bluuebunny/crossref_metadata_2025 huggingface dataset:
Valuation of Biodiversity
Authors: Bartkowski Bartosz
Published: January 2018

Massive population declines and species extinction have characterized the 20th and early 21st centuries. These local and global phenomena do not only involve the loss of particular species, habitats, and ecosystem services; they also result in a general reduction in biotic diversity. Ecological research has long indicated the importance of biodiversity within and across ecosystems. However, capturing the economic value of biodiversity remains a challenge.

Biodiversity is a multidimensional public good; it encompasses the diversity of genes, species, functional groups, habitats, and ecosystems. A large empirical literature in biology and ecology indicates that biodiversity has a stabilizing effect on ecosystems—the higher the biodiversity within a given ecosystem type, the more well-functioning (productive, stable, and resilient) is the ecosystem. However, the economic importance of biodiversity goes beyond this stabilizing effect.

The multidimensionality and complexity of the biodiversity concept has resulted in a multitude of approaches to its economic valuation. While the theoretical and conceptual literature has focused on biodiversity as insurance and as a pool of options, empirical studies have been much more diverse. Given the public-good nature and complexity of biodiversity, stated preference methods are particularly common. The focus on biodiversity valuation has fostered many important theoretical and methodological developments. Many estimates exist of the willingness to pay for biodiversity conservation in different countries across the world; however, relatively few studies have been conducted in developing countries despite the considerably higher biodiversity levels there as compared with the better-covered developed countries.

Valuation of biodiversity is a controversial subject, and the economic, predominantly anthropocentric approach has been criticized frequently. However, non-anthropocentric accounts of biodiversity value are problematic for their own reasons; an important question is whether biodiversity has intrinsic value and, if yes, whether this can be captured within the economic perspective. Valuation of biodiversity remains a vibrant topic at the intersections of disciplines such as ecology, environmental ethics, and economics.
Socio-Technical Transitions to Sustainability
Authors: Geels Frank W.
Published: January 2018

Addressing persistent environmental problems such as climate change or biodiversity loss requires shifts to new kinds of energy, mobility, housing, and agro-food systems. These shifts are called socio-technical transitions because they involve not just changes in technology but also changes in consumer practices, policies, cultural meanings, infrastructures, and business models. Socio-technical transitions to sustainability are challenging for mainstream social sciences because they are multiactor, long-term, goal-oriented, disruptive, contested, and nonlinear processes. Sustainability transitions are being investigated by a new research community, which uses a socio-technical Multi-Level Perspective (MLP) as one of its orienting frameworks. Focusing on multidimensional struggles between “green” innovations and entrenched systems, the MLP suggests that transitions involve alignments of processes within and between three analytical levels: niche innovations, socio-technical regimes, and an exogenous socio-technical landscape. To understand more specific change mechanisms, the MLP mobilizes ideas from evolutionary economics, sociology of innovation, and institutional theory. Different phases, actors, and struggles are distinguished to understand the complexities of sustainability transitions, while still providing analytical traction and policy advice. The MLP draws attention to socio-technical systems as a new unit of analysis, which is more comprehensive than a micro-focus on individuals and more concrete than a macro-focus on a green economy. It also forms a new analytical framework that spans several stale dichotomies in environmental social science debates related to agency or structure and behavioral or technical change. The MLP accommodates stability and change and offers an integrative view on transitions, ranging from local projects to niche innovations to sector-level regimes and broader societal contexts. This new interdisciplinary research is attracting increasing attention from the European Environment Agency, International Panel on Climate Change (IPCC), and Organization for Economic Cooperation and Development (OECD).
Community-Embedded Philanthropic Foundations
Authors: Allen-Meares Paula
Published: January 2018

A growing subset of place-based foundations in the United States have adopted an embedded philanthropic approach, in which funders “dig in” and “dig deeper” into the life of communities. Embedded philanthropy and embedded funders may change the landscape of community-building efforts in significant ways. Funding approaches and innovative efforts include the use of a “bottom up” approach to social change, a focus on helping communities to build capacity, and the building of community assets through grants that are more strategically focused. As these approaches continue to evolve and more evaluations take place, greater understanding will develop regarding the way forward for foundations in the United States to enhance effectiveness.
Introduction
Authors: Davis Stephen J.
Published: January 2018

The Introduction explains that the aim of this book is to address basic questions about monastic social forms and spirituality. What is monasticism and how is it distinguished from other kinds of religious and non-religious practice? What is our earliest evidence for monasticism and what different types have developed from antiquity to the present day? How are monastic communities organized? What do stories about saints communicate about monastic identity and ethics? Where and in what kinds of physical settings are monasteries located, and how do these settings impact the monks and nuns who dwell there? Finally, what place is there for monasticism in the modern world?
Introduction
Authors: Vincent Warwick F.
Published: January 2018

What is a lake? At first glance, this seems like such an easy question: a lake is simply a body of water surrounded by land. But this sterile, physical definition is only a beginning, and there are so many other more interesting ways to consider the nature and meaning of lakes. The ‘Introduction’ outlines the aim of this VSI: to provide a condensed overview of scientific knowledge about lakes, their functioning as ecosystems that we are part of and depend upon, and their responses to environmental change. It considers the physical, biological, and chemical features of lakes as well as their importance in environmental sciences, engineering, and society.
Sunlight and motion
Authors: Vincent Warwick F.
Published: January 2018

