bluuebunny/crossref_metadata_2025 huggingface dataset:
Change in functional status among children treated in the intensive care unit after injury
Authors: Ahmed Omar Z. , Holubkov Richard , Dean J. Michael , Bennett Tellen D. , Meert Kathleen L. , Berg Robert A. , Newth Christopher J.L. , Carcillo Joseph A. , Burd Randall S. , Pollack Murray M.
Published: November 2018

BACKGROUND

Because pediatric trauma-related mortality continues to decline, metrics assessing morbidity are needed to evaluate the impact of treatment after injury. Based on its value for assessing children with traumatic brain injuries and other critical illnesses, Functional Status Scale (FSS), a tool that measures function in six domains (communication, feeding, mental, motor, sensory, and respiratory), was evaluated as an outcome measure for the overall population of injured children.

METHODS

Children with at least one injury (Abbreviated Injury Scale [AIS] severity ≥1) surviving to discharge between December 2011 and April 2013 were identified in a previous study of intensive care unit admissions. Morbidity was defined as additional morbidity in any domain (domain FSS change ≥2 or "new domain morbidity") and additional overall morbidity (total FSS change ≥3) between preinjury status and discharge. Associations between injury profiles and the development of morbidity were analyzed.

RESULTS

We identified 553 injured children, with a mean of 2.0 ± 1.9 injuries. New domain and overall morbidity were observed in 17.0% and 11.0% of patients, respectively. New domain morbidity was associated with an increasing number of body regions with an injury with AIS ≥ 2 (p < 0.001), with severe (AIS ≥ 4) head (p = 0.04) and spine (p = 0.01) injuries and with at moderately severe (AIS ≥ 2) lower extremity injuries (p = 0.01). New domain morbidity was more common among patients with severe spine and lower extremity injuries (55.6% and 48.7%, respectively), with greatest impact in the motor domain (55.6% and 43.6%, respectively). New domain morbidity was associated with increasing injury severity score, number of moderately severe injuries and number of body regions with more than a moderately severe injury (p < 0.001 for all).

CONCLUSIONS

Higher morbidity measured by the FSS is associated with increasing injury severity. These findings support the use of the FSS as a metric for assessing outcome after pediatric injury.

LEVEL OF EVIDENCE

Prognostic/Epidemiologic, level III.
Near hangings: Epidemiology, injuries, and investigations
Authors: Schellenberg Morgan , Inaba Kenji , Warriner Zachary , Alfson Daniel , Roman Jordan , Van Velsen Valery , Lam Lydia , Demetriades Demetrios
Published: November 2018

BACKGROUND

Near hangings are an infrequent cause of trauma, and the optimal workup for these patients is unclear. The study objectives were to define the epidemiology, injury patterns, and use of investigations, including computed tomographic angiography (CTA) neck, after near hangings.

METHODS

All patients presenting to LAC+USC Medical Center (2008–2015) after near hanging (International Classification of Diseases, Ninth Revision, code of E913.8, E953.0, E963, or E983.0) were screened for inclusion. Transferred patients were excluded. Patient demographics, clinical data, injury data, investigations performed, and outcomes were collected.

RESULTS

Over the study period, 71 patients were identified. Median age was 32 years (interquartile range [IQR], 24-44), and 85% (n=64) were male. Median Glasgow Coma Scale was 12 [IQR 5-15], and median Injury Severity Score was 1 [IQR 1-2]. Mortality rate was 14% (n = 10). The most common finding on physical examination was a ligature mark (n = 38, 54%). Cervical injuries after near hangings occurred infrequently (five injuries in four patients [6%]: 3 [4%] arterial injuries and 2 [3%] laryngotracheal injuries). Only one patient (1%) required surgical and/or endovascular intervention. Two (3%) arrived in cardiac arrest, underwent resuscitative thoracotomy, and were pronounced dead. All others (n = 69, 97%) underwent CTA of the neck. No patient in this series manifested signs or symptoms of cervical injury during hospitalization after a normal CTA neck on presentation.

CONCLUSION

Near hangings infrequently result in cervical injury, and intervention is rarely needed. When injuries are sustained, they occur to critical structures such as the larynx, trachea, and cervical vasculature. Therefore, effective injury screening is important. We recommend CTA of the neck as the optimal initial imaging investigation after near hangings.

LEVEL OF EVIDENCE

Epidemiologic, level IV; therapeutic/care management, level IV.
Analysis of over 2 decades of colon injuries identifies optimal method of diversion: Does an end justify the means?
Authors: Manley Nathan R. , Sharpe John P. , Lewis Richard H. , Iltis Mark S. , Chaudhuri Rishi , Fabian Timothy C. , Croce Martin A. , Magnotti Louis J.
Published: November 2018

INTRODUCTION

Conflicting evidence exists regarding the definitive management of destructive colon injuries. Although diversion with an end ostomy can theoretically decrease initial complications, it mandates a more extensive reversal procedure. Conversely, anastomosis with proximal loop ostomy diversion, while simplifying the reversal, increases the number of suture lines and potential initial morbidity. Thus, the purpose of this study was to evaluate the impact of diversion technique on morbidity and mortality in patients with destructive colon injuries.

