bluuebunny/crossref_metadata_2025_split huggingface dataset:
BK viremia surveillance and outcomes in simultaneous pancreas‐kidney transplant recipients
Authors: Westphal Scott G. , Lyden Elizabeth R. , Langewisch Eric D. , Miles Clifford D. 
Published: May 2017

AbstractBackgroundWhile screening for asymptomatic BK viremia (BKV) has been well studied in isolated kidney transplant recipients, there is a paucity of published outcomes in simultaneous pancreas‐kidney (SPK) transplant recipients who underwent BKV screening followed by pre‐emptive reduction in immunosuppression.MethodsThis is a single‐center, retrospective review of 31 consecutive SPK recipients who were transplanted over a 5‐year period following the initiation of a serum BKV screening protocol.ResultsBK viremia developed in 11 (35.5%) patients, and all patients achieved complete viral clearance following reduction in immunosuppression. Two patients (6.5%) developed BK virus nephropathy, but both had preserved allograft function. One patient developed mild rejection of the kidney allograft following clearance of BKV, and two patients developed mild rejection of the pancreas allograft after reduction in immunosuppression, but there were no kidney or pancreas allograft losses due to rejection. The development of BK viremia did not impact overall patient survival or kidney and pancreas allograft survival.ConclusionScreening asymptomatic SPK recipients for BKV followed by reduction in maintenance immunosuppression appears to be an effective strategy to prevent kidney allograft dysfunction and graft loss due to BK virus nephropathy, without compromising pancreas allograft outcomes.
Contrasting impacts of an alien invasive shrub on mammalian savanna herbivores revealed on a landscape scale
Authors: Rozen‐Rechels David , te Beest Mariska , Dew L. Alexander , le Roux Elizabeth , Druce Dave J. , Cromsigt Joris P. G. M. 
Published: May 2017

AbstractAimHabitat loss and fragmentation is one of the main drivers of defaunation, that is the loss of large mammals. Biological invasions could be drivers of such phenomenon. However, their impact on large herbivore communities has not been studied to our knowledge. We made use of a landscape‐scale control programme of one of the world's worst invaders, the shrub Chromolaena odorata, as a natural experiment to assess how this alien invader affects habitat use by 14 species of ungulates in an African savanna.LocationHluhluwe‐iMfolozi Park, KwaZulu‐Natal, South Africa.MethodsAt the height of the invasion in 2004, a large‐scale control programme was initiated that successfully reduced densities of C. odorata across the park. We estimated mammalian herbivore habitat and patch use by dung counts and the presence and density of C. odorata along 24 line transects with a total length of 190 km during the peak of the invasion (2004) and a decade after the initiation of a successful control programme (2014). To account for differences in herbivore assemblies between habitats and the preferential invasion of closed savanna woodlands, we analysed the recolonization of previously invaded patches by herbivores based on the change in dung abundance.ResultsHerbivore species differed in how they responded to invaded patches of this non‐native shrub. Grazers were the most negatively affected, especially those that avoid predators by running. Browsers were negatively impacted only at the highest invasive shrub densities. Some species, especially bushpig, positively selected invaded patches.Main conclusionsLarge herbivores varied in their response to invasion with differences in impact depending on feeding strategy and predator avoidance strategy, but the majority of ungulates responded positively to the removal of this invasive shrub.
Bird responses to forest loss are influence by habitat specialization
Authors: Zurita G. A. , Pe'er G. , Bellocq M. I. 
Published: May 2017

