bluuebunny/crossref_metadata_2025 huggingface dataset:
The historical demise of Pinus nigra forests in the Northern Iberian Plateau (south‐western Europe)
Authors: Morales‐Molino César , Tinner Willy , García‐Antón Mercedes , Colombaroli Daniele
Published: November 2016

Pinus nigra Arn. forests dominated over extensive areas of the Northern Iberian Plateau (Spain) during the Holocene, but a strong decline during the historical period (c. 1300–700 cal. bp) led to the present fragmented populations. This demise has been generally attributed to land‐use changes or climate, but the specific roles of disturbance regimes such as fire variability and grazing on the long‐term are not fully understood yet.

We combine multi‐proxy palaeoecological data (fossil pollen, spores, conifer stomata, microscopic and macroscopic charcoal) together with quantitative analyses (ordination and peak detection) from a high‐resolution sedimentary sequence (Tubilla del Lago, 900 m a.s.l.) to assess the causes of pine forests demise. A new microscopic charcoal record from an additional sequence (Espinosa de Cerrato, 885 m a.s.l.) is used to assess burning and pine decline at a more regional (100‐km radius) scale.

Pinus nigra forests could cope with drought and fire regime variability (FRI = 110–500 years), with forest recovery taking c. 100–200 years after fires. Only at 1300–1200 cal. bp a long‐lasting irrecoverable demise of P. nigra forests occurred when human‐induced fires together with arable and pastoral farming became widespread in the area. Subsequently, Quercus woodlands expanded in the remnant patchy pinewoods. This vegetation shift was primarily caused by three particularly important fire episodes in less than a century (c. 1300–1200 cal. bp).

Synthesis. Pinus nigra forests have shown a millennial resilience to the natural fire regime of the Northern Iberian Plateau that was characterized by relatively frequent small‐moderate fires and rare high‐intensity fires. However, frequent human‐caused crown fires and the onset of intensive farming caused their demise over an extensive area. Ongoing land‐use abandonment in the Iberian mountains could promote the occurrence of high‐intensity, severe fires due to the rapid build‐up of high fuel loads. Forest management could mimic the natural fire regime by periodically reducing fuel loads for a transitional period until natural disturbance variability is fully restored, thus preserving these relict native plant communities.
Spartina alterniflora genotypic identity affects plant and consumer responses in an experimental marsh community
Authors: Zerebecki Robyn A. , Crutsinger Gregory M. , Hughes A. Randall
Published: November 2016

Competition and herbivory are ubiquitous processes known to interactively shape plant performance, distribution and community assembly. Likewise, plant genetic variation and associated trait differences can impact both plant–plant and plant–herbivore interactions individually, yet few studies have explored these interactions simultaneously.

Saltmarsh communities are an ideal system to study these questions, as they are dominated along the Atlantic and Gulf coasts of the United States by a foundation plant species, Spartina alterniflora, with high levels of genetically based trait variation. Furthermore, consumer pressure and plant competitors are known to influence both the distribution and production of Spartina. We manipulated Spartina genetic identity, neighbour identity (needlerush, Juncus roemerianus) and consumer presence (snail, Littoraria irrorata) in a 1‐year field experiment in St. Joseph Bay, FL, to test how the strength and direction of neighbour and consumer interactions vary by plant genotype.

Consumer effects on Spartina were generally stronger and more variable than those of the plant neighbourhood, and these effects were generally consistent across Spartina genotypes. However, genotype‐specific variation in morphology, phenology and palatability significantly influenced both consumer and neighbour responses to Spartina: the consumer Littoraria was more likely to climb palatable Spartina genotypes, and neighbouring Juncus had shorter stems in the presence of highly productive Spartina genotypes.

Synthesis. Our results add to the growing list of examples high‐lighting the role of intraspecific variation in species interactions and suggest that variation in these interactions may promote the maintenance of plant genetic variation and community composition.
What is the matter with transcendence? On the place of religion in the new anthropology of ethics★
Authors: Robbins Joel
Published: November 2016

A focus on ordinary or everyday ethics has become perhaps the dominant concern in the rapidly developing anthropology of ethics. In this article, I argue that this focus tends to marginalize the study of the ways in which religion contributes to people's moral lives. After defining religion and transcendence in terms that make them less uncongenial to the study of ethics than many proponents of ordinary ethics suggest, I examine values as one sometimes transcendent cultural form that often informs ethical life. I draw on Victor Turner (along with Durkheim) to develop an account of how rituals often both present people with and allow them to perform transcendent versions of values. These encounters, in turn, shape people's ethical sensibilities, including those they bring to bear in everyday life, in ways we cannot understand unless we accord religion a more central role in the anthropology of ethics than it has played to this point. I illustrate my arguments with material drawn both from Turner's Ndembu ethnography and from my own research on Christianity in Papua New Guinea.
Analysing the emergency department patient journey: Discovery of bottlenecks to emergency department patient flow
Authors: Khanna Sankalp , Boyle Justin , Good Norm , Bell Anthony , Lind James
Published: November 2016

Objective

Despite significant workflow reform to comply with the federally mandated National Emergency Access Target (NEAT), Australian public hospitals continue to face significant barriers in achieving good ED patient flow. This study was undertaken to identify and analyse the impact of individual waypoints on an ED patient's journey and identify which waypoints act as bottlenecks to a hospital's 4 h ED disposition performance.