METHODS

Consecutive patients with destructive colon injuries managed with diversion from 1996 to 2016 were stratified by demographics, severity of shock and injury, operative management, and timing of reversal. Outcomes, including ostomy complications (obstruction, ischemia, readmission) and reversal complications (obstruction, abscess, suture line failure, fascial dehiscence), were compared between patients managed with a loop versus end colostomy. Patients with rectal injuries and who died within 24 hours were excluded.

RESULTS

A total of 115 patients were identified: 80 with end colostomy and 35 with loop ostomy. Ostomy complications occurred in 22 patients (19%), and 11 patients (10%) suffered reversal complications. There was no difference in ostomy-related (2.9% vs. 3.8%, p = 0.99) mortality. For patients without a planned ventral hernia (PVH), there was no difference in ostomy complications between patients managed with a loop versus end colostomy (12% vs. 18%, p = 0.72). However, patients managed with a loop ostomy had a shorter reversal operative time (95 vs. 245 minutes, p = 0.002) and reversal length of stay (6 vs. 10, p = 0.03) with fewer reversal complications (0% vs. 36%, p = 0.02). For patients with a PVH, there was no difference in outcomes between patients managed with a loop versus end colostomy.

CONCLUSION

For patients without PVH, anastomosis with proximal loop ostomy reduced reversal-related complications, operative time, LOS, and hospital charges without compromising initial morbidity. Therefore, loop ostomy should be the preferred method of diversion, if required, following destructive colon injury.

LEVEL OF EVIDENCE

Therapeutic, level IV.
The impact of hypothermia on outcomes in massively transfused patients
Authors: Lester Erica Louise Walsh , Fox Erin E. , Holcomb John B. , Brasel Karen J. , Bulger Eileen M. , Cohen Mitchell J. , Cotton Bryan A. , Fabian Timothy C. , Kerby Jeffery D. , O'Keefe Terrence , Rizoli Sandro B. , Scalea Thomas M. , Schreiber Martin A. , Inaba Kenji
Published: November 2018

BACKGROUND

Hypothermia is associated with poor outcomes after injury. The relationship between hypothermia during contemporary large volume resuscitation and blood product consumption is unknown. We evaluated this association, and the predictive value of hypothermia on mortality.

METHODS

Patients predicted to receive massive transfusion at 12 level 1 trauma centers were randomized in the Pragmatic Randomized Optimal Platelet and Plasma Ratios (PROPPR) trial and were grouped into those who were hypothermic (<36°C) or normothermic (36–38.5°C) within the first 6 hours of emergency department arrival. The impact of hypothermia or normothermia on the volume of blood product required during the first 24 hours was determined via negative binomial regression, adjusting for treatment arm, injury severity score, mechanism, demographics, pre–emergency department fluid volume, blood administered before becoming hypothermic, pulse and systolic blood pressure on arrival, and the time exposed to hypothermic or normothermic temperatures.

RESULTS

Of 680 patients, 590 had a temperature measured during the first 6 hours in hospital, and 399 experienced hypothermia. The mean number of red blood cell (RBC) units given to all patients in the first 24 hours of admission was 8.8 (95% confidence interval [CI], 7.9–9.6). In multivariable analysis, every 1°C decrease in temperature below 36.0°C was associated with a 10% increase (incidence rate ratio, 0.90; 95% CI, 0.89–0.92; p < 0.00) in consumption of RBCs during the first 24 hours of admission. There was no association between RBC administration and a temperature above 36°C. Hypothermia on arrival was an independent predictor of mortality, with an adjusted odds ratio of 2.7 (95% CI, 1.7–4.5; p < 0.00) for 24-hour mortality and 1.8 (95% CI, 1.3–2.4; p < 0.00) for 30-day mortality.

CONCLUSION

Hypothermia is associated with increase in blood product consumption and mortality. These findings support the maintenance of normothermia in trauma patients and suggest that further investigation on the impact of cooling or rewarming during massive transfusion is warranted.

LEVEL OF EVIDENCE

Prognostic, level III.
Reevaluation of the Kidney Donor Risk Index
Authors: Zhong Yingchao , Schaubel Douglas E. , Kalbfleisch John D. , Ashby Valarie B. , Rao Panduranga S. , Sung Randall S.
Published: November 2018

Background.

The Kidney Donor Risk Index (KDRI) is a score applicable to deceased kidney donors which reflects relative graft failure risk associated with deceased donor characteristics. The KDRI is widely used in kidney transplant outcomes research. Moreover, an abbreviated version of KDRI is the basis, for allocation purposes, of the “top 20%” designation for deceased donor kidneys. Data upon which the KDRI model was based used kidney transplants performed between 1995 and 2005. Our purpose in this report was to evaluate the need to update the coefficients in the KDRI formula, with the objective of either (a) proposing new coefficients or (b) endorsing continued used of the existing formula.

Methods.