AbstractAimDue to intrinsic differences in the sensitivity to habitat grain among species, studies performed at different extent are necessary to understand the consequences of forest loss and fragmentation. Using a large database, we explored the responses of birds to changes in forest cover and the role of habitat specialization in the strength of this response.LocationSouthern Atlantic forest of Argentina, Brazil and Paraguay.MethodsWe used data on bird occurrences recorded in 1,384 point counts (2004–2011), estimated forest cover and number of forest fragments in two radii (60 and 960 m), centred at each point count. For each bird species, we extracted the geographical and altitudinal range as two indirect measures of habitat specialization. We used general linear model and Akaike information criterion to explore the influence of the type of habitat, the amount of habitat and fragmentation pattern on the probability of species occurrence and the influence of habitat specialization on the strength of response.ResultsOf the 28 species analysed, 15 (55%) responded either to forest loss or the number of fragments, either positively or negatively. In these 15 species, the probability of occurrence of 67% was better explained by a specific extent (either 60 or 960 m). The strength of the response to forest loss decreased with both the geographical and the altitudinal range of species.Main conclusionsOur study shows that a large proportion of species responded to forest loss at a specific extent and that the magnitude of the response is related to species specialization. A single‐extent approach to multispecies studies may not be enough to preserve the whole community due to differences in sensitivity to habitat grain. Maintaining forest cover at multiple extents and managing anthropogenic habitats to increase their suitability for native species are essential to preserve communities in highly fragmented landscapes such as the Atlantic forest.
Opt‐in or opt‐out to increase organ donation in South Africa? Appraising proposed strategies using an empirical ethics analysis
Authors: Etheredge Harriet , Penn Claire , Watermeyer Jennifer 
Published: May 2017

AbstractUtilising empirical ethics analysis, we evaluate the merits of systems proposed to increase deceased organ donation in South Africa (SA). We conclude that SA should maintain its soft opt‐in policy, and enhance it with ‘required transplant referral’ in order to maximise donor numbers within an ethically and legally acceptable framework.In SA, as is the case worldwide, the demand for donor organs far exceeds the supply thereof. Currently utilising a soft opt‐in system, SA faces the challenge of how to increase donor numbers in a context which is imbued with inequalities in access to healthcare, multiplicitous personal beliefs and practices, distrust of organ transplant and varying levels of education and health literacy.We argue that a hard opt‐in, opt‐out or mandated consent system would be problematic, and we present empirical data from Gauteng Province illustrating barriers to ethically sound practice in soft consent systems. Ultimately, we argue that in spite of some limitations, a soft opt‐in system is most realistic for SA because its implementation does not require extensive public education campaigns at national level, and it does not threaten to further erode trust at a clinical level.However, to circumvent some of the clinical‐level barriers identified in our empirical study, we propose a contextually sensitive option for “enabling” soft opt‐in through “required transplant referral”. We argue that this system is legally defensible, enhances ethical practice and could also increase donor numbers as it has in many other countries.
Assessments of pain in children and adolescents with cerebral palsy: a retrospective population‐based registry study
Authors: Westbom Lena , Rimstedt Amanda , Nordmark Eva 
Published: May 2017

AimTo explore pain screening in CPUP, a follow‐up surveillance programme for people with cerebral palsy (CP), specifically to describe reported pain prevalence, localizations, patterns of distribution; to compare with studies using psychometrically sound assessment instruments; and to assess agreement between pain documented in CPUP and medical records.MethodRegistry study of a population with CP, born 1993 to 2008, living in Skåne, Sweden in 2013. Descriptive data, cross‐tabulations, and chi‐square tests to characterize and compare the study groups. Kappa analysis to test the concordance between register and medical record reports on pain.ResultsPain was reported by 185 out of 497 children (37%; females 40%, males 35%). Level V in both Gross Motor Function Classification System (GMFCS) and Manual Ability Classification System (MACS) was associated with highest prevalence of pain (50% and 54%), and level I with lowest prevalence of pain (30% and 32%). Pain was most frequent in dyskinetic CP (46%) and least frequent in unilateral spastic CP (33%). Feet and knees were the dominant localizations. Fair–moderate agreement (kappa 0.37, prevalence‐adjusted bias‐adjusted kappa [PABAK] 0.44) was found between documented pain in CPUP and medical records, although more seldom recognized in medical records.InterpretationThe distribution of pain between CP subtypes, functional levels, sex, and age in CPUP is concordant with previous population‐based studies, indicating the validity of the CPUP pain screening. Despite this, further clinical evaluation with extended pain assessments and pain management were largely neglected in children reporting chronic pain.
Adult height and glucose tolerance: a re‐appraisal of the importance of body mass index
Authors: Rehunen S. K. J. , Kautiainen H. , Eriksson J. G. , Korhonen P. E. 
Published: May 2017

