bluuebunny/crossref_metadata_2025 huggingface dataset:
The Effects of Environmental Information Disclosure and Energy Types on the Cost of Equity: Evidence from the Energy Industry in China
Authors: Fonseka Mohan , Rajapakse Theja , Tian Gao‐Liang
Published: June 2019

This study investigates whether environment information disclosure (EID) and different energy sources have any effect on the cost of equity capital (COEC), and how the EID effect on the COEC varies with different types of energy. We find a negative relationship between EID and COEC. Thus, EID reduces the agency problem and information asymmetry between firms and investors, and also supports the legitimacy and stakeholder theories’ explanation of the effect of EID on the COEC in China. We find a positive (negative) relationship between some energy sources such as gas, fossil‐fuelled thermal power generation, and oil (hydro‐power generation, solar, and wind) and the COEC. The finding explains the polluting nature, risk of replacement, regulation risk, and regulatory costs of different energy types, and those risks have been accounted by investors. We also find that when gas, fossil‐fuelled thermal power, and oil firms increase their level of EID, their COEC increases, whereas when power grid, solar, and wind power firms increase their level of EID, their COEC decreases. This finding is supported by the combination of polluting nature, risk of replacement, regulation risk, and regulatory costs of different energy sources and legitimacy and stakeholder theories. Our findings are robust to several endogeneity checks and additional tests for several unique features of Chinese capital markets.
Ethanol Exposure Impairs AMPK Signaling and Phagocytosis in Human Alveolar Macrophages: Role of Ethanol Metabolism
Authors: Kaphalia Lata , Srinivasan Mukund P. , Kakumanu Ramu D. , Kaphalia Bhupendra S. , Calhoun William J.
Published: June 2019

Background

Chronic alcohol consumption impairs alveolar macrophage's (AM) function and increases risk for developing lung infection and pneumonia. However, the mechanism and metabolic basis of alcohol‐induced AM dysfunction leading to lung infection are not well defined, but may include altered ethanol (EtOH) and reactive oxygen species metabolism and cellular energetics. Therefore, oxidative stress, endoplasmic reticulum (ER) stress, the formation of fatty acid ethyl esters [FAEEs, nonoxidative metabolites of EtOH], AMP‐activated protein kinase (AMPK) signaling, and phagocytic function were examined in freshly isolated AM incubated with EtOH.

Methods

AMs separated from bronchoalveolar lavage fluid samples obtained from normal volunteers were incubated with EtOH for 24 hours. AMPK signaling and ER stress were assessed using Western blotting, FAEEs by GC‐MS, oxidative stress by immunofluorescence using antibodies to 4‐hydroxynonenal, and phagocytosis by latex beads. Oxidative stress was also measured in EtOH‐treated AMs with/without AMPK activator [5‐aminoimidazole‐4‐carboxamide ribonucleotide (AICAR)] or inhibitor (Compound C), and in AMs incubated with FAEEs. mRNA expression for interleukins (IL‐6 and IL‐8), monocyte chemoattractant protein (MCP)‐1, and transforming growth factor (TGF)‐β was measured in AM treated with EtOH or FAEEs using RT‐PCR.

Results

EtOH exposure to AM increased oxidative stress, ER stress, and synthesis of FAEEs, decreased phosphorylated AMPK, and impaired phagocytosis. Attenuation or exacerbation of EtOH‐induced oxidative stress by AICAR or Compound C, respectively, suggests a link between AMPK signaling, EtOH metabolism, and related oxidative stress. The formation of FAEEs may contribute to EtOH‐induced oxidative stress as FAEEs also produced concentration‐dependent oxidative stress. An increased mRNA expression of IL‐6, IL‐8, and MCP‐1 by FAEEs is key finding to suggest a metabolic basis of EtOH‐induced inflammatory response.

Conclusions

EtOH‐induced impaired phagocytosis, oxidative stress, ER stress, and dysregulated AMPK signaling are plausibly associated with the formation of FAEEs and may participate in the pathogenesis of nonspecific pulmonary inflammation.
Effects of Acute Ethanol Administration on Brain Oxidative Status: The Role of Acetaldehyde
Authors: Baliño Pablo , Romero-Cano Ricard , Sánchez‐Andrés Juan Vicente , Valls Victoria , Aragón Carlos González , Muriach María
Published: June 2019

Background

Ethanol (EtOH), one of the most widely consumed substances of abuse, can induce brain damage and neurodegeneration. EtOH is centrally metabolized into acetaldehyde, which has been shown to be responsible for some of the neurophysiological and cellular effects of EtOH. Although some of the consequences of chronic EtOH administration on cell oxidative status have been described, the mechanisms by which acute EtOH administration affects the brain's cellular oxidative status and the role of acetaldehyde remain to be elucidated in detail.

Methods

Swiss CD‐I mice were pretreated with the acetaldehyde‐sequestering agent d‐penicillamine (DP; 75 mg/kg, i.p.) or the antioxidant lipoic acid (LA; 50 mg/kg, i.p.) 30 minutes before EtOH (2.5 g/kg, i.p.) administration. Animals were sacrificed 30 minutes after EtOH injection. Glutathione peroxidase (GPx) mRNA levels; GPx and glutathione reductase (GR) enzymatic activities; reduced glutathione (GSH), glutathione disulfide (GSSG), glutamate, g‐L‐glutamyl‐L‐cysteine (Glut‐Cys), and malondialdehyde (MDA) concentrations; and protein carbonyl group (CG) content were determined in whole‐brain samples.