Water transparency powerfully indicates the state of health of a lake ecosystem. The water’s turbidity defines the physical habitat characteristics of lakes, strongly influencing their chemistry, biology, and ecosystem services. ‘Sunlight and motion’ explains the methods for measuring water transparency and how the penetration of sunlight into water declines with depth. The different colours, hues, and brightness levels of lakes are due to the materials dissolved and suspended within them. The layering of different temperature water in lakes is also described. This stratification varies greatly with the seasons. Mixing of the waters is mainly due to slow waves at and just below the surface as well as deeper currents.
4. Single market, single currency
Authors: Usherwood Simon , Pinder John
Published: January 2018

Monetary union requires that money in all its forms be able to move freely across frontiers between member states and that exchange rates changes between them be abolished. ‘Single market, single currency’ explains how the single market programme went far towards fulfilling the first requirement and the Exchange Rate Mechanism prepared the ground for the second. The legislative framework guarantees producers an extensive market and consumers a reasonable assurance of competitive behaviour between them. The euro was initially acclaimed as marking a new stage in European integration, but recent financial crises have exposed the flipside of this, with the euro as the crucible of political commitment to the EU.
6. Social policy, environmental policy
Authors: Usherwood Simon , Pinder John
Published: January 2018

The EU has been given some of its powers because its size offers advantages not available to individual member states. Other powers prevent member states from damaging each other, including: the environmental policy, which is generally agreed to be desirable; and social policy, although with sharp disagreement as to the degree of EU intervention required. ‘Social policy, environmental policy’ examines the powerful impact of EU action on climate change internally and worldwide. The SEA extended the scope of social policy in two directions: providing for legislation on health and safety at work, and for the encouragement of dialogue between representatives of management and labour at European level.
10. The EU in the world
Authors: Usherwood Simon , Pinder John
Published: January 2018

‘The EU in the world’ considers how EU policies for dealing with the rest of the world have been developed. China seems likely to catch up with the US as a military and economic power. However, it is argued that the EU has the potential to be, much sooner, at least an equal partner with the US in matters of the economy, environment, and soft security, if not defence. It should not be difficult for Americans to adjust to a more powerful EU, after four decades of reasonable trade cooperation where both already have equivalent strength and with no prospect of rivalry in respect of military power.
11. Much accomplished … but what next?
Authors: Usherwood Simon , Pinder John
Published: January 2018

In March 2017, two events illustrated the EU’s achievement and fragility. The first, the sixtieth anniversary of the signing of the Rome treaties, was an opportunity to reflect on how the integration process has become fundamental to European governance and government, reaching into almost every area of public policy. The second was the UK’s submission of their intention to withdraw from the EU. ‘Much accomplished … but what next?’ asks whether the EU has the necessary powers and structures to achieve its objectives, but also whether its objectives are even the right ones. Without considering the latter, the former risks becoming an exercise in political narcissism.
1. The worlds of faery
Authors: Warner Marina
Published: January 2018

‘The worlds of faery: far away and down below’ explains that the ‘Other Worlds’ which fairy tales explore open a way for writers and storytellers to speak in ‘Other’ terms, especially when the native inhabitants of the imaginary places do not belong to an established living faith and do not command belief or repudiation. Fairies do not need to appear to stamp a story a fairy tale, but magic needs to be implied and present to conjure the presence of another world. Fairylands are zones of enchantment, but both dangers and pleasures are found. The powerful underlying motives for the construction of fairy tales include a need to move beyond the limits of reality.
8. Double vision
Authors: Warner Marina
Published: January 2018

The tradition of fairy tale has lent itself, in the name and interest of rationality, to some of the most acute intellectual creations. Writers have wrapped themselves in fairytale themes and motifs in order to communicate political and philosophical thinking, sometimes in conditions of censorship, sometimes in the interests of amusing their audience and so persuading them more effectively. ‘Double vision: the dream of reason’ explains how magical realist fiction, whether believing or doubting, dips into the streams of fairy story for its material and authors such as Swift, Voltaire, and Kafka have also found inspiration for their fantastic fiction in fairytale conventions.
Introduction: the Greek way
Authors: Heilbron J. L.
Published: January 2018

The Introduction explains that Greek physics—physica—with its eye to ethics, its indifference to mathematics and experiment, and its independence of states and courts, is noticeably different from the modern field of physics. This VSI describes some of the ways by which ancient physica became modern physics. It sketches the place and purpose of physica in the societies that supported it. Hence the primary sites of cultivation receive special emphasis: the independent private school (antiquity), court and library (Islam), university (later Middle Ages), court again (Renaissance), academy (late 17th and 18th centuries), university again (modernity), and university-government-industry (postmodernity).
3. Domestication in Europe
Authors: Heilbron J. L.
Published: January 2018