Using data obtained from the Scientific Registry of Transplant Recipients, we analyzed n = 156069 deceased donor adult kidney transplants occurring from 2000 to 2016. Cox regression was used to model the risk of graft failure. We then tested for differences between the original and updated regression coefficients and compared the performance of the original and updated KDRI formulas with respect to discrimination and predictive accuracy.

Results.

In testing for equality between the original and updated KDRIs, few coefficients were significantly different. Moreover, the original and updated KDRI yielded very similar risk discrimination and predictive accuracy.

Conclusions.

Overall, our results indicate that the original KDRI is robust and is not meaningfully improved by an update derived through modeling analogous to that originally employed.
Cell-free MicroRNA miR-505-3p in Graft Preservation Fluid Is an Independent Predictor of Delayed Graft Function After Kidney Transplantation
Authors: Roest Henk P. , Ooms Liselotte S.S. , Gillis Ad J.M. , IJzermans Jan N.M. , Looijenga Leendert H.J. , Dorssers Lambert C.J. , Dor Frank J.M.F. , van der Laan Luc J.W.
Published: November 2018

Background

Delayed graft function (DGF), a common complication after transplantation of deceased donor kidneys, affects both short- and long-term outcomes. Currently available biomarkers during graft preservation lack sensitivity in predicting risk for DGF. The aim of this study is to identify cell-free micro ribonucleic acid (miRNA) biomarkers in graft preservation fluid predictive of DGF after kidney transplantation.

Methods

Vascular bed preservation fluid was collected from 48 kidney grafts from donation after circulatory death (DCD) or donation after brain death (DBD) donors. miRNA profiles were determined by polymerase chain reaction (PCR) array (n = 8) and validated by reverse transcription and quantitative PCR (n = 40). Graft function posttransplantation was defined as immediate good function (IF) or DGF.

Results

A total of 223 miRNAs fulfilled the preset parameters (Ct < 40 in 3 or more samples) and were included in the analysis. Thirty-two miRNAs were significantly different between DGF and IF kidney grafts (P < 0.05) but, after correction for multiple testing, only miR-505-3p remained significant. The significant association of high miR-505-3p levels with DGF was confirmed in an independent validation cohort using conventional reverse transcription and quantitative PCR detection. Multivariate analyses showed miR-505-3p as an independent predictor for DGF (odds ratio, 1.12; P = 0.028). If stratified for donor type, miR-505-3p levels remained significantly different between IF and DGF in DCD grafts (P < 0.01), but not in DBD grafts. Receiver operating characteristic curve analysis showed a high sensitivity and specificity (area under the curve, 0.833).

Conclusions

In DCD grafts, high levels of miR-505-3p in preservation fluid are associated with increased risk of DGF after kidney transplantation. Further study is required to confirm the utility of cell-free miR-505-3p as prognostic biomarker for DGF.
A Propensity-matched Survival Analysis: Do Simultaneous Liver-lung Transplant Recipients Need a Liver?
Authors: Freischlag Kyle , Ezekian Brian , Schroder Paul M. , Mulvihill Michael S. , Cox Morgan L. , Hartwig Matthew G. , Knechtle Stuart
Published: November 2018

Background.

There is debate whether simultaneous lung-liver transplant (LLT) long-term outcomes warrant allocation of 2 organs to a single recipient. We hypothesized that LLT recipients would have improved posttransplant survival compared with matched single-organ lung recipients with an equivalent degree of liver dysfunction.

Methods.

The Organ Procurement and Transplant Network/United Network for Organ Sharing STAR file was queried for adult candidates for LLT and isolated lung transplantation from 2006 to 2016. Waitlist mortality and transplant odds were calculated for all candidates. Donor and recipient demographic characteristics were compiled and compared. The LLT recipients were matched 1:2 with a nearest neighbor method to single-organ lung recipients. Kaplan-Meier methods with log-rank test compared long-term survival between groups. Univariate regression was used to calculate the association of LLT and mortality within 6 months of transplant. A proportional hazards model was used to calculate risk-adjusted mortality after 6 months posttransplantation.

Results.

Thirty-eight LLT patients were matched to 75 single-organ lung recipients. After matching, no differences in baseline demographics or liver function were observed between cohorts. Length of stay was significantly longer in LLT recipients compared to isolated lung recipients (45.89 days vs 22.44 days,P< 0.001). There was no significant difference in survival probability between LLT and isolated lung transplant (1 y, 89.5% vs 86.7%; 5 y, 67.0% vs 64.6%;P= 0.20).

Conclusions.

After matching for patient characteristics and level of liver dysfunction, survival in simultaneous LLT was comparable to isolated lung transplantation. Although this population is unique, the clinical picture prompting liver transplant is not clear. National guidelines to better elucidate patient selection are needed.
Recipient Outcomes From Nondirected Live Kidney Donors: A UK-based Cohort Study
Authors: Nath Jay , Patel Kamlesh , Field Melanie , Hodson James , Sharif Adnan , Inston Nicholas G. , Ready Andrew R.
Published: November 2018

Background

Increasing numbers of patients with end-stage renal failure are receiving kidneys from nondirected kidney donors (NKDs), also known as altruistic donors. Transplant outcomes for recipients of such kidneys are largely inferred from studies on specified kidney donors (SKDs), which may be inaccurate due to differences in donor, recipient and transplant specific factors. We report the outcomes for recipients of NKD in the United Kingdom.