Results

Acute EtOH administration enhanced GPx activity and the GSH/GSSG ratio, while it decreased GR activity and GSSG concentration. Pretreatment with DP or LA only prevented GPx activity changes induced by EtOH.

Conclusions

Altogether, these results show the capacity of a single dose of EtOH to unbalance cellular oxidative homeostasis.
Reduced post‐operative urinary tract infection using the National Surgical Quality Improvement Program
Authors: Scanlon Kate , Shakeshaft Anthony J. , Cox Michael R.
Published: June 2019

Background

The incidence of post‐operative urinary tract infection (UTI) is frequently unknown or underestimated. Failure to recognize a clinical problem results in no action occurring to improve outcomes. The aims of this study were firstly to define the incidence of post‐operative UTI in general surgery patients using the American College of Surgeons National Surgical Quality Improvement Program (ACS‐NSQIP). Secondly to design and implement an intervention to reduce the incidence of post‐operative UTI and assess the extent of improvement.

Methods

ACS‐NSQIP data were collected and analysed from June 2015 to June 2016 and reported in the Semi Annual Report (SAR). A quality improvement programme was designed and implemented to manage the high incidence of UTI. The outcomes were assessed by the subsequent ACS‐NSQIP SAR.

Results

The SAR in 2016 reported that Nepean Hospital as a significant outlier with an incidence of post‐operative UTI of 3.62% (odds ratio 2.21, confidence limits 1.51–3.44, P < 0.001). A hospital‐wide policy for catheter insertion in surgical patients was developed including: education, workshops, accreditation for aseptic technique for catheter insertion, reduced rates of insertion, reduced duration of use and improved catheter care. There was a significant improvement in the incidence of UTI (1.21%) reported by the 2018 SAR (odds ratio 1.01, confidence limits 0.64–1.60, P = 0.68).

Conclusions

ACS‐NSQIP identified a 2.2‐fold increased risk of post‐operative UTI. There was no increased risk of UTI after the programme to reduce UTI was introduced.
Short‐term physiological response to high‐frequency‐actuated pVAD support
Authors: Rebholz Mathias , Dual Seraina , Batliner Martin , Meboldt Mirko , Schmid Daners Marianne
Published: June 2019

Ventricular assist devices (VADs) are an established treatment option for heart failure (HF). However, the devices are often plagued by material‐related hemocompatibility issues. In contrast to continuous flow VADs with high shear stresses, pulsatile VADs (pVADs) offer the potential for an endothelial cell coating that promises to prevent many adverse events caused by an insufficient hemocompatibility. However, their size and weight often precludes their intracorporeal implantation. A reduction of the pump body size and weight of the pump could be achieved by an increase in the stroke frequency while maintaining a similar cardiac output. We present a new pVAD system consisting of a pump and an actuator specifically designed for actuation frequencies of up to 240 bpm. In vitro and in vivo results of the short‐term reaction of the cardiovascular system show no significant changes in left ventricular and aortic pressure between actuation frequencies from 60 to 240 bpm. The aortic pulsatility increases when the actuation frequency is raised while the heart rate remains unaffected in vivo. These results lead us to the conclusion that the cardiovascular system tolerates short‐term increases of the pVAD stroke frequencies.
Effect of the outer stent position on efficacy after minimally invasive transscleral glaucoma gel stent implantation
Authors: Lenzhofer Markus , Strohmaier Clemens , Sperl Philipp , Hohensinn Melchior , Hitzl Wolfgang , Steiner Veit , Moussa Sarah , Motloch Karolina , Baca Björn , Krall Eva , Reitsamer Herbert A.
Published: June 2019

Purpose

The outer stent lumen can be located either deeper (in or under Tenon's layer) or more superficially in the conjunctival stroma after the transscleral XEN Glaucoma Gel Microstent (XEN‐GGM; Allergan Plc., USA) implantation. The present study aimed to investigate the effect of the postoperative conjunctival implant position on surgical success and intraocular pressure (IOP) after XEN‐GGM.

Methods

Prospective data from 66 consecutive open‐angle glaucoma eyes of 54 patients were collected preoperatively and 1 and 2 weeks, and 1, 6 and 12 months postoperatively. The layer of implantation was determined in the first month postoperatively as intra‐ and subtenon or intraconjunctival depending on the location of the outer lumen of the stent in OCT (Visante OCT; Zeiss, Germany). Primary outcome measures were differences in relative IOP reduction at 12 months between the two groups. Further, complete and qualified surgical success, number of secondary needlings and number of IOP‐lowering medications and absolute IOP were assessed.

Results

Relative IOP reduction was higher in intra‐ and subtenon group (n = 37/66, 56%) at week 1 (−54% versus −19%, p < 0.001), week 2 (−39% versus −21%, p = 0.02), month 1 (−42% versus −28%, p = 0.035) and month 12 (−39% versus −24%, p = 0.024). The mean absolute IOP was lower in intra‐ and subtenon group at week 1 (10.8 [95%CI, 8.8–14.1] versus 16.6 [95%CI, 14.1–19.0] mmHg, p < 0.001) and months 12 (13.9 [95%CI, 12.4–15.4] versus 16.7 [95%CI, 14.6–18.8] mmHg, p = 0.041). At month 6, a lower burden for IOP‐lowering medication was shown for the intra‐ and subtenon group (0.2 ± 0.5 versus 1.0 ± 1.1, p = 0.034). The mean number of secondary needlings, which were done in 47/66 (71%) of the eyes, was lower in the intra‐ and subtenon group in the first year (1.9 ± 1.7 versus 1.2 ± 1.2, p = 0.03). Qualified surgical success was higher in the intra‐ and subtenon group (90% versus 61%, p = 0.01) after 1 year.