Domestication of Greek and Arabic physica and mixed mathematics in the Latin West took c.400 years: from the 12th-century first translations to the 16th-century printing of Archimedes and Ptolemy, and the revitalization of Aristotle’s ancient rivals. With the generation of Copernicus, Galileo, Kepler, and Francis Bacon, physica’s place in the body of knowledge began to slip, although the Aristotelian world picture still hung securely, if awry, in universities and theological seminaries. ‘Domestication in Europe’ explains that the slippage owed much to social factors associated, as in Islamic times, with the needs of newly centralizing states, and with the discovery of new worlds on the Earth and in the heavens.
4. Second creation
Authors: Heilbron J. L.
Published: January 2018

The throwing of all philosophy into doubt inspired three important schemes for placing physica on firm foundations or limiting its claims to secure natural knowledge. ‘Second creation’ explains that by the middle of the 18th century, Newton’s scheme had won out over those of Descartes and Leibniz, although only by reducing their rigorous logic to the easy-going ‘reason’ of the Enlightenment, and replacing their specifications of God’s place in His creation by assimilating Him in to Nature. Enlightened Newtonianism prepared the way for the invention of physics and its first standard model by overcoming the dichotomies between mixed mathematics and physica, and between celestial and terrestrial mechanics.
6. The Native novel
Authors: Teuton Sean
Published: January 2018

‘The Native novel’ outlines the first Native American novels— John Rollin Ridge’s Life and Adventures of Joaquin Murieta, the Celebrated California Bandit (1854) and Sophia Alice Callahan’s Wynema, a Child of the Forest (1891). It then goes on to describe the novels of Cherokee writer John Milton Oskison, Osage writer John Joseph Mathews, Salish writer D’Arcy McNickle, and Mourning Dove as well as the Red Power writing of the 1960s and 1970s. Since the first two novels, Native writers have used the form to test various responses to North American colonialism, from violent resistance to passive acceptance. The Native American novelist seeks to mediate, often subversively, between the “novel of resistance” and the “novel of assimilation.”
Ethno-cultural origins, health beliefs and mothers’ behavior regarding infant vaccinations in Israel
Authors: Sarid O , Shraga Y , Cwikel J , Reuveni H
Published: January 2018

To compare the health beliefs and infant vaccination behavior of mothers of four different ethno-cultural backgrounds: Israeli-born Jewish and Arab-Bedouin and immigrants from the Former Soviet Union and Ethiopia; to examine the associations between initial and subsequent infant vaccination behaviors of mothers and to identify predictors of vaccination behaviors. A comparative cross-sectional study was conducted in selected community neighborhoods. A quota sample included 100 mothers with infants aged 18–24 months (N = 400) from each of the four ethno-cultural groups. Data were collected through questionnaires and examination of the infant vaccination cards. Both groups of immigrant mothers had the lowest adherence to the recommended vaccination regime. Our findings indicate that maternal behaviors regarding infant vaccinations were determined mainly by the behavior at the previous recommended vaccination stage. Different ethno-cultural groups presented different sociodemographic predictors of vaccination behaviors. These predictors only affected the vaccinations at the early stage of 2 months. Policy makers should be aware that mother’s vaccination behaviors vary according to ethno-cultural groups to establish culturally tailored intervention programs.
Basic Principles Underlying Treatment and Outline of the Treatment Procedures
Authors: Barlow David H. , Farchione Todd J. , Sauer-Zavala Shannon , Latin Heather Murray , Ellard Kristen K. , Bullis Jacqueline R. , Bentley Kate H. , Boettcher Hannah T. , Cassiello-Robbins Clair
Published: January 2018

Chapter 2 of Unified Protocol for Transdiagnostic Treatment of Emotional Disorders: Therapist Guide notes that the Unified Protocol (UP) is based on traditional cognitive-behavioral principles, but the particular emphasis on the way individuals experience and respond to their emotions is unique in that it brings emotional processes to the forefront, making them available to fundamental psychological mechanisms of change. Core skills of the UP are introduced. These include mindful emotion awareness, which involves the practice of nonjudgmental, present-focused attention toward emotional experiences; challenging automatic thoughts related to external threats and internal threats and increasing cognitive flexibility; identifying and modifying problematic action tendencies, or emotional behaviors; increasing awareness and tolerance of physical sensations through interoceptive exposures; and engagement in emotion exercises. The chapter concludes with a description of the treatment modules.
Module 5: Countering Emotional Behaviors
Authors: Barlow David H. , Farchione Todd J. , Sauer-Zavala Shannon , Latin Heather Murray , Ellard Kristen K. , Bullis Jacqueline R. , Bentley Kate H. , Boettcher Hannah T. , Cassiello-Robbins Clair
Published: January 2018

Chapter 10 of Unified Protocol for Transdiagnostic Treatment of Emotional Disorders: Therapist Guide focuses on the behavioral component of the emotional response and begins by reviewing the role of emotional behaviors (i.e., behaviors that are used to control strong emotions) in the development and maintenance of maladaptive emotional responding. In this module, therapists help patients to identify relevant emotional behaviors and then work with them to develop and engage in Alternative Actions. Over time, it is expected that these Alternative Actions will help remediate cognitive and behavioral patterns contributing to the frequent occurrence of strong negative affect and maintaining patient distress in response to experience of strong emotions.
Mindful Emotion Awareness
Authors: Barlow David H. , Sauer-Zavala Shannon , Farchione Todd J. , Latin Heather Murray , Ellard Kristen K. , Bullis Jacqueline R. , Bentley Kate H. , Boettcher Hannah T. , Cassiello-Robbins Clair
Published: January 2018