Methods

Outcomes for 6861 patients receiving a living donor kidney transplant between January 2007 and December 2014 were analyzed using both the National Health Service Blood and Transplant and the UK Renal Registry datasets. Graft and patient outcomes were compared for patients receiving NKD and SKD organs using univariable and multivariable analyses.

Results

There was significant discordance between the NKD and SKD donors and recipients. These included increased donor age (median, 58 years vs 47 years;P< 0.001) and higher rates of hemodialysis and previous transplants in the NKD group (bothP< 0.001). Despite such markers of increased risk among both donors and recipients of NKD kidneys, there was no difference in graft survival on univariable (hazard ratio, 1.20; 95% confidence interval, 0.77-1.86;P= 0.419) or multivariable analysis (hazard ratio, 1.13; 95% confidence interval, 0.65-1.95;P= 0.665).

Conclusions

Despite some markers of transplant complexity, nondirected kidney donor organs are an excellent source of organs for transplantation.
Vestibular rehabilitation: advances in peripheral and central vestibular disorders
Authors: Dunlap Pamela M. , Holmberg Janene M. , Whitney Susan L.
Published: November 2018

Purpose of review

Rehabilitation for persons with vertigo and balance disorders is becoming commonplace and the literature is expanding rapidly. The present review highlights recent findings of both peripheral and central vestibular disorders and provides insight into evidence related to new rehabilitative interventions. Risk factors will be reviewed to create a better understanding of patient and clinical characteristics that may effect recovery among persons with vestibular disorders.

Recent findings

Clinical practice guidelines have recently been developed for peripheral vestibular hypofunction and updated for benign paroxysmal positional vertigo. Diagnoses such as persistent postural-perceptual dizziness (PPPD) and vestibular migraine are now defined, and there is growing literature supporting the effectiveness of vestibular rehabilitation as a treatment option. As technology advances, virtual reality and other technologies are being used more frequently to augment vestibular rehabilitation. Clinicians now have a better understanding of rehabilitation expectations and whom to refer based on evidence in order to improve functional outcomes for persons living with peripheral and central vestibular disorders.

An up-to-date understanding of the evidence related to vestibular rehabilitation can assist the practicing clinician in making better clinical decisions for their patient and hopefully result in optimal functional recovery.
Is intravenous thrombolysis still necessary in patients who undergo mechanical thrombectomy?
Authors: Katsanos Aristeidis H. , Tsivgoulis Georgios
Published: November 2018

Purpose of review

To summarize available evidence on the potential utility of pretreatment with intravenous thrombolysis (IVT) using recombinant tissue-plasminogen activator (rt-PA) in acute ischemic stroke (AIS) patients with large vessel occlusions (LVO) who are treated with mechanical thrombectomy.

Recent findings

Despite theoretical concerns of a higher bleeding risk with IVT pretreatment, there are no data showing increased risk of symptomatic intracerebral hemorrhage (sICH) in patients with LVO receiving bridging therapy (IVT and mechanical thrombectomy) compared with direct mechanical thrombectomy (dMT). Additionally, evidence from observational studies suggest lower rates of infarctions in previously unaffected territories and higher rates of successful reperfusion, with lower number of device passes, in patients receiving bridging therapy. There are substantial discrepancies in studies comparing clinical outcomes between dMT and bridging therapy that are directly related to the inclusion of patients with contraindications to IVT in the dMT group. Ongoing clinical trials will provide definitive answers on the potential additional benefit of IVT in LVO patients receiving mechanical thrombectomy.

IVT and mechanical thrombectomy are two effective reperfusion therapies that should be used in a swift and noncompeting fashion in AIS patients. AIS patients with LVO and no contraindications for IVT should receive promptly rt-PA bolus followed by immediate initiation of mechanical thrombectomy as indicated by current international recommendations, unless future randomized controlled trials provide evidence to proceed differently.
New concepts on acute ocular ischemia
Authors: Sharma Rahul A. , Newman Nancy J. , Biousse Valérie
Published: November 2018

Purpose of review

To review recent advances in the management of acute ocular ischemic events, including: transient monocular vision loss, central and branch retinal artery occlusions, and nonarteritic anterior ischemic optic neuropathy.

Recent findings

Transient monocular vision loss and acute retinal arterial occlusions require immediate diagnosis and management, with recognition of these events as transient ischemic attack or stroke equivalents, respectively. Patients should undergo an immediate stroke workup in a stroke center, similar to patients with acute cerebral ischemia. The treatment of central retinal artery occlusions remains limited despite the growing use of thrombolytic treatments. The indication for these treatments remains under debate. No quality evidence exists to support any therapy, including corticosteroids, in the treatment of nonarteritic anterior ischemic optic neuropathy. The highest priority in management is to rule-out giant cell arteritis.