Methods

This study involves retrospective analysis and simulation employing 2 years of ED administrative data from a sample of two major and two large metropolitan hospitals in Queensland, Australia. The main outcome measures included waypoint wait times (Treatment Delay and Departure Delay), ED length of stay (EDLOS) and compliance with the NEAT target, measured for all (overall NEAT) and admitted (Admitted NEAT) patients. Variations in outcome measures were analysed as functions of hour of day, day of week, departure status and triage category. Simulations identified the impact of potential ED workflow changes in the context of NEAT performance.

Results

Departure Delay accounted for 60 and 20% of EDLOS across large and major metropolitan hospitals, respectively. Higher gains in NEAT compliance are associated with improvements in departure delay rather than treatment delay. Simulation identified that halving Departure Delay improves Admitted NEAT by up to 22 and 4% at large and major metropolitan hospitals, respectively.

Conclusions

The results reinforces the need for a whole‐of‐hospital effort to address flow bottlenecks, and identify moving a patient from emergency to inpatient care as the critical bottleneck in ED system performance.
Ectopic Cushing syndrome in small cell lung cancer: A case report and literature review
Authors: Zhang Hang‐yu , Zhao Jun
Published: November 2016

Small cell lung cancer (SCLC) is a neuroendocrine tumor with the potential to secrete various peptides or hormones that can lead to paraneoplastic syndromes, such as Ectopic Cushing syndrome (ECS). Because of the aggressive nature of the syndrome and its atypical features, ECS in small‐cell lung cancer is difficult to diagnose and has a poor prognosis. We report a case of a 74‐year‐old male patient who presented with severe hypokalemia, proximal muscle weakness, peripheral edema, metabolic alkalosis, and worsening hyperglycemia. The patient was eventually diagnosed with stage IV primary small‐cell lung cancer and survived three months after diagnosis. We reviewed published articles to determine any new diagnostic techniques or advantages in the treatment regimen.
A multistate dynamic site occupancy model for spatially aggregated sessile communities
Authors: Fukaya Keiichi , Royle J. Andrew , Okuda Takehiro , Nakaoka Masahiro , Noda Takashi
Published: November 2016

Estimation of transition probabilities of sessile communities seems easy in principle but may still be difficult in practice because resampling error (i.e. a failure to resample exactly the same location at fixed points) may cause significant estimation bias. Previous studies have developed novel analytical methods to correct for this estimation bias. However, they did not consider the local structure of community composition induced by the aggregated distribution of organisms that is typically observed in sessile assemblages and is very likely to affect observations.

We developed a multistate dynamic site occupancy model to estimate transition probabilities that accounts for resampling errors associated with local community structure. The model applies a nonparametric multivariate kernel smoothing methodology to the latent occupancy component to estimate the local state composition near each observation point, which is assumed to determine the probability distribution of data conditional on the occurrence of resampling error.

By using computer simulations, we confirmed that an observation process that depends on local community structure may bias inferences about transition probabilities. By applying the proposed model to a real data set of intertidal sessile communities, we also showed that estimates of transition probabilities and of the properties of community dynamics may differ considerably when spatial dependence is taken into account.

Results suggest the importance of accounting for resampling error and local community structure for developing management plans that are based on Markovian models. Our approach provides a solution to this problem that is applicable to broad sessile communities. It can even accommodate an anisotropic spatial correlation of species composition, and may also serve as a basis for inferring complex nonlinear ecological dynamics.
Ecological forensics: using single point stable isotope values to infer seasonal schedules of animals after two diet switches
Authors: Jouta Jeltje , Dietz Maurine W. , Reneerkens Jeroen , Piersma Theunis , Rakhimberdiev Eldar , Hallgrímsson Gunnar T. , Pen Ido
Published: November 2016

Animals adjust to seasonal challenges in physical, behavioural and spatial ways. Such adjustments are commonly associated with diet changes that often can be characterised isotopically.

We introduce the ‘double diet switch model’, with which the occurrence and timing of two subsequent diet switches of an individual animal can be traced with a single sample assayed for stable isotopes. We demonstrate the model for Sanderling, Calidris alba, a small shorebird that migrates from the Nearctic tundra breeding grounds to the intertidal flats of the Wadden Sea; during this migration some birds may stage in the North Atlantic areas.

The ‘double diet switch model’ successfully predicted the occurrence and timing of two diet switches in 59 Sanderlings captured in the Wadden Sea in July–September. Excluding birds that likely had over‐summered at North Atlantic staging areas, the model predicted that Sanderlings departed from the Arctic on 13 July (range: 9–17 July), had a staging duration of 18·6 days in the North Atlantic, and arrived in the Wadden Sea on 1 August (31 July–1 August).The estimated mean Arctic departure dates coincided with the mean hatching date, suggesting that many individuals failed to produce young or left the care to a partner. Estimated mean arrival date matched the main arrival period in the Wadden Sea obtained from observation data. In this study we did not use lipid‐free tissues, which may bias model predictions. After correcting for lipid components, the estimated departure date was 11 days later and the staging duration 8·5 days shorter, while arrival date was similar.

