 10 s. OM was measured using a centrifuge‐ and a filter paper‐based method. Crystal morphology and size, solid fat content (SFC), melting behavior, and hardness were evaluated after 90 min, 48 hr, and after OM. Results showed that HIU reduced OM (P < 0.05) by 52.0% when measured using the filter paper method while a reduction of 97.4% was observed when measured with the centrifuge method. HIU also reduced the crystal size (P < 0.05) and formed a more organized crystalline network. A reduction in peak temperature (Tp) after 90 min of crystallization and 48 hr of storage was observed in sonicated samples without affecting the enthalpy. However, enthalpy and Tp were higher in the sample without HIU analyzed after OM due to the migration of low melting point triacylglycerols out of the crystalline network. HIU also increased the hardness (P < 0.05) from 1.37 N and 3.17 N. But no differences (P > 0.05) were found on SFC due to sonication. Overall, HIU changed the crystalline structure of the fat allowing for a better entrapment of liquid oil in the crystalline matrix. Results from this study will benefit food producers that are looking for fat sources with better capacity to entrap oil.

Practical Application

OM is one of the main problems facing the fat industry, especially since the elimination of partially hydrogenated fats from foods. Efforts are being focused on finding new technologies to reduce OM and therefore to improve the shelf life of the product. This study introduces for the first time, a new processing technology to reduce OM in a palm kernel fat with high content of saturated fatty acids that is commonly used in confectionery applications.
Novel processing techniques and spinach juice: Quality and safety improvements
Authors: Manzoor Muhammad Faisal , Ahmed Zahoor , Ahmad Nazir , Aadil Rana Muhammad , Rahaman Abdul , Roobab Ume , Rehman Abdur , Siddique Rabia , Zeng Xin‐An , Siddeeg Azhari
Published: March 2020

In this study, the combined effect of ultrasound (US) and pulsed electric field (PEF) techniques was analyzed for the quality improvement and microbial safety of spinach juice. The spinach juice was treated with US at frequency of 40 kHz, radiating power of 200 W below 30 ± 2 °C temperature for 21 min in ultrasonic bath cleaner, and PEF treatment (pulse frequency: 1 kHz, flow rate: 60 mL/min, temperature: 30 ± 2 °C, time: 335 µs, electric field strength 9 kV/cm) was done. In results, the combined (US‐PEF) treatment attained the highest value of minerals and total free amino acids as compared to US or PEF treatment alone. US‐PEF treatment significantly reduced the total plate count (3.83 to 1.97 log CFU/mL),E. coli/Coliform (1.90 to 0.75 log CFU/mL) and yeast and mold (4.23 to 2.22 log CFU/mL). Fourier‐transform infrared spectroscopy (FT‐IR) spectra showed that all nonthermal treatments led to a higher concentration of carbonyl compounds rather generate new carbonyl compounds. US‐PEF treatment significantly reduced the particle size. The rheology of spinach juice was drastically changed by all nonthermal techniques, indicating non‐Newtonian modal accompanied by a decrease of consistency index (K), apparent viscosity (η), and increase of flow behavior (n). Overall, the improved quality of spinach juice shows the suitability of both technologies for industrial applications despite the variations in rheological properties.

Practical Application

Nowadays, nonthermal technologies like US and PEF are being used to enhance the nutritional quality and stability of different fruits and vegetable juices. The current research shows that US‐PEF application can enhance the free amino acids and mineral contents while significantly decrease microbial activities and particle size. The rheology of spinach juice can be dramatically changed, through the reduction of consistency index (K), apparent viscosity (η) and elevation of flow behavior (n). The results of this research proposed that US‐PEF treatment can be a more suitable nonthermal application to enhance the quality of spinach juice at an industrial scale.
Granite is an Effective Helium Source Rock: Insights from the Helium Generation and Release Characteristics in Granites from the North Qinling Orogen, China
Authors: ZHANG Wen , LI Yuhong , ZHAO Fenghua , ZHOU Zheng , HAN Wei , ZHOU Junlin , ZHANG Qiao
Published: March 2020