Conclusion

The present study demonstrates a higher efficacy achieved with lower secondary needling rates in deeper implant positions in conjunctiva after XEN‐GGM.
Perioperative subconjunctival triamcinolone acetonide injection for prevention of inflammation and macular oedema after cataract surgery
Authors: Lindholm Juha‐Matti , Taipale Claudia , Ylinen Petteri , Tuuminen Raimo
Published: June 2019

Purpose

To compare the efficacy, safety and tolerability of a single perioperative subconjunctival injection of triamcinolone acetonide (TA) with steroid drops for the prevention of macular oedema and ocular inflammation after cataract surgery.

Methods

This prospective non‐randomized controlled clinical trial analysed 101 eyes of 101 patients having an elective cataract surgery at Kymenlaakso Central Hospital, Kotka, Finland. Fifty eyes received conventional postoperative care with dexamethasone 1 mg/ml eye drops (DEX), and 51 eyes received a perioperative 20 mg subconjunctival injection of TA. None of the eyes received postoperative topical antibiotic prophylaxis. The main outcome measures were aqueous flare, central retinal thickness (CRT), corrected distance visual acuity (CDVA) and intraocular pressure (IOP) measured at 7, 28 and 90 days after surgery.

Results

Central retinal thickness (CRT) increased in DEX but not in TA‐treated eyes at 7 days (+1.2 ± 20.1 μm and −9.2 ± 24.8 μm, p = 0.031), at 28 days (+23.8 ± 62.6 μm and −3.3 ± 27.7 μm, p = 0.008) and at 90 days (+8.5 ± 24.4 μm and −5.5 ± 33.4 μm, p = 0.026). Aqueous flare increased from baseline in both groups but remained higher in DEX eyes at 90 days (+3.3 ± 9.9 photons/ms and −0.2 ± 6.6 photons/ms, p = 0.021). Corrected distance visual acuity (CDVA) and IOP changes were similar, and ocular tolerance was good in both groups. No serious adverse events were observed.

Conclusions

Perioperative subconjunctival TA was effective in preventing ocular inflammation and macular oedema after cataract surgery. Subconjunctival TA combined with intracameral cefuroxime provides a noteworthy option for dropless postoperative care in modern cataract surgery.
Throwing our bodies against the white background of academia
Authors: Johnson Azeezat
Published: June 2019

This paper addresses the difficulty of conducting research about non‐white racialised persons while working within predominantly white academic institutions. Specifically, I examine how to conduct research without representing Black bodies as a fixed, exoticised Other that is oppositional to a disembodied white Self. To do so, I use double consciousness alongside Black feminist work on dialogues as a methodological framework to centre Black Muslim women as knowledge producers. This novel approach moves away from simply describing (and fixing) racialised bodies to a particular performance/experience, and instead explores how performances shift as we negotiate different bodies, objects, and spaces. The paper advances discussions in critical race studies and the ethics of geographical research by illustrating how the situated experiences of the researcher and the participant are embedded in processes of knowledge production: I look to subvert the fixing of racialised bodies as deviations from the normative white background of academia.
Hunting practices in northern Australia and their implication for disease transmission between community dogs and wild dogs
Authors: Gabriele‐Rivet V , Brookes VJ , Arsenault J , Ward MP
Published: June 2019

Objective

This survey aimed to understand hunting practices involving domestic dogs in remote Indigenous communities in northern Australia and, in the context of disease transmission, describe the domestic–wild dog interface and intercommunity interactions of hunting dogs during hunting activities.

Methods

A cross‐sectional survey of 13 hunters from communities of the Northern Peninsula Area (NPA) of Queensland gathered information on demographics of hunters and hunting dogs, hunting practices and past encounters with wild dogs during hunting trips. Social networks that described the connections of hunters between NPA communities from hunting expeditions were developed.

Results

Most hunters interviewed were not aware of any diseases that could be transmitted to dogs (n = 11) or humans (n = 9) from wild animals while hunting. More than half (n = 7) of the respondents had experienced at least one wild dog encounter during hunting in the year prior to the interview. A map of the relative risk of interactions between wild and hunting dogs during hunting trips allowed the identification of high‐risk areas in the NPA; these areas are characterised by dense rainforests. The social networks at the community level resulted in relatively large density measures reflecting a high level of intercommunity connectedness.

Conclusions

This study contributes to our knowledge of Australian Indigenous hunting practices and supports the potential for disease transmission at the domestic–wild dog interface and intercommunity level through contacts between hunting dogs during hunting activities. Insights from this study also highlight the need for educational programs on disease management in Indigenous communities of northern Australia.
Remote sensing of coastal vegetation: Dealing with high species turnover by mapping multiple floristic gradients
Authors: Unberath Iris , Vanierschot Laura , Somers Ben , Van De Kerchove Ruben , Vanden Borre Jeroen , Unberath Mathias , Feilhauer Hannes
Published: June 2019

Aims

Mapping gradual transitions in plant species composition via a combination of ordination and regression from remote sensing data is becoming an established approach. However, straightforward analysis of areas with high species turnover rates may result in a loss of information since a high level of generalization is required. In this study, we investigate whether analysis of more homogeneous subsets, in contrast to processing of the complete dataset, is a viable approach to mapping multiple floristic gradients.