The ‘double diet switch model’ successfully identified the occurrence and timing of two subsequent diet switches. The ‘double diet switch model’ will not only apply to switches between three isotopic levels (as in the case study on Sanderling) but also to scenarios where the second switch reverses to the initial isotopic level. Due to this general applicability, the model can be adapted to a wide range of taxa and situations. Foreseeable applications include changes in habitat and food type, ontogenetic development or drastic phenotypic changes such as the metamorphosis in insects and amphibians.
Fourier analysis to detect phenological cycles using long‐term tropical field data and simulations
Authors: Bush Emma R. , Abernethy Katharine A. , Jeffery Kathryn , Tutin Caroline , White Lee , Dimoto Edmond , Dikangadissi Jean‐Thoussaint , Jump Alistair S. , Bunnefeld Nils
Published: November 2016

Changes in phenology are an inevitable result of climate change, and will have wide‐reaching impacts on species, ecosystems, human society and even feedback onto climate. Accurate understanding of phenology is important to adapt to and mitigate such changes. However, analysis of phenology globally has been constrained by lack of data, dependence on geographically limited, non‐circular indicators and lack of power in statistical analyses.

To address these challenges, especially for the study of tropical phenology, we developed a flexible and robust analytical approach – using Fourier analysis with confidence intervals – to objectively and quantitatively describe long‐term observational phenology data even when data may be noisy. We then tested the power of this approach to detect regular cycles under different scenarios of data noise and length using both simulated and field data.

We use Fourier analysis to quantify flowering phenology from newly available data for 856 individual plants of 70 species observed monthly since 1986 at Lopé National Park, Gabon. After applying a confidence test, we find that 59% of the individuals have regular flowering cycles, and 88% species flower annually. We find time‐series length to be a significant predictor of the likelihood of confidently detecting a regular cycle from the data. Using simulated data we find that cycle regularity has a greater impact on detecting phenology than event detectability. Power analysis of the Lopé field data shows that at least 6 years of data are needed for confident detection of the least noisy species, but this varies and is often >20 years for the most noisy species.

There are now a number of large phenology datasets from the tropics, from which insights into current regional and global changes may be gained, if flexible and quantitative analytical approaches are used. However, consistent long‐term data collection is costly and requires much effort. We provide support for the importance of such research and give suggestions as to how to avoid erroneous interpretation of shorter length datasets and maximise returns from long‐term observational studies.
Using a functional approach to test trending volatility in the price of Mexican and international agricultural products
Authors: Guerrero Santiago , Hernández‐del‐Valle Gerardo , Juárez‐Torres Miriam
Published: November 2016

In this article, we extend the traditional GARCH(1,1) model by including a functional trend term in the conditional volatility of a time series. We derive the main properties of the model and apply it to all agricultural commodities in the Mexican CPI basket, as well as to the international prices of maize, wheat, swine, poultry, and beef products for three different time periods that implied changes in price regulations and behavior: before the North American Free Trade Agreement (NAFTA; 1987–1993), post‐NAFTA (1994–2005), and commodity supercycle (2006–2014). The proposed model seems to adequately fit the volatility process and, according to heteroscedasticity tests, also outperforms the ARCH(1) and GARCH(1,1) models, some of the most popular approaches used in the literature to analyze price volatility. Our results show that, consistent with anecdotal evidence, price volatility trends increased from the period 1987–1993 to 1994–2005. From 1994–2005 to 2006–2014, trends decreased but the persistence of volatility increased for most products, especially for international commodities. In addition, we identify some agricultural products such as avocado, beans, and chicken that, due to their increasing price volatility trends in the 2006–2014 period, may present a risk for food inflation in the short run.
Social context and perspectives of non‐medical prescription opioid use among young adults in Rhode Island: A qualitative study
Authors: Yedinak Jesse L. , Kinnard Elizabeth N. , Hadland Scott E. , Green Traci C. , Clark Melissa A. , Marshall Brandon D.L.
Published: November 2016

Background and Objectives

This pilot study examined the context of nonmedical prescription opioid (NMPO) use and related risk behaviors among young adults in Rhode Island, a New England region with markedly high prevalence of NMPO use and overdose mortality.

Methods

We conducted semi‐structured interviews (n = 13) with young adults (18–29 year‐olds) who reported current or recent NMPO use. We also conducted focus groups (two groups, n = 14 total) with professional service providers recruited from service organizations. Data were audio‐recorded, transcribed, and key themes were analyzed.

Results

Participants discussed high levels of access to prescription opioids for nonmedical use via prescriptions originally provided to family and friends. The contexts described by participants included social environments such as parties, in which mixing opiates with benzodiazepines, alcohol or other types of drugs, and incidents of unintentional overdose were reported. Participants attributed risk for overdose to individual‐level factors (eg, users who “couldn't handle it”), rather than contextual factors, and described negative reactions to being labeled as an “addict” or “addicted.” Professional service providers had first‐hand experience with young adults in treatment settings, yet limited exposure to young adults who were treatment‐naïve.

Conclusions

Young adult NMPO users described social settings where polysubstance use and pill use were common, and highlighted an aversion to being labeled as having a substance use disorder.

Scientific Significance

To reduce harms of NMPO use among young adults, interventions should address the social context in which drug use and risk behaviors occur. (Am J Addict 2016;25:659–665)
Postcolonial Development, (Non)Sovereignty and Affect: Living On in the Wake of Caribbean Political Independence
Authors: Pugh Jonathan
Published: November 2016

This paper sets out a new research agenda for work on postcolonial development, sovereignty and affect. It examines how ideals of postcolonial independence play out through the more heterogeneous affective atmospheres that disrupt neat paradigms of sovereign control and non‐sovereignty in everyday life. The example employed is everyday life in a Caribbean government office, but the paper develops a wider set of new conceptual tools and ethnographic approaches so as to facilitate research in postcolonial studies and affect more generally.
Surgical Transapical Approach for Prosthetic Mitral Paravalvular Leak Closure: Early Results
Authors: Aydin Unal , Sen Onur , Kadirogullari Ersin , Onan Burak , Yildirim Aydin , Bakir Ihsan
Published: November 2016

