bluuebunny/crossref_metadata_2025 huggingface dataset:
MACULAR BUCKLING WITH ANDO PLOMBE MAY INCREASE CHOROIDAL THICKNESS AND MIMIC SEROUS RETINAL DETACHMENT SEEN IN THE TILTED DISK SYNDROME
Authors: Mateo Carlos , Burés-Jelstrup Anniken
Published: January 2016

Purpose:

Serous subfoveal detachment has been described in the literature as a complication that appears at the border of the staphyloma. Macular buckling induces a postoperative inward bulge that resembles the ridge of a staphyloma. We describe three patients who developed a serous subfoveal detachment after uneventful macular buckling. To our knowledge, this complication, that shares similarities with the staphyloma ridge detachment, has not been previously reported.

Methods:

The clinical records of all cases that underwent macular buckling at our clinic were reviewed.

Results:

Three patients developed a serous subfoveal detachment that could not be explained by choroidal neovascularization or polypoidal vascular choroidopathy. Along with the development of the subfoveal detachment, we observed an increase of the choroidal thickness beneath the fovea. This thickening, that tended to progress during the follow-up, resolved spontaneously after explantation of the buckle. The decrease in foveal thickness did also lead to resolution of the subfoveal detachment.

Conclusion:

The development of the subfoveal detachment in our patients was closely associated with a focal increase of the choroidal thickness after the macular buckling. After the buckle was removed, the choroidal thickness went back to the normal prebuckling values and the detachment resolved in all three patients. This leads us to think that there is a close association between choroidal thickness and the serous subfoveal detachment.
Rapid Development and Implementation of an ECMO Program
Authors: Moll Vanessa , Teo Elrond Y.L. , Grenda David S. , Powell Cindy D. , Connor Michael J. , Gartland Bryce T. , Zellinger Mary J. , Bray H. Bruce , Paciullo Christopher A. , Kalin Craig M. , Wheeler Jean M. , Nguyen Duc Q. , Blum James M.
Published: January 2016

Extracorporeal membrane oxygenation (ECMO) is an established therapy in the management of patients with refractory cardiogenic shock or acute respiratory failure. In this report, we describe the rapid development and implementation of an organized ECMO program at a facility that previously provided ad hoc support. The program provides care for patients within the Emory Healthcare system and throughout the Southeastern United States. From September 2014 to February 2015, 16 patients were treated with either venovenous or venoarterial ECMO with a survival to decannulation of 53.3% and survival to intensive care unit discharge of 40%. Of the 16 patients, 10 were transfers from outside facilities of which 2 were remotely cannulated and initiated on ECMO support by our ECMO transport team. Complications included intracerebral hemorrhage, bleeding from other sites, and limb ischemia. The results suggest that a rapidly developed ECMO program can provide safe transport services and provide outcomes similar to those in the existing literature. Key components appear to be an institutional commitment, a physician champion, multidisciplinary leadership, and organized training. Further study is required to determine whether outcomes will continue to improve.
Saved Lives at Risk in the Middle East
Authors: Skouri Hadi , Shurrab Mohammed , Haj-Yahia Saleem
Published: January 2016

In the Middle East, heart failure prevalence seems to be high as the rest of the world. Few countries in the region recently have started implanting left ventricular assist devices (LVADs), basically as destination therapy. Terrorism and terrorist activities have been expanded worldwide especially in this part of the world. We present a case that highlights the relation between suicide bombers and LVAD patients.
Recurrent CIC Gene Abnormalities in Angiosarcomas
Authors: Huang Shih-Chiang , Zhang Lei , Sung Yun-Shao , Chen Chun-Liang , Kao Yu-Chien , Agaram Narasimhan P. , Singer Samuel , Tap William D. , D’Angelo Sandra , Antonescu Cristina R.
Published: January 2016

Angiosarcoma (AS) is a rare sarcoma subtype showing considerable clinicopathologic and genetic heterogeneity. Most radiation-induced AS show MYC gene amplifications, with a subset of cases harboring KDR, PTPRB, and PLCG1 mutations. Despite recent advances, the genetic abnormalities of most primary AS remain undefined. Whole-transcriptome sequencing was initiated in 2 index cases of primary soft tissue AS with epithelioid morphology occurring in young adults for novel gene discovery. The candidate abnormalities were validated and then screened by targeted sequencing and fluorescence in situ hybridization in a large cohort of 120 well-characterized AS cases. Findings were subsequently correlated with the status of KDR, PLCG1, MYC, and FLT4 gene abnormalities. The clinicopathologic relevance and prognostic significance of these genetic changes were analyzed by statistical methods. Concurrent CIC mutations and CIC rearrangements were identified in both index cases, with a CIC-LEUTX fusion detected in 1 case. Upon screening, an additional visceral AS in a young adult had a complex CIC rearrangement, whereas 6 others harbored only CIC mutations. All 3 CIC-rearranged AS cases lacked vasoformation and had a solid growth of round, epithelioid to rhabdoid cells, showing immunoreactivity for CD31 and Ets-related gene and sharing a transcriptional signature with other round cell sarcomas, including CIC-rearranged tumors. Overall, CIC abnormalities occurred in 9% (9/98) of cases, affecting younger patients with primary AS, with an inferior disease-free survival. In contrast, PLCG1 and KDR mutations occurred in both primary and secondary AS cases, accounting for 9.5% and 7%, respectively, with a predilection for breast and bone/viscera location, regardless of MYC status. MYC amplification was present in most secondary AS related to breast cancer (91%) compared with other causes (25%) or primary AS (7%). FLT4-amplified AS lacked PLCG1/KDR mutations, occurring predominantly in MYC-amplified population, and showed poor prognosis.
Reliable Gait Recognition Using 3D Reconstructions and Random Forests – An Anthropometric Approach
Authors: Sandau Martin , Heimbürger Rikke V. , Jensen Karl E. , Moeslund Thomas B. , Aanæs Henrik , Alkjær Tine , Simonsen Erik B.
Published: January 2016