Location

The coastal nature reserve “Zwin” (Belgium).

Methods

The measured dataset is partitioned into more homogeneous subsets based upon species composition using hierarchical classification. The dataset and subsets are then processed separately. First, ordination is performed to extract floristic gradients in plant species composition; second, these gradients are related to airborne hyperspectral remote sensing data through regression models and mapped by projecting these models on image data. Regression validation and Mantel tests are used to compare the results within the study and to other studies.

Results

Hierarchical classification resulted in two homogeneous vegetation subsets. Ordination yielded four gradients in the area and all regression models compared favorably to similar studies in other areas with R² values ranging from 0.47 to 0.74. The Mantel test showed that by dividing the dataset into subsets, higher resemblance to the original vegetation data can be achieved.

Conclusion

We showed that mapping gradual transitions in plant species composition across multiple subsets sampled from one measured vegetation dataset is a promising approach for retrospective analysis of areas with high species turnover rates. In addition to potential improvements in performance, this complementary analysis enables mapping of additional gradients, suggesting that all conventionally predicted maps remain available, valuable, and necessary for thorough understanding of plant species composition.
Preschool developmental concerns and adjustment in the early school years: Evidence from a Scottish birth cohort
Authors: Sim Fiona , Thompson Lucy , Marryat Louise , Law James , Wilson Philip
Published: June 2019

Background

Preschool language and behavioural difficulties impact on multiple domains of the child's early life and can endure into adulthood, predicting poor educational, social, and health outcomes. Highlighting risk factors associated with poor outcomes following language and behavioural difficulties raised in early childhood may facilitate early identification and intervention.

Methods

Data from the Growing Up in Scotland national birth cohort study were used. Language and behavioural difficulties were assessed at age 4 years using parent‐reported language concerns and the Strengths and Difficulties Questionnaire. Measures of adjustment were collated into four key outcome domains: attitude to school life, language and general development, behaviour, and general health at age 6 years. Both univariate and multivariate logistic regression models were fitted in order to explore independent associations between language and behavioural difficulties at age 4 years and adjustment to life circumstances at age 6 years, whilst controlling for other risk factors.

Results

Language difficulties at age 4 years increased the odds of the child experiencing difficulty with language and general development, poorer health outcomes, and behavioural difficulties at age 6 years. Behavioural difficulties alone at age 4 years were associated with increased odds of the child experiencing all of the aforementioned outcomes and difficulties in early school life. Lone parent family, low income, and male gender were identified as risk factors for poorer outcomes in the domains measured. At age 4 years, there was no additive effect found with the presence of behaviour difficulties on the relationship between language difficulties and language and developmental outcomes at 6 years.

Conclusions

This paper demonstrates language and behavioural difficulties are associated with poor social, educational, health, and behavioural outcomes. Taking seriously parent‐reported concerns and identifying risk factors could limit negative outcomes for the child, their family, and society.
The experiences of young people with chronic illness in New Zealand: A qualitative study
Authors: Sligo Judith , Jones Bernadette , Davies Cheryl , Egan Richard , Ingham Tristram , Hancox Robert J. , Richards Rosalina
Published: June 2019

Background

Around 10% of young people suffer from chronic health conditions, and their health care needs are different from those of children or adults. Most research about young people's chronic illness focuses on specific conditions, on younger children's experience, and on the perspectives of parents. This study explored the experiences of young people with two very different chronic conditions (asthma and cancer) and their perception of the New Zealand health system's response to their needs.

Methods

This was a collaborative research process where eight young co‐researchers who had asthma or cancer were employed to work alongside the research team to develop protocols, interview peers, and assist with analysis. The challenges of this process are described in the article. Twenty‐one young people between ages 15 and 27 from two urban areas of New Zealand participated in semistructured open‐ended interviews about their health care experiences. Sixteen participants were female, and five male. Eleven of the participants had finished cancer treatment (with an average of 3.6 years since diagnosis), and 10 had asthma. Purposeful sampling meant that 80% of the participants with asthma were identified as Māori and the other participants identified with a range of other ethnic groups. Data were thematically coded, and coresearchers were consulted to derive the ultimate findings.

Results

Chronic illness disrupted the trajectory of young people's lives and had significant effects on their relationships. The New Zealand health system generally did not respond well to the needs of these young people, but many encountered extraordinary individuals who supported them effectively. The experiences of some indigenous participants indicate that health professionals require effective cultural competence training.

Conclusions

This study provides insights into how young people with very different conditions experience the health system. Young people should be consulted and actively included in decision making about making health systems responsive to their diverse needs.
Prevalence of oral mucosal lesions in population‐based studies: A systematic review of the methodological aspects
Authors: da Silva Karine D. , de O. da Rosa Wellington L. , Sarkis‐Onofre Rafael , Aitken-Saavedra Juan P. , Demarco Flávio F. , Correa Marcos B. , Tarquinio Sandra B. C.
Published: June 2019

Objectives

To conduct a systematic review of the literature to evaluate the methodological aspects of population‐based studies on the prevalence of oral mucosal lesions (OMLs).