The objective is to demonstrate safety and early clinical results of surgical transapical closure of paravalvular leaks (PVLs) following mitral valve replacement in significant regurgitation. Between March 2014 and February 2015, 12 patients (mean age 52.1 ± 6.0 years, 66.6% male) with severe symptomatic mitral PVLs (n = 13) underwent surgical transapical closure procedure through left mini‐thoracotomy. All patients were in NYHA functional class III–IV and median logistic EuroSCORE was 24.2 ± 6.4% (range, 13.5–34.6%). Indications were heart failure (n = 10) and symptomatic hemolysis (n = 2) due to severe mitral regurgitation (MR). Amplatzer Vascular Plug‐III devices (n = 9) were used for smaller and regular defects; whereas Atrial Septal Defect closure devices (n = 4) were used for larger defects. Technical success was achieved in 10 (83.3%) patients. One (8.5%) patient with 2 + MR was treated medically. A patient with residual 4 + MR underwent re‐operation. There was no procedure‐related complication including mortality, device migration, embolization, or cardiac laceration. Mean procedure and fluoroscopy times were 166.4 ± 39.5 (range, 90–210) and 25.7 ± 17.3 (range, 16–64) minutes, respectively. The mean intensive care and hospital stays were 2.1 ± 1.3 and 10.3 ± 6.5 days, respectively. Clinical efficacy was achieved in 9 (75%) of 12 patients at early follow‐up of 8.5 ± 2.1 months. NYHA status was class II in two patients, and no hemolytic anemia was diagnosed. Echocardiographic studies revealed a significant reduction of preoperative MR (3–4+) to less than 1+ MR after operations (P < 0.05). Surgical transapical approach to PVL closure is a safe and effective procedure following mitral valve replacement. Early results show that this procedure can be an alternative to re‐operation for high‐risk patients. Further studies are needed to prove its effectiveness in the long term.
Interferon‐free regimens improve portal hypertension and histological necroinflammation in HIV/HCV patients with advanced liver disease
Authors: Schwabl P. , Mandorfer M. , Steiner S. , Scheiner B. , Chromy D. , Herac M. , Bucsics T. , Hayden H. , Grabmeier‐Pfistershammer K. , Ferlitsch A. , Oberhuber G. , Trauner M. , Peck‐Radosavljevic M. , Reiberger T.
Published: November 2016

Background

HIV/HCV co‐infected patients show accelerated fibrosis progression and higher risk for complications of portal hypertension (PHT).

Aim

To assess the effects of interferon‐free therapy on portal pressure, liver histology and plasma biomarkers in HIV/HCV‐coinfected patients with PHT.

Methods

Twenty‐two patients with paired hepatic venous pressure gradient (HVPG) measurements prior and after successful treatment (SVR) with interferon‐free regimens were included. Liver stiffness was assessed by transient elastography and biopsies were scored according to METAVIR. Plasma biomarkers were determined by ELISA.

Results

Overall, HVPG decreased from 10.7 ± 4.1 mmHg at baseline to 7.4 ± 4.2 mmHg after HCV treatment (Δ:‐3.3 ± 2.7 mmHg; p < 0.001). In patients with clinically significant PHT (HVPG≥10 mmHg, n = 11), HVPG decreased from 14.1 ± 2.9 to 10.4 ± 3.9 mmHg (Δ:‐3.7 ± 3.3 mmHg; p = 0.004) and a haemodynamic response (HVPG decrease ≥10%) was observed in 73%. In 64% of patients with subclinical PHT (HVPG 6–9 mmHg, n = 11), portal pressure normalised at SVR. Mean liver stiffness decreased from 20.8 kPa to 11.5 kPa (Δ:‐8.8 ± 7.4 kPa; p < 0.001). Fifty percent (7/14) of patients with cirrhosis were re‐classified as METAVIR ≤F3 and all patients with decompensated cirrhosis improved their Child–Pugh stage. After successful HCV treatment, 39% still had persistent histological necroinflammatory activity (METAVIR A1), which correlated with less HVPG response and more steatosis. While most biomarkers improved with SVR, METAVIR A1 patients had significantly higher plasma levels of fibrogenic (PDGF, TGF‐β) and angiogenic (VEGF, Angiopoietin1) biomarkers.

Conclusions

Interferon‐free therapy reduces PHT and halts histological necroinflammatory activity in the majority of HIV/HCV‐coinfected patients after SVR, which may lead to re‐compensation of liver function in cirrhosis. Biomarkers could identify patients with persisting hepatic necroinflammation.
In vitro ruminal fermentation and in situ ruminal degradation of tamarind kernel powder extract residue in wethers
Authors: Wang Lin , Oishi Kazato , Sato Yoshiaki , Nakanishi Takashi , Hirooka Hiroyuki , Takahashi Kei , Kumagai Hajime
Published: November 2016