Photogrammetric measurements of bodily dimensions and analysis of gait patterns in CCTV are important tools in forensic investigations but accurate extraction of the measurements are challenging. This study tested whether manual annotation of the joint centers on 3D reconstructions could provide reliable recognition. Sixteen participants performed normal walking where 3D reconstructions were obtained continually. Segment lengths and kinematics from the extremities were manually extracted by eight expert observers. The results showed that all the participants were recognized, assuming the same expert annotated the data. Recognition based on data annotated by different experts was less reliable achieving 72.6% correct recognitions as some parameters were heavily affected by interobserver variability. This study verified that 3D reconstructions are feasible for forensic gait analysis as an improved alternative to conventional CCTV. However, further studies are needed to account for the use of different clothing, field conditions, etc.
Association of dietary carotenoids and the incidence of insulin resistance in adults: Tehran lipid and glucose study
Authors: Mirmiran Parvin , Khalili Moghadam Sajjad , Bahadoran Zahra , Tohidi Maryam , Azizi Fereidoun
Published: January 2016

Aim

Carotenoids may reduce the risk of insulin resistance (IR) due to their antioxidant properties. The aim of the present study was to investigate the relationship between dietary intake of carotenoids and the risk of IR in Iranian adults.

Methods

In this longitudinal study, 1106 men and women, aged 19–74 years, were studied within the framework of Tehran Lipid and Glucose Study among Tehran an adults. Fasting serum insulin and glucose were measured at baseline and again after three years of follow up; IR was defined according to optimal cut‐off values. The usual dietary intake of carotenoids including α‐carotene, β‐carotene, lycopene, lutein and β‐cryptoxanthin was measured using a validated 168‐item semi‐quantitative food frequency questionnaire. Logistic regression models were used to estimate the occurrence of IR across tertiles of carotenoids with adjustment for potential confounding variables.

Results

Mean age of participants was 40.71 ± 12.14 years, and mean body mass index was 27.23 ± 4.9 kg/m2, at baseline. Mean intake of total carotenoids was 10.1 ± 7.3 mg/day. Highest compared to the lowest dietary intake of β‐carotene was significantly associated with a lower risk of IR (OR = 0.42, 95% CI = 0.25–0.72, P for trend = 0.01). Higher intake of β‐cryptoxanthin was also significantly associated with a lower risk of IR (OR = 0.51, 95% CI = 0.30–0.84, P for trend = 0.01).

Conclusions

Higher consumption of dietary carotenoids such as β‐carotene and β‐cryptoxanthin may be associated with a reduced risk of IR.
Genome Update. Let the consumer beware: Streptomyces genome sequence quality
Authors: Studholme David J.
Published: January 2016

A genome sequence assembly represents a model of a genome. This article explores some tools and methods for assessing the quality of an assembly, using publicly available data for Streptomyces species as the example. There is great variability in quality of assemblies deposited in GenBank. Only in a small minority of these assemblies are the raw data available, enabling full appraisal of the assembly quality.
Hypofractionated versus conventionally fractionated radiotherapy for ductal carcinoma in situ (DCIS) of the breast
Authors: Oar Andrew J , Boxer Miriam M , Papadatos George , Delaney Geoff P , Phan Penny , Descallar Joseph , Duggan Kirsten , Tran Kelvin , Yap Mei Ling
Published: January 2016

Introduction

Hypofractionated radiotherapy (RT) in the setting of early invasive breast cancer has been shown to have similar local control rates and cosmetic outcomes as conventionally fractionated RT. This study compares ipsilateral recurrence rates between hypofractionated and conventional RT, with and without a boost. The effect of hypofractionated RT and chest wall separation (CWS) on cosmetic outcome was also assessed.

Methods

All patients with ductal carcinoma in situ (DCIS) treated between 1998 and 2012 across two sites of a single cancer institution were retrospectively studied. Patients were analysed according to those receiving conventional RT (≤2 Gy per fraction) and those receiving hypofractionated RT (>2 Gy per fraction), as well as the presence or absence of a tumour bed boost. Data were collected through electronic medical records and local cancer registry. Cosmetic outcome was scored by physicians on a four‐point scale during clinical follow‐up appointments.