Methods

Two reviewers independently conducted a literature search in three databases (PubMed, Web of Science and Scopus) and extracted data using a standardized form. Data on the following characteristics of the included studies were collected: sample size; age of participants; references used to define the diagnostic criteria, training of the examiners, and data collection; type, grouping and characteristics of the lesions; and lesions excluded and measures of agreement between examiners. Data were analysed descriptively, and data synthesis was performed for each of the studies included in the analysis. A quality analysis of the studies was conducted, and the risk of bias was evaluated.

Results

A total of 29 studies were included in the analysis. Most of the published studies on the prevalence of OMLs were performed in Asian countries. The sample sizes ranged from 255 to 39 206. The World Health Organization guidelines were followed by most of the studies, in terms of design, examiner training and data collection. Approximately 25% of the studies did not determine inter‐examiner reliability. Moreover, almost half of the studies included did not report the response rate nor did they present the results with the appropriate confidence intervals.

Conclusions

Several important points need to be improved in population‐based studies focusing on the prevalence of OMLs. In particular, these studies should adequately report the response rate and findings, and to a lesser extent, the diagnostic criteria and training of the examiners. We encourage more research in this field and reinforce the importance of standardized studies to facilitate the comparison of different findings. PROSPERO registration number: CRD42018099386.
Transnational review of visual standards for driving: How Australia compares with the rest of the world
Authors: Yan Mabel K. , Kumar Himeesh , Kerr Nathan , Medeiros Felipe A. , Sandhu Sukhpal S. , Crowston Jonathan , Kong Yu X. G.
Published: June 2019

Importance

Driving is a highly visual task and a primary mode of transportation for many people around the world.

Background

There appears to be little uniformity of vision standards across the world for driving. We reviewed the basic screening visual requirements for obtaining standard private and commercial driving licences for a total of 70 jurisdictions, and reviewed the evidence behind these standards.

Design

Systematic review of basic screening vision standards worldwide for driving and literature review.

Samples

Published online documentation on visual acuity and field requirements for driving.

Methods

Journal articles, government reports and websites obtained via a Google search were used to review the regulations for driving. This was limited by the comprehensiveness of resources, and countries were excluded if the requirements were unclear or unattainable. A literature review was performed using Medline with keywords vision, driving and visual field.

Main Outcome Measures

Visual parameters used for driving assessment.

Results

The results suggest significant variations across the world. The visual acuity requirements for a private licence range from a minimum of 6/9 to 6/60. The minimum binocular horizontal field requirement ranges from 110° to 150°. In general, standards for a commercial licence are stricter compared to a private licence. A literature review could not support the current driving standards as evidence‐based.

Conclusions and Relevance

The disunity of driving vision requirements worldwide likely reflects the inconclusive evidence base. Accounting for individual differences and the ability to predict individual risk is important in the context of determining driving licensure.
Reserve design to optimize functional connectivity and animal density
Authors: Gupta Amrita , Dilkina Bistra , Morin Dana J. , Fuller Angela K. , Royle J. Andrew , Sutherland Christopher , Gomes Carla P.
Published: June 2019

Ecological distance‐based spatial capture–recapture models (SCR) are a promising approach for simultaneously estimating animal density and connectivity, both of which affect spatial population processes and ultimately species persistence. We explored how SCR models can be integrated into reserve‐design frameworks that explicitly acknowledge both the spatial distribution of individuals and their space use resulting from landscape structure. We formulated the design of wildlife reserves as a budget‐constrained optimization problem and conducted a simulation to explore 3 different SCR‐informed optimization objectives that prioritized different conservation goals by maximizing the number of protected individuals, reserve connectivity, and density‐weighted connectivity. We also studied the effect on our 3 objectives of enforcing that the space‐use requirements of individuals be met by the reserve for individuals to be considered conserved (referred to as home‐range constraints). Maximizing local population density resulted in fragmented reserves that would likely not aid long‐term population persistence, and maximizing the connectivity objective yielded reserves that protected the fewest individuals. However, maximizing density‐weighted connectivity or preemptively imposing home‐range constraints on reserve design yielded reserves of largely spatially compact sets of parcels covering high‐density areas in the landscape with high functional connectivity between them. Our results quantify the extent to which reserve design is constrained by individual home‐range requirements and highlight that accounting for individual space use in the objective and constraints can help in the design of reserves that balance abundance and connectivity in a biologically relevant manner.
Site‐selection bias and apparent population declines in long‐term studies
Authors: Fournier Auriel M.V. , White Easton R. , Heard Stephen B.
Published: June 2019

Detecting population declines is a critical task for conservation biology. Logistical difficulties and the spatiotemporal variability of populations make estimation of population declines difficult. For statistical reasons, estimates of population decline may be biased when study sites are chosen based on abundance of the focal species. In this situation, apparent population declines are likely to be detected even if there is no decline. This site‐selection bias is mentioned in the literature but is not well known. We used simulations and real population data to examine the effects of site‐selection biases on inferences about population trends. We used a left‐censoring method to detect population‐size patterns consistent with site‐selection bias. The site‐selection bias is an important consideration for conservation biologists, and we offer suggestions for minimizing or mitigating it in study design and analysis.