Effective therapies for the treatment of ischemic events of the retina and optic nerve remain elusive. Clinicians should focus on the prompt recognition of these events as ocular emergencies and immediately refer patients with vascular transient visual loss and acute central and branch retinal arterial occlusions to the nearest stroke center.
Multidimensional dynamics of the proteome in the neurodegenerative and ageing mammalian brain
Authors: Andrews Byron , Maslen Sarah , Almeida-Souza Leonardo , Skehel J Mark , Frank René
Published: November 2018

The amount of any given protein in the brain is determined by the rates of its synthesis and destruction, which are regulated by different cellular mechanisms. Here, we combine metabolic labelling in live mice with global proteomic profiling to simultaneously quantify both the flux and amount of proteins in mouse models of neurodegeneration. In multiple models, protein turnover increases were associated with increasing pathology. This method distinguishes changes in protein expression mediated by synthesis from those mediated by degradation. In the AppNL-F knockin mouse model of Alzheimer’s disease increased turnover resulted from imbalances in both synthesis and degradation, converging on proteins associated with synaptic vesicle recycling (Dnm1, Cltc, Rims1) and mitochondria (Fis1, Ndufv1). In contrast to disease models, ageing in wildtype mice caused a widespread decrease in protein recycling associated with a decrease in autophagic flux. This simple multidimensional approach enables the comprehensive mapping of proteome dynamics and identifies affected proteins in mouse models of disease and other live animal test settings.
MRE11-RAD50-NBS1 activates Fanconi Anemia R-loop suppression at transcription-replication conflicts
Authors: Chang Emily Yun-chia , Wells James P. , Tsai Shu-Huei , Coulombe Yan , Chan Yujia A. , Zhu Yi Dan , Fournier Louis-Alexandre , Hieter Philip , Masson Jean-Yves , Stirling Peter C.
Published: November 2018

Ectopic R-loop accumulation causes DNA replication stress and genome instability. To avoid these outcomes, cells possess a range of anti-R-loop mechanisms, including RNaseH that degrades the RNA moiety in R-loops. To comprehensively identify anti-R-loop mechanisms, we performed a genome-wide trigenic interaction screen in yeast lacking RNH1 and RNH201. We identified >100 genes critical for fitness in the absence of RNaseH, which were enriched for DNA replication fork maintenance factors such as RAD50. We show in yeast and human cells that R-loops accumulate during RAD50 depletion. In human cancer cell models, we find that RAD50 and its partners in the MRE11-RAD50-NBS1 complex regulate R-loop-associated DNA damage and replication stress. We show that a non-nucleolytic function of MRE11 is important for R-loop suppression via activation of PCNA-ubiquitination by RAD18 and recruiting anti-R-loop helicases in the Fanconi Anemia pathway. This work establishes a novel role for MRE11-RAD50-NBS1 in directing tolerance mechanisms of transcription-replication conflicts.
Dynamic constriction and fission of ER membranes by reticulon
Authors: Espadas Javier , Pendin Diana , Bocanegra Rebeca , Escalada Artur , Misticoni Giulia , Trevisan Tatiana , Velasco del Olmo Ariana , Bova Sergio , Ibarra Borja , Kuzmin Peter I. , Shnyrova Anna V. , Frolov Vadim A. , Daga Andrea
Published: November 2018

The endoplasmic reticulum (ER) is a continuous cell-wide membrane network. Network formation has been widely associated with proteins producing membrane curvature and fusion, such as reticulons and atlastin. Regulated network fragmentation, occurring in different physiological contexts, is less understood. We found that the ER network has an embedded fragmentation mechanism based upon the ability of reticulons to produce fission of elongating network branches. In Drosophila, fission is counterbalanced by atlastin-driven fusion, with their imbalance leading to ER fragmentation. Live imaging of ER network dynamics upon ectopic expression of Drosophila reticulon linked fission to augmented membrane friction. Consistently, in vitro analysis revealed that purified reticulon produced velocity-dependent constriction and fission of lipid nanotubes pulled from a flat reservoir membrane. Fission occurred at elongation rates and pulling force ranges intrinsic to the ER network, thus suggesting a novel principle of organelle morphology regulation where the dynamic balance between fusion and fission is governed by membrane motility.
What makes me think that this product fits me? The impact of perceptual processing style on product preference among female consumers in emerging Asian countries
Authors: Charinsarn Alisara Rungnontarat
Published: November 2018

Purpose

The purpose of this paper is to study whether the consumer’s perceptual processing style impacts consumer preference. Specifically, whether consumers with local perceptual processing style in emerging Asian countries are more likely to perceive that Asian skincare brands are suitable for them, compared with emerging Asian consumers with global perceptual processing.

Design/methodology/approach

An experiment was conducted with 249 Asian female respondents in an emerging Asian market. The Navon letter – a hierarchical letter – is used to classify the respondents’ perceptual processing style. The Navon stimulus used is a big letter H made up of small letter Ls. Those who saw letter H (L) at first glance were classified as consumers with global (local) perceptual processing style. ANCOVA was used to analyze the main effect of global/local perceptual processing style on product preference, as well as to test the moderating effect of age.

