bluuebunny/crossref_metadata_2025 huggingface dataset:
Trade‐offs in the multi‐use potential of managed boreal forests
Authors: Strengbom Joachim , Axelsson E. Petter , Lundmark Tomas , Nordin Annika
Published: September 2017

Implementing multi‐use forest management to account for both commercial and non‐commercial ecosystem services is gaining increased global recognition. Despite its spatial extent, and great economic and ecological values, few studies have evaluated the boreal forest and its management to assess the potential for simultaneous delivery of a suite of ecosystem services.

Using data from a Swedish long‐term experiment, this study explores how biodiversity of the ground vegetation and potential delivery of multiple ecosystem services (timber production, carbon [C] storage and non‐timber forest products) are influenced by two common silvicultural practices (thinning, fertilization and their interaction).

Diversity (diversity indices and species richness) of the ground vegetation was higher in thinned than in unthinned forest, a result attributable in part to six species of lichens that only occurred in thinned forest. In addition, supply of lichens for reindeer forage was three times higher in thinned forest. Fertilization negatively affected the lingonberry shrub (Vaccinium vitis‐idaea). Timber production increased with fertilization, but decreased with thinning. The potential for C storage was highest in fertilized forests, which, apart from having the highest timber production, also supported the highest standing tree biomass.

The silvicultural practices evaluated induced trade‐offs among the ecosystem features studied as thinning increased biodiversity of the ground vegetation, production potential of wild berries and lichens, but reduced timber production and the potential for C storage. Fertilization had the opposite effect, promoting the potential for C storage at the expense of biodiversity and the ecosystem services delivered by the ground vegetation.

Synthesis and applications. Increased multi‐use potential is a common goal for forest management in many parts of the world. Our result shows that commonly used silvicultural practices can be used to determine the multi‐use output, and might be applied to maintain, or even increase the multi‐use potential of the boreal forest biome. Nevertheless, trade‐offs among values were common, indicating that the multi‐use potential will be limited at the site level. Allowing management objectives to vary across the landscape might, in such cases, be a preferable way to achieve high multi‐use potential.
Prolapse surgery with or without incontinence procedure: a systematic review and meta‐analysis
Authors: van der Ploeg JM , van der Steen A , Zwolsman S , van der Vaart CH , Roovers JPWR
Published: September 2017

Background

To reduce the risk of postoperative stress urinary incontinence (POSUI) prolapse repair might be combined with incontinence surgery.

Objectives

Compare efficacy and safety of prolapse surgery with and without incontinence surgery.

Search strategy

Including our earlier review a systematic search in PubMed, EMBASE, the Cochrane Library and the Register of Current Controlled Trials was performed from 1995 to 2017.

Selection criteria

Randomised trials comparing prolapse surgery with a midurethral sling (MUS) or Burch colposuspension.

Data collection and analysis

Two reviewers selected eligible articles and extracted data. Stress urinary outcomes were pooled for preoperative SUI. Urgency incontinence and adverse events were pooled for incontinence procedure.

Main results

Ten trials were included. Women with preoperative SUI symptoms or occult SUI had a lower risk to undergo subsequent incontinence surgery for POSUI after vaginal prolapse surgery with a MUS than after prolapse surgery only: 0 versus 40% [relative risk (RR) 0.0; 95% CI 0.0–0.2] and 1 versus 15% (RR 0.1; 95% CI 0.0–0.6), respectively. These differences were not significant in continent women not tested for occult SUI or without occult SUI. Serious adverse events were more frequent after vaginal prolapse repair with MUS (14 versus 8%; RR 1.7; 95% CI 1.1–2.7), but not after sacrocolpopexy with Burch colposuspension. Combination surgery did not increase the risk of overactive bladder symptoms, urgency incontinence and surgery for voiding dysfunction.

Conclusions

Vaginal prolapse repair with MUS reduced the risk of postoperative SUI in women with preoperative SUI symptoms or occult SUI, but serious adverse events were more frequent.

Tweetable abstract

Less stress incontinence after vaginal prolapse repair with sling, but more adverse events.
Functional airway obstruction observed with hyperpolarized 129Xenon‐MRI
Authors: Song Erin J , Kelsey Chris R , Driehuys Bastiaan , Rankine Leith
Published: September 2017

Hyperpolarized 129Xenon‐MRI (HP 129Xe MRI) is an emerging imaging modality that allows assessment of both ventilation and gas transfer. Most research to date has focused on non‐malignant pulmonary diseases. However, the capability of evaluating the two primary physiological processes of the lung (ventilation and gas transfer) makes HP 129Xe MRI a promising imaging modality in the management of patients with lung cancer.
Protection against cold – a survey of available equipment in Swedish pre‐hospital services
Authors: Henriksson O. , Björnstig U. , Saveman B.‐I. , Lundgren P. J.
Published: September 2017

Background

The aim of this study was to survey the current equipment used for prevention, treatment and monitoring of accidental hypothermia in Swedish pre‐hospital services.

Methods

A questionnaire was sent to all road ambulance services (AS), the helicopter emergency medical services (HEMS), the national helicopter search and rescue service (SAR) and the municipal rescue services (RS) in Sweden to determine the availability of insulation, active warming, fluid heating, and low‐reading thermometers.