Article impact statement: Estimates of population declines are biased if studies begin in large populations, and time‐series data show a signature of such an effect.
The many meanings of autism: conceptual and ethical reflections
Authors: Hens Kristien
Published: June 2019

Autism is a polysemous concept. It is defined as a neurodevelopmental disorder that is diagnosed based on an assessment of behaviour and dysfunction. Autism also refers to a specific way of information or sensorial processing. For those diagnosed with autism, it is a real and shared experience. In this paper, I sketch the moral work that biological conceptions of autism perform. They help to conceptualize the diagnosis and associated challenges as real and they remove some of the blame from the diagnosed person and/or their parents. But such approaches also risk neglecting the role of behaviour as a meaningful reaction to experiences. In thinking about the ethics of autism research, diagnosis of autism, and autism care, the recent findings of epigenetics and systems biology may help us overcome the dichotomy between biology and psyche, and point the way to a more nuanced and ethical view.

What this paper adds

The meaning of ‘autism’ has different layers and as such autism is a polysemous concept.

The lived experience of autistic people matters in research.
Deep brain stimulation for cerebral palsy: where are we now?
Authors: Sanger Terence D
Published: June 2019

Cerebral palsy (CP) is a complex disorder and children frequently have multiple impairments. Dystonia is a particularly frustrating impairment that interferes with rehabilitation and function and is difficult to treat. Of the available treatments, deep brain stimulation (DBS) has emerged as an option with the potential for large effect size in a subgroup of children. While brain stimulation has been used in CP for more than 40 years, modern devices and targeting methods are improving both the safety and efficacy of the procedure. Successful use of DBS depends on appropriate selection of patients, identification of effective neuroanatomical targets in each patient, careful neurosurgical procedure, and detailed follow‐up evaluation and programming. The use of functional neurosurgery for neuromodulation in CP remains a technology in its infancy, but improving experience and knowledge are likely to make this one of the safest and most effective interventions for children with moderate‐to‐severe motor disorders. This review summarizes the current procedures for patient and target selection, and surgical implantation of DBS electrodes for CP. The history of DBS and future directions when used in secondary dystonia are also examined.

What this paper adds

Selection of candidates for deep brain stimulation (DBS) requires understanding of dystonia in cerebral palsy .

DBS could become a first‐line treatment option in some children.
Sodium‐glucose co‐transporter inhibitors: Medications that mimic fasting for cardiovascular prevention
Authors: Giaccari Andrea
Published: June 2019

Recent evidence that some diabetes drugs can prevent cardiovascular disease (CVD) has profoundly modified the treatment approach to type 2 diabetes mellitus. Sodium‐glucose co‐transporter‐2 (SGLT2) inhibitors and almost all glucagon‐like peptide‐1 receptor agonists (GLP‐1RAs) have been shown, beyond their effect on glucose control, to lead to a significant decrease in the cardiovascular burden of diabetes. Although these results are well known, the mechanisms of action by which they prevent cardiovascular events are still poorly understood. Both GLP‐1RAs and SGLT2 inhibitors promote weight loss, although through different mechanisms. SGLT2 inhibitors promote glycosuria, leading to significant caloric deficit and weight loss. Similarly, GLP‐1RAs, probably through an anorexic effect on certain brain areas, inhibit calorie intake, with ensuing weight loss. Although it features less prominently in current treatment pathways, pioglitazone has also demonstrated cardiovascular benefits. Pioglitazone profoundly modifies several mechanisms and risk factors responsible for CVD; however, these mechanisms certainly do not include weight loss. Obesity, and consequent insulin resistance, are well known risk factors for CVD, and it would appear logical to attribute the positive cardiovascular effects of these two classes of drugs to weight loss. The direct metabolic effects of these two classes, however, are profoundly different. The present review proposes a unifying hypothesis to explain the reduction in CVD through three different mechanisms of curbing free fatty acid excess, all leading to the common mechanism of cellular caloric restriction. If this hypothesis is correct, the excellent results obtained with SGLT2 inhibitors could be attributed to their close simulation of fasting.
Clinical and echocardiographic presentation of postmyocardial infarction papillary muscle rupture
Authors: Leroux Émilie , Chauvette Vincent , Voisine Pierre , Dagenais François , Charbonneau Éric , Beaudoin Jonathan , Dubois‐Sénéchal Élie , Dubois Michelle , Sénéchal Mario
Published: June 2019

Background

Severe mitral regurgitation (MR) can occur following myocardial infarction (MI) with either partial or complete papillary muscle rupture (pPMR or cPMR). Although the incidence of this complication has significantly decreased, it is still associated with significant mortality. We sought to evaluate the different echocardiographic and clinical presentations of pPMR and cPMR.

Methods and Results

A review of all the urgent procedures for ischemic MR between January 2000 and June 2016 was performed to identify patients who underwent surgery for PMR. Surgical protocols and echocardiographic studies were used to identify patients with cPMR and pPMR. A total of 37 patients had cardiac surgery for PMR (18 cPMR, 19 pPMR). All patients with cPMR were in cardiogenic shock at the time of diagnosis, as opposed to only 53% of patients with pPMR (P = 0.0008). Between the time of diagnosis and surgery, 7 patients with pPMR developed cardiogenic shock. Transthoracic echocardiography (TTE) led to the diagnosis in 72% of cPMR and 32% of pPMR (P = 0.02). TEE had a yield of 100% for both cPMR and pPMR. Six pathologic varieties of post‐MI PMR were recognized on echocardiography and during surgery. Early postoperative, 1 (72% vs 84%), 3 (67% vs 84%), and 5 years (67% vs 74%) survival rates were similar for cPMR and pPMR (P = 0.26).

