24-year Study Period Research Articles

Are human-induced changes good or bad to dynamic landscape connectivity?

Land managers must find a compromise between rapidly changing landscapes and biodiversity conservation through ecological networks. Estimating ecological networks is a key approach to enhance or maintain functional connectivity by identifying the nodes and links of a graph, which represent habitats and their corresponding functional corridors, respectively. To understand the current state of biodiversity, it is necessary to consider dynamic landscape connectivity while relying on relevant land cover maps. Although a current land cover map is relatively easy to produce using existing data, this is challenging for past landscapes. Here we investigated the impact of changes in landscape connectivity in an urban landscape at a fine scale on the habitat availability of two bird species: the tree pipit Anthus trivialis and the short-toed treecreeper Certhia brachydactyla. These species, exhibiting different niche ecologies, have shown contrasting population trends at a medium-term scale. The occurrences of C. brachydactyla were better correlated with resistance values that maximise the use of corridors, whereas the occurrences of A. trivialis better fitted with intermediate resistance values. The statistical approach indirectly highlighted relevant information about the ecology the capacity of both species to use urban habitats. Landscape connectivity increased for both species over the 24-year study period and may have implications for local abundances, which could explain, at the national scale, the increase in populations of C. brachydactyla, but not the decrease in populations of A. trivialis. Thus, more attention must be paid on rural habitats and their associated species that are more impacted by human activities, but efforts could also be achieved in urban areas especially for highly corridor-dependent species. Studying dynamic landscape connectivity at a fine scale is essential for estimating past and future land cover changes and their associated impacts on ecological networks, to better reconcile human and biodiversity concerns in land management.

Long-term and real-life incidence of cancer therapy-related cardiovascular toxicity in patients with breast cancer: a swedish cohort study

Abstract Background Cancer treatment and cancer itself increase the risk for cardiovascular disease (CVD) which in its turn contributes to cancer therapy-related cardiovascular toxicity (CTR-CVT). The aim of this study was to evaluate the long-term risk and predictors of CTR-CVT as well as all-cause mortality in women diagnosed with early breast cancer (BC) who were candidates for adjuvant chemotherapy. Methods Data from 433 women aged 18-60 years who were diagnosed with lymph node-positive BC between 1998-2002 and were eligible for adjuvant chemotherapy, were collected from Swedish health registers and medical records. For this study CTR-CVT was defined as hypertension (HT), coronary artery disease (CAD), heart failure (HF) or atrial fibrillation (AF) after the diagnosis of BC. Follow-up was from the date of BC diagnosis until November 30, 2021, or death. The incidence of CTR-CVT and all-cause mortality were calculated and hazard ratios (HR) for various factors associated with CTR-CVT were determined. Results The median age of the study population was 50 years (interquartile range (IQR) 32 years). A total of 910 CTR-CVT events were diagnosed in 311 women with a median of 19.3 years of follow-up (IQR 15.3 years). The proportions of CTR-CVT events were as follows: HT 281 (64%); CAD 198 (46%); HF 206 (47%); and AF 225 (51%). The cumulative incidence of CTR-CVT was 71.8% and 50% of all 433 patients developed CTR-CVT within 11.7 years of BC diagnosis (standard deviation (SD) 0.57, 95% confidence interval (CI) 10.6-12.9). Age was a risk factor for CTR-CVT. Treatment with anthracyclines increased the risk for HF (p=0.001; HR 2.0; 95%CI 1.4-2.8), CAD (p= 0.002; HR 1.7; 95% CI 1.2-2.4), and AF (p=0.013; HR 1.5; 95%CI 1.0-2.0). At the end of the 24-year study period, 227 of the 433 women were alive and the total cumulative mortality was 47.6%. Chemotherapy (anthracyclines or other agent) and older age at the time of BC diagnosis were associated with higher mortality rate. Conclusions In this cohort study the incidence of CTR-CVT and all-cause mortality after BC diagnosis and treatment was high, particularly in older patients and those receiving anthracyclines. This finding together with the time to onset of CTR-CVT, supports the current cardio-oncology guidelines recommending initial risk stratification, cardiovascular monitoring during treatment, followed by long-term annual screening for cardiovascular risk factors and CTR-CVT among BC survivors.Incidence CTR-CVTSurvival rate