Results

One hundred and ninety‐seven patients were treated for DCIS during the study period. One hundred and forty‐one were treated with conventional RT, and 56 with hypofractionated RT. After a median follow up of 4.4 years, there were 12 ipsilateral recurrences, of which seven were invasive disease and five DCIS. Ten recurrences occurred in patients who received conventional RT (7.1% recurrence rate) and two in those who received hypofractionated RT (3.6% recurrence rate) (P = 0.48). Cosmetic outcomes were not significantly different between conventional and hypofractionated RT (P = 0.06).

Conclusions

Hypofractionation represents a suitable alternative for treating DCIS in the absence of randomised data.
The Association Between Bleeding and the Incidence of Warfarin Discontinuation in Patients with Atrial Fibrillation
Authors: Simon Teresa A. , Pan Xianying , Kawabata Hugh , Huang Han‐Yao , Azoulay Laurent
Published: January 2016

Aim

While bleeding is a well‐known complication of warfarin use and is thought to be a contributory cause of treatment discontinuation, studies quantifying this association are limited. The objective of this study was to quantify the association between bleeding events and subsequent warfarin discontinuation in patients with nonvalvular atrial fibrillation (NVAF).

Methods

A nested case–control analysis was conducted within a cohort of patients with NVAF newly treated with warfarin. All patients who discontinued warfarin (at least 60 days from last day of warfarin supply) during follow‐up were identified as cases and matched with up to 10 controls on age, sex, and duration of follow‐up. The index date was defined as the date of warfarin treatment discontinuation of the cases. Conditional logistic regression was used to estimate odds ratios (ORs) and 95% confidence intervals (CIs) of warfarin treatment discontinuation associated with a bleeding event in the 60 days before the index date.

Results

The cohort included 24,243 patients who initiated warfarin treatment, of whom 13,482 discontinued treatment during follow‐up (cases). Bleeding was associated with an increased risk of warfarin treatment discontinuation (3.55% vs. 0.85%; OR, 4.31; 95% CI, 3.87–4.81). When including only bleeds as the first listed diagnosis, the unadjusted OR was 4.64 (95% CI, 4.10–5.26), and the adjusted OR was 4.65 (95% CI, 4.10–5.27).

Conclusions

Bleeding was significantly associated with warfarin discontinuation, and thus, the selection of an effective treatment regimen associated with a lower bleeding rate could be a desirable treatment approach.
Disruption of hippocampal synaptic transmission and long‐term potentiation by psychoactive synthetic cannabinoid ‘Spice’ compounds: comparison with Δ9‐tetrahydrocannabinol
Authors: Hoffman Alexander F. , Lycas Matthew D. , Kaczmarzyk Jakub R. , Spivak Charles E. , Baumann Michael H. , Lupica Carl R.
Published: January 2016

There has been a marked increase in the availability of synthetic drugs designed to mimic the effects of marijuana. These cannabimimetic drugs, sold illicitly as ‘Spice’ and related products, are associated with serious medical complications in some users. In vitro studies suggest that synthetic cannabinoids in these preparations are potent agonists at central cannabinoid CB1 receptors (CB1Rs), but few investigations have delineated their cellular effects, particularly in comparison with the psychoactive component of marijuana, Δ9‐tetrahydrocannabinol (Δ9‐THC). We compared the ability of three widely abused synthetic cannabinoids and Δ9‐THC to alter glutamate release and long‐term potentiation in the mouse hippocampus. JWH‐018 was the most potent inhibitor of hippocampal synaptic transmission (EC50 ~15 nM), whereas its fluoropentyl derivative, AM2201, inhibited synaptic transmission with slightly lower potency (EC50 ~60 nM). The newer synthetic cannabinoid, XLR‐11, displayed much lower potency (EC50 ~900 nM) that was similar to Δ9‐THC (EC50 ~700 nM). The effects of all compounds occurred via activation of CB1Rs, as demonstrated by reversal with the selective antagonist/inverse agonist AM251 or the neutral CB1R antagonist PIMSR1. Moreover, AM2201 was without effect in the hippocampus of transgenic mice lacking the CB1R. Hippocampal slices exposed to either synthetic cannabinoids or Δ9‐THC exhibited significantly impaired long‐term potentiation (LTP). We find that, compared with Δ9‐THC, the first‐generation cannabinoids found in Spice preparations display higher potency, whereas a recent synthetic cannabinoid is roughly equipotent with Δ9‐THC. The disruption of synaptic function by these synthetic cannabinoids is likely to lead to profound impairments in cognitive and behavioral function.
Quantitative trait loci for a neurocranium deformity, lack of operculum, in gilthead seabream (Sparus aurata L.)
Authors: Negrín‐Báez D. , Navarro A. , Afonso J. M. , Toro M. A. , Zamorano M. J.
Published: January 2016