Results

The response rate was 77% (n = 255). All units carried woollen or polyester blankets for basic insulation. Specific windproof insulation materials were common in the HEMS, SAR and RS units but only present in about half of the AS units. Active warming equipment was present in all the SAR units, but only in about two‐thirds of the HEMS units and about one‐third of the AS units. About half of the RS units had the ability to provide a heated tent or container. Low‐reading thermometers were present in less than half of the AS and HEMS units and were non‐existent in the SAR units. Pre‐warmed intravenous fluids were carried by almost all of the AS units and half of the HEMS units but infusion heaters were absent in most units.

Conclusion

Basic insulation capabilities are well established in the Swedish pre‐hospital services. Specific wind and waterproof insulation materials, active warming devices, low‐reading thermometers and IV fluid heating systems are less common. We suggest the development and implementation of national guidelines on accidental hypothermia that include basic recommendations on equipment requirements.
Choledochal Cyst with 17q12 Chromosomal Duplication
Authors: Kotalova Radana , Dusatkova Petra , Drabova Jana , Elblova Lenka , Dedic Tomas , Cinek Ondrej , Lebl Jan , Pruhova Stepanka
Published: September 2017

The 17q12 chromosomal region carries the HNF1B gene, mutations of which cause various conditions. When searching for HNF1B/17q12 rearrangements among children with biliary atresia and/or choledochal cysts, we identified a male proband carrying a 17q12 duplication spanning 1698 kb that included 24 genes from TBC1D3C to HNF1B. The boy presented with cholestatic jaundice at the age of 2 weeks due to a choledochal cyst sized 15 ×12 mm (type Ia according to the Todani classification). He underwent a shunt surgery consisting of a hepaticojejunostomy using Roux‐en‐Y loop at the age of 2 months, which led to a permanent relief of cholestasis. Perioperative liver histology revealed significant hepatic fibrosis and bile ductular proliferation. At 17 years, he has a mildly enlarged liver with decreased elasticity, an upper‐normal–sized spleen, normal biochemistry values, and no renal or hepatic cysts. We report the first hepatobiliary phenotype in a patient with an HNF1B overdosage.
Cerebral oximetry and postoperative delirium after cardiac surgery: a randomised, controlled trial
Authors: Lei L. , Katznelson R. , Fedorko L. , Carroll J. , Poonawala H. , Machina M. , Styra R. , Rao V. , Djaiani G.
Published: September 2017

Postoperative delirium is associated with increased morbidity and mortality. We hypothesised that restoration of regional cerebral oxygen desaturation would reduce the incidence of postoperative delirium in elderly patients after cardiac surgery. After institutional ethics review board approval and informed consent, a double‐blinded, prospective, randomised, controlled trial was conducted in patients ≥ 60 years of age undergoing cardiac surgery with cardiopulmonary bypass. In the intervention group, an algorithm was commenced if regional cerebral oxygen saturation decreased below 75% of baseline value for 1 min or longer. In the control group, the cerebral oximetry monitor screen was electronically blinded. Assessment of delirium was performed with confusion assessment method for intensive care unit or confusion assessment method after discharge from intensive care unit at 12‐h intervals for seven postoperative days. Postoperative delirium was present in 30 out of 123 (24.4%) and 31 out of 126 (24.6%) patients in the intervention and control groups, respectively, odds ratio 0.98 (95%CI 0.55–1.76), p = 0.97. Postoperative delirium was present in 20 (71%) out of 28 and in 41 (18%) out of 221 patients with baseline regional cerebral oxygen saturation ≤ 50, or > 50%, respectively, p = 0.0001. Higher baseline regional cerebral oxygen saturation and body mass index were protective against postoperative delirium. Restoration of regional cerebral oxygen desaturation did not result in lower postoperative delirium after cardiac surgery. Pre‐operative regional cerebral oxygen saturation ≤ 50% was associated with increased postoperative delirium rates in elderly patients following cardiac surgery.
Empirical Null Estimation Using Zero-inflated Discrete Mixture Distributions and Its Application to Protein Domain Data
Authors: Gauran Iris Ivy M. , Park Junyong , Lim Johan , Park DoHwan , Zylstra John , Peterson Thomas , Kann Maricel , Spouge John L.
Published: September 2017

In recent mutation studies, analyses based on protein domain positions are gaining popularity over gene-centric approaches since the latter have limitations in considering the functional context that the position of the mutation provides. This presents a large-scale simultaneous inference problem, with hundreds of hypothesis tests to consider at the same time. This article aims to select significant mutation counts while controlling a given level of Type I error via False Discovery Rate (FDR) procedures. One main assumption is that the mutation counts follow a zero-inflated model in order to account for the true zeros in the count model and the excess zeros. The class of models considered is the Zero-inflated Generalized Poisson (ZIGP) distribution. Furthermore, we assumed that there exists a cut-off value such that smaller counts than this value are generated from the null distribution. We present several data-dependent methods to determine the cut-off value. We also consider a two-stage procedure based on screening process so that the number of mutations exceeding a certain value should be considered as significant mutations. Simulated and protein domain data sets are used to illustrate this procedure in estimation of the empirical null using a mixture of discrete distributions. Overall, while maintaining control of the FDR, the proposed two-stage testing procedure has superior empirical power.
More than just side‐effects: The role of clinical and psychosocial factors in non‐adherence to tamoxifen
Authors: Moon Zoe , Moss‐Morris Rona , Hunter Myra S. , Hughes Lyndsay D.
Published: September 2017

Objectives

Tamoxifen non‐adherence is apparent in up to half of breast cancer survivors and is associated with increased risk of recurrence and reduced quality of life. However, factors contributing to non‐adherence in this population are currently poorly understood. This study explored the relationship between key components of the Common Sense Model of Illness Representations (CSM)/the Theory of Planned Behaviour (TPB) and intentional and unintentional non‐adherence in a large sample of women prescribed tamoxifen following primary breast cancer.