We examined the in vitro fermentation characteristics and in situ dry matter (DM) and crude protein (CP) degradability of tamarind kernel powder extract residue (TKPER), a by‐product of polysaccharides thickener processing. Two types of TKPER (I and II), of which the CP and neutral detergent fiber organic matter basis contents (%) were 41.4 and 42.0 and 1.4 and 0.5, respectively, were compared with dry heat soybean (SB), soybean meal (SBM) and dry soybean curd residue (SBCR). The TKPERs had significantly lower in vitro gas production compared to the other products at each observation time (P < 0.05). The in vitro DM and CP digestibility (%) of TKPER I and II were 67.7 and 64.9, and 64.5 and 58.0, respectively, significantly lower than those of SB and SBM (P < 0.05). We used four wethers (55.6 ± 4.6 kg) with ruminal cannulas to investigate the in situ degradability of TKPER I, SB, SBM and SBCR. At the ruminal outflow rate of 0.05/h, the effective degradability (%) values of the DM and CP of TKPER I were 64.1 and 49.7, respectively, which were similar to those of SBM. In conclusion, TKPER had high CP and exhibited in situ degradability similar to that of SBM, suggesting that TKPER could be used as a protein source feed.
Venlafaxine and oxycodone have different effects on spinal and supraspinal activity in man: a somatosensory evoked potential study
Authors: Lelic Dina , Valeriani Massimiliano , Fischer Iben W. D. , Dahan Albert , Drewes Asbjørn M.
Published: November 2016

Aims

Opioids and antidepressants that inhibit serotonin and norepinephrine reuptake (SNRI) are recognized as analgesics to treat severe and moderate pain, but their mechanisms of action in humans remain unclear. The present study aimed to explore how oxycodone (an opioid) and venlafaxine (an SNRI) modulate spinal and supraspinal sensory processing.

Methods

Twenty volunteers were included in a randomized, double‐blinded, three‐way (placebo, oxycodone, venlafaxine), crossover study. Spinal and full scalp cortical evoked potentials (EPs) to median nerve stimulation were recorded before and after 5 days of treatment. Assessment of the central effects of the three treatments involved: (i) amplitudes and latencies of spinal EPs (spinal level); (ii) amplitudes and latencies of the P14 potential (subcortical level); (iii) amplitudes and latencies of early and late cortical EPs (cortical level); (iv) brain sources underlying early cortical Eps; and (v) brain networks underlying the late cortical EPs.

Results

In the venlafaxine arm, the spinal P11 and the late cortical N60–80 latencies were reduced by 1.8% [95% confidence interval (CI) 1.7%, 1.9%) and 5.7% (95% CI 5.3%, 6.1%), whereas the early cortical P25 amplitude was decreased by 7.1% (95%CI 6.1%, 8.7%). Oxycodone increased the subcortical P14 [+25% (95% CI 22.2%, 28.6%)], early cortical N30 [+12.9% (95% CI 12.5%, 13.2%)] amplitudes and the late cortical N60–80 latency [+2.9% (95% CI 1.9%, 4.0%)]. The brainstem and primary somatosensory cortex source strengths were increased by 66.7% (95% CI 62.5%, 75.0%) and 28.8% (95% CI 27.5%, 29.6%) in the oxycodone arm, whereas the primary somatosensory cortex strength was decreased in the venlafaxine arm by 18.3% (95% CI 12.0%, 28.1%).

Conclusions

Opioids and SNRI drugs exert different central effects. The present study contributed to the much‐needed human models of the mechanisms of action of drugs with effects on the central nervous system.
A prospective and randomised trial comparing fluoroscopic, total ultrasonographic, and combined guidance for renal access in mini‐percutaneous nephrolithotomy
Authors: Zhu Wei , Li Jiasheng , Yuan Jian , Liu Yongda , Wan Shaw P. , Liu Guanzhao , Chen Wenzhong , Wu Wenqi , Luo Jintai , Zhong Dongliang , Qi Defeng , Lei Ming , Zhong Wen , Zhang Ze , He Zhaohui , Zhao Zhijian , Lu Suilin , Wu Yuji , Zeng Guohua
Published: November 2016

Objective

To compare the safety and efficacy of fluoroscopic guidance (FG), total ultrasonographic guidance (USG), and combined ultrasonographic and fluoroscopic guidance (CG) for percutaneous renal access in mini‐percutaneous nephrolithotomy (mini‐PCNL).

Patients and methods

The present study was conducted between July 2014 and May 2015 as a prospective randomised trial at the First Affiliated Hospital of Guangzhou Medical University. In all, 450 consecutive patients with renal stones of >2 cm were randomised to undergo FG, USG, or CG mini‐PCNL (150 patients for each group). The primary endpoints were the stone‐free rate (SFR) and blood loss (haemoglobin decrease during the operation and transfusion rate). Secondary endpoints included access failure rate, operating time, and complications. S.T.O.N.E. score was used to document the complexity of the renal stones. The study was registered at http://clinicaltrials.gov/ (NCT02266381).

Results

The three groups had similar baseline characteristics. With S.T.O.N.E. scores of 5–6 or 9–13, the SFRs were comparable between the three groups. For S.T.O.N.E. scores of 7–8, FG and CG achieved significantly better SFRs than USG (one‐session SFR 85.1% vs 88.5% vs 66.7%, P = 0.006; overall SFR at 3 months postoperatively 89.4% vs 90.2% vs 69.8%, P = 0.002). Multiple‐tracts mini‐PCNL was used more frequently in the FG and CG groups than in the USG group (20.7% vs 17.1% vs 9.5%, P = 0.028). The mean total radiation exposure time was significantly greater for FG than for CG (47.5 vs 17.9 s, P < 0.001). The USG had zero radiation exposure. There was no significant difference in the haemoglobin decrease, transfusion rate, access failure rate, operating time, nephrostomy drainage time, and hospital stay among the groups. The overall operative complication rates using the Clavien–Dindo grading system were similar between the groups.