Findings

The results suggest that consumers with local perceptual processing style are significantly more likely to perceive that Asian brands are suitable for them, compared with respondents with global perceptual processing style. Additionally, the covariate “age” is not the covariate between global/local perceptual processing and skincare preference.

Practical implications

Managers can apply the findings to their targeting and communication strategies. First, it will be advantageous for managers marketing Asian skincare products to target Asian consumers with local perceptual processing style. For managers marketing Western skincare products in Asia, it will be better to target Asian consumers with global perceptual processing style. In terms of communication strategy development, managers marketing Asian skincare products to Asian consumers are recommended to encourage local perceptual processing, while managers marketing Western skincare brands to emerging Asian consumers should encourage global perceptual processing.

Originality value

The value of this paper is that it applies the perceptual processing style to explain consumer decision-making in the context of consumers in emerging Asian countries. It also highlights a new perspective that helps managers craft targeting and communication strategies that help make their products to be perceived as a better fit or to facilitate consumer processing style so the product becomes a preferred choice.
Demographic and clinical characteristics of spinal calcinosis in systemic sclerosis: Possible association with peripheral angiopathy
Authors: Motegi Sei‐ichiro , Sekiguchi Akiko , Yonemoto Yukio , Mieda Tokue , Chikuda Hirotaka , Ishikawa Osamu
Published: November 2018

The objective was to evaluate the demographic and clinical characteristics of systemic sclerosis (SSc) patients with spinal calcinosis. Paraspinal and intraspinal calcinosis was assessed blindly by orthopedic surgeons specializing in spinal diseases using chest high‐resolution computed tomography (CT) that was performed for the screening and prospecting of interstitial lung disease in 159 Japanese SSc patients. Among these patients, we identified 27 (17%) with spinal calcinosis, and the most common site was cervical level at 77.8% (21/27). The frequency of spinal calcinosis in the late stage was higher than in the early stage (44.4% vs 29.6%). Multiple calcinosis was identified in 18.5% (5/27). The frequency of paraspinal calcinosis only was 59.3%, intraspinal calcinosis only 18.5%, and both intraspinal and paraspinal calcinosis 22.2%. Among SSc patients, 4.4% (7/159) had CT‐based evidence of spinal cord compression. Among cases with spinal cord compression, only one had neurological symptoms, and surgical removal improved the symptoms. The other six SSc patients with spinal calcinosis (3.8% of 159) had no symptoms. Male sex (29.6%) and severe peripheral vasculopathy such as digital ulcers (55.6%) and acro‐osteolysis (33.3%) were significantly more frequent in the SSc patients with spinal calcinosis than in the SSc patients without spinal calcinosis (10.6%, 32.6% and 14.4%, respectively). Our results suggest that severe peripheral vasculopathy may be associated with the development of spinal calcinosis. Because SSc patients are prone to spinal calcinosis, when SSc patients claim symptoms such as pain, numbness and movement disorder of the extremities, spinal calcinosis is a complication that should be taken into consideration.
Disentangling the effect of drought on stand mortality and productivity in northern temperate and boreal forests
Authors: Laginha Pinto Correia David , Bouchard Mathieu , Filotas Élise , Raulier Frédéric
Published: November 2018

It has recently been reported that changing precipitation patterns increase tree mortality and reduce biomass accumulation in northern temperate and boreal forests. Functional diversity can mitigate the impacts of climate extremes in different types of ecosystems, but few studies have focused on tree functional diversity in forest ecosystems. It is critical to identify functional traits that could help anticipate the impact of drought on tree mortality, and how these affect above‐ground tree biomass productivity at the ecosystem level.

We tested how three functional traits (ratio of dry leaf mass per unit area [LMA], xylem pressure at which 50% of stem xylem conductivity is lost through cavitation [Ψ50] and leaf area to sapwood ratio) influence severe drought impacts on stand mortality and productivity. We used structural equation modelling to compare the effect of a latent variable composed of these three traits between plots that had suffered drought and plots that had not, on the mortality and productivity of northern temperate and boreal forests of Québec, Canada.

A latent variable composed of LMA and Ψ50 significantly explained drought‐induced tree mortality, but did not explain stand productivity response to severe drought. Therefore, even if these traits relate to the ability of species to survive drought (drought tolerance) at the tree level, they did not affect the maintenance of plant productivity during drought events (drought resistance) at the stand scale. We hypothesize that the effect of tree mortality on productivity was likely compensated by the formation of canopy openings that stimulate the growth of surviving trees.