Design

Cross‐sectional questionnaire study (n = 777).

Methods

Women were eligible if they were over 18, had been diagnosed with primary breast cancer, and had been prescribed tamoxifen. Participants were recruited in clinic or online and completed questionnaires assessing illness perceptions, treatment beliefs, adherence, quality of life, social support, distress, and the key TPB components. Logistic regressions were conducted to test elements from each model and to identify correlates of intentional and unintentional non‐adherence.

Results

Patients were classified as non‐adherent based on Medication Adherence Rating Scale scores; 44% of the population were non‐adherent; 41% reported unintentional non‐adherence, and 9% reported intentional non‐adherence. Study variables accounted for more variance in intentional (Nagelkerke R2 = 46%) than unintentional non‐adherence (Nagelkerke R2 = 17%). Intentional non‐adherence was best explained by a combination of TPB and CSM variables, but these variables did not contribute significantly to unintentional non‐adherence.

Conclusions

The TPB and the CSM provide a useful framework for understanding intentional tamoxifen non‐adherence. Elements from both models should be considered when designing interventions to increase adherence rates.

Statement of contribution

What is already known about this subject?

Non‐adherence to tamoxifen is common and is associated with poor clinical outcomes.

Few modifiable predictors of tamoxifen non‐adherence have been identified.

What does this study add?

Unintentional non‐adherence is reported much more frequently than intentional non‐adherence.

Elements from the CSM and TPB provide a useful framework for understanding non‐adherence to tamoxifen.

Unique correlates were found for intentional and unintentional non‐adherence.
Personalized peptide vaccination as second‐line treatment for metastatic upper tract urothelial carcinoma
Authors: Suekane Shigetaka , Ueda Kousuke , Nishihara Kiyoaki , Sasada Tetsuro , Yamashita Takuto , Koga Noriko , Yutani Shigeru , Shichijo Shigeki , Itoh Kyogo , Igawa Tsukasa , Noguchi Masanori
Published: September 2017

This study investigated the applicability of personalized peptide vaccination (PPV) for patients with metastatic upper tract urothelial cancer (mUTUC) after failure of platinum‐based chemotherapy. In this single arm, open‐label, phase II clinical trial, patients with mUTUC received PPV at a single institution. Personalized peptide vaccination treatment used a maximum of four peptides chosen from 27 candidate peptides according to human leukocyte antigen types and peptide‐reactive IgG titers, for six s.c. injections weekly as one cycle. The safety of PPV, as well as its influence on host immunity and effect on overall survival were assessed. Forty‐eight patients were enrolled in this study. Personalized peptide vaccinations were well tolerated without severe adverse events. Median survival time was 7.3 months (95% confidence interval [CI], 5.3–13.1) with 13.0 months for patients receiving combined salvage chemotherapy (95% CI, 5.7–17.5) and 4.5 months for patients receiving PPV alone (95% CI, 1.7–10.1) (P = 0.080). Patients with positive CTL responses showed a significantly longer survival than patients with negative CTL responses (hazard ratio, 0.37; 95% CI, 0.16–0.85; P = 0.019). Multivariate Cox regression analysis showed that lower numbers of Bellmunt risk factors and lower levels of B‐cell activating factor were significantly associated with favorable overall survival for patients under PPV treatment. This study indicated that PPV for patients with mUTUC after failure of platinum‐based chemotherapy induced substantial peptide‐specific CTL responses without severe adverse events and has the potential to prolong survival when combined with salvage chemotherapy.

UMIN Clinical Trials Registry ID: 000001854.
INPP5K variant causes autosomal recessive congenital cataract in a Pakistani family
Authors: Yousaf S. , Sheikh S.A. , Riazuddin S. , Waryah A.M. , Ahmed Z.M.
Published: September 2017

Congenital cataract (CC) is clinically and genetically highly heterogeneous. Here, we enrolled a consanguineous kindred (LUCC15) from Pakistan, with 3 affected individuals suffering with CC. Exome sequencing revealed a transition mutation [c.149 T > C; p.(Ile50Thr)] in INPP5K. Inositol polyphosphate‐5‐phosphatase K, encoded by INPP5K, is involved in dephosphorylation of phosphatidylinositol (PtdIns) 4,5‐bisphosphate, and PtdIns 3,4,5‐trisphosphate. Recently, pathogenic variants in INPP5K have been reported in families with congenital muscular dystrophies, intellectual disability, and cataract. In our family LUCC15, mild to moderate intellectual disability along with speech impairment was observed in 2 affected individuals. Magnetic resonance imaging of brain and muscles tissues did not reveal any cerebellar or muscular atrophy. However, electromyography of both upper and lower limbs revealed irritable myopathy. Comparison of clinical phenotype of all the known affected individuals, including LUCC15 family, homozygous for INPP5K alleles revealed reduced penetrance of muscular dystrophy and intellectual disability. Similarly, skeletal muscle abnormalities were highly variable among inpp5ka zebrafish mutants analyzed in this study. These phenotypic variabilities may be due to epigenetic factors and/or genetic modifiers.
Contact dermatitis caused by tulips: identification of contact sensitizers in tulip workers of Kashmir Valley in North India
Authors: Hassan Iffat , Rasool Farhan , Akhtar Saniya , Kamili Afifa , Rather Parvaiz , Kanth Raihana , Bhat Yasmeen , Rather Shagufta , Mubashir Syed , Yaseen Atiya , Bashir Safia
Published: September 2017

Background

Tulip, belonging to the genus Tulipa and family Liliaceae, is a spring‐blooming perennial that grows from bulbs. Owing to manual handling, contact dermatitis can occur in professionals at any stage of the growth cycle of the tulip plant.