Global helium (He) shortage is a challenging problem; however, the types of helium source rock and the mechanisms of He generation and release therein remain still poorly understood. In this study, in order to evaluate the potential of granite as an effective helium source rock, we collected granitic samples from the North Qinling Orogen, Central China, in the south of the helium‐rich Weihe Basin. The helium generation and release behaviors in granite were studied through analysis of U and Th concentrations, EMPA images, and He and Ar concentrations and isotopic ratios extracted by crushing and stepwise heating. The results indicate that Ar has a better retention and a lower mobility than He. 3He/4He ratios released by crushing and stepwise heating are 0.016–0.056 RA and 0.003–0.572 RA, respectively, where RA is the atmospheric 3He/4He of 1.4×10‐6, reflecting a crustal and radiogenic source. Helium concentrations extracted by the two ways are 0.13–0.95 ucm3 STP/g and 7.82–115.62 ucm3 STP/g, respectively, suggesting that matrix‐sited He accounts for more than 98% of total helium preserved in granite. In addition, the total generated He amounts in granites are calculated based on the measured U and Th concentrations in granitic samples. Dividing the preserved He quantities by the generated He amounts, it turned out that less than 10% of He produced since the formation of the granite is preserved in the rock over geological time, suggesting that more than 90% generated He can be transferred to the Weihe Basin. Temperature and fracture are the two critical factors controlling He release. Based on the relationship between He diffusivity of granites and temperature and the He closure temperatures of a variety of U‐ and Th‐rich minerals (27–250°C), we estimate that He can be partially released out of granite at the depths <400 m and totally released at the depths >7800 m. Fractures provide effective transfer of free He from deep source rocks to shallow reservoirs. Finally, a model on granite as an effective helium source rock is established. We suggest exploring He resources in hydrocarbon basins with granitic basement (or adjacent to granite bodies), high geothermal field, and young active fractures.
Early‐Middle Paleozoic Andes‐type Continental Margin in the Chifeng Area, Inner Mongolia: Framework, Geochronology and Geochemistry and Implications for Tectonic Evolution of the Central Asian Orogenic Belt
Authors: YAN Linjie , XU Bei , ZHANG Jiaming , WANG Yanyang
Published: March 2020

Three tectonic units have been recognized in the Chifeng area, Inner Mongolia, from north to south, including the Qiganmiao accretionary prism, Jiefangyingzi arc belt and Sidaozhangpeng molasse basin, which formed an Andean‐type active continent margin during the early to middle Paleozoic. The Qiganmiao accretionary prism is characterized by a mélange that consists of gabbro, two‐mica quartz schist and basic volcanic rock blocks and heterogeneously deformed marble matrix. Two zircon U‐Pb ages of 446.0±6.3 Ma and 1104±27 Ma have been acquired and been interpreted as the metamorphic and forming ages for the gabbro and two‐mica quartz schist, respectively. The prism formed during the early to middle Paleozoic southward subduction of the Paleo Asian Ocean (PAO) and represents a suture between the North China craton (NCC) and Central Asian Orogenic Belt (CAOB). The Jiefangyingzi arc belt consists of pluton complex and volcanic rocks of the Xibiehe and Badangshan Formations, and Geochronology analysis indicates that the development of it can be divided into two stages. The first stage is represented by the Xibiehe Formation volcanic rocks, which belong to the subalkaline series, enriched LREE and LILE and depleted HFSE, with negative Eu anomalies, and plot in the volcanic arc field in discrimination diagrams. These characters indicate that the Xibiehe Formation results from to the continental arc magmatic activity related to the subduction of the PAO during 400‐420 Ma. Magmatism of the second stage in 380‐390 Ma consists of the Badangshan Formation volcanic rocks. Geochemistry analysis reveals that rhyolite, basaltic andesite and basalt of the Badangshan Formation were developed in continental margin arc setting. Moreover, the basaltic andesite and basalt display positive Sr anomalies, and the basalt have very low Nb/La values, suggesting that fluid is involved in magma evolution and the basalts were contaminated by continental crust. The sequence of Sidaozhangpeng molasse basin is characterized by proximity, coarseness and large thickness, similar to the proximity molasses basin. According to our field investigation, geochronological and geochemical data, combined with previous research in this area, a tectonic evolutionary model for Andes‐type active continental margin of the CAOB has been proposed, including a development of the subduction‐free PAO before 446 Ma, a subduction of the PAO and arc‐related magmatism during 446‐380 Ma, and formation of a molasse basin during 380‐360 Ma.
Subxiphoid uniportal thoracoscopic pulmonary segmentectomy for stage I non‐small cell lung cancer: Feasibility, quality of life and financial worthiness
Authors: Abdellateef Amr , Ma Xiaoyu , Chen Zhigang , Wu Liang , Cai Jianqiao , Jiang Lei
Published: March 2020

Background

Subxiphoid uniportal video‐assisted thoracoscopic surgery (SVATS) is more technically challenging than intercostal uniportal video‐assisted thoracoscopic surgery (UVATS), especially in more complex procedures such as segmentectomy. We therefore aimed to investigate the worthiness of undertaking the more demanding subxiphoid approach in patients who had undergone anatomical segmentectomy for stage IA non‐small cell lung cancer (NSCLC).

Methods

A total of 491 patients were included in our study who had undergone anatomical segmentectomy for stage IA non‐small cell lung cancer from September 2014 to April 2018. They were divided into two groups; 278 patients in the UVATS group and 213 patients in the SVATS group. Different perioperative variables, postoperative pain, quality of life and cost were analyzed and compared between both groups.