Chapter 7 of Unified Protocol for Transdiagnostic Treatment of Emotional Disorders: Workbook presents the benefits of applying mindful awareness, a nonjudgmental present-focused stance, to emotional experiences. Mindful awareness is first practiced through a formal meditation exercise that introduces readers to applying this quality of attention to their emotions. Next, readers are encouraged to continue practicing mindful emotion awareness though the use of a Mindful Mood Induction exercise. Finally, the chapter continues by focusing on the Anchoring in the Present skill, which allows us to apply the concept of mindful emotion awareness to emotional experiences as they are coming up in daily life.
Countering Emotional Behaviors
Authors: Barlow David H. , Sauer-Zavala Shannon , Farchione Todd J. , Latin Heather Murray , Ellard Kristen K. , Bullis Jacqueline R. , Bentley Kate H. , Boettcher Hannah T. , Cassiello-Robbins Clair
Published: January 2018

Chapter 9 of Unified Protocol for Transdiagnostic Treatment of Emotional Disorders: Workbook looks at another part of our emotional experiences—emotional behaviors, which refer to the things we do to manage our emotions. This chapter presents skills to help us identify and evaluate our emotional behaviors by examining both the short term and long term consequences of these actions. In general, unhelpful emotional behaviors provide short term relief from strong emotions but set us up to experience even more strong emotions in the future. Lastly, we learn to counter unhelpful emotional behaviors by replacing current emotional behaviors with new, alternative behaviors, a skill called choosing an Alternative Action.
Bacillus velezensis CC09: A Potential ‘Vaccine’ for Controlling Wheat Diseases
Authors: Kang Xingxing , Zhang Wanling , Cai Xunchao , Zhu Tong , Xue Yarong , Liu Changhong
Published: January 2018

Biocontrol bacteria that can act like a “vaccine”, stimulating plant resistance to pathogenic diseases, are still not fully elucidated. In this study, an endophytic bacterium, Bacillus velezensis CC09, labeled with green fluorescent protein, was tested for its colonization, migration, and expression of genes encoding iturin A synthetase within wheat tissues and organs as well as for protective effects against wheat take-all and spot blotch diseases. The results showed that strain CC09 not only formed biofilm on the root surface but was also widely distributed in almost every tissue, including the epidermis, cortex, and xylem vessels, and even migrated to stems and leaves, resulting in 66.67% disease-control efficacy (DCE) of take-all and 21.64% DCE of spot blotch. Moreover, the gene cluster encoding iturin A synthase under the control of the pitu promoter is expressed in B. velezensis CC09 in wheat tissues, which indicates that iturin A might contribute to the in-vivo antifungal activity and leads to the disease control. All these data suggested that strain CC09 can act like a ‘vaccine’ in the control of wheat diseases, with a single treatment inoculated on roots through multiple mechanisms.
Ascospore Inoculum Density and Characterization of Components of Partial Resistance to Sclerotinia sclerotiorum in Soybean
Authors: Huzar-Novakowiski Jaqueline , Dorrance Anne E.
Published: January 2018

Germplasm screening programs have primarily relied on inoculation with mycelia to determine the resistance reaction of soybean genotypes to Sclerotinia sclerotiorum. However, under field conditions, ascospores are the primary source of inoculum. Therefore, the objective of this study was to determine which components most accurately differentiate the resistance reaction of soybean genotypes inoculated with ascospores of S. sclerotiorum. Ascospores were produced in the laboratory and all of the experiments were carried out under controlled conditions with inoculations at flowering stage. Initially, inoculum densities of 1 × 104, 1 × 105 and 1 × 106 ascospores ml−1 were compared on six soybean genotypes with known resistance reactions. Disease symptoms developed on all genotypes and at all inoculum densities. The highest ascospore concentration increased infection efficiency but it was not correlated with an increase in lesion length. Components of resistance were then measured on a set of 17 cultivars with known resistance reactions at 1 × 105 ascospores ml−1. Resistance reactions could be differentiated based on the level of infection efficiency and lesion length on the main stem. Although inoculation with ascospores presents some limitations such as the time required for inoculum production as well as the time and space required for plant growth, it has the potential to be used to complement other methods for the characterization of resistance of soybean genotypes.
A Multidisciplinary QI Initiative to Improve OR–ICU Handovers
Authors: Krimminger Dawn , Sona Carrie , Thomas-Horton Elaine , Schallom Marilyn
Published: January 2018

Background: Handover from the operating room (OR) staff to the ICU staff is a critical transition time for patients, in which the potential for error and miscommunication is high. Therefore, minimization of extraneous interruptions during the exchange of crucial information between the anesthesia and surgical teams and the nursing, respiratory therapy, and medical teams is imperative.