Objectives

To determine the clinical pattern of contact dermatitis resulting from tulip plant cultivation, and to assess contact allergy in workers coming into contact with this plant.

Methods

One hundred and sixty‐four tulip workers were screened, and 48 patients with suspected contact dermatitis were patch tested with 39 allergens, including haptens from the Indian baseline series, a plant series, and extracts from different parts of the tulip plant.

Results

Thirty‐nine positive patch test reactions were observed in 21 patients. Seventeen patients showed positive reactions to either α‐methylene‐γ‐butyrolactone or to tulip plant extract. Clinical relevance was observed for 13 of 17 positive patch test reactions.

Conclusions

Contact dermatitis is an important health hazard in workers dealing with tulip bulbs. Further studies to identify and isolate other possible tulip allergens, and to quantify the amounts of allergens in different parts of the tulip plant, are recommended.
Contact allergy to lanolin: temporal changes in prevalence and association with atopic dermatitis
Authors: Fransen Marloes , Overgaard Line E. K. , Johansen Jeanne D. , Thyssen Jacob P.
Published: September 2017

Background

Lanolin has been tested as lanolin alcohols (30% pet.) in baseline patch test series since 1969, and this has shown clinically relevant allergic contact dermatitis cases.

Objectives

To investigate the temporal development of lanolin allergy (i.e. positive reaction to lanolin alcohols and/or Amerchol™ L‐101), and the association between contact allergy to lanolin and patient characteristics from the MOAHLFA index.

Methods

A retrospective observational study of consecutively patch tested dermatitis patients (n = 9577) between 1 January 2004 and 31 December 2015 with lanolin alcohols 30% pet. and Amerchol™ L‐101 50% pet. was performed.

Results

The prevalence of lanolin allergy increased from 0.45% in 2004 to 1.81% in 2015. In age‐adjusted and sex‐adjusted analyses, weak, significant associations were found between atopic dermatitis and lanolin and lanolin alcohols allergy, respectively, but no association with Amerchol™ L‐101 allergy was found. Among 9286 dermatitis patients who were tested with both allergens, 108 had a positive test reaction to either lanolin alcohols or Amerchol™ L‐101, whereas only 29 patients had positive test reactions to both markers.

Conclusions

The prevalence of lanolin contact allergy has increased over a 12‐year period, and inclusion of Amerchol™ L‐101 will increase the chance of detecting lanolin contact allergy. Patch testing with lanolin is helpful in atopics with dermatitis and suspected cosmetic allergy.
Carpal tunnel syndrome in mucopolysaccharidosis: the value of rare disease registries
Authors: White Klane K
Published: September 2017

This commentary is on the original article by Viskochil et al. on pages 1269–1275.
Clinical impact ofKMT2C andSPRY4 expression levels in intensively treated younger adult acute myeloid leukemia patients
Authors: Kayser Sabine , Feszler Maximilian , Krzykalla Julia , Schick Matthias , Kramer Michael , Benner Axel , Thol Felicitas , Platzbecker Uwe , Müller‐Tidow Carsten , Ho Anthony D. , Ehninger Gerhard , Heuser Michael , Schlenk Richard F. , Thiede Christian , Röllig Christoph , Krämer Alwin
Published: September 2017

Objective

To evaluate the prognostic impact of gene expression levels (ELs) of two tumor suppressor genes, sprouty 4 (SPRY4, located on 5q) and lysine methyltransferase 2C (KMT2C, located on 7q) in correlation with clinical characteristics and genetic abnormalities assessed at initial diagnosis in acute myeloid leukemia (AML).

Method

Gene expression levels were measured oncDNAbyRT‐qPCRfrom diagnostic bone marrow samples of 275 intensively treated adultAMLpatients (median age, 48 years).

Results

KMT2CELs were significantly lower in abn7q/‐7 (P = .001), whereasSPRY4ELs were not associated with abn5q/‐5. HigherKMT2C andSPRY4ELs were significantly associated with lower genetic risk groups as defined by the European LeukemiaNet classification. Additionally,KMT2CELs were lower in cytogenetically normal patients withDNMT3A(P = .01) orFLT3‐ITDmutations (P = .05).KMT2CELs were not associated with prognosis, whereas higherSPRY4ELs showed a favorable impact on event‐free (EFS,P = .01), relapse‐free (RFS,P = .01) and in‐trend on overall survival (P = .06) for cytogenetically abnormal patients, which was confirmed in multivariable analysis forEFS(HR, 0.84; 95%‐CI, 0.73‐0.97;P = .02) andRFS(HR, 0.85; 95%‐CI, 0.73‐0.98;P = .02).