Conclusions

Mini‐PCNL under USG is as safe and effective as FG or CG in the treatment of simple kidney stones (S.T.O.N.E. scores 5–6) but with no radiation exposure. FG or CG is more effective for patients with S.T.O.N.E. scores of 7–8, where multiple percutaneous tracts may be necessary.
Robot‐assisted partial nephrectomy: continued refinement of outcomes beyond the initial learning curve
Authors: Paulucci David J. , Abaza Ronney , Eun Daniel D. , Hemal Ashok K. , Badani Ketan K.
Published: November 2016

Objectives

To evaluate trends in peri‐operative outcomes of 250 consecutive cases beyond the initial learning curve (LC) of robot‐assisted partial nephrectomy (RAPN) among multiple surgeons.

Patients and Methods

A multi‐institutional database was used to evaluate trends in patient demographics (e.g. age, gender, comorbidities), tumour characteristics (e.g. size, complexity) and peri‐operative outcomes (e.g. warm ischaemia time [WIT], operating time, complications, estimated blood loss [EBL], trifecta achievement) in consecutive cases 50–300 (n = 960) from 2008 to 2016 among four experienced surgeons. Trends in outcomes were assessed using multivariable regression models adjusted for demographic and tumour‐specific variables. Outcomes for cases 50–99 were compared with those for cases 250–300.

Results

In the study period RAPN was increasingly performed in patients with larger tumours (β = 0.001, P = 0.048), hypertension (odds ratio [OR] 1.003; P = 0.008) diabetes (OR 1.003; P = 0.025) and previous abdominal surgery (OR 1.003; P = 0.006). Surgeon experience was associated with more trifecta achievement (OR 1.006; P < 0.001), shorter WIT (β = −0.036, P < 0.001), less EBL (β = −0.154, P = 0.009), fewer blood transfusions (OR 0.989, P = 0.024) and a reduced length of hospital stay (β = −0.002, P = 0.002), but not with operating time (P = 0.243), complications (P = 0.587) or surgical margin status (P = 0.102). Tumour size and WIT in cases 50–99 vs 250–300 were 2.7 vs 3.2 cm (P = 0.001) and 21.4 vs 16.2 min (P < 0.001), respectively.

Conclusion

Refinement of RAPN outcomes, concomitant with the treatment of a patient population with larger tumours and more comorbidities, occurs after the initial LC is reached. Although RAPN can consistently be performed safely with acceptable outcomes after a small number of cases, improvement in trifecta achievement, WIT, EBL, blood transfusions and a shorter hospitalization continues to occur up to 300 procedures.
New age constraints from the SW Baltic Sea area – implications for Scandinavian Ice Sheet dynamics and palaeo‐environmental conditions during MIS 3 and early MIS 2
Authors: Kenzler Michael , Tsukamoto Sumiko , Meng Stefan , Frechen Manfred , Hüneke Heiko
Published: November 2016

The study of two cliff outcrops from the Jasmund Peninsula provides new information on the ice‐sheet dynamics and palaeo‐environmental conditions during MIS 3 and the ensuing transition to MIS 2 in the southwestern Baltic Sea region. We identified interstadial fluvial sediments, with mollusc and vertebrate fauna, which were deposited between 47 and 42 ka in a steppe‐like landscape. A subsequent cooling phase led to the formation of a proglacial lake, between 30 and 22 ka, indicated by varve‐like, rhythmically bedded silty clay. This proglacial lake formation can be correlated to the blocking of the Baltic Basin by the Kattegat ice advance, previously dated to c. 29–26 ka. The transition from proglacial to terminoglacial lacustrine deposits reflects the immediate advance of the Scandinavian Ice Sheet (SIS) into the study area after the transition from MIS 3 to early MIS 2. The SIS finally reached the area at 23±2 ka (Brandenburgian phase; advance from the northeast). A subsequent ice retreat accompanied by the deposition of meltwater sediments was followed by a re‐advance of the SIS, resulting in a glaciotectonic deformation event across the study area. The age control for our study is based on optically stimulated luminescence (OSL). The investigated Pleistocene sediments show ice‐free conditions during MIS 3 and early MIS 2, indicating that neither the Ristinge nor the Klintholm advance reached the SW Baltic Sea coast of Jasmund.
Synthesis and anticholinesterase activity of new substituted benzo[d]oxazole‐based derivatives
Authors: Pouramiri Behjat , Moghimi Setareh , Mahdavi Mohammad , Nadri Hamid , Moradi Alireza , Tavakolinejad‐Kermani Esmat , Firoozpour Loghman , Asadipour Ali , Foroumadi Alireza
Published: November 2016

A series of novel benzo[d]oxazole derivatives (6a–n) have been synthesized and biologically evaluated as potential inhibitors of acetylcholinesterases (AChE) and butyrylcholinesterase (BChE). The chemical structures of all final compounds were confirmed by spectroscopic methods. In vitro studies showed that most of the synthesized compounds are potent acetylcholinesterase and butyrylcholinesterase inhibitors. Among them, compounds 6a and 6j strongly inhibited AChE and BChE activities with IC50 values of 1.03–1.35 and 6.6–8.1 μm, respectively. Docking studies also provided the binding modes of action and identified hydrophobic pi forces as the main interaction.
Producing Spatial Words Is Not Enough: Understanding the Relation Between Language and Spatial Cognition
Authors: Miller Hilary E. , Vlach Haley A. , Simmering Vanessa R.
Published: November 2016