AbstractAimTo study both the association between adult height and glucose regulation based on findings from a 75‐g oral glucose tolerance test, and the combined effect of height and adiposity on glucose values.MethodsWe conducted a population‐based, cross‐sectional study among apparently healthy people with high cardiovascular risk living in south‐western Finland. The study included 2659 participants aged 45–70 years, who had at least one cardiovascular risk factor but no previously diagnosed diabetes or manifested cardiovascular disease. An oral glucose tolerance test was performed in all participants. Height and weight were measured and BMI was calculated. The participants were divided into five height groups based on normal distribution. For further analysis of the association between height and glucose concentrations the participants were divided into four BMI groups (<25.0 kg/m2; 25–29.9 kg/m2; 30–34.9 kg/m2; ≥35 kg/m2). Data were analysed using age‐adjusted linear regression models.ResultsHeight was inversely associated with 2‐h plasma glucose, but not with fasting plasma glucose concentration. No gender difference was observed. The 2‐h plasma glucose values increased with an increase in BMI, so that height was inversely associated with 2‐h plasma glucose in the three lowest BMI groups, but not in the highest BMI group (P=0.33).ConclusionsTaller people had lower 2‐h plasma glucose concentrations than shorter people, up to a BMI of 35 kg/m2. Adjustment for height and BMI is needed for accurate interpretation of oral glucose tolerance tests.
The real East Asian Aid model: Development assistance as an instrument of comprehensive security in Japan, South Korea and Taiwan
Authors: Atkinson Joel 
Published: May 2017

AbstractDiscussion of East Asian aid modes has remained superficial. And one donor, Taiwan, has been overlooked. This article reconsiders East Asian donorship, and places Taiwan within this category. It argues that East Asian donors are insecure, and see aid as part of a wider security policy. Aid policy pursues two main goals: economic strength and international influence. The aid apparatus is insulated from legislative and public pressure. Due to the nature of the goals pursued, relations with recipient governments in general are good, and recipient publics bad, relative to other Development Assistance Committee (DAC) donors. Relations with other donors are ambivalent; good relations are important, but can interfere with other goals. As such, Taiwan is a quintessential East Asian donor.
Movement behaviour of large female yellow European eel (Anguilla anguilla L.) in a freshwater polder area
Authors: Verhelst Pieterjan , Reubens Jan , Pauwels Ine , Buysse David , Aelterman Bart , Van Hoey Stijn , Goethals Peter , Moens Tom , Coeck Johan , Mouton Ans 
Published: May 2017

AbstractDue to a recruitment decline of more than 90% in 30 years, the European eel (Anguilla anguilla L.) has been classified by IUCN as critically endangered. Although the species has been studied intensively to obtain knowledge to improve management, studies about the resident yellow stage are relatively scarce. In this study, 52 large female yellow eels were tagged with acoustic transmitters in a Belgian polder system and tracked by a network of 23 automatic listening stations. We studied both circadian and seasonal movement patterns and the effect of environmental variables on these patterns. Large female yellow eels were most active at night in late summer and early autumn. A generalised linear mixed model showed that their movement is only slightly influenced by environmental variables. Moreover, as yellow eels show high site fidelity (i.e., the majority was detected only in the habitat type of their catch‐release location), they do not encounter many human‐induced connectivity problems in polder systems, which makes these systems highly suitable as eel growth habitat. These results can contribute to an effective eel management regarding habitat protection and restoration.
Constraints on trait combinations explain climatic drivers of biodiversity: the importance of trait covariance in community assembly
Authors: Dwyer John M. , Laughlin Daniel C. 
Published: May 2017