Synthesis and applications. Our results show that mitigation of water loss and xylem resistance to cavitation contribute similarly to severe drought tolerance in trees within northern temperate and boreal forests. Therefore, including drought‐resistant trees in fine‐scale mixtures might mitigate the impacts of drought on forest productivity due to the survivors’ response to released resources.
Valuing height: diagnosis, valuation and the case of idiopathic short stature
Authors: Morrison Michael
Published: November 2018

This paper proposes a ‘valuographic’ approach to diagnosis, exploring how values and valuation practices are implicated in the contested diagnostic category of idiopathic short stature (ISS). ISS describes children who are ‘abnormally’ short but do not have any other detectable pathology. In the USA growth‐promoting hormone therapy has been approved for ISS children, since 2003. However, no other jurisdiction has approved this treatment and the value of ISS as a diagnostic category remains disputed among healthcare professionals. Drawing on qualitative interviews with paediatric endocrinologists in the UK and the US, this study presents a historical snapshot illustrating how the problematisation of ISS as a diagnosis involved multiple registers of value including epistemic, economic and moral calculations of worth. Contestation of the diagnosis was not just about what counts but about what ought to be counted, as respondents’ accounts of ISS gave differential weight to a range of types of evidence and methods of assessment. Ultimately what was at stake was not just the value of increased height for short patients, but what it meant to properly practice paediatric endocrinology. Consideration is then given to how a valuographic approach can be applied to sociological studies of diagnosis more broadly.
Endoscopic bariatric and metabolic therapies: Another tool for the management of diabetes and obesity
Authors: Chablaney Shreya , Kumta Nikhil A.
Published: November 2018

Endoscopic bariatric and metabolic therapies (EBMTs) have sparked significant interest as minimally invasive therapeutic options for weight loss. Although bariatric surgery remains an effective option for sustained weight loss and improvement in the metabolic syndrome, access and utilization are limited. Various EBMTs have been designed to emulate the physiologic effects of established surgical interventions, including space‐occupying and non‐space‐occupying gastric therapies, gastric remodeling procedures, and small bowel therapies. This review discusses the safety and efficacy of available US Food and Drug Administration‐approved minimally invasive endoscopic bariatric interventions, as well as those currently under investigation. In addition, the role of endoscopic revision after failed surgical intervention is discussed.
Cutaneous malignancies in Indigenous Peoples of urban Sydney
Authors: Slape Dana R‐ML , Saunderson Rebecca B , Tatian Artiene HJ , Forstner Dion F , Estall Vanessa J
Published: November 2018

Introduction

Despite 3% of Australians identifying as Indigenous, cutaneous malignancies in these patients, including incidence, risk factors and outcomes have not been investigated. This is despite recognition that cancer outcomes in this population are significantly poorer.

Methods

We undertook a retrospective case series of Indigenous Peoples who presented to two urban cancer therapy centres for the management of cutaneous malignancies from 2003 to 2017. Risk factors, tumour‐specific characteristics, treatments and outcomes were reviewed.

Results

Twenty‐two patients identified as Aboriginal and/or Torres Strait Islander. The median age at presentation was 61 years and the majority were male (63.6%) and had skin phototype III (86.4%). Patients presented with basal cell carcinoma (50%), squamous cell carcinoma (31.8%), melanoma (9.1%) and cutaneous sarcomas (9.1%). The majority (68.2%) presented with stage II or higher disease, and there were high rates of immunosuppression (45.5%). At the time of reporting, 68.2% patients were alive, 18.2% had died from their skin cancers and 13.6% had died from unrelated causes.

Conclusion

This cohort has demonstrated late‐stage presentation of skin cancers, with substantial morbidity and mortality from potentially treatable cutaneous malignancies. This parallels other health conditions in Indigenous Australians and has highlighted the need for improved data collection of Indigenous status to better quantify the epidemiology of skin cancer in this population. There is an imperative to improve skin cancer awareness in this population to allow earlier detection and management to ensure better outcomes.
The role of habitat and daily activity patterns in explaining the diversity of mountain Neotropical dung beetle assemblages
Authors: da Silva Pedro G. , Lobo Jorge M. , Hernández Malva Isabel Medina
Published: November 2018

The interaction between land use and climate change is expected to strongly affect species distributions along high elevation landscapes. We aimed to test the effect of climatic variables on community metrics among five types of land use in a high elevation landscape. We described dung beetle spatial and temporal taxonomic and functional diversity patterns, and partitioned β‐diversity into turnover and nestedness components. The interaction between land use and daily period of activity mostly drives abundance, functional richness and functional diversity, but not dung beetle species richness. Unlike Neotropical lowlands, species richness and abundance in open environments are similar to those existing in forests. Temperature is an important predictor of abundance and functional divergence. There is a higher spatial component of the taxonomic β‐diversity, which is highly driven by species turnover. The temporal component of the taxonomic β‐diversity was strongly driven by nestedness, where night assemblages are sub‐sets, although not entirely, of diurnal assemblages. For functional diversity, the temporal β‐diversity was much higher than the spatial β‐diversity, but both were similarly represented by functional group turnover and nestedness. The composition of nocturnal and diurnal assemblages is clearly different, even more than the differences observed between habitats. However, taxonomic turnover is the dominant force between sampling sites while nestedness dominates the daily pattern. This means that forest habitats are unlikely to act as shelters for grassland species under a scenario of rising temperature.
Habitat selection by the Superb Lyrebird (Menura novaehollandiae), an iconic ecosystem engineer in forests of south‐eastern Australia
Authors: Maisey Alex C. , Nimmo Dale G. , Bennett Andrew F.
Published: November 2018