Objectives: The aim of this quality improvement (QI) initiative was, first, to examine the impact of a standardized handover process between the OR and the ICU on process and information-sharing errors, and second, to examine provider satisfaction with the handover process.

Methods: We conducted prospective observations of the handover process before and after implementation of the QI initiative. In the pre–process improvement period, 38 cardiothoracic patients were observed during handover. In the post–process improvement period, 38 patients were observed after implementation of the newly developed, standardized handover process and communication template. Provider satisfaction surveys were distributed at each observation during the pre– and post–process improvement periods.

Results: Compared with the pre–process improvement period, there was a significant decrease in interruptions during report in the post–process improvement period (1.7 ± 1.1 to 0.13 ± 0.34). There were also significantly fewer handover process errors (6.1 ± 2.8 to 1.7 ± 1.5), and fewer information-sharing errors (5.2 ± 2.7 to 2.3 ± 1.5). Average report time increased slightly, from 13.2 ± 6.8 minutes to 14.6 ± 3.8 minutes, but the increase was not significant. A total of 211 provider satisfaction surveys were completed in the pre–process improvement period and 95 in the post–process improvement period. Providers in all disciplines completed surveys in both time periods, and there was no significant difference in the percentage of respondents from any discipline. Responses to the following survey items showed significant improvement in the post–process improvement period: surgery report was satisfactory, anesthesia report was satisfactory, could hear all the report, pre-op anesthesia information was helpful, and start and end of handover were clear. Post–process improvement as well, more respondents disagreed that the person handing off the patient was under time pressure and that the person taking on responsibility for the patient was under time pressure.

Conclusion: A standardized OR–ICU handover process developed by a multidisciplinary team decreased handover process and information-sharing errors and increased provider satisfaction, with no significant increase in handover time.
Opioid and Nonopioid Analgesics Provide Similar Relief From Acute Extremity Pain
Authors: Rosenberg Karen
Published: January 2018

According to this study:

For adult patients presenting to the ED with acute extremity pain, a single dose of ibuprofen plus acetaminophen is as effective as three different opioid-plus-acetaminophen combination analgesics in reducing pain.

Altered prescribing practices as a result of this finding could reduce the number of people exposed to opioids and thus the risk of addiction.
Was the Enalapril Dose Too Low in the PARADIGM-HF Trial?
Authors: Bernardez-Pereira Sabrina , Ramires Felix José Alvares , de Melo Rachel Figueiredo Tavares , Pereira-Barretto Antonio Carlos
Published: January 2018

Heart failure (HF) is a common clinical syndrome associated with significant morbidity and mortality, and there remains a clear need for innovative therapies that can modify disease progression. Sacubitril/valsartan (LCZ696) is a novel complex that combines simultaneous neprilysin inhibition and angiotensin II receptor blockade, that has demonstrated significant cardiovascular death or HF hospitalization reduction in the Prospective Comparison of Angiotensin Receptor/Neprilysin Inhibitor (ARNI) With Angiotensin-Converting Enzyme (ACE) Inhibitors to Determine Impact on Global Mortality and Morbidity in Heart Failure (PARADIGM-HF) trial when compared with evidence-based doses of the gold standard ACE inhibitor enalapril. In this comprehensive review, the authors discuss historical trials that have investigated clinical outcomes utilizing variable dosing levels of ACE inhibitors or angiotensin receptor blockers in patients with HF with reduced ejection fraction. A critical analysis of the highlighted studies is proposed in the context of current HF management guidelines and HF clinical practice. In conclusion, based on current evidence, it is unclear whether a maximum recommended enalapril dose would promote improved patient outcomes compared with an intermediate dose. However, no prospective study to date comparing ACE inhibitor doses has documented that higher doses result in significant mortality reduction, although the data suggest that there may be a decrease in HF hospitalizations when compared with lower doses.
A Pattern-Based Approach Combining Tumor Morphology on MRI With Distinct Signal Patterns on Diffusion-Weighted Imaging to Assess Response of Rectal Tumors After Chemoradiotherapy
Authors: Lambregts Doenja M.J. , Delli Pizzi Andrea , Lahaye Max J. , van Griethuysen Joost J.M. , Maas Monique , Beets Geerard L. , Bakers Frans C.H. , Beets-Tan Regina G.H.
Published: January 2018

BACKGROUND:

Diffusion-weighted imaging is increasingly used in rectal cancer MRI to assess response after chemoradiotherapy. Certain pitfalls (eg, artefacts) may hamper diffusion–MRI assessment, leading to suboptimal diagnostic performance. Combining diffusion-weighted MRI with the underlying morphology on standard (T2-weighted) MRI may help overcome these pitfalls.

OBJECTIVE:

The purpose of this study was to evaluate the diagnostic performance of a pattern-based approach combining tumor morphology on T2-weighted MRI with distinct diffusion-weighted imaging signal patterns to assess response after chemoradiotherapy in rectal cancer.