Results

The SVATS group showed a significantly longer operative time (P = 0.007) and more operative blood loss than the intercostal group (P = 0.004). There was no significant difference between both groups regarding postoperative drainage, duration of chest tube, postoperative hospital stay, operative conversion or postoperative complications. The SVATS group showed a significantly lower pain score postoperatively (P < 0.001). In addition, the SVATS group showed a significantly better postoperative quality of life score along the first postoperative year (P < 0.001). UVATS segmentectomy appeared to be significantly cheaper than SVATS segmentectomy (P < 0.001).

Conclusions

SVATS segmentectomy for stage IA lung cancer is a safe procedure that is worth proceeding with as it is associated with better postoperative pain and better quality of life in the first postoperative year. Further studies are recommended to evaluate the actual cost‐effectiveness of SVATS segmentectomy.

Key points

• Significant findings of the study

Subxiphoid uniportal approach for pulmonary segmentectomy is safe and feasible approach. It has better postoperative pain and better quality of life than the uniportal intercostal approach; however, it is more expensive.

• What this study adds

Subxiphoid uniportal approach for pulmonary segmentectomy gives a better quality of life in Chinese patients than the intercostal approach; however, it is more expensive.
Share repurchases and firm innovation
Authors: Nguyen Lily , Vu Le , Yin Xiangkang
Published: March 2020

We examine whether corporate decisions such as share repurchases influence a firm’s intangible assets and their production. We find a significantly negative relationship between share repurchases and firm innovation. The negative relationship survives all considered robustness tests. We further apply two identification strategies, namely, difference‐in‐differences analysis and instrumental variables estimation, to establish that the negative effect is causal; that is, from share repurchases to innovation.
Enhancing tropical conservation and ecology research with aquatic environmental DNA methods: an introduction for non‐environmental DNA specialists
Authors: Huerlimann R. , Cooper M. K. , Edmunds R. C. , Villacorta‐Rath C. , Le Port A. , Robson H. L. A. , Strugnell J. M. , Burrows D. , Jerry D. R.
Published: March 2020

Biodiversity conservation is a worldwide concern and proper management of threatened species or communities depends on reliable and accurate data collection. Despite the broad utility of environmental DNA (eDNA) for conservation management and the necessity for appropriate biodiversity management in the tropics, eDNA‐based research conducted in tropical regions so far comprises only a small proportion of the cumulative eDNA literature. To address the growing demand for rapid and reliable species and community level ecological data in tropical regions, we provide an aquatic eDNA‐focused review of (1) challenges and considerations for sampling design and inference of eDNA data in the tropics, and (2) eDNA applications relevant to ecological research and biodiversity management in the tropics. We propose that the collaborative incorporation of eDNA sampling with conventional field surveys harbours the potential to revolutionize the effectiveness of biodiversity conservation management in tropical regions.
Use of in situ simulation to evaluate the operational readiness of a high‐consequence infectious disease intensive care unit
Authors: Fregene T. E. , Nadarajah P. , Buckley J. F. , Bigham S. , Nangalia V.
Published: March 2020

On 30 January 2020, the World Health Organization (WHO) declared that the outbreak of a coronavirus disease‐2019 (COVID‐19) was a public health emergency of international concern. The WHO guidance states that patients with (COVID‐19) should be managed by staff wearing appropriate personal protective equipment; however, working whilst wearing personal protective equipment is unfamiliar to many healthcare professionals. We ran high‐fidelity, in‐situ simulation of high‐risk procedures on patients with COVID‐19 in a negative‐pressure side room on our intensive care unit (ICU). Our aim was to identify potential problems, test the robustness of our systems and inform modification of our standard operating procedures for any patients with COVID‐19 admitted to our ICU. The simulations revealed several important latent risks and allowed us to put corrective measures in place before the admission of patients with COVID‐19. We recommend that staff working in clinical areas expected to receive patients with COVID‐19 conduct in‐situ simulation in order to detect their own unique risks and aid in the creation of local guidelines of management of patients with COVID‐19.
The Italian coronavirus disease 2019 outbreak: recommendations from clinical practice
Authors: Sorbello M. , El‐Boghdadly K. , Di Giacinto I. , Cataldo R. , Esposito C. , Falcetta S. , Merli G. , Cortese G. , Corso R. M. , Bressan F. , Pintaudi S. , Greif R. , Donati A. , Petrini F. ,   The Società Italiana di Anestesia Analgesia Rianimazione e Terapia Intensiva (SIAARTI) Airway Research Group, and The European Airway Management Society
Published: March 2020