AbstractTrade‐offs maintain diversity and structure communities along environmental gradients. Theory indicates that if covariance among functional traits sets a limit on the number of viable trait combinations in a given environment, then communities with strong multidimensional trait constraints should exhibit low species diversity. We tested this prediction in winter annual plant assemblages along an aridity gradient using multilevel structural equation modelling. Univariate and multivariate functional diversity measures were poorly explained by aridity, and were surprisingly poor predictors of community richness. By contrast, the covariance between maximum height and seed mass strengthened along the aridity gradient, and was strongly associated with richness declines. Community richness had a positive effect on local neighbourhood richness, indicating that climate effects on trait covariance indirectly influence diversity at local scales. We present clear empirical evidence that declines in species richness along gradients of environmental stress can be due to increasing constraints on multidimensional phenotypes.
Large‐scale responses of herbivore prey to canid predators and primary productivity
Authors: Letnic Mike , Ripple William J. 
Published: May 2017

AbstractAimThe primacy of top‐down (consumption) and bottom‐up effects (primary productivity) as forces structuring ecological communities is a controversial topic. The exploitation ecosystems hypothesis (EEH) was invoked to explain biogeographical trends in plant and consumer biomass, and differs from the top‐down/bottom‐up dichotomy by predicting that the relative strength of these processes will vary along gradients of primary productivity. Here we test the prediction of the EEH that herbivore biomass should increase with increasing primary productivity where predators are rare, but show a negligible response to primary productivity where predators are common due to population regulation by predators.LocationBoreal and temperate regions of North America and Eurasia, and deserts of Australia.Time period1970–2016.Major taxa studiedCervids and kangaroos.MethodsWe obtained abundance indices of cervids at 42 locations from the literature and conducted spotlight surveys at 27 locations to derive estimates of kangaroo abundance. For analyses, herbivore abundances were converted to biomass per km2. We tested our prediction using linear mixed effects models.ResultsHerbivore biomass showed divergent responses to increasing primary productivity and the abundance of canid predators (grey wolves, Canis lupus/dingoes, Canis dingo). The slope of the relationship between herbivore biomass and net primary productivity did not differ between Australia and the northern boreal and temperate regions. Herbivore biomass increased in response to primary productivity where canid predators were rare, but showed muted responses to increasing productivity where canid predators were common.Main conclusionsCanid predators have strong suppressive effects on herbivore biomass that scale with primary productivity. Our study shows that the EEH has wide application to canid‐predator–herbivore dynamics and may be relevant to the management of herbivores because it can provide an indication of how herbivore biomass and densities may vary in relation to ecosystem productivity and the presence and absence of canid predators.
High sodium continuous veno‐venous hemodialysis with regional citrate anticoagulation and online dialysate generation in patients with acute liver failure and cerebral edema
Authors: Hamdi Tamim , Yessayan Lenar , Yee Jerry , Szamosfalvi Balazs 
Published: May 2017