Conclusion

Our data indicate thatKMT2CELs are associated with specific genetic features and thatSPRY4ELs may add prognostic information.
A drug development perspective on targeting tumor‐associated myeloid cells
Authors: Majety Meher , Runza Valeria , Lehmann Christian , Hoves Sabine , Ries Carola H.
Published: September 2017

Despite decades of research, cancer remains a devastating disease and new treatment options are needed. Today cancer is acknowledged as a multifactorial disease not only comprising of aberrant tumor cells but also the associated stroma including tumor vasculature, fibrotic plaques, and immune cells that interact in a complex heterotypic interplay. Myeloid cells represent one of the most abundant immune cell population within the tumor stroma and are equipped with a broad functional repertoire that promotes tumor growth by suppressing cytotoxic T cell activity, stimulating neoangiogenesis and tissue remodeling. Therefore, myeloid cells have become an attractive target for pharmacological intervention. In this review, we summarize the pharmacological approaches to therapeutically target tumor‐associated myeloid cells with a focus on advanced programs that are clinically evaluated. In addition, for each therapeutic strategy, the preclinical rationale as well as advantages and challenges from a drug development perspective are discussed.
In situ monitoring of particle fracture in aluminium alloys
Authors: Wisner B. , Kontsos A.
Published: September 2017

Material damage at the microscale involves both initiation and interaction effects that are typically activated long before the appearance of macroscopically observable failure events. These early appearances of damage have been broadly classified as microstructure‐sensitive damage precursors or indicators. A particular class of such precursors which is of importance to aluminium and other precipitate‐hardened alloys is the focus of this article. Specifically, the hard, intermetallic particles in aluminium alloys fracture before significant failure occur in the surrounding matrix. In this investigation, an effort to directly assess particle fracture activity at the time and scale that it occurs is made by coupling mechanical testing inside a scanning electron microscope with nondestructive evaluation techniques including digital image correlation as well as real‐time acoustic emission monitoring. The use of a surface measurement technique along with a volumetric monitoring method at the microscope scale provides a way for coupling of fracture information at locations which are directly related to the particle activity. In this article, Al2024‐T3 specimens in the as‐received condition were subjected to tension as well as to tension‐tension cyclic loading. The obtained in situ results demonstrate, for the first time to the best knowledge of the authors, that particle fracture occurs early in the damage process which justifies its characterization as a material damage precursor. The overall approach provides datasets capable to detect particle fracture initiation, which could become useful in future structural health monitoring applications.
The Importance of Integrating Supply‐Side Factors in Economic Base Models
Authors: Vollet Dominique , Aubert Francis , Frère Quentin , Lépicier Denis , Truchet Stéphanie
Published: September 2017

Economic base (or export‐base) theory (EBT) is often presented as a Keynesian‐inspired theory that only accounts for demand‐side factors. However, the recent integration of supply‐side factors into economic base models (EBMs) can contribute to renewing applications of this type of model in regional economics. This paper proposes a literature review focused on new EBMs that explicitly take into account supply effects and includes both North American and European studies. It first explains why integrating supply‐side factors is relevant for EBMs. Second, the paper shows how to integrate these supply‐side factors into the various types of models, focusing on two production factors: land and its amenities and labor. Third, the paper discusses the conditions for integrating such supply‐side factors into EBMs.
Evaluating Renewable Groundwater Stress with GRACE Data in Greece
Authors: Gemitzi Alexandra , Lakshmi Venkat
Published: September 2017

Groundwater is a resilient water source and its importance is even greater in periods of drought. Areas such as the Mediterranean where adverse climate change effects are expected are bell‐weather locations for groundwater depletion and are of considerable interest. The present study evaluates renewable groundwater stress (RGS) as the ratio of groundwater use to groundwater availability, quantifying use as the trend in gravity recovery and climate experiment‐derived (GRACE) subsurface anomalies (ΔGWtrend) and renewable groundwater availability as mean annual recharge. Estimates for mean annual recharge for the various regions in Greece have been derived using numerical models. Our results highlight two RGS regimes in Greece (variable stress and unstressed) of the four characteristic stress regimes, that is, overstressed, variable stress, human‐dominated stress, and unstressed, defined as a function of the sign of use and the sign of groundwater availability (positive or negative). Variable stress areas are found in Central Greece (Thessaly region), where intensive agriculture results in negative ΔGWtrend values combined with positive mean annual recharge rates. RGS values range from −0.05 to 0, indicating a low impact area. Within this region, adverse effects of groundwater overexploitation are already evident based on the negative GRACE anomalies; however, recharge is still positive, mitigating the effects of over‐pumping. The rest of Greek aquifers fall within the unstressed category, with RGS values from 0.02 to 0.05, indicating that the rate of use is less than the natural recharge rate.
Presence of Antibiotics in Shallow Groundwater in the Northern and Southwestern Regions of China
Authors: Chen Liang , Lang Hang , Liu Fei , Jin Song , Yan Tao
Published: September 2017