Novel coronavirus 2019 is a single‐stranded, ribonucleic acid virus that has led to an international pandemic of coronavirus disease 2019. Clinical data from the Chinese outbreak have been reported, but experiences and recommendations from clinical practice during the Italian outbreak have not. We report the impact of the coronavirus disease 2019 outbreak on regional and national healthcare infrastructure. We also report on recommendations based on clinical experiences of managing patients throughout Italy. In particular, we describe key elements of clinical management, including: safe oxygen therapy; airway management; personal protective equipment; and non‐technical aspects of caring for patients diagnosed with coronavirus disease 2019. Only through planning, training and team working will clinicians and healthcare systems be best placed to deal with the many complex implications of this new pandemic.
Consensus guidelines for managing the airway in patients with COVID‐19
Authors: Cook T. M. , El‐Boghdadly K. , McGuire B. , McNarry A. F. , Patel A. , Higgs A.
Published: March 2020

Severe acute respiratory syndrome‐corona virus‐2, which causes coronavirus disease 2019 (COVID‐19), is highly contagious. Airway management of patients with COVID‐19 is high risk to staff and patients. We aimed to develop principles for airway management of patients with COVID‐19 to encourage safe, accurate and swift performance. This consensus statement has been brought together at short notice to advise on airway management for patients with COVID‐19, drawing on published literature and immediately available information from clinicians and experts. Recommendations on the prevention of contamination of healthcare workers, the choice of staff involved in airway management, the training required and the selection of equipment are discussed. The fundamental principles of airway management in these settings are described for: emergency tracheal intubation; predicted or unexpected difficult tracheal intubation; cardiac arrest; anaesthetic care; and tracheal extubation. We provide figures to support clinicians in safe airway management of patients with COVID‐19. The advice in this document is designed to be adapted in line with local workplace policies.
Imperial Remains and Imperial Invitations: Centering Race within the Contemporary Large‐Scale Infrastructures of East Africa
Authors: Kimari Wangui , Ernstson Henrik
Published: March 2020

In this paper we combine infrastructure studies and black radical traditions to foreground how imperial remains deeply inform the logics that bring forth contemporary large‐scale infrastructures in Africa. The objective, prompted by the ongoing avid promotion of such architectures on the continent, is to contribute to an analysis that centres race in these projects. Our argument is that these initiatives have to be understood in relation to inherited material and discursive scaffoldings that remain from the colonial period, through what we refer to as imperial remains and imperial invitations. These remains and invitations demonstrate how recent mega infrastructures inhere, in their planning, financing and implementation, a colonial racialism, despite rhetorical claims to the opposite. Empirically, we draw, principally, on China built and financed infrastructure projects from Kenya, and theoretically upon black radical traditions in order to foreground a longer genealogy of black pathologising and resistance to it on the continent.
Bowel damage and disability in Crohn's disease: a prospective study in a tertiary referral centre of the Lémann Index and Inflammatory Bowel Disease Disability Index
Authors: Lauriot dit Prevost Clémentine , Azahaf Mustapha , Nachury Maria , Branche Julien , Gerard Romain , Wils Pauline , Lambin Thomas , Desreumaux Pierre , Ernst Olivier , Pariente Benjamin
Published: March 2020

Background

The notion of Crohn's disease (CD) as a chronic, progressive and disabling condition has led to the development of new indexes: the Lémann Index measuring cumulative bowel damage and the Inflammatory Bowel Disease (IBD) Disability Index, assessing functional disability.

Aims

To measure the Lémann Index and the IBD Disability Index in a large prospective cohort of CD patients and to assess the correlation between these two indexes.

Methods

We performed a prospective study in a tertiary referral centre including all consecutive CD outpatients. We assessed the Lémann Index and the IBD Disability Index questionnaire in all patients.

Results

One hundred and thirty CD patients were consecutively included. The mean Lémann Index (±SD) was 11.9 ± 14.1 and ranged from 0 to 72.5 points. Factors associated with a high bowel damage score were: disease duration, anal location, previous intestinal resection, clinical and biological disease activity, exposure to immunosuppressants, and exposure to anti‐TNF (P < 0.005). Among patients exposed to anti‐TNF, the Lémann Index was lower in those who were exposed in the first 2 years of their disease (P = 0.015). The mean IBD Disability Index was 28.8 ± 6.3 and ranged from 0 to 71 points. The factors associated with high disability score were: female gender, anal location, extra digestive manifestations, clinical and biological disease activity and exposure to anti‐TNF (P < 0.005). No correlation was observed between the Lémann Index and IBD Disability Index (P = 0.15).