Lack of operculum, a neurocranial deformity, is the most common external abnormality to be found among industrially produced gilthead seabream (Sparus aurata L.), and this entails significant financial losses. This study conducts, for the first time in this species, a quantitative trait loci (QTL) analysis of the lack of operculum. A total of 142 individuals from a paternal half‐sibling family (six full‐sibling families) were selected for QTL mapping. They had previously shown a highly significant association with the prevalence of lack of operculum in a segregation analysis. All the fish were genotyped for 106 microsatellite markers using a set of multiplex PCRs (ReMsa1–ReMsa13). A linear regression methodology was used for the QTL analysis. Four QTL were detected for this deformity, two of which (QTLOP1 and QTLOP2) were significant. They were located at LG (linkage group) nine and LG10 respectively. Both QTL showed a large effect (about 27%), and furthermore, the association between lack of operculum and sire allelic segregation observed was statistically significant in the QTLOP1 analysis. These results represent a significant step towards including marker‐assisted selection for this deformity in genetic breeding programmes to reduce the incidence of the deformity in the species.
Discrepancy in compliance between the clinical and genetic diagnosis of choroidal hypoplasia in Danish Rough Collies and Shetland Sheepdogs
Authors: Fredholm M. , Larsen R. C. , Jönsson M. , Söderlund M. A. , Hardon T. , Proschowsky H. F.
Published: January 2016

Collie eye anomaly (CEA) is a congenital, inherited ocular disorder which is widespread in herding breeds. Clinically, the two major lesions associated with CEA are choroidal hypoplasia (CH) and coloboma, and both lesions are diagnosed based on ophthalmological examination. A 7.8‐kb intronic deletion in the gene encoding non‐homologous end‐joining factor 1 (NHEJ1) has been reported to be the causative mutation underlying CH when present in the homozygous state. In this study, we have investigated the compliance between the clinical and genetic diagnosis of CH in the Danish Rough Collie and Shetland Sheepdog populations. Our results show that the deletion in NHEJ1 is not predictive for CH in the Danish Rough Collie population, whereas the clinical and genetic diagnosis is in accordance with each other in the Shetland Sheepdog population. Based on these results, it can be concluded that the intronic deletion in NHEJ1 is not the causative mutation but, rather, a marker linked to the locus underlying the trait in some populations but linked to both the wild‐type and CH‐causing locus in most dogs in the Danish Rough Collie population.
How to Create an Embryo Penetration Route
Authors: Uchida Hiroshi , Maruyama Tetsuo , Masuda Hirotaka , Uchida Sayaka , Miki Fumie , Hihara Hanako , Katakura Satomi , Yoshimasa Yushi , Tanaka Mamoru
Published: January 2016

Numerous past investigations into human implantation have tended to pay attention to the mechanism of embryo adhesion to endometrial cells or embryo invasion into endometrial stromal tissue. For successful pregnancy, however, embryo penetration through the endometrial epithelial cell (EEC) sheet is also absolutely required. To improve the performance of assisted reproductive technology, implantation studies should also focus on EEC dynamics, in particular, the action of EECs during embryo penetration. Although only EEC apoptosis has been proposed as a mechanism for the formation of the embryo penetration route, we have also recently reported that characteristic EEC collective motion, regulated by the epithelial to mesenchymal transition, also plays a key role in permitting embryo penetration. We review here how EECs form embryo penetration routes in light of our findings.
The prevalence of structural pituitary abnormalities by MRI scanning in men presenting with isolated hypogonadotrophic hypogonadism
Authors: Dalvi Mazhar , Walker Brian R. , Strachan Mark W.J. , Zammitt Nicola N. , Gibb Fraser W.
Published: January 2016

Objective

Hypogonadotrophic hypogonadism (HH) is commonly associated with ageing, obesity and type 2 diabetes. The indications for pituitary imaging are controversial, and current guidelines are based on small case series.

Design

Retrospective case series from a secondary/tertiary endocrinology referral centre.

Patients

All men presenting to the Edinburgh Centre for Endocrinology and Diabetes with hypogonadotrophic hypogonadism (testosterone <10 nmol/l and normal prolactin) from 2006 to 2013, in whom pituitary MRI was performed (n = 281). All HH patients referred in 2011 (n = 86) were reviewed to assess differences between those selected for pituitary MRI and those who were not scanned.

Results

Pituitary MRI was normal in 235 men (83·6%), with 24 microadenomas (8·5%), 5 macroadenomas (1·8%) and 1 craniopharyngioma (0·4%) identified. The remaining 16 (5·7%) comprised a range of minor pituitary abnormalities including small cysts and empty sella. All men with abnormal imaging studies had otherwise normal pituitary function. Imaging abnormalities were associated with a significantly lower age at presentation (50 vs 54 years, P = 0·02), but no differences in testosterone or gonadotrophin levels were observed. Current Endocrine Society guidelines would have prompted imaging in only three of six patients with significant pituitary pathology.

Conclusions

Structural pituitary disease is more common in isolated HH than in the general population, and current guidelines do not accurately identify ‘at‐risk’ individuals. Full anterior pituitary function testing has a low yield in patients presenting with hypogonadism. The optimal strategy for determining the need for pituitary imaging remains uncertain.
Time‐efficiency analysis of the treatment with monolithic implant crowns in a digital workflow: a randomized controlled trial
Authors: Joda Tim , Brägger Urs
Published: January 2016

Objectives

The aim of the randomized controlled trial was to analyze time‐efficiency of a treatment with implant crowns made of monolithic lithium disilicate (LS2) plus titanium base vs. porcelain fuse to zirconium dioxide (ZrO2) in a digital workflow.