Landscape heterogeneity, from both natural and anthropogenic causes, fundamentally influence the distribution of species. Conservation management requires an understanding of how species respond to heterogeneity at different spatial scales and whether differences may occur between demographic components of a species population. We examined the spatial pattern of activity of the superb lyrebird (Menura novaehollandiae), an iconic forest species of south‐eastern Australia, in the Dandenong Ranges National Park, Victoria. Specifically, we quantified at landscape and local scales, the factors that influence nest site location and foraging activity of lyrebirds. Compared with randomly located sites, nest sites were more likely to occur in wet forest or rainforest close to creek lines; where there were deep litter and complex vegetation in the mid (1.5–2 m) and high (>2 m) strata. Foraging by lyrebirds was more likely to occur in wet forest and rainforest, with increasing distance from creeks; at sites where low vegetative cover (<30 cm) was sparse and the ground layer open. Thus, lyrebirds respond to different cues for different activities (nest sites and foraging), using different resources in the landscape. These results highlight the importance of (i) knowing the range of resources, at both landscape and local scales, required by a species to ensure its persistence and (ii) adopting a landscape approach for conservation planning that incorporates the heterogeneity of the ecosystem, especially that provided by landscape components that may be limited in area but disproportionately valuable for providing habitat resources.
Islands of the Anthropocene
Authors: Larjosto Vilja
Published: November 2018

The accelerating and intensifying dynamics of the Anthropocene are highly topical for island studies. Manifold effects of urbanisation, offshoring, migration and climate change become heightened in the context of island spatiality as global connections, fascination and conservation ideals produce tax havens, mass tourism, ecological enclaves and novel island ecosystems. The Anthropocene calls for a rethinking of relations between humans and nature. Recent research highlights the usefulness of islands in providing models of intensely coupled human–environmental systems. However, there is little research about where and how forces of the Anthropocene and natural dynamics physically intersect and how island spatiality intervenes. Contributing to a better understanding of island landscapes and seascapes, this paper explores how the scales and volumes of the Anthropocene shape spaces in small islands. In considering islands’ characteristics of smallness, borders, isolation and littorality, the paper illustrates the distinct spatial developments on islands in the Anthropocene, such as resort sprawl, airports and artificial coastlines. The observations demonstrate how forces of the Anthropocene challenge island isolation, stretch and reshape island borders. They manipulate islands’ smallness and congest small island spaces, and intervene in the manageability of island systems. Furthermore, developments of the Anthropocene highlight the paradoxical and hybrid nature of islands. I suggest that developing and better understanding concepts of island spatiality can be meaningful for informing future spatial transformation in, and for adopting contextualised approaches to, both islands and the Anthropocene.
Testing a clinical staging model for bipolar disorder using longitudinal life chart data
Authors: van der Markt Afra , Klumpers Ursula MH , Draisma Stasja , Dols Annemiek , Nolen Willem A , Post Robert M , Altshuler Lori L , Frye Mark A , Grunze Heinz , Keck Paul E , McElroy Susan L , Suppes Trisha , Beekman Aartjan TF , Kupka Ralph W
Published: November 2018

Objective

Bipolar disorder has a wide range of clinical manifestations which may progress over time. The aim of this study was to test the applicability of a clinical staging model for bipolar disorder and to gain insight into the nature of the variables influencing progression through consecutive stages.

Methods

Using retrospectively reported longitudinal life chart data of 99 subjects from the Stanley Foundation Bipolar Network Naturalistic Follow‐up Study, the occurrence, duration and timely sequence of stages 2‐4 were determined per month. A multi‐state model was used to calculate progression rates and identify determinants of illness progression. Stages 0, 1 and several other variables were added to the multi‐state model to determine their influence on the progression rates.

Results

Five years after onset of BD (stage 2), 72% reached stage 3 (recurrent episodes) and 21% had reached stage 4 (continuous episodes), of whom 8% recovered back to stage 3. The progression from stage 2 to 3 was increased by a biphasic onset for both the depression‐mania and the mania‐depression course and by male sex.

Conclusions

Staging is a useful model to determine illness progression in longitudinal life chart data. Variables influencing transition rates were successfully identified.
Social psychological research on prejudice as collective action supporting emergent ingroup members
Authors: Ferguson Mark A. , Branscombe Nyla R. , Reynolds Katherine J.
Published: November 2018

Why does social psychological research on prejudice change across time? We argue that scientific change is not simply a result of empirical evidence, technological developments, or social controversies, but rather emerges out of social change‐driven shifts in how researchers categorize themselves and others within their larger societies. As mainstream researchers increasingly recategorize former outgroup members as part of a novel ingroup, prejudice research shifts in support of emergent ingroup members against their emergent outgroup opponents. Although social change‐driven science results in valuable opportunities for researchers, it also results in significant risks for research – collective, scientific biases in the inclusion and exclusion of social groups in prejudice research that are not readily detected or managed by traditional controls. We present the Emergent Ingroup Model (EIM) to encourage reflection on shared biases, as well as to spark a broader conversation on how to strengthen our field for a rapidly changing and increasingly global world.