Prior research has investigated the relation between children's language and spatial cognition by assessing the quantity of children's spatial word production, with limited attention to the context in which children use such words. This study tested whether 4‐year‐olds children's (N = 41, primarily white middle class) adaptive use of task‐relevant language across contexts predicted their spatial skills. Children were presented with a spatial scene description task, four spatial tasks, and vocabulary assessments. Children's adaptive use of task‐relevant language was more predictive of their spatial skills than demographic and language factors (e.g., quantity of spatial words produced). These findings identify new links between language and spatial cognition and highlight the importance of understanding the quality, not just quantity, of children's language use.
Scoring system for the diagnosis of bilateral primary aldosteronism in the outpatient setting before adrenal venous sampling
Authors: Kobayashi Hiroki , Haketa Akira , Ueno Takahiro , Ikeda Yukihiro , Hatanaka Yoshinari , Tanaka Sho , Otsuka Hiromasa , Abe Masanori , Fukuda Noboru , Soma Masayoshi
Published: November 2016

Objective

The only reliable method for subtyping primary aldosteronism (PA) is adrenal venous sampling (AVS), which is costly and time‐consuming. Considering the limited availability of AVS, it would be helpful to obtain information on the diagnosis of bilateral hyperaldosteronism (BHA) from routine tests. We aimed to establish new, simple criteria for outpatients to diagnose BHA from PA before AVS.

Design

We retrospectively analysed 82 patients who were diagnosed with PA and underwent AVS. Thirty‐seven patients were diagnosed with unilateral hyperaldosteronism (UHA), and 36 with BHA and nine were undetermined. Among the variables that were significantly different between UHA and BHA in the univariate analysis, we chose three variables to be included in multivariate logistic regression models and constructed a subtype prediction score.

Results

The subtype prediction score was calculated as follows: 3 points for no adrenal nodules on computed tomography imaging, 2 for serum potassium of ≥3·5 mmol/l and 2 for aldosterone‐to‐renin ratio of <490 after a captopril challenge test. Receiver operating characteristic curve analysis for the ability to discriminate BHA from UHA showed that a score of 7 points had 50% sensitivity and 100% specificity and a score of 5 points had 67% sensitivity and 94% specificity (area under the curve: 0·922; 95% CI: 0·863–0·980).

Conclusions

Our new, simple criteria specifically distinguished BHA from UHA in the outpatient setting before AVS. Furthermore, not only endocrinologists but also general internists can use this convenient, safe scoring system.
Autosomal recessive variations of TBX6, from congenital scoliosis to spondylocostal dysostosis
Authors: Lefebvre M. , Duffourd Y. , Jouan T. , Poe C. , Jean‐Marçais N. , Verloes A. , St‐Onge J. , Riviere J.‐B. , Petit F. , Pierquin G. , Demeer B. , Callier P. , Thauvin‐Robinet C. , Faivre L. , Thevenon J.
Published: November 2016

Proximal 16p11.2 microdeletions are recurrent microdeletions with an overall prevalence of 0.03%. In patients with segmentation defects of the vertebra (SDV), a burden of this microdeletion was observed with TBX6 as a candidate gene for SDV. In a published cohort of patients with congenital scoliosis (CS), TBX6 haploinsufficiency was compound heterozygous with a common haplotype. Besides, a single three‐generation family with spondylocostal dysostosis (SCD) was reported with a heterozygous stop‐loss of TBX6. These observations questioned both on the inheritance mode and on the variable expressivity associated with TBX6‐associated SDV. Based on a national recruitment of 56 patients with SDV, we describe four patients with variable SDV ranging from CS to SCD associated with biallelic variations of TBX6. Two patients with CS were carrying a proximal 16p11.2 microdeletion associated with the previously reported haplotype. One patient with extensive SDV was carrying a proximal 16p11.2 microdeletion associated with a TBX6 rare missense change. One patient with a clinical diagnosis of SCD was compound heterozygous for two TBX6 rare missense changes. The three rare variants were affecting the chromatin‐binding domain. Our data illustrate the variable expressivity of recessive TBX6 ranging from CS to SCD.
Alport syndrome: impact of digenic inheritance in patients management
Authors: Fallerini C. , Baldassarri M. , Trevisson E. , Morbidoni V. , La Manna A. , Lazzarin R. , Pasini A. , Barbano G. , Pinciaroli A.R. , Garosi G. , Frullanti E. , Pinto A.M. , Mencarelli M.A. , Mari F. , Renieri A. , Ariani F.
Published: November 2016

Alport syndrome (ATS) is a genetically heterogeneous nephropathy with considerable phenotypic variability and different transmission patterns, including monogenic (X‐linked/autosomal) and digenic inheritance (DI). Here we present a new series of families with DI and we discuss the consequences for genetic counseling and risk assessment. Out of five families harboring variants in more than one COL4 gene detected by next generation sequencing (NGS), minigene‐splicing assay allowed us to identify four as true digenic. Two families showed COL4A3/A4 mutations in cis, mimicking an autosomal dominant inheritance with a more severe phenotype and one showed COL4A3/A4 mutations in trans, mimicking an autosomal recessive inheritance with a less severe phenotype. In a fourth family, a de novo mutation (COL4A5) combined with an inherited mutation (COL4A3) triggered a more severe phenotype. A fifth family, predicted digenic on the basis of silico tools, rather showed monogenic X‐linked inheritance due to a hypomorphic mutation, in accordance with a milder phenotype. In conclusion, this study highlights the impact of DI in ATS and explains the associated atypical presentations. More complex inheritance should be therefore considered when reviewing prognosis and recurrence risks. On the other side, these findings emphasize the importance to accompany NGS with splicing assays in order to avoid erroneous identification of at risk members.
Informing Strategic Efforts to Expand and Connect Protected Areas Using a Model of Ecological Flow, with Application to the Western United States
Authors: Dickson Brett G. , Albano Christine M. , McRae Brad H. , Anderson Jesse J. , Theobald David M. , Zachmann Luke J. , Sisk Thomas D. , Dombeck Michael P.
Published: November 2016