AbstractIntroduction: Acute liver failure is associated with a high mortality rate. Induction of plasma hypertonicity with mannitol or hypertonic saline remains the cornerstone in the management of resultant cerebral edema. Significant disadvantages of this approach include poor or unpredictable control of serum sodium concentration and volume expansion, among others.Methods: We used high sodium continuous veno‐venous hemodialysis with regional citrate anticoagulation and online dialysate generation to accurately control the serum sodium in eleven patients with acute liver failure, renal failure, and cerebral edema. We used a Fresenius 2008 K/K2 machine in hemodialysis mode to deliver a blood flow of 60 ml/minute and dialysate flow of 400 ml/minute. Our previously published protocol results in complete removal of infused citrate by the dialyzer. On‐line clearance calculations were used to model the time required to reach the target serum sodium.Findings: All patients achieved serum sodium within 2 mEq/L of target without fluctuations or rebound. Nine patients survived without requiring liver transplantation and two died despite reaching the prescribed serum sodium target. We did not encounter any citrate toxicity.Discussion: We describe a novel approach for delivering continuous osmotherapy to patients with acute liver failure, renal failure, and cerebral edema. In comparison to standard therapy, the described modality enables precise titration of serum sodium without undesirable fluctuations in extracellular fluid volume. A particular advantage is zero delivery of citrate to this vulnerable group of patients with acute liver failure.
37 year snacking trends for US children 1977–2014
Authors: Dunford E. K. , Popkin B. M. 
Published: May 2017

SummaryBackgroundPrevious studies have indicated that snacking is contributing to increased calorie intake of American children and that the energy density of snacks in US diets has increased in recent decades.ObjectiveExamine short‐term and long‐term trends in the energy density and food sources of snacks for US children from 1977 to 2014, and examine whether trends differ between socio‐demographic groups.MethodsWe used data collected from eight nationally representative surveys of food intake in 49,952 US children age 2–18 years, between 1977 and 2014. Overall patterns of snacking, trends in energy intake from snacking, trends in food and beverage sources and energy density of snacks across race‐ethnic, age, gender, education and income groups were examined.ResultsIn all socio‐demographic groups, there was a significant increase in per capita energy intake deriving from snacks from 1977 to 2014 (P < 0.01). Salty snack intake doubled over the study period, and sugar‐sweetened beverage intake decreased overall from 1977 to 2014 but increased in Non‐Hispanic Blacks. Non‐Hispanic Blacks had the largest increase in per capita intake from foods as a snack from 1977 to 2014. Children in the lowest poverty level and household education groups had more than 100% increase in calorie intake from snacks from 1977 to 2014.ConclusionsWe found that snacking behaviour in the USA differs between race‐ethnic, household education, gender and income groups, yet snacking remains a significant component of children's diets and the foods consumed at these snacks are not the types of foods recommended by the US dietary guidelines.
Inpatient iron deficiency detection and management: how do general physicians and gastroenterologists perform in a tertiary care hospital?
Authors: Fazal Muhammad W. , Andrews Jane M. , Thomas Josephine , Saffouri Eliana 
Published: May 2017

AbstractBackgroundIron deficiency (ID) is often an indicator of underlying pathology. Early detection and treatment avoids long‐term morbidity and allows for prompt iron repletion, avoiding ID anaemia (IDA) and the need for blood transfusion.AimTo evaluate the management of ID in two internal medicine units (general medical (GM) and gastroenterology (GE)) in a large metropolitan hospital and compare it to international guidelines.MethodsAll consecutive inpatient admissions in the GM and GE units were retrospectively reviewed until 40 patients in each service were identified with anaemia and/or microcytic hypochromic blood counts. Patient records and electronic discharge summaries were then reviewed to assess the recognition, investigation and management of these abnormalities.ResultsOverall, only 60% (48/80) of the cases of microcytic hypochromic picture and/or anaemia were recognised. Cases were more likely to be detected under the GE unit, 77.5% (31/40) versus 42% (17/40) in GM (P < 0.002). Of the 31 recognised GE cases, 28 (90%) were investigated further with iron studies and/or endoscopic procedures. ID was confirmed in nearly half (5/11) of those tested; however, only 2 of 5 received iron replacement. Among GM patients, only 11 of the 17 recognised cases (64%) were investigated further. Iron studies were performed in all 11, confirming IDA in 4 (36%), all of whom received intravenous iron. A faecal human haemoglobin test was performed in two GM patients and one GE patient.ConclusionThere remains significant room for improvement in the recognition, investigation and management of ID in hospital practice in Australia.