DESIGN:

Response to chemoradiotherapy was scored according to 4 patterns: 1) cases with either a clear residual mass with corresponding high-diffusion signal (A+) or completely normalized wall without diffusion signal (A–); 2) cases with circular and/or irregular fibrosis with (B+) or without (B–) small foci of diffusion signal scattered throughout the fibrosis; 3) cases with semicircular fibrosis with (C+) or without (C–) high diffusion signal at the inner margin of the fibrosis; and 4) polypoid tumors showing regression of the polyp and fibrosis at the site of the stalk with (D+) or without (D–) focal high-diffusion signal in the stalk. A total of 75 cases were rescored by an independent second reader to study interobserver variations. Standard of reference was histopathology or long-term outcome.

SETTINGS:

The study was conducted at a single tertiary referral center.

PATIENTS:

A total of 222 patients with locally advanced rectal cancer undergoing chemoradiotherapy were included.

MAIN OUTCOME MEASURES:

Diagnostic performance to discriminate between a complete response and residual tumor was measured.

RESULTS:

The pattern-based approach resulted in a sensitivity of 94%, specificity of 77%, positive predictive value of 88%, negative predictive value of 87%, and overall accuracy of 88% to differentiate between tumor versus complete response. Accuracies per pattern were 100% (A), 74% (B), 86% (C), and 92% (D). Interobserver agreement was good (κ = 0.75).

LIMITATIONS:

The study included no comparison with routine (nonpattern) diffusion–MRI assessment.

CONCLUSIONS:

A pattern-based approach combining tumor morphology with distinct diffusion-weighted imaging patterns results in good diagnostic performance to assess response. See Video Abstract at http://links.lww.com/DCR/A433.
Optimized Protocol for Testing Multipurpose Contact Lens Solution Efficacy Against Acanthamoeba
Authors: Fedorko Daniel P. , Brocious Jeffrey M. , Adams Katherine D. , Hitchins Victoria M. , Hampton Denise L. , Eydelman Malvina B.
Published: January 2018

Objectives:

To evaluate the interlaboratory and intralaboratory reproducibility of a proposed protocol for multipurpose contact lens solution (MPS) disinfection efficacy against Acanthamoeba.

Methods:

Acanthamoeba castellanii and Acanthamoeba polyphaga and four MPS with different biocidal agents were used to evaluate the protocol in two different laboratories. In addition to the negative control, a positive control and neutralization control were used. One experiment was performed in triplicate, and all other experiments were performed in duplicate in each laboratory. Acanthamoeba trophozoites were grown axenically, and cysts were generated using the starvation method. Trophozoites and cysts at a concentration of 2.0 × 103 to 2.0 × 104 organisms per milliliter were exposed to the test MPS for 0, 4 or 6 (manufacturer's recommended soak time [MRST]), 8, and 24 hr. Survivors were determined by a limiting dilution method that used a most probable number evaluation.

Results:

The positive and negative controls displayed consistent results and trends both within each laboratory and between each laboratory for trophozoites and cysts of both A. castellanii and A. polyphaga. The neutralization control consistently demonstrated the ability of the neutralizing agents to neutralize the MPS and the positive control and demonstrated no inhibition of Acanthamoeba by the negative control. Testing in triplicate and duplicate demonstrated the reproducibility of the protocol both within each laboratory and between the laboratories. Our results demonstrated that the MPS at the MRST and at 8 hr (likely overnight soak time) are generally more effective against trophozoites than they are against cysts. Only the MPS with hydrogen peroxide as the biocidal agent was able to provide a greater than three-log kill of cysts at the MRST and longer. Among the MPS we tested, trophozoites of A. castellanii and A. polyphaga showed similar responses. Some variability was observed when testing cysts of both species. In both laboratories, one nonhydrogen peroxide containing MPS had some effect (>1 log kill) on A. polyphaga cysts. This solution had no effect (<1 log kill) on A. castellanii cysts, A. castellanii trophozoites, and A. polyphaga trophozoites.

Conclusions:

The protocol that we have revised and evaluated is a well-controlled and reproducible procedure that can effectively evaluate the efficacy of MPS against Acanthamoeba trophozoites. Some variability was observed when testing the cyst stage.
Bibliometric Study of Scientific Research on Scleral Lenses
Authors: Povedano-Montero Francisco Javier , Álvarez-Peregrina Cristina , Hidalgo Santa Cruz Fernando , Villa-Collar César , Sánchez Valverde José
Published: January 2018

Purpose:

To analyze the state of scientific publications in the field of scleral lenses applying a bibliometric study.

Methods:

The database used in this bibliometric study was SCOPUS, the largest abstract and citation database of peer-reviewed literature: scientific journals, books, and conference proceedings. Using remote download techniques, articles published between 1962 (year of first registrations) and 2015 were selected by entering the main descriptors: “scleral contact lenses” and “scleral lenses,” limiting the field for the article, keywords, and abstract, linked with the OR tab. We applied the following bibliometric indicators: Price index, doubling time and annual growth rate, Price transience index, Lotka law of scientific productivity, and Bradford zones.