Antibiotics are widely used, and there is a serious concern about its adverse impacts on the environment and human health. To our knowledge, prior to this work, there was no evidence of the potential presence of antibiotics in groundwater in China, despite populous speculations. This study reported the detection of 35 target antibiotics of 6 groups (chloramphenicois, lincosamides, marcrolides, quinolones, sulfonamides, and tetracyclines), in shallow groundwater samples collected in northern and southwestern China. Thirty‐four of thirty‐five target antibiotics were detected in the groundwater samples; 73 of 74 monitoring wells contained at least one antibiotic; and at least two antibiotics were detected in 72 of the 74 wells. Ofloxacin (1199.7 ng/L), lincomycin (860.7 ng/L), and norfloxacin (441.9 ng/L) as well as antibiotics with the highest detection frequency such as sulfapyridine (70%), norfloxacin (69%), and lincomycin (64%) were detected at elevated concentrations. The highest detection frequency and concentration of lincosamides were observed in those groundwater samples, but no clear distribution patterns were observed for the six antibiotic groups. Moreover, shallow groundwater in southwestern China seemed to contain most antibiotics, likely due to the high antibiotics discharge and frequent exchange of groundwater with surface matrices. The findings from this work suggest that groundwater in China has been widely contaminated by antibiotics, and presumably other pharmaceutical compounds that have not been investigated to date.
Evaluation of Bias Associated with Capture Maps Derived from Nonlinear Groundwater Flow Models
Authors: Nadler Cara , Allander Kip , Pohll Greg , Morway Eric , Naranjo Ramon , Huntington Justin
Published: September 2017

The impact of groundwater withdrawal on surface water is a concern of water users and water managers, particularly in the arid western United States. Capture maps are useful tools to spatially assess the impact of groundwater pumping on water sources (e.g., streamflow depletion) and are being used more frequently for conjunctive management of surface water and groundwater. Capture maps have been derived using linear groundwater flow models and rely on the principle of superposition to demonstrate the effects of pumping in various locations on resources of interest. However, nonlinear models are often necessary to simulate head‐dependent boundary conditions and unconfined aquifers. Capture maps developed using nonlinear models with the principle of superposition may over‐ or underestimate capture magnitude and spatial extent. This paper presents new methods for generating capture difference maps, which assess spatial effects of model nonlinearity on capture fraction sensitivity to pumping rate, and for calculating the bias associated with capture maps. The sensitivity of capture map bias to selected parameters related to model design and conceptualization for the arid western United States is explored. This study finds that the simulation of stream continuity, pumping rates, stream incision, well proximity to capture sources, aquifer hydraulic conductivity, and groundwater evapotranspiration extinction depth substantially affect capture map bias. Capture difference maps demonstrate that regions with large capture fraction differences are indicative of greater potential capture map bias. Understanding both spatial and temporal bias in capture maps derived from nonlinear groundwater flow models improves their utility and defensibility as conjunctive‐use management tools.
“Telling” and assent: Parents’ attitudes towards children's participation in a birth cohort study
Authors: Ri Izen , Suda Eiko , Yamagata Zentaro , Nitta Hiroshi , Muto Kaori
Published: September 2017

Introduction

One of the ethical issues surrounding birth cohort studies is how to obtain informed assent from children as they grow up. What and how parents tell their children affects children's future choices about the study, yet few studies have focused on parents’ influence on children.

Objective

This study examines parents’ attitudes towards telling their children about their participation in a specific birth cohort study.

Methods

We conducted surveys and in‐depth interviews with the parents of children who participated in the “Japan Environment and Children's Study” (JECS), which follows children from the foetal stage to age 13.

Results

Forty‐four mothers and 23 fathers answered the survey, and 11 mothers and 3 fathers participated in in‐depth interviews. Parents’ attitudes towards “telling” were categorized into 3 communication styles depending on their perception of the risk/benefits for their children. Most parents predicted that the study would benefit their children and preferred “directive telling,” which we divided into “empowered telling” (provides children with a positive identity as participants) and “persuasive telling” (attempts to persuade children even if they express reluctance as they grow). A few parents, weighing the study's potential risk, preferred “non‐directive telling,” which respects children's choices even if that means withdrawing from the study.

Discussion

While “directive telling” may lead children to have positive associations with the study, children should also be told about the risks. Investigators can provide materials that support parents and give children age‐appropriate information about their participation, as well as ensure opportunities for children to express their feelings.
Digital pathology for the primary diagnosis of breast histopathological specimens: an innovative validation and concordance study on digital pathology validation and training
Authors: Williams Bethany Jill , Hanby Andrew , Millican‐Slater Rebecca , Nijhawan Anju , Verghese Eldo , Treanor Darren
Published: September 2017

Aim

To train and individually validate a group of breast pathologists in specialty‐specific digital primary diagnosis by using a novel protocol endorsed by the Royal College of Pathologists’ new guideline for digital pathology. The protocol allows early exposure to live digital reporting, in a risk‐mitigated environment, and focuses on patient safety and professional development.

Methods and results

Three specialty breast pathologists completed training in the use of a digital microscopy system, and were exposed to a training set of 20 challenging cases, designed to help them identify personal digital diagnostic pitfalls. Following this, the three pathologists viewed a total of 694 live, entire breast cases. All primary diagnoses were made on digital slides, with immediate glass slide review and reconciliation before final case sign‐out. There was complete clinical concordance between the glass and digital impression of the case in 98.8% of cases. Only 1.2% of cases had a clinically significant difference in diagnosis/prognosis on glass and digital slide reads. All pathologists elected to continue using the digital microscope as the standard for breast histopathology specimens, with deferral to glass for a limited number of clinical/histological scenarios as a safety net.