Conclusions

Partial PMR is associated with a different clinical and echocardiographic presentation than cPMR. Still, most pPMR patients progress toward cardiogenic shock. Prompt diagnosis and referral for surgery are critical and could potentially decrease mortality.
Echocardiographic mimicker of thrombus on a mechanical aortic valve prosthesis due to cavitation: A paradoxical phenomenon of pressure recovery
Authors: Wang Zhenzhen , Ayoub Chadi , Thaden Jeremy J. , Alsidawi Said , Miller Fletcher A. , Sinak Lawrence J. , Rihal Charanjit S. , Melduni Rowlens M.
Published: June 2019

We describe a case of a mass‐like echocardiographic density on a mechanical prosthetic aortic valve. We initially suspected a thrombus vs vegetation on transthoracic echocardiography, but after transesophageal echocardiography, the density was subsequently determined to be cavitation by reviewing the initial images in slow motion.
Distribution of Bemisia tabaci within soybean plants and on individual leaflets
Authors: Pozebon Henrique , Cargnelutti Filho Alberto , Guedes Jerson V.C. , Ferreira Dener R. , Marques Rafael P. , Bevilaqua Júlia G. , Patias Leonardo S. , Colpo Tiago L. , Arnemann Jonas A.
Published: June 2019

To control whiteflies on soybean crops in an effective and economically viable way, it is necessary to quantify the occurrence and density of Bemisia tabaci (Gennadius) (Hemiptera: Aleyrodidae) on the leaflets. Estimating the number of B. tabaci cm‐2 on leaflets is difficult, because its distribution pattern on the various parts of the plant canopy and on the leaflet surface is unknown. The aim of this study was to evaluate the distribution of B. tabaci nymphs on soybean plants and leaflets, under greenhouse and field conditions. One hundred soybean plants infested with all nymph stages were randomly selected in a greenhouse, and 25 in a field. Of each plant, a trifoliate leaf of the middle third of the plant’s height was selected and its central leaflet was collected (greenhouse experiment), or a trifoliate leaf of each third layer (upper, middle, and lower), of which the left, central, and right leaflets were collected (field experiment). The collected leaflets were divided into 32 sections (1 cm2 per section), arranged in an array of eight rows and four columns to count whitefly nymphs. The Morisita index (Iδ), the negative binomial parameter k, and the dispersion index (I) were calculated for each leaflet, using the number of nymphs as variable. The highest population densities of whitefly nymphs were found in the middle third of the soybean plants. In leaflets from the middle third, the nymphs concentrated in the middle and bottom parts of the leaflets, whereas in the upper and lower thirds of the plant, they were randomly distributed on the leaflets.
Observational evidence from patients diagnosed with chronic lymphocytic leukaemia (CLL) in Finland between 2005‐2015 show improved survival over time
Authors: Lindström Vesa , Hakkarainen Katja M. , Mehtälä Juha , Klement Riho , Leval Amy , Järvinen Tiina M.
Published: June 2019

Objectives

We aimed to describe treatment patterns of chronic lymphocytic leukaemia (CLL) patients in routine practice settings, compare overall survival and time‐to‐next‐treatment among patients treated in different time periods (2005‐2008, 2009‐2013, 2014‐2015), and explore associated factors.

Methods

This retrospective cohort study included adult CLL patients from the Finnish Hematology Registry.

Results

In total, 124 and 64 CLL patients received first‐ and second‐line treatments, respectively. The use of first‐ and second‐line treatments with bendamustine‐rituximab (BR) increased, while chlorambucil‐based treatments decreased over time. Patients treated in more recent years showed a trend towards longer first‐ and second‐line survival. A trend towards inferior overall survival was detected in first‐ and second‐line treatment with B/BR. First‐line time‐to‐next‐treatment was longer for patients treated in the later years towards 2015, while second‐line time‐to‐next‐treatment did not improve over time.

Conclusions

This study identified that improved treatment outcomes over time were likely influenced by patient characteristics and treatments, but also through other factors unexplored in this study. Hence, further research on the factors influencing patients’ survival over time is needed. In particular, research on using B/BR in clinical practice is warranted.
The tumour microenvironment is immuno‐tolerogenic and a principal determinant of patient outcome in EBV‐positive diffuse large B‐cell lymphoma
Authors: Keane Colm , Tobin Joshua , Gunawardana Jay , Francis Santiyagu , Gifford Grace , Gabrielli Sara , Gill Anthony , Stevenson William , Talaulikar Dipti , Gould Clare , Jain Sanjiv , Birch Simone , Hertzberg Mark , Gandhi Maher K.
Published: June 2019

Objective

Epstein‐Barr virus‐positive diffuse large B‐cell lymphoma (EBV‐pos DLBCL) is a recently identified entity. Data regarding outcome to frontline immuno‐chemotherapy are conflicting. Although the prognostic impact of the tumour microenvironment (TME) in EBV‐neg DLBCL is well‐established, it remains untested whether the TME influences survival in EBV‐pos DLBCL. There are no data with new digital gene expression technologies that simultaneously interrogate the virus, B cells and the tumour microenvironment (TME).