Under rapid landscape change, there is a significant need to expand and connect protected areas (PAs) to prevent further loss of biodiversity and preserve ecological functions across broad geographies. We used a model of landscape resistance and electronic circuit theory to estimate patterns of ecological flow among existing PAs in the western United States. We applied these results to areas previously identified as having high conservation value to distinguish those best positioned to maintain and enhance ecological connectivity and integrity. We found that current flow centrality was highest and effective resistance lowest in areas that spanned the border between southern Oregon and Idaho, and in northern Arizona and central Utah. Compared to other federal jurisdictions, Bureau of Land Management lands contributed most to ecological connectivity, forming “connective tissue” among existing PAs. Our models and maps can inform new conservation strategies and critical land allocation decisions, within or among jurisdictions.
Occupied! Property, Citizenship and Peasant Movements in Rural Java
Authors: Lund Christian , Rachman Noer Fauzi
Published: November 2016

Recent land occupations by peasant movements in Indonesia have done more than challenge the existing ownership of plantations and forests. They have restructured local property and authority relations by stimulating a strategic critique of public authority and governance practice within the peasant movement. ‘Plantation’ and ‘forest’ are structured under different legal regimes and institutional arrangements, which offer varied opportunities for occupation and subsequent legalization of smallholder land control. Different strategies of occupation and interaction with plantation and forest companies have therefore been pursued. However, legalization of land occupations has remained rudimentary, and possession has not been recognized as property by government institutions. Two cases of occupation history demonstrate in detail how claims to citizenship and property have been opposed, ignored and denied by statutory institutions. Furthermore, they demonstrate how land‐occupying farmers have attempted to become ‘visible’ to and recognized by government institutions, and how — while waiting for this to happen — the peasant movement experiences a sovereign moment.
Making Territory: War, Post‐war and the Entangled Scales of Contested Forest Governance in Mid‐Western Nepal
Authors: Byrne Sarah , Nightingale Andrea J. , Korf Benedikt
Published: November 2016

Ruptures that constitute exceptional events in national politics intersect in different ways with local politics, where more ongoing, continuous processes of both contestation and conservation around natural resource use may persist amidst a turbulent political landscape on other scales. Nepal, with its series of unfinished revolutions, civil war (1996–2006), and recurrently contested process of state (trans‐)formation, is a case in point. Through a study of a contested forest in mid‐western Nepal, this article analyses the entanglement of rupture and realignment of contentious claims to political authority across different scales, as well as the continuities of negotiations over claims to recognition of forest use and citizenship rights. The authors analyse some of the messy and complex practices through which authority to govern forests is claimed and legitimated, and citizenship rights are asserted and defined. They show that while political ruptures caused by the war and post‐war dynamics unsettle and reshuffle the political terrain, claims to citizenship and property rights endure, even if the language and form of the claim are adapted. These claims are embedded within existing jurisdictions but, at the same time, actors lay claims to property and citizenship rights by working across scales and re‐negotiating their boundaries. ‘Making territory’, the authors conclude, is the effect of the entanglement of these different territorial politics and practices.
The UNDP, the World Bank and Human Development through the World Market
Authors: Cammack Paul
Published: November 2016

This article offers a critical review of the UNDP's understanding of human development, and of recent Human Development Reports, with a principal focus on those from 2010 to the present. It argues that they show that the UNDP is now fully aligned with the World Bank in its overall policy stance and its underlying logic, and that this marks the end of the project of setting market‐led growth in a broader conception of human development that began with the first report (1990). The idea that the UNDP/HDR conception of human development represents an alternative to World Bank orthodoxy is a myth.
Correlation of FDG‐PET hypometabolism and SEEG epileptogenicity mapping in patients with drug‐resistant focal epilepsy
Authors: Lamarche Florence , Job Anne‐Sophie , Deman Pierre , Bhattacharjee Manik , Hoffmann Dominique , Gallazzini‐Crépin Céline , Bouvard Sandrine , Minotti Lorella , Kahane Philippe , David Olivier
Published: November 2016

Objective

Interictal [18F]fluorodeoxyglucose–positron emission tomography (FDG‐PET) is used in the presurgical evaluation of patients with drug‐resistant focal epilepsy. We aimed at clarifying its relationships with ictal high‐frequency oscillations (iHFOs) shown to be a relevant marker of the seizure‐onset zone.

Methods

We studied the correlation between FDG‐PET and epileptogenicity maps in an unselected series of 37 successive patients having been explored with stereo‐electroencephalography (SEEG).

Results

At the group level, we found a significant correlation between iHFOs and FDG‐PET interictal hypometabolism only in cases of temporal lobe epilepsy. This correlation was found with HFOs, and the same comparison between FDG‐PET and ictal SEEG power of lower frequencies during the same epochs did not show the same significance.

Significance

This finding suggests that interictal FDG‐PET and ictal HFOs may share common underlying pathophysiologic mechanisms of ictogenesis in temporal lobe epilepsy, and combining both features may help to identify the seizure‐onset zone.