Conclusion

Individual training and validation for digital primary diagnosis allows pathologists to develop competence and confidence in their digital diagnostic skills, and aids safe and responsible transition from the light microscope to the digital microscope.
Novel processing approach to polymer‐derived ceramic matrix composites
Authors: King Derek , Apostolov Zlatomir , Key Thomas , Carney Carmen , Cinibulk Michael
Published: September 2017

The rheological properties of commercially available polycarbosilane, SMP‐10, were analyzed as a function of temperature, to guide development of thermal treatment processes for the improved yield and functionality of polymer ceramic precursors. The curing onset temperature for SMP‐10 was determined to be as low as 100°C for a heating rate of 1°C/min enabling a heat treatment process at 90°C, where low molecular weight oligomers volatilize from the liquid precursor prior to curing. By driving off the low molecular weight oligomers before fabrication of a composite, the mass yield of SMP‐10, from a room temperature liquid state was increased from 77% to 83%. The development of B‐staging processes, or a semicure of SMP‐10, were also demonstrated. B‐staging processes were then applied to polymer infiltration and pyrolysis processing and compared with traditional wet layup CMC processing. It was determined that B‐staging processes did not adversely affect ceramic matrix composite fabrication. B‐staged processing methods were determined to result in less waste, allow ply‐by‐ply control of matrix compositions, and enable time independent processing when compared to traditional wet layup processing methods.
Projecting the impact of a nationwide school plain water access intervention on childhood obesity: a cost–benefit analysis
Authors: An R. , Xue H. , Wang L. , Wang Y.
Published: September 2017

Objective

This study aimed to project the societal cost and benefit of an expansion of a water access intervention that promotes lunchtime plain water consumption by placing water dispensers in New York school cafeterias to all schools nationwide.

Methods

A decision model was constructed to simulate two events under Markov chain processes – placing water dispensers at lunchtimes in school cafeterias nationwide vs. no action. The incremental cost pertained to water dispenser purchase and maintenance, whereas the incremental benefit was resulted from cases of childhood overweight/obesity prevented and corresponding lifetime direct (medical) and indirect costs saved.

Results

Based on the decision model, the estimated incremental cost of the school‐based water access intervention is $18 per student, and the corresponding incremental benefit is $192, resulting in a net benefit of $174 per student. Subgroup analysis estimates the net benefit per student to be $199 and $149 among boys and girls, respectively. Nationwide adoption of the intervention would prevent 0.57 million cases of childhood overweight, resulting in a lifetime cost saving totalling $13.1 billion. The estimated total cost saved per dollar spent was $14.5.

Conclusion

The New York school‐based water access intervention, if adopted nationwide, may have a considerably favourable benefit–cost portfolio.
Neurotransmitter signalling via NMDA receptors leads to decreased T helper type 1‐like and enhanced T helper type 2‐like immune balance in humans
Authors: Orihara Kanami , Odemuyiwa Solomon O. , Stefura William P. , Ilarraza Ramses , HayGlass Kent T. , Moqbel Redwan
Published: September 2017

Given the pivotal roles that CD4+ T cell imbalance plays in human immune disorders, much interest centres on better understanding influences that regulate human helper T‐cell subset dominance in vivo. Here, using primary CD4+ T cells and short‐term T helper type 1 (Th1) and Th2‐like lines, we investigated roles and mechanisms by which neurotransmitter receptors may influence human type 1 versus type 2 immunity. We hypothesized that N‐methyl‐d‐aspartate receptors (NMDA‐R), which play key roles in memory and learning, can also regulate human CD4+ T cell function through induction of excitotoxicity. Fresh primary CD4+ T cells from healthy donors express functional NMDA‐R that are strongly up‐regulated upon T cell receptor (TCR) mediated activation. Synthetic and physiological NMDA‐R agonists elicited Ca2+ flux and led to marked inhibition of type 1 but not type 2 or interleukin‐10 cytokine responses. Among CD4+ lines, NMDA and quinolinic acid preferentially reduced cytokine production, Ca2+ flux, proliferation and survival of Th1‐like cells through increased induction of cell death whereas Th2‐like cells were largely spared. Collectively, the findings demonstrate that (i) NMDA‐R is rapidly up‐regulated upon CD4+ T cell activation in humans and (ii) Th1 versus Th2 cell functions such as proliferation, cytokine production and cell survival are differentially affected by NMDA‐R agonists. Differential cytokine production and proliferative capacity of Th1 versus Th2 cells is attributable in part to increased physiological cell death among fully committed Th1 versus Th2 cells, leading to increased Th2‐like dominance. Hence, excitotoxicity, beyond its roles in neuronal plasticity, may contribute to ongoing modulation of human T cell responses.
Negotiating Identity and Belonging through the Invisibility Bargain: Colombian Forced Migrants in Ecuador
Authors: Pugh Jeffrey D.
Published: September 2017

This article argues that an “invisibility bargain” constrains migrants’ identities and political participation, demanding their economic contributions plus political and social invisibility in exchange for tolerance of their presence in the host country. In response, migrants negotiate their visible identity differences, minimize social distance from the host population, and build informal coalitions with non-state brokers to avoid citizen backlash against overt political activism. Examining Colombian forced migrants in Ecuador, the article challenges state-centric governance approaches, underscoring migrant agency in negotiating identity to influence social hierarchies, coexistence, and human security. Its findings advance the broader understanding of migration in the Global South.
Double atrial potentials in left‐sided accessory pathways are associated with paroxysmal atrial fibrillation
Authors: Błaszyk Krzysztof , Gwizdała Adrian , Waśniewski Michał , Hiczkiewicz Jarosław , Seniuk Wojciech , Michalak Michał
Published: September 2017

Introduction

Muscular connections between the coronary sinus (CS) and left atrium probably impact distribution of electrical activity. Double atrial potentials (DP) may be their presentation.