Conclusions

This is the first study to prospectively evaluate the Lémann Index and the IBD Disability Index in a large cohort of CD patients in a tertiary centre. Early introduction of anti‐TNF treatment was associated with lower bowel damage scores, and no correlation was observed between the Lémann Index and the IBD Disability Index. Further dedicated prospective studies are necessary to confirm these results.
Integrated omics analysis of sweat reveals an aberrant amino acid metabolism pathway in Vogt–Koyanagi–Harada disease
Authors: Cui X , Su G , Zhang L , Yi S , Cao Q , Zhou C , Kijlstra A , Yang P
Published: March 2020

Vogt–Koyanagi–Harada (VKH) disease is an autoimmune disease leading to visual impairment. Its pathogenic mechanisms remain poorly understood. Our purpose was to investigate the distinctive protein and metabolic profiles of sweat in patients with VKH disease. In the present study, proteomics and metabolomics analysis was performed on 60 sweat samples (30 VKH patients and 30 normal controls) using liquid chromatography tandem mass spectrometry. Parallel reaction monitoring (PRM) analysis was used to validate the results of our omics analysis. In total, we were able to detect 716 proteins and 175 metabolites. Among them, 116 proteins (99 decreased and 17 increased) were observed to be significantly different in VKH patients when compared to controls. Twenty-one differentially expressed metabolites were identified in VKH patients, of which 18 included choline, L-tryptophan, betaine and L-serine were reduced, while the rest were increased. Our multi-omics strategy reveals an important role for the amino acid metabolic pathway in the pathogenesis of VKH disease. Significant differences in proteins and metabolites were identified in the sweat of VKH patients and, to some extent, an aberrant amino acid metabolism pathway may be a pathogenic factor in the pathogenesis of VKH disease.
Effects of caffeine consumption on intraocular pressure during low‐intensity endurance exercise: A placebo‐controlled, double‐blind, balanced crossover study
Authors: Vera Jesús , Redondo Beatriz , Bardón Anabel , Pérez‐Castilla Alejandro , García‐Ramos Amador , Jiménez Raimundo
Published: March 2020

Importance

Intraocular pressure (IOP) is sensitive to caffeine intake and physical exercise. However, the combined effect of caffeine intake and physical exercise on IOP levels remains unknown.

Background

We aimed to assess the effects of caffeine consumption before exercise on the IOP behaviour during low‐intensity endurance exercise.

Design

A placebo‐controlled, double‐blind, balanced crossover study at the University of Granada.

Participants

Eighteen physically active young adults (age = 23.3 ± 2.4 years) participated in this study.

Methods

Participants performed 30 minutes of cycling at 10% of maximal power production after 30 minutes of ingesting a capsule of caffeine (~4 mg/kg) and placebo in two different days and following a double‐blind procedure.

Main Outcome Measure

IOP was measured at baseline (before caffeine/placebo ingestion), after 5 minutes of warm‐up, during cycling (6, 12, 18, 24 and 30 minutes) and recovery (5 and 10 minutes) by rebound tonometry.

Results

There was a significant effect of caffeine consumption (P < .001, η2 = 0.50), showing that the ingestion of caffeine before exercise counteracted the IOP‐lowering response to low‐intensity endurance exercise. Greater IOP values at 12, 18, 24 and 30 minutes (corrected P‐values<.05, ds = 0.90‐1.08) of cycling were observed for the caffeine in comparison to the placebo condition.

Conclusions and Relevance

The ingestion of caffeine (~4 mg/kg) 30 minutes before performing low‐intensity endurance exercise counteracts the IOP‐lowering effect of low‐intensity exercise. These results highlight that the ingestion of a considerable amount of caffeine before exercise should be discouraged for individuals who would benefit from the IOP reduction associated with low‐intensity exercise (ie, glaucoma patients or those at risk).
A study of deep neural networks for human activity recognition
Authors: Sansano Emilio , Montoliu Raúl , Belmonte Fernández Óscar
Published: March 2020

Human activity recognition and deep learning are two fields that have attracted attention in recent years. The former due to its relevance in many application domains, such as ambient assisted living or health monitoring, and the latter for its recent and excellent performance achievements in different domains of application such as image and speech recognition. In this article, an extensive analysis among the most suited deep learning architectures for activity recognition is conducted to compare its performance in terms of accuracy, speed, and memory requirements. In particular, convolutional neural networks (CNN), long short‐term memory networks (LSTM), bidirectional LSTM (biLSTM), gated recurrent unit networks (GRU), and deep belief networks (DBN) have been tested on a total of 10 publicly available datasets, with different sensors, sets of activities, and sampling rates. All tests have been designed under a multimodal approach to take advantage of synchronized raw sensor' signals. Results show that CNNs are efficient at capturing local temporal dependencies of activity signals, as well as at identifying correlations among sensors. Their performance in activity classification is comparable with, and in most cases better than, the performance of recurrent models. Their faster response and lower memory footprint make them the architecture of choice for wearable and IoT devices.
Height mismatch: An overlooked component of adult heart transplant outcomes
Authors: Rudasill Sarah E. , Sanaiha Yas , Mardock Alexandra L. , Xing Hanning , Khoury Habib , Kwon Murray , Benharash Peyman
Published: March 2020