Materials and Methods

Twenty study participants were included for single‐tooth replacement in premolar and molar sites. Baseline was the start of the prosthetic treatment. All patients received transocclusal screw‐retained implant reconstructions on a soft tissue level‐type implant. The 3D implant position was captured with intraoral optical scanning (IOS). After randomization, ten patients were restored with CAD‐/CAM‐produced monolithic LS2‐crowns bonded to prefabricated titanium abutments without any physical models (test), and ten patients with CAD‐/CAM‐fabricated ZrO2‐suprastructures and hand‐layered ceramic veneering with milled master models (control). Every single clinical and laboratory work step was timed in minutes and then analyzed for time‐efficiency with Wilcoxon Rank Sum Tests. Direct costs were assessed for laboratory fees for first line production in Swiss Francs (CHF).

Results

Two clinical appointments were necessary for IOS and seating of all implant crowns. The mean total production time, as the sum of clinical plus laboratory work steps, was significantly different, resulting in 75.3 min (SD ± 2.1) for test and 156.6 min (SD ± 4.6) for control [P = 0.0001]. Analysis for clinical treatment sessions showed a significantly shorter mean chair time for the complete digital workflow of 20.8 min (SD ± 0.3) compared to 24.1 min (SD ± 1.1) [P = 0.001]. Even more obvious were the results for the mean laboratory work time with a significant reduction of 54.5 min (SD ± 4.9) vs. 132.5 min (SD ± 8.7), respectively [P = 0.0001].

Conclusion

The test workflow was more time‐efficient than the controls for implant‐supported crowns; notably, laboratory fabrication steps could be effectively shortened with the digital process of monolithic LS2 plus titanium base resulting in more than 30% reduced overall treatment costs.
Life after PROSPER. What do people do for external rectal prolapse?
Authors: Gunner C. K. , Senapati A , Northover J. M. A. , Brown S. R.
Published: January 2016

Aim

A questionnaire completed by members of the ACPGBI in 1997 was a precursor to the PROSPER trial. It showed a significant variation in favoured practice for the surgical treatment of external rectal prolapse. We repeated the same questionnaire to assess how practice has changed since the completion of the trial and its publication.

Method

An online survey was circulated to all members of the ACPGBI with identical questions to those used in the original in 1997.

Results

Similar numbers of recipients responded (122/791 [15.4%] in 2014;153/600 [25.5%] in 1997). The median number of operations per surgeon per year was unchanged (6 [0‐30] vs 6 [0–25]). The percentage of surgeons who favoured an abdominal approach in fit patients in 1997 rose significantly from 63.5% to 81.7% in 2014 (P < 0.01). Delorme's remains the most popular perineal procedure (78.5% vs 93.3%), but the Altemeier procedure increased from 14.9% to 39.3%. Ventral rectopexy was the preferred abdominal approach in 2014 (48.6% vs 5.9% [P < 0.01]), with 96.3% of these being performed laparoscopically. The number of surgeons carrying out posterior rectopexy decreased from 92.6% to 45.9% (P < 0.01). Only 9.9% of surgeons still undertook resection rectopexy compared with 39.7% in 1997 (P < 0.01). The numbers of surgeons favouring a perineal approach decreased (18.3% vs 36.5%) although the use of a perineal procedure in elderly or unfit patients was unchanged (38.5% vs 37.9%).

Conclusion

The surgical management of external rectal prolapse had changed. More surgeons favoured a laparoscopic abdominal approach in 2014 than in 1997 and the use of perineal approaches had decreased. Of these Delorme's operation remained the most popular but the incidence of the use of Altmeier's procedure had increased.
The dynamic regeneration niche of a forest following a rare disturbance event
Authors: Smith Annabel L. , Blanchard Wade , Blair David P. , McBurney Lachlan , Banks Sam C. , Driscoll Don A. , Lindenmayer David B.
Published: January 2016

Aim

Knowledge of how climate and fire regimes affect regeneration in foundation species is critical to the conservation of entire ecosystems. Different stages of regeneration often require different ecological conditions, but dynamic constraints on regeneration are poorly known for species that regenerate only after infrequent wildfires. Focussing on a long‐lived, foundation tree species (Eucalyptus regnans), we tested the hypothesis that the relative importance of fire regime variables (fire severity and time since previous fire) and environmental gradients on post‐fire regeneration would shift as seedlings developed.

Location

South‐eastern Australia.

Methods

Following a large (> 59,000 ha) summer wildfire in 2009, we sampled 131 sites (61 burnt) annually for four years (2009–2012), representing the range of environmental conditions in which E. regnans occurs. We analysed the effect of fire severity, time since fire and environmental variables on early regeneration processes critical for post‐fire species distributions: seedling establishment, seedling density and growth through different height stages (10 cm, 25 cm, 50 cm and 200 cm).

Results

The regeneration niche of E. regnans was defined by different factors at different stages of development. Initially, seedlings established prolifically on burnt sites, regardless of severity. Three years into the regeneration process, high‐severity fire became the dominant driver of seedling persistence and growth over 25 cm. Growth over 50 cm was dependent on environmental conditions relating to elevation and precipitation.