The aim was to investigate the presence of DP in CS recordings during atrioventricular reentrant tachycardia (AVRT) and its contribution to the occurrence of paroxysmal atrial fibrillation (AF).

Methods

A group of 247 patients with accessory pathways (AP) were screened for DP. The patients with DP during AVRT were compared to those without DP.

Results

DP during AVRT were found only among the left‐sided AP (AP‐L). Patients with AP‐L were divided into Group 1 (n  =  17) with DP during AVRT and Group 2 (n  =  108) without DP. Patients in Group 1 had higher incidence of AF in history (47.1% vs. 23.1%; P  =  0.0376), AF induced during electrophysiological (EP) study (70.6% vs. 25%; P  =  0.0002). Group 1 had higher heart rate (HR) during AVRT in the EP study (197.2 ± 27 vs. 175.1 ± 26.3 bpm; P  =  0.0019), but HR of clinical AVRT (208.5 ± 30.8 vs. 191.6 ± 27.8 bpm) was not significant different (P  =  ns). Additionally, electrical alternans of QRS amplitude during AVRT in the EP study was more frequent in Group 1 (52.9 vs. 20.4 %; P  =  0.0048).

Conclusion

Patients with DP and AP‐L were more prone to develop AF. The presence of DP was associated with faster AVRT rate. The direction of atrium depolarization during AVRT may be different in the presence of DP and probably plays a role in development of AF in this group of patients.
Potential role of the methylation of VEGF gene promoter in response to hypoxia in oxygen‐induced retinopathy: beneficial effect of the absence of AQP4
Authors: Pisani Francesco , Cammalleri Maurizio , Dal Monte Massimo , Locri Filippo , Mola Maria Grazia , Nicchia Grazia Paola , Frigeri Antonio , Bagnoli Paola , Svelto Maria
Published: September 2017

Hypoxia‐dependent accumulation of vascular endothelial growth factor (VEGF) plays a major role in retinal diseases characterized by neovessel formation. In this study, we investigated whether the glial water channel Aquaporin‐4 (AQP4) is involved in the hypoxia‐dependent VEGF upregulation in the retina of a mouse model of oxygen‐induced retinopathy (OIR). The expression levels of VEGF, the hypoxia‐inducible factor‐1α (HIF‐1α) and the inducible form of nitric oxide synthase (iNOS), the production of nitric oxide (NO), the methylation status of the HIF‐1 binding site (HBS) in the VEGF gene promoter, the binding of HIF‐1α to the HBS, the retinal vascularization and function have been determined in the retina of wild‐type (WT) and AQP4 knock out (KO) mice under hypoxic (OIR) or normoxic conditions. In response to 5 days of hypoxia, WT mice were characterized by (i) AQP4 upregulation, (ii) increased levels of VEGF, HIF‐1α, iNOS and NO, (iii) pathological angiogenesis as determined by engorged retinal tufts and (iv) dysfunctional electroretinogram (ERG). AQP4 deletion prevents VEGF, iNOS and NO upregulation in response to hypoxia thus leading to reduced retinal damage although in the presence of high levels of HIF‐1α. In AQP4 KO mice, HBS demethylation in response to the beginning of hypoxia is lower than in WT mice reducing the binding of HIF‐1α to the VEGF gene promoter. We conclude that in the absence of AQP4, an impaired HBS demethylation prevents HIF‐1 binding to the VEGF gene promoter and the relative VEGF transactivation, reducing the VEGF‐induced retinal damage in response to hypoxia.
Future Dietitian 2025: informing the development of a workforce strategy for dietetics
Authors: Hickson M. , Child J. , Collinson A.
Published: September 2017

Background

Healthcare is changing and the professions that deliver it need to adapt and change too. The aim of this research was to inform the development of a workforce strategy for Dietetics for 2020–2030. This included an understanding of the drivers for change, the views of stakeholders and recommendations to prepare the profession for the future.

Methods

The research included three phases: (i) establishing the context which included a literature and document review (environmental scan); (ii) discovering the profession and professional issues using crowd‐sourcing technology; and (iii) articulating the vision for the future using appreciative inquiry.

Results

The environmental scan described the current status of the dietetic profession, the changing healthcare environment, the context in which dietitians work and what future opportunities exist for the profession. The online conversation facilitated by crowd‐sourcing technology asked the question: ‘How can dietitians strengthen their future role, influence and impact?’ Dietitians and interested stakeholders (726 and 109, respectively) made 6130 contributions. Seven priorities were identified and fed into the appreciative inquiry event. The event bought together 54 dietitians and analysis of the discussions generated five themes: (i) professional identity; (ii) strong foundations‐creating structure and direction for the profession; (iii) amplifying visibility and influence; (iv) embracing advances in science and technology; and (v) career advancement and emerging opportunities.

Conclusions

A series of recommendations were made for the next steps in moving the workforce to a new future. The future for dietetics looks bright, embracing technology, as well as exploring different ways of working and new opportunities, as this dynamic profession continues to evolve.