Heart transplantation guidelines recommend against matching donors with significant weight but not height discrepancies. This study analyzed the impact of donor‐recipient height mismatch on mortality among heart transplant recipients. We retrospectively analyzed all adult patients in the United Network for Organ Sharing (UNOS) registry undergoing heart transplantation from 1990 to September 2016. Moderate and severe height mismatch were classified as >10% and >15% difference in donor height from recipient height, respectively. The primary outcome was 1‐year mortality. Adjusted Cox hazards regression was performed, and Kaplan‐Meier estimates illustrated 10‐year survival. Of 44 877 transplants, 4822 (10.7%) were moderately height mismatched. Height‐mismatched recipients were more frequently female (41.6% vs 21.8%, P < .001), sex mismatched (53.8% vs 24.9%, P < .001), and weight mismatched (4.9% vs 1.9%, P < .001). After adjustment, recipients of moderately (HR = 1.15 [1.02‐1.30]) and severely (HR = 1.38 [1.10‐1.74]) taller donor hearts were at increased risk of mortality at 1 year relative to height‐matched recipients. Furthermore, of 1042 (21.6%) severe mismatches, recipients with taller (HR = 1.39 [1.11‐1.74]) but not shorter (HR = 0.79 [0.44‐1.43]) donors faced increased 10‐year mortality. The effect was pronounced among re‐transplant candidates (HR = 1.96 [1.07‐3.59]). In conclusion, matching with moderately or severely taller donors is an independent predictor of mortality among primary and re‐transplant candidates.
Proposed brief diagnostic observational scale for autism spectrum disorder
Authors: Fein Deborah
Published: March 2020

This commentary is on the original article by Sanchez and Constantino on pages 806–812 of this issue.
Characteristics of organic material inputs affect soil microbial NO3− immobilization rates calculated using different methods
Authors: Chen Zhao‐Xiong , Zhang Hui‐Min , Tu Xiao‐Shun , Sun Xin , Wang Jing , Cheng Yi , Zhang Jin‐Bo , Cai Zu‐Cong , Chang Scott X.
Published: March 2020

Microbial immobilization of nitrate (NO3−) is considered to be an important process in reducing NO3 − accumulation and regulating nitrogen (N) retention capacity in soils. Accurately quantifying the rate of microbial NO3− immobilization is, therefore, necessary to predict its role in lowering NO3− accumulation in soils. We compared microbial NO3− immobilization rates using a 15NO3− labelling technique in three different ways: (a) 15N pool dilution, (b) organic 15N recovery and (c) microbial biomass 15N recovery, in a nitrate‐rich upland soil with and without amendment with organic materials with differing carbon‐to‐nitrogen ratios (C/N). The three methods generated similar NO3− immobilization rates, except when the soil was amended with easily decomposable organic materials (glucose and sucrose). We also developed a microbial NO3− immobilization‐specific quality index that incorporates the C/N ratio, lignin, cellulose and hemicellulose contents and pH for slowly decomposing organic materials (plant residues). This study provides direct empirical evidence that the results of different methods for calculating soil microbial NO3− immobilization rates are affected by the characteristics of organic materials added to the soil.

Highlights

Three methods for estimating microbial NO3− immobilization were compared

The methods generated similar NO3− immobilization rates when amended with plant residues

Higher NO3− immobilization when measured with 15N dilution with readily available C input

A microbial NO3− immobilization‐specific index for plant residues was developed
Posttraumatic epilepsy in intensive care unit–treated pediatric traumatic brain injury patients
Authors: Mikkonen Era D. , Skrifvars Markus B. , Reinikainen Matti , Bendel Stepani , Laitio Ruut , Hoppu Sanna , Ala‐Kokko Tero , Karppinen Atte , Raj Rahul
Published: March 2020

Objective

Posttraumatic epilepsy (PTE) is a well‐described complication of traumatic brain injury (TBI). The majority of the available data regarding PTE stem from the adult population. Our aim was to identify the clinical and radiological risk factors associated with PTE in a pediatric TBI population treated in an intensive care unit (ICU).

Methods

We used the Finnish Intensive Care Consortium database to identify pediatric (<18 years) TBI patients treated in four academic university hospital ICUs in Finland between 2003 and 2013. Our primary outcome was the development of PTE, defined as the need for oral antiepileptic medication in patients alive at 6 months. We assessed the risk factors associated with PTE using multivariable logistic regression modeling.