Results:

The authors recovered 361 contributions (articles, reviews, letters to the editor, etc.) for 1962 to 2016. The distribution for five-year periods shows a significant increase in 2012 to 2016, with a growth of 222.22% in comparison with the previous period 2012 to 2016. The countries with the highest production are the United states with 135 contributions, United Kingdom with 46, and India with 19. The most productive institutions are Harvard Medical school, Boston Foundation for Sight, and Moorfields Eye Hospital National Health Service Foundation Trust. Classification of authors based on productivity is strongly concentrated in small producers, with a transient index of 59.03. The total number of authors is 891, representing a coauthor index of 2.47 for the 361 documents retrieved. The authors with the highest productivity are Kenneth W. Pullum, Perry Rosenthal, and Deborah S. Jacobs, with an h-index between 12 and 19 documents. The number of documents published on scleral lenses shows a significant increase in the last 5 years, and currently, they represent only 1.44% of all publications on contact lenses.

Conclusions:

Bibliometric studies have become essential tools for evaluating scientific activity, allowing an overview of the growth, size, and distribution of scientific literature associated with a particular discipline.
Effect of the Rigid Gas-Permeable Contact Lens Use on the Endothelial Cells in Patients With Keratoconus
Authors: Dogan Cezmi , Hagverdiyeva Samira , Mergen Burak , İskeleli Guzin
Published: January 2018

Objectives:

To compare the changes in the corneal endothelial cells of both the patients with keratoconus who use rigid gas-permeable (RGP) contact lens and who do not use any contact lens with healthy population.

Methods:

Thirty-three patients with keratoconus who use RGP contact lenses (group 1), 20 patients with keratoconus who do not use any contact lens (group 2), and 40 healthy controls were included in the study. Changes in the corneal endothelial cells of all patients were evaluated using a noncontact specular microscope. Endothelial cell density (ECD), coefficient of variability (CV), hexagonal cell percentage (%HEX), and central corneal thickness (CCT) of the patients were evaluated in the study.

Results:

In the groups 1, 2, and 3, the mean ECD was 2,420.8±247, 2,579.5±240, and 2,589.5±271 cells/mm2, the mean CV was 357±9, 34±7, and 34±6, the mean %HEX was 54.3±13, 59.1±14, and 57.4±10, and the mean CCT was 508±33, 504±43, and 561±34 μm, respectively. There was no significant difference between the groups in terms of ECD, CV, and %HEX. Although significant differences between the groups 1 to 3 and groups 2 to 3 in terms of CCT were detected (P=0.001 and P=0.004, respectively), no significant difference was observed between the groups 1 and 2.

Conclusions:

Although significant difference was found between the groups 1 to 2 and normal population in terms of CCT, no difference was detected between all the groups in terms of the other parameters. In this study, we report that long-term use of RGP contact lens in patients with keratoconus had no effect on the corneal endothelial cells.
Marijuana—Perinatal and Legal Issues With Use During Pregnancy
Authors: Krening Cynthia , Hanson Keri
Published: January 2018

Although still illegal at the federal level, marijuana has been legalized for medical and/or recreational use in 29 states, causing a dynamically changing legal and social landscape. While the legalization of marijuana at the state level provides criminal protection for use by adults, there remain civil legal implications for families brought about by mandated reporting laws. Mandated reporting requirements have not been updated to account for the movement toward legalization, risking overload of community child protection resources. There is little evidence to inform development of guidelines and protocols for screening, educating, testing of mothers and newborns, and reporting. There are perinatal issues in this evolving environment as well. Discriminatory testing, length of time the drug remains in the system, potential for compromised provider-patient relationships, inconsistent education and referrals, breastfeeding during marijuana use, punitive or legal interventions that may have a negative psychosocial impact on a new family, and the risk for development of community standards of care based on opinion rather than science are just a few of the issues realized after marijuana legalization. These legal and perinatal issues are discussed in detail, along with considerations for practice and policy in caring for cannabis-exposed pregnant women and newborns.
Care Through the Newborn's Eyes
Authors: Francis Kim , Pugsley Lori
Published: January 2018

Separation of mothers and infants after birth is standard practice for many hospitals, yet not evidence-based. Nonseparation clearly has numerous benefits. However, newborns lack a voice to make choices to direct their course of care. The evidence supports nonseparation strategies for mothers and infants that promote attachment, physiologic regulation, nutrition, sleep, communication, and management of stress/pain. Moreover, the evidence is compelling that nonseparation is essential. The time has come to act on the evidence and begin seeing the care we provide through the newborn's eyes.
Athletic Remodeling in Female College Athletes: The “Morganroth Hypothesis” Revisited
Authors: Kooreman Zoe , Giraldeau Geneviève , Finocchiaro Gherardo , Kobayashi Yukari , Wheeler Matthew , Perez Marco , Moneghetti Kegan , Oxborough David , George Keith P. , Myers Jonathan , Ashley Euan , Haddad François
Published: January 2018

Background:

There is limited data regarding ventricular remodeling in college female athletes, especially when appropriate scaling of cardiac dimensions to lean body mass (LBM) is considered. Moreover, it is not well established whether cardiac remodeling in female athletes is a balanced process with proportional increase in left ventricular (LV) mass and volume or the right and LV size.