Main conclusions

Our results describe how fire occurrence, fire severity and environmental gradients affected seedling establishment, persistence and growth. The dynamic constraints on regeneration likely reflect temporal changes in the biotic and abiotic environment and variation in resource requirements during the early post‐fire years. Our findings will enable more accurate forecasts of species distributions to assist forest conservation in the face of global changes in climate and fire regimes.
Environmental dynamics and anthropogenic development alter philopatry and space‐use in a North American cervid
Authors: Northrup Joseph M. , Anderson Charles R. , Wittemyer George
Published: January 2016

Aim

The space an animal uses over a given time period must provide the resources required for meeting energetic needs, reproducing and avoiding predation. Anthropogenic landscape change in concert with environmental dynamics can strongly structure space‐use. Investigating these dynamics can provide critical insight into animal ecology, conservation and management.

Location

The Piceance Basin, Colorado, USA.

Methods

We applied a novel utilization distribution estimation technique based on a continuous‐time correlated random walk model to characterize range dynamics of mule deer during winter and summer seasons across multiple years. This approach leverages second‐order properties of movement to provide a probabilistic estimate of space‐use. We assessed the influence of environmental (cover and forage), individual and anthropogenic factors on interannual variation in range use of individual deer using a hierarchical Bayesian regression framework.

Results

Mule deer demonstrated remarkable spatial philopatry, with a median of 50% overlap (range: 8–78%) in year‐to‐year utilization distributions. Environmental conditions were the primary driver of both philopatry and range size, with anthropogenic disturbance playing a secondary role.

Main conclusions

Philopatry in mule deer is suspected to reflect the importance of spatial familiarity (memory) to this species and, therefore, factors driving spatial displacement are of conservation concern. The interaction between range behaviour and dynamics in development disturbance and environmental conditions highlights mechanisms by which anthropogenic environmental change may displace deer from familiar areas and alter their foraging and survival strategies.
Behavioural and physiological plasticity of gypsy moth larvae to host plant switching
Authors: Milanović Slobodan , Janković‐Tomanić Milena , Kostić Igor , Kostić Miroslav , Morina Filis , Živanović Bojana , Lazarević Jelica
Published: January 2016

Larvae of the gypsy moth, Lymantria dispar L. (Lepidoptera: Lymantriidae), a generalist species, frequently encounter spatial and temporal variations in diet quality. Such variation favoured the evolution of high behavioural and physiological plasticity which, depending on forest stand composition, enables more or less successful exploitation of the environment. Even in mixed oak stands, a suitable habitat, interspecific and intraspecific host quality variation may provoke significant variation in gypsy moth performance and, consequently, defoliation severity. To elucidate the insufficiently explored relationship between gypsy moth and oaks (Fagaceae), we carried out reciprocal switches between Turkey oaks (Quercus cerris L.) and less nutritious Hungarian oaks (Quercus frainetto Ten.) (TH and HT groups), under controlled laboratory conditions, and compared larval performance between the switched larvae and larvae continuously fed on either Turkey oak (TT) or Hungarian oak (HH). We found that larval traits were most strongly affected by among‐tree variation in oak quality and identity of the host consumed during the fourth instar. Switching from Turkey to Hungarian oak (TH) led to a longer period of feeding, decrease of mass gain, growth, and consumption rate, lower efficiency of food use and nutrient conversion, and increase of protease and amylase activities. Larvae exposed to the reverse switch (HT) attained values of these traits characteristic for TT larvae. It appeared that the lower growth in the TH group than in the TT group was caused by both behavioural (consumption, pre‐ingestive) and metabolic (post‐digestive) effects from consuming oaks. Multivariate analyses of growth, consumption, and efficiency of food use revealed that early diet experience influenced the sensitivity of the most examined traits to less suitable Hungarian oaks, suggesting the development of behavioural and physiological adjustments. Our results indicate that lower risks of defoliation by gypsy moth might be expected in mixed stands with a higher proportion of Hungarian oak.
Acoustic Preference of Frog‐Biting Midges (Corethrella spp) Attacking Túngara Frogs in their Natural Habitat
Authors: Aihara Ikkyu , de Silva Priyanka , Bernal Ximena E.
Published: January 2016

In many animals, males aggregate to produce mating signals that attract conspecific females. These leks, however, also attract eavesdropping predators and parasites lured by the mating signal. This study investigates the acoustic preferences of eavesdroppers attracted to natural choruses in a Neotropical frog, the túngara frog (Engystomops pustulosus). In particular, we examined the responses of frog‐biting midges to natural variation in call properties and signaling rates of males in the chorus. These midges use the mating calls of the frogs to localize them and obtain a blood meal. Although it is known that the midges prefer complex over simple túngara frog calls, it is unclear how these eavesdroppers respond to natural call variation when confronted with multiple males in a chorus. We investigated the acoustic preference of the midges using calling frogs in their natural environment and thus accounted for natural variation in their call properties. We performed field recordings using a sound imaging system to quantify the temporal call properties of males in small choruses. During these recordings, we also collected frog‐biting midges attacking calling males. Our results revealed that, in a given chorus, male frogs calling at higher rates and with higher call complexity attracted a larger number of frog‐biting midges. Call rate was particularly important at increasing the number of midges attracted when males produced calls of lower complexity. Similarly, call complexity increased attractiveness to the midges especially when males produced calls at a low repetition rate. Given that female túngara frogs prefer calls produced at higher repetition rates and higher complexity, this study highlights the challenge faced by signalers when increasing attractiveness of the signal to their intended receivers.
Diluted serum from calorie‐restricted animals promotes mitochondrial β‐cell adaptations and protect against glucolipotoxicity
Authors: Cerqueira Fernanda M. , Chausse Bruno , Baranovski Boris M. , Liesa Marc , Lewis Eli C. , Shirihai Orian S. , Kowaltowski Alicia J.
Published: January 2016