Results

Of the 290 patients included in the study, 59 (20%) developed PTE. Median age was 15 years (interquartile range [IQR] 13‐17), and 80% had an admission Glasgow Coma Scale (GCS) score ≤12. Major risk factors for developing PTE were age (adjusted odds ratio [OR] 1.08, 95% confidence interval [CI] 1.00‐1.16), obliterated suprasellar cisterns (OR 6.53, 95% CI 1.95‐21.81), and an admission GCS score of 9‐12 in comparison to a GCS score of 13‐15 (OR 2.88, 95% CI 1.24‐6.69).

Significance

We showed that PTE is a common long‐term complication after ICU‐treated pediatric TBI. Higher age, moderate injury severity, obliterated suprasellar cisterns, seizures during ICU stay, and surgical treatment are associated with an increased risk of PTE. Further studies are needed to identify strategies to decrease the risk of PTE.
Long‐term safety, efficacy, and quality of life outcomes with adjunctive brivaracetam treatment at individualized doses in patients with epilepsy: An up to 11‐year, open‐label, follow‐up trial
Authors: O’Brien Terence J. , Borghs Simon , He Qin (Jane) , Schulz Anne‐Liv , Yates Stephen , Biton Victor
Published: March 2020

Objective

To evaluate long‐term safety/tolerability of brivaracetam at individualized doses ≤200 mg/d (primary) and maintenance of efficacy over time (secondary) in adults with focal seizures or primary generalized seizures (PGS) enrolled in phase 3, open‐label, long‐term follow‐up trial N01199 (NCT00150800).

Methods

Patients ≥16 years of age who had completed double‐blind, placebo‐controlled adjunctive brivaracetam trials NCT00175825, NCT00490035, NCT00464269, or NCT00504881 were eligible. Outcomes included safety, efficacy, and quality of life.

Results

The safety set included 667 patients (focal seizures, 97.8%; PGS, 2.2%); the efficacy set included 648 patients with focal seizures and 15 patients with PGS. Overall, 49.2% of patients had ≥48 months of exposure. Treatment‐emergent adverse events (TEAEs) occurred in 91.2% of all patients (91.3% of focal seizures group), brivaracetam discontinuation due to TEAEs in 14.8%, drug‐related TEAEs in 56.7%, and serious TEAEs in 22.8%. The most common TEAEs in the focal seizures group (≥15%) were headache (25.3%) and dizziness (21.9%). Mean changes from baseline in Hospital Anxiety and Depression Scale scores at last value during 2‐year evaluation were −0.7 (standard deviation [SD] = 4.3) and −0.2 (SD = 4.4) overall. In the focal seizures group, median reduction from baseline in focal seizure frequency/28 days was 57.3%, 50% responder rate was 55.6%, and 6‐month and 12‐month seizure freedom rates were 30.3% and 20.3%, respectively. Efficacy outcomes improved by exposure duration cohort and then stabilized through the 108‐month cohort. Mean improvement from baseline in Patient‐Weighted Quality of Life in Epilepsy Inventory total score (efficacy set) was 5.7 (SD = 16.1, Cohen's d = 0.35) at month 12 and 6.5 (SD = 18.0, Cohen's d = 0.36) at month 24.

Significance

Adjunctive brivaracetam was well tolerated, with a good safety profile in long‐term use in adults with epilepsy at individualized doses. Approximately half of the patients remained in the trial at 4 years. Brivaracetam reduced focal seizure frequency versus baseline. Efficacy improved with increasing exposure duration and remained stable through the 9‐year cohort.
Behavioral Observation and Analysis of Participants in Foster Care Visits
Authors: Salas María D. , Bernedo Isabel M. , García‐Martín Miguel A. , Fuentes María J.
Published: March 2020

Objective

To identify situations and behaviors occurring during contact visits that are likely to have an impact on a foster child's well‐being.

Background

It has been argued that contact visits between foster children and birth parents can help to maintain attachment bonds and support the child's development. However, contact continues to be a subject of controversy, and evidence of both benefits and drawbacks has been reported in the literature. Few studies have examined what actually occurs during such visits, how parents and children interact, and what role is played by those involved.

Method

We conducted an in‐depth qualitative observational analysis of the behavior of participants in contact visits (birth parent, child, and social worker), as well as of the characteristics of the venue. Participants were 20 children in nonkinship foster care and their birth parents. Information regarding the characteristics of visits was provided by the child protection services and the fostering agencies involved.

Results

The analysis revealed a large number of positive behaviors among parents, children, and social workers, but also the need for improvement in several areas (e.g., family relationships, social/communication skills, and presents).

Conclusions

This study highlights the need to improve contact visits by developing intervention strategies targeting all those involved. Notably, the support and supervision provided by social workers was not always adequate.