Methods:

During the preparticipation competitive screening, 72 female college athletes volunteered to undergo dual energy x-ray absorptiometry scan for quantification of LBM and comprehensive 2D echocardiography including assessment of longitudinal myocardial strain. The athletes were divided in 2 groups according to the intensity of the dynamic and static components of their sport categories, ie, a higher intensity dynamic and resistive group (n = 37 participating in rowing, water polo and lacrosse) and a lower intensity group (n = 35, participating in short distance running, sailing, synchronized swimming, and softball). In addition, we recruited a group of 31 age-matched nonathlete controls.

Results:

The mean age of the study population was 18.7 ± 1.0 years. When scaled to body surface area, the higher intensity group had 17.1 ± 3.6% (P < 0.001) greater LV mass when compared with the lower intensity group and 21.7 ± 4.0% (P < 0.001) greater LV mass than the control group. The differences persisted after scaling to LBM with 14.2 ± 3.2% (P < 0.001) greater LV mass in the higher intensity group. By contrast, there was no difference in any of the relative remodeling indices including the LV mass to volume ratio, right to LV area ratio, or left atrial to LV volume ratio (P > 0.50 for all). In addition, no significant difference was noted among the 3 groups in LV ejection fraction (P = 0.22), LV global longitudinal strain (P = 0.55), LV systolic strain rate (P = 0.62), or right ventricular global longitudinal strain (P = 0.61).

Conclusion:

Female collegiate athletes participating in higher intensity dynamic and resistive sports have higher indexed LV mass even when scaled to LBM. The remodeling process does however appear to be a balanced process not only at the intraventricular level but also at the interventricular and atrioventricular levels.
Hepatic actions of androgens in the regulation of metabolism
Authors: Birzniece Vita
Published: January 2018

Purpose of review

The purpose of this review is to summarize recent findings on hepatic actions of androgens in the regulation of protein, lipid and glucose metabolism. The rationale for liver-targeted testosterone use will be provided.

Recent findings

Liver-targeted testosterone administration, via the oral route, induces protein anabolic effect by reducing the rate of protein oxidation to a similar extent to that of systemic testosterone administration. Recent evidence indicates that testosterone exerts whole-body anabolic effect through inhibition of nitrogen loss via the hepatic urea cycle. Several hepatic effects of androgens, particularly on glucose metabolism, are direct and take place before any changes in body composition occur. This includes an increase in insulin secretion and sensitivity, and reduction in hepatic glucose output by testosterone. Furthermore, lack of testosterone in the liver exacerbates diet-induced impairment in glucose metabolism. In the liver, androgens induce the full spectrum of metabolic changes through interaction with growth hormone or aromatization to estradiol.

Liver-targeted testosterone therapy may open up a new approach to achieve whole-body anabolism without systemic side-effects. Aromatizable androgens may be superior to nonaromatizable androgens in inducing a complex spectrum of direct, estrogen-mediated and other hormone-mediated effects of androgens.
Differences in Mental Health Service Use Among Unemployed Veterans of Different Eras
Authors: Levine Debra S. , Valenstein Marcia , Yosef Matheos , Mavandadi Shahrzad , Oslin David W. , Himle Joseph A. , Zivin Kara
Published: January 2018

Mental disorders have been linked to unemployment among veterans. Improving mental health conditions, such as depression, can improve veteran employment outcomes. This study compared mental health treatment among unemployed Operation Enduring Freedom (OEF; in Afghanistan) and Operation Iraqi Freedom (OIF; in Iraq) veterans and veterans from other service eras. The study included 3165 unemployed veterans from six Veterans Affairs medical centers with a positive screen that indicates a possible mental disorder. Chi-squared tests and logistic regression analyses assessed whether veteran era was associated with mental health treatment. Unemployed OEF/OIF veterans were less likely to receive psychotropic medication and four or more psychotherapy sessions compared to veterans from other eras. Multivariable analyses controlling for age found associations based on younger age rather than era. Younger unemployed veterans received fewer mental health services, which is concerning because reducing mental health symptoms may increase employment and employment may reduce symptoms, which are key factors in reintegration into civilian life.
Natural Medicines for Psychotic Disorders
Authors: Hoenders H.J. Rogier , Bartels-Velthuis Agna A. , Vollbehr Nina K. , Bruggeman Richard , Knegtering Henderikus , de Jong Joop T.V.M.
Published: January 2018

Patients with psychotic disorders regularly use natural medicines, although it is unclear whether these are effective and safe. The aim of this study was to provide an overview of evidence for improved outcomes by natural medicines. A systematic literature search was performed through Medline, PsycINFO, CINAHL, and Cochrane until May 2015. In 110 randomized controlled trials, evidence was found for glycine, sarcosine, N-acetylcysteine, some Chinese and ayurvedic herbs, ginkgo biloba, estradiol, and vitamin B6 to improve psychotic symptoms when added to antipsychotics. Ginkgo biloba and vitamin B6 seemed to reduce tardive dyskinesia and akathisia. Results on other compounds were negative or inconclusive. All natural agents, except reserpine, were well tolerated. Most study samples were small, study periods were generally short, and most results need replication. However, there is some evidence for beneficial effects of certain natural medicines.