β‐cells quickly adjust insulin secretion to oscillations in nutrients carried by the blood, acting as fuel sensors. However, most studies of β‐cell responses to nutrients do not discriminate between fuel levels and signaling components present in the circulation. Here we studied the effect of serum from calorie‐restricted rats versus serum from rats fed ad libitum, diluted tenfold in the medium, which did not contribute significantly to the pool of nutrients, on β‐cell mitochondrial function and dynamics under regular and high‐nutrient culture conditions. Insulin secreting beta‐cell derived line (INS1) cells incubated with serum from calorie‐restricted rats (CR serum) showed higher levels of peroxisome proliferator‐activated receptor gamma coactivator 1‐α (PGC‐1α) and active nitric oxide synthase. The expression of mitofusin‐2 (Mfn‐2) and optic atrophy 1 (OPA‐1), proteins involved in mitochondrial fusion, was increased, while the levels of the mitochondrial fission mediator dynamin related protein 1 (DRP‐1) were reduced. Consistent with changes in mitochondrial dynamics protein levels, CR serum treatment increased mitochondrial fusion rates, as well as their length and connectivity. These changes in mitochondrial morphology were associated with prolonged glucose‐stimulated insulin secretion and mitochondrial respiration. When combining CR serum and high levels of glucose and palmitate (20 and 0.4 mm, respectively), an in vitro model of type II diabetes, we observed that signaling promoted by CR serum was enough to overcome glucolipotoxicity, as indicated by CR‐mediated prevention of mitochondrial fusion arrest and reduced respiratory function in INS1 cells under glucolipotoxicity. Overall, our results provide evidence that non‐nutrient factors in serum have a major impact on β‐cell mitochondrial adaptations to changes in metabolism.
Perceptions of crisis care in populations who self‐referred to a telephone‐based mental health triage service
Authors: Sands Natisha , Elsom Stephen , Keppich‐Arnold Sandra , Henderson Kathryn , Thomas Phillipa A.
Published: January 2016

Although psychiatric crises are very common in people with mental illness, little is known about consumer perceptions of mental health crisis care. Given the current emphasis on recovery‐oriented approaches, shared decision‐making, and partnering with consumers in planning and delivering care, this knowledge gap is significant. Since the late 1990s, access to Australian mental health services has been facilitated by 24/7 telephone‐based mental health triage systems, which provide initial psychiatric assessment, referral, support, and advice. A significant proportion of consumers access telephone‐based mental health triage services in a state of crisis, but to date, there has been no published studies that specifically report on consumer perceptions on the quality and effectiveness of the care provided by these services. This article reports on a study that investigated consumer perceptions of accessing telephone‐based mental health triage services. Seventy‐five mental health consumers participated in a telephone interview about their triage service use experience. An eight‐item survey designed to measure the responsiveness of mental health services was used for data collection. The findings reported here focus on the qualitative data produced in the study. Consumer participants shared a range of perspectives on telephone‐based mental health triage that provide invaluable insights into the needs, expectations, and service use experiences of consumers seeking assistance with a mental health problem. Consumer perceptions of crisis care have important implications for practice. Approaches and interventions identified as important to quality care can be used to inform educational and practice initiatives that promote person‐centred, collaborative crisis care.
‘It's the little things that count’: healthcare professionals’ views on delivering dignified care: a qualitative study
Authors: Williams Veronika , Kinnear Deborah , Victor Christina
Published: January 2016

Aims

To explore healthcare professionals’ perspectives of dignified care and experiences of providing care.

Background

Although ‘care’ and dignity in care are seen as central to the delivery of good care by patients, families and professionals, we still lack a clear understanding of what these, often contested and elusive concepts, mean in the practice setting, particularly from the perspective of healthcare professionals.

Design

Interview based qualitative research design.

Methods

In‐depth interviews were conducted with healthcare professionals working in four UK NHS trusts. Data were collected between June–November 2012. Interviews were audio‐recorded, transcribed and analysed using thematic analysis.

Findings

Forty‐eight healthcare professionals took part in this interview based study. Two main themes that encapsulated how care and dignity in care is enacted by professionals were identified: focusing on the ‘little’ things that matter to both professionals and patients; and improving care by making poor care ‘visible’.

Conclusion

Our findings show that the ‘little things’ in care allow professionals to ‘care for’ but also ‘care about’ patients, suggesting that these two aspects of caring become intrinsically interlinked. Our findings also suggest that ‘making poor care visible’ challenges engrained and task rather than human focused care in a non‐threatening way, which can be the catalyst for providing care that is caring and dignified.
Patients with acute abdominal pain describe their experiences of fundamental care across the acute care episode: a multi‐stage qualitative case study
Authors: Jangland Eva , Kitson Alison , Muntlin Athlin Åsa
Published: January 2016

Aim

To explore how patients with acute abdominal pain describe their experiences of fundamental care across the acute care episode.