Implications

The results of this study could be used to develop an instrument for assessing the quality of contact visits and identifying aspects that need to be improved.
Protein level variability determines phenotypic heterogeneity in proteotoxic stress response
Authors: Guilbert Marie , Anquez François , Pruvost Alexandra , Thommen Quentin , Courtade Emmanuel
Published: March 2020

Cell‐to‐cell variability in stress response is a bottleneck for the construction of accurate and predictive models which could guide clinical diagnosis and treatment of certain diseases, for example, cancer. Indeed, such phenotypic heterogeneity can lead to fractional killing and persistence of a subpopulation of cells which are resistant to a given treatment. The heat shock response network plays a major role in protecting the proteome against several types of injuries. Here, we combine high‐throughput measurements and mathematical modeling to unveil the molecular origin of the phenotypic variability in the heat shock response network. Although the mean response coincides with known biochemical measurements, we found a surprisingly broad diversity in single‐cell dynamics with a continuum of response amplitudes and temporal shapes for several stimulus strengths. We theoretically predict that the broad phenotypic heterogeneity is due to network ultrasensitivity together with variations in the expression level of chaperones controlled by the transcription factor heat shock factor 1. Furthermore, we experimentally confirm this prediction by mapping the response amplitude to chaperone and heat shock factor 1 expression levels.
A Flux Detection Probe to Quantify Dynamic Groundwater‐Surface Water Exchange in the Hyporheic Zone
Authors: Thomle Jonathan , Strickland Chris , Johnson Tim C. , Zhu Yue , Stegen James
Published: March 2020

A new probe was designed to quantify groundwater‐surface water exchange in the hyporheic zone under dynamic stage condition. Current methods focus on either vertical pore water velocity or Darcy flux measurements. Both parameters must be understood to evaluate residence time and mass flux of constituents. Furthermore, most instruments are not well suited for monitoring instantaneous velocity or flux under dynamic exchange conditions. For this reason, the flux detection probe (FDP) was designed that employs electrogeophysical measurements to estimate in situ sediment porosity, which can be used to convert pore water velocity to Darcy flux. Dynamic pore water velocity is obtained by monitoring fluid conductivity and temperature along the FDP probe. Pressure sensors deployed at the top and bottom of the probe provide the additional information necessary to estimate vertical permeability. This study focuses on the use of a geophysical method to estimate pore water velocity, porosity, and permeability within a controlled soil column where simulated river water displaces simulated groundwater. The difference between probe derived and theoretical pore water velocity using natural tracers such as electrical conductivity and temperature was −4.9 and 3.9% for downward flow and 1.1 and 12.8% for upward flow, respectively. The difference in porosity calculated from mass and volume packed in the soil column and probe measure porosity ranged between −3.2% and 1.5%. Also, the calculated hydraulic conductivity differed from probe derived values by −8.9%.
A comparative study of fibrinogen measurement using TEG® functional fibrinogen and Clauss in adolescents undergoing scoliosis surgery
Authors: Chen Weiyun , Hu Ai , Chen Qian , Zhang Yuelun , Yu Xuerong , Huang Yuguang
Published: March 2020

Introduction

Thromboelastography (TEG®) functional fibrinogen (FF) test is a point‐of‐care test for fibrinogen measurement and is preferred for its rapid turnaround time. This study was designed to compare TEG® functional fibrinogen level (FLEV) with classic Clauss fibrinogen in patients undergoing scoliosis surgery and to evaluate the concordance between the two methods.

Methods

Patients in this study were part of a larger study evaluating the effect of fibrinogen concentrate (FC) supplementation on perioperative blood loss in scoliosis surgery. Paired samples for TEG® FF and Clauss fibrinogen assays were taken from 40 patients at three different timepoints perioperatively. The agreement between FLEV and Clauss was assessed, and the possibility of using FLEV measurements to predict Clauss fibrinogen was explored.

Results

One hundred and seventeen paired samples from 39 patients were finally analyzed. Pearson correlation test confirmed positive linear correlations between FLEV and Clauss at all three timepoints (r = .70, .67, and .66 at baseline, before FC administration, and after FC administration, respectively; P < .001 for all) and together for all measures (r = .76, P < .001), while Bland‐Altman plots showed FLEV significantly overestimated Clauss constantly. Optimum diagnostic values of FLEV at 4.27 and 3.77 g/L were generated to predict normal fibrinogen as Clauss ≥ 3.0 g/L (AUROC 0.941, 95% CI: 0.891‐0.991) and critical intraoperative hypofibrinogenemia as Clauss ≤ 2.0g/L (AUROC 0.894, 95% CI: 0.838‐0.950), respectively.

Conclusions

In adolescents undergoing scoliosis surgery, FLEV correlated linearly with Clauss fibrinogen. Though FLEV overestimates Clauss constantly, FLEV values are able to predict hypofibrinogenemia and normal fibrinogen with both AUROC > 0.85.