999 The Incidence of Foetal Scoliosis and the Chances of Successful Delivery

Abstract Aim Foetal scoliosis can be detected on antenatal ultrasound and may be associated with other spinal abnormalities such as hemivertebrae. Little is known regarding its incidence and implications. Method The computerised foetal medicine ultrasound database at a tertiary hospital was retrospectively analysed using the search terms “spine” and “scoliosis”, between 1997 and 2021. The reports were manually reviewed, and patients removed that showed no abnormalities. Demographics of the mother, pregnancy and outcome data were collated. Results During the 24-year study period, 600,000 antenatal ultrasound scans were available. A duplicate rate was calculated, resulting in a total population of 378,000 foetuses. Initial results yielded 195 scans, and after removal of duplicates and manual checking of reports, there were 123 cases of confirmed spinal deformities, with an incidence of approximately 0.33 per 1000 foetuses (1 in 3000). Of the 123, there were 59 (48%) that reached term and 64 (52%) which did not. Of those that survived to term, 36/59 (61%) had normal development and no other concerns. The remaining patients had other non-fatal abnormalities, including VACTERL association in 5 cases (8.4%). Of those that did not survive, only one patient did not have other significant abnormalities. In most cases, there were multiple significant abnormalities, and the decision was taken for termination of pregnancy (52 cases, 81%). Conclusions This study represents the largest database review of antenatal scans for spinal abnormalities. The incidence of foetal spinal deformity is approximately 1 in 3000, and prognosis is generally determined by the presence of other significant abnormalities.

Long-term and real-life incidence of cancer therapy-related cardiovascular toxicity in patients with breast cancer: a Swedish cohort study.

The administration of anticancer drugs in females with comorbidity increases the risk for cancer therapy-related cardiovascular toxicity (CTR-CVT), which in turn contributes to cardiovascular disease (CVD). Furthermore, a pathophysiological connection between cancer and cardiovascular disease may exist. To assess the long-term risks and predictors of CTR-CVT, including clinical hypertension (HT), coronary artery disease (CAD), heart failure (HF), atrial fibrillation (AF), as well as all-cause mortality in women diagnosed with early breast cancer (BC) and eligible for adjuvant chemotherapy in Sweden. Data were extracted from Swedish registers and medical records on 433 women, 18-60 years of age, diagnosed 1998-2002 with lymph node-positive BC, and considered for adjuvant chemotherapy. CTR-CVT was defined as HT, CAD, HF, or AF after the diagnosis of BC. Follow-up was from the date of BC diagnosis until November 30, 2021, or death. Prevalence of CTR-CVT and all-cause mortality were calculated. Hazard ratios (HR) were determined for factors associated with CTR-CVT. The median age was 50 (interquartile range (IQR) 32) years. 910 CTR-CVT events were diagnosed in 311 women with a median of 19.3 (IQR 15,3) years follow-up. The proportions of CTR-CVT events were: HT 281 (64%); CAD 198 (46%); HF 206 (47%); and AF 225 (51%). The cumulative incidence of CTR-CVT was 71.8%, and 50% of all 433 patients developed CTR-CVT within 11.7 years of BC diagnosis (standard deviation (SD) 0.57, 95% confidence interval (CI) 10.6-12.9). Age was a risk factor for CTR-CVT. Anthracycline increased the risk for HF (p=0,001; HR 2,0; 95%CI 1,4-2,8), CAD (p= 0,002; HR 1,7; 95% CI 1,2-2,4), and AF (p=0,013; HR 1,5; 95% CI 1,0-2,0). At the end of the 24-year study period, 227 of the 433 women were alive, and the total cumulative mortality was 47,6%. The prevalence of CTR-CVT and all-cause mortality is high after BC diagnosis and treatment, particularly in older patients and those receiving anthracyclines. These findings and the onset of CTR-CVT support cardio-oncology guidelines recommending initial risk stratification and cardiovascular monitoring during treatment, followed by long-term annual screening for cardiovascular risk factors and CTR-CVT among BC survivors.

Long-Term (1990–2013) Changes and Spatial Variations of Cropland Runoff across China

Quantitative information on regional cropland runoff is important for sustainable agricultural water quantity and quality management. This study combined the Soil Conservation Service Curve Number (SCS-CN) method and geostatistical approaches to quantify long-term (1990–2013) changes and regional spatial variations of cropland runoff in China. Estimated CN values from 17 cropland study sites across China showed reasonable agreement with default values from the National Engineering Handbook (R2 = 0.76, n = 17). Among four commonly used geostatistical interpolation methods, the inverse distance weighting (IDW) method achieved the highest accuracy (R2 = 0.67, n = 209) for prediction of cropland runoff. Using default CN values and the IDW method, estimated national annual cropland runoff volume and runoff depth in 1990–2013 were 253 ± 25 km3 yr−1 and 182 ± 15 mm yr−1, respectively. Estimated cropland runoff depth gradually increased from the drier northwest inland region to the wetter southeast coastal region (range: 2–1375 mm yr−1). Regionally, eastern, central and southern China accounted for 39% of the cultivated area and 53% of the irrigated land area and contributed to 68% of the national cropland runoff volume. In contrast, northwestern, northern, southwestern and northeastern China accounted for 61% of the cultivated area and 47% of the irrigated land area and contributed to 32% of the runoff volume. Rainfall was the main source (72%) of cropland runoff for the entire nation, while irrigation became the main source of cropland runoff in drier regions (northwestern and southwestern China). Over the 24-year study period, estimated cropland runoff depth showed no significant trends, whereas cropland runoff volume and irrigation-contributed percentages decreased by 7% and 35%, respectively, owing to implementation of water-saving irrigation technologies. To reduce excessive runoff and increase water utilization efficiencies, regionally specific water management strategies should be further promoted. As the first long-term national estimate of cropland runoff in China, this study provides a simple framework for estimating regional cropland runoff depth and volume, providing critical information for guiding developments of management practices to mitigate agricultural nonpoint source pollution, soil erosion and water scarcity.

Effect of crop rotation and straw application in combination with mineral nitrogen fertilization on soil carbon sequestration in the Thyrow long-term experiment Thy_D5

AimsThe aim of study was to quantify the temporal change of soil organic carbon content in relation to agricultural management for a dry sandy arable soil and to derive the C sequestration potential.MethodsWe analyzed data from a long-term field experiment with three crop rotations of different cereal proportions, with two levels of straw application (removal/return) in combination with four mineral nitrogen rates (40 … 160 kg ha-1 yr-1). Treatments are arranged in a two-factorial block design with two replicates for each rotation. During the 24-year study period, grain and straw yield of two cereal test crops and soil organic carbon content in topsoil were determined annually from each plot.ResultsSoil organic carbon content was positively influenced by removing non-cereal crops from the rotation and – to a smaller extent – by straw application. Increasing mineral N-fertilization from 40 kg ha-1 yr-1 to higher rates increased grain yield of rye but not barley, increased straw yield of both cereals more, with no effect of higher straw yields on soil organic carbon content.ConclusionsDespite the overall soil organic carbon content of the sandy soil under study is comparatively low, the results indicate that agricultural management has a relevant impact on soil carbon stocks. Straw return contributes to carbon sequestration even in rotations with a low potential for reproduction of organic matter. High mineral N-fertilization is not an adequate measure to sequester carbon in these soils.

Plant dynamics in a tropical dry forest are strongly associated with climate and fire and weakly associated with stabilizing neighborhood effects.

Studies comparing the relative strengths of multiple key drivers of forest dynamics are rare, but can inform both our fundamental understanding of plant communities as well as community-ecology theory. We studied the dynamics of a woody plant community in a southern Indian seasonally-dry tropical forest (SDTF) in relation to environmental factors (precipitation, temperature, fire, soil nutrients, and topography) and conspecific and heterospecific plant neighborhoods to identify which of these best predicted recruitment, survival and growth of dominant species over a 24-year study period. We also assessed the relative prevalence of density-independent and density-dependent responses in the community. Climate and fire were more important than plant neighborhoods and topographic and edaphic variables in explaining variation in plant performance. Recruitment, survival and growth were lower during periods of low precipitation and immediately following fires. Recruitment increased, and growth and survival largely decreased, with increasing temperatures. Smaller-sized individuals were disproportionately strongly affected by the vagaries of climate and fire. Conspecific negative density-dependence, a population-fluctuation stabilizing process, was relatively unimportant. Density-dependent effects decayed rapidly with distance from the focal plant (growth, survival) or quadrat (recruitment); positive density-dependence was frequently found in recruitment, possibly resulting from limited dispersal and/or facilitation. Woody plant dynamics in this SDTF appear to be responding largely to fluctuations in environmental conditions, particularly precipitation, temperature, and fire. In contrast to wetter forests, population-fluctuation stabilizing processes in this ecosystem appear to be relatively weak. Changes in climatic or fire regimes are likely to result in large compositional shifts in this SDTF.

Trends in Allogeneic Stem Cell Transplantation for Myelofibrosis in Europe between 1995-2018: An EBMT Retrospective Analysis

Aim: Dynamic assessment of trends over time in patient- and transplant-specific characteristics and outcomes for patients undergoing 1st allogeneic haematopoietic cell transplant (allo-HCT) for Myelofibrosis (MF). Methods and Results: A total of 4142 MF patients were analysed who underwent allo-HCT between 1995-2018 (24-year period) across 278 centres based on data reported to the European Society for Blood and Marrow Transplantation. For analysis, 4 cohorts were considered based on year of allo-HCT: <2006 n=389 (9.4%), 2006-2010 n=910 (22%), 2011-2014 n=1148 (27.7%) and 2015-2018 n=1695 (40.9%). A steady increase in MF allo-HCT activity over time was apparent paralleled with increasing numbers of participating transplant centres. A total of 2603 (62.8%) patients were male, 3239 (78.2%) had Primary MF, 409 (9.9%) and 494 (11.9%) post-Polycythaemia Vera and post-Essential Thrombocythaemia MF, respectively. An increased median interval (lnterquartile range (IQR)) between diagnosis and transplant was evident over time (<2006 median 20.8 (8.9-62.2) months versus 36.2 (11.6-107.5) months in 2015-2018 period;p<0.001), potentially reflecting increased availability of therapeutics in recent eras (untreated patients <2006= 59.4% versus 2015-2018=23.7%). Median recipient age (IQR) increased over time by ~ a decade between earliest cohort and most recent: <2006, 49.4 years (43.1-55.3) versus 59.3 years (53.4-64.8)2015-2018. Prior to 2006, patients >60 years accounted for 8.7% of adults undergoing allo-HCT whereas for 2015-2018 this was 47%. Over time, increasing number of patients with a Karnofsky performance status (KPS) <90 underwent allo-HCT (<2006=19.7% versus 36.1% 2015-18; p<0.001). Peripheral Blood (PB) was the predominant stem cell source and utilisation increased over time, accounting for 74.8% <2006 and 92.2% within 2015-2018 cohort. Cord blood utilisation was limited to <1% throughout the 24-year study period. Significant shifts towards use of unrelated donors (URD) in more recent periods was apparent (p<0.001). Moreover, increased use of mismatched related donors (MMRD) was particularly evident in 2015-2018 cohort; n=152 (9%) versus n=74 (3%) cumulative for other 3 cohorts combined; p<0.001. Decreased use of myeloablative and TBI- based conditioning was evident over time (p<0.001). Specifically, there was increased use of busulphan-based regimens (<2006: 44.2% versus 2015-2018: 72%). Regarding T cell depletion, trends demonstrated increased use of anti-thymocyte globulin (ATG) over time (<2006=37.3% vs 69.9% 2015-2018; p<0.001). Median time to both neutrophil (median 18 days across all cohorts) and platelet engraftment was similar in all 4 cohorts, with no significant variation when stratified by period of transplantation. Allo-HCT outcomes, survival, GVHD and relapse endpoints are shown for all 4 cohorts in Table 1. Overall for the entire group, significant factors associated with worse OS, RFS and NRM remained older age and a poor KPS (<90). No significant differences between cohorts were noted for either estimated 3-year OS (<2006=55% (50-60%), 2006-2010=60% (56-63%), 2011-2014 and 2015-2018= 58% (55-61%); p=0.299) or non-relapse mortality (NRM (Table 1); p=0.523), despite increasing numbers of older, less fit patients, and more frequent HLA-mismatched transplants over time. To investigate survival findings in more detail an adjusted model will be presented including period of allo-HCT and transplant-related variables. Cumulative incidence of relapse at 3 years was similar across all cohorts, suggesting no significant changes with time. Most common causes of death across all 4 cohorts remained GVHD and infection. Of note, rates of acute (a)GVHD grade II-IV by day +100 decreased from the earliest cohort <2006 compared to the later groups (p=0.027) as did rates of overall chronic (c) GVHD whereby this was evident in 57% (95% CI 52-62%) <2006 cohort compared to 44% (95% CI 42-47%) in the 2015-2018 group, predominantly reflected by reductions in extensive cGVHD (Table 1). Conclusions: Despite a marked increase over this 24-year period in recipient age, RIC regimen utilisation and use of both URD and MMRD, this comprehensive analysis demonstrates stable OS and EFS rates. However, rates of GVHD have decreased over time, in particular extensive cGVHD. Further work is required to improve both the considerable NRM and relapse rates which remain significant. Disclosures McLornan: JAZZ PHARMA: Honoraria, Speakers Bureau; CELGENE: Honoraria, Speakers Bureau; NOVARTIS: Honoraria, Speakers Bureau. Platzbecker:Amgen: Honoraria, Research Funding; Janssen: Consultancy, Honoraria, Research Funding; Takeda: Consultancy, Honoraria; BMS: Consultancy, Honoraria; Geron: Consultancy, Honoraria; AbbVie: Consultancy, Honoraria; Novartis: Consultancy, Honoraria, Research Funding. Chevallier:Incyte Corporation: Honoraria. Martínez-Lopez:Altum, Hosea: Membership on an entity's Board of Directors or advisory committees, Patents & Royalties; Vivia Biotech: Honoraria; Amgen: Speakers Bureau; Takeda: Speakers Bureau; Roche: Speakers Bureau; Janssen: Speakers Bureau; Incyte: Research Funding, Speakers Bureau; Bristol Myers Squibb: Research Funding, Speakers Bureau; Novartis: Research Funding. Yakoub-Agha:Celgene: Honoraria; Jazz Pharmaceuticals: Honoraria; Novartis: Honoraria; Gilead/Kite: Honoraria, Other: travel support