Background

Acute abdominal pain is one of the most common conditions to present in the acute care setting. Little is known about how patients’ fundamental care needs are managed from presentation to post discharge.

Design

A multi‐stage qualitative case study using the Fundamentals of Care framework as the overarching theoretical and explanatory mechanism.

Methods

Repeated reflective interviews were conducted with five adult patients over a 6‐month period in 2013 at a university hospital in Sweden. The interviews (n = 14) were analysed using directed content analysis.

Results

Patients’ experiences across the acute care episode are presented as five patient narratives and synthesized into five descriptions of the entire hospital journey. The patients talked about the fundamentals of care and had vivid accounts of what they meant to them. The experiences of each of the patients were influenced by the extent to which they felt engaged with the health professionals. The ability to engage or build a rapport was identified as a central component across the fundamental care elements, but it varied in visibility.

Conclusion

Consistent pain management, comfort, timely and accurate information, choice and dignity and relationships were identified as essential fundamental care needs of patients experiencing acute abdominal pain regardless of setting, diagnosis, or demographic variables. These were variously achieved and the patients’ narratives raised areas for improvement in several areas.
Transforming practice into clinical scholarship
Authors: Limoges Jacqueline , Acorn Sonia
Published: January 2016

Aim

The aims of this paper were to explicate clinical scholarship as synonymous with the scholarship of application and to explore the evolution of scholarly practice to clinical scholarship.

Background

Boyer contributed an expanded view of scholarship that recognized various approaches to knowledge production beyond pure research (discovery) to include the scholarship of integration, application and teaching. There is growing interest in using Boyer's framework to advance knowledge production in nursing but the discussion of clinical scholarship in relation to Boyer's framework is sparse.

Design

Discussion paper.

Data sources

Literature from 1983–2015 and Boyer's framework.

Implications for nursing

When clinical scholarship is viewed as a synonym for Boyer's scholarship of application, it can be aligned to this well established framework to support knowledge generated in clinical practice. For instance, applying the three criteria for scholarship (documentation, peer review and dissemination) can ensure that the knowledge produced is rigorous, available for critique and used by others to advance nursing practice and patient care. Understanding the differences between scholarly practice and clinical scholarship can promote the development of clinical scholarship. Supporting clinical leaders to identify issues confronting nursing practice can enable scholarly practice to be transformed into clinical scholarship.

Conclusion

Expanding the understanding of clinical scholarship and linking it to Boyer's scholarship of application can assist nurses to generate knowledge that addresses clinical concerns. Further dialogue about how clinical scholarship can address the theory‐practice gap and how publication of clinical scholarship could be expanded given the goals of clinical scholarship is warranted.
Prospective Evaluation of Electromyography‐Guided Phrenic Nerve Monitoring During Superior Vena Cava Isolation to Anticipate Phrenic Nerve Injury
Authors: MIYAZAKI SHINSUKE , ICHIHARA NOBORU , NAKAMURA HIROAKI , TANIGUCHI HIROSHI , HACHIYA HITOSHI , ARAKI MAKOTO , TAKAGI TAKAMITSU , IWASAWA JIN , KUROI AKIO , HIRAO KENZO , IESAKA YOSHITO
Published: January 2016

Right Diaphragmatic CMAP During SVC Isolation

Background

Right phrenic nerve injury (PNI) is a major concern during superior vena cava (SVC) isolation due to the anatomical close proximity. The functional and histological severity of PNI parallels the degree of the reduction in the compound motor action potential (CMAP) amplitude. This study aimed to evaluate the feasibility of monitoring CMAPs during SVC isolation to anticipate PNI during atrial fibrillation (AF) ablation.

Methods

Thirty‐nine paroxysmal AF patients were prospectively enrolled. Radiofrequency energy was delivered point‐by‐point for 30 seconds with 20 W until eliminating all SVC potentials after the pulmonary vein isolation. Right diaphragmatic CMAPs were obtained from modified surface electrodes by pacing from the right subclavian vein. Radiofrequency applications were applied without fluoroscopy under CMAP monitoring at sites with phrenic nerve capture by high output pacing.

Results

Electrical SVC isolation was successfully achieved with a mean of 9.4 ± 3.3 applications in all patients. In 3 (7.5%) patients, the SVC was isolated without radiofrequency delivery at phrenic nerve capture sites. Among a total of 346 applications in the remaining 36 patients, 71 (20.5%) were delivered while monitoring CMAPs. In 1 (1.4%) application, the RF application was interrupted due to a decrease in the CMAP amplitude. However, no PNI was detected on fluoroscopy, and the decreased amplitude recovered spontaneously. The remaining 70 (98.6%) applications exhibited no significant changes in the CMAP amplitude throughout the applications (from 1.01 ± 0.47 to 0.98 ± 0.45 mV, P = 0.383).

Conclusions

Stable right diaphragmatic CMAPs could be obtained, and monitoring CMAPs might be useful for anticipating right PNI during SVC isolation.