Methods

We used the NanoString™ platform in a population‐based cohort of 433 patients to establish if the technology could detect EBV in the tumour biopsies and to investigate the influence that EBV has on the complex tumour microenvironment of DLBCL.

Results

Incidence of EBV‐pos DLBCL was 6.9% with 5‐year survival of 65% vs 82% in EBV‐neg DLBCL (P = 0.018). EBV‐pos tissues had similar expression of T‐cell genes compared to EBV‐neg DLBCL but higher levels of the antigen‐presenting molecule B2M. This was countered by elevated PD‐L1, PD‐L2, LAG3 and TIM3 immune checkpoints and a higher CD163/CD68 “M2” macrophage score.

Conclusion

In EBV‐pos DLBCL, the TME is immuno‐tolerogenic and may explain the poor outcomes seen in this subtype of DLBCL.
Fatal disseminated enterovirus infection in a patient with follicular lymphoma undergoing obinutuzumab maintenance therapy
Authors: Heger Jan‐Michel , Eichenauer Dennis A. , Kasper Philipp , Böll Boris , Shimabukuro‐Vornhagen Alexander , Kochanek Matthias
Published: June 2019

Follicular lymphoma is the most common subtype of the indolent non‐Hodgkin lymphomas. Treatment usually consists of immuno‐chemotherapy and results in long‐lasting remissions in most cases. Progression‐free survival with the second‐generation anti‐CD20 antibody obinutuzumab was shown to be better than with rituximab when given in combination with either bendamustine or anthracycline‐based chemotherapy. Although treatment is generally well tolerated without an excessive rate of toxicities, there appear to be slightly more adverse events with obinutuzumab than with rituximab. Here, we report the case of a 45‐year‐old female patient that was diagnosed with a disseminated enterovirus infection while undergoing maintenance therapy with obinutuzumab after induction treatment with the combination of bendamustine and rituximab. Enterovirus RNA was detected in the blood, the cerebrospinal fluid, and the colon. A therapy with intravenous immunoglobulins was initiated since the patient presented with a severe treatment‐related immunosuppression indicated by hypogammaglobulinemia. Nonetheless, she eventually died from the enterovirus infection without evidence of lymphoma progression. This case underscores that clinicians should be aware of rare but potentially fatal infectious complications related to treatment protocols containing anti‐CD20 antibodies.
The demographic effects of functional traits: an integral projection model approach reveals population‐level consequences of reproduction‐defence trade‐offs
Authors: Struckman Soren , Couture John J. , LaMar M. Drew , Dalgleish Harmony J.
Published: June 2019

Quantitatively linking individual variation in functional traits to demography is a necessary step to advance our understanding of trait‐based ecological processes. We constructed a population model for Asclepias syriaca to identify how functional traits affect vital rates and population growth and whether trade‐offs in chemical defence and demography alter population growth. Plants with higher foliar cardenolides had lower fibre, cellulose and lignin levels, as well as decreased sexual and clonal reproduction. Average cardenolide concentrations had the strongest effect on population growth. In both the sexual and clonal pathway, the trade‐off between reproduction and defence affected population growth. We found that both increasing the mean of the distribution of individual plant values for cardenolides and herbivory decreased population growth. However, increasing the variance in both defence and herbivory increased population growth. Functional traits can impact population growth and quantifying individual‐level variation in traits should be included in assessments of population‐level processes.
A potential role of hypophosphatemia for diagnosing convulsive seizures: A case‐control study
Authors: Barras Pierre , Siclari Francesca , Hügli Olivier , Rossetti Andrea O. , Lamy Olivier , Novy Jan
Published: June 2019

Objective

Transient loss of consciousness (TLOC) is a common presentation in the emergency room, where patient history can usually differentiate syncope from generalized tonic‐clonic (GTC) seizures. Several serum markers, such as creatine kinase and lactate, can be helpful, especially when history is unreliable. Here, we explore a potential supporting role of electrolyte plasma levels in a case‐control study.

Methods

In our electroencephalographic database, we retrospectively identified consecutive episodes of loss of consciousness in adults seen over 3 years in our hospital emergency department for a case‐control study. We investigated plasma levels of several electrolytes (sodium, potassium, phosphate, calcium, magnesium) at the emergency visit, as well as demographics, diagnosis, blood‐sample delay time, and history of alcohol abuse.

Results

Of the 126 patients identified, 75 had GTC seizures and 46 had other TLOC causes. Among electrolyte levels, only hypophosphatemia was associated with GTC seizures (median = 0.79 mmol·L–1, range = 0.34‐1.37 in GTC seizures vs 0.93 mmol·L–1, range = 0.52‐1.56, P = 0.001 in TLOC). After adjusting for blood sampling delay, alcohol abuse, and other electrolyte levels, only hypophosphatemia was associated with GTC seizures, occurring in 37 (51%) of GTC seizures and 12 (22%) of other TLOC (odds ratio = 3.5, 95% confidence interval = 1.5‐8.3, P = 0.003). Hypophosphatemia < 0.6 mmol·L–1 was 93% specific and 20% sensitive for GTC seizure occurrence. In follow‐ups, hypophosphatemia was transitory.

Significance

Transient hypophosphatemia is common after GTC seizures and could represent an additional biological marker to help differentiate GTC seizures from other TLOC, especially when history is unclear. This hypothesis needs to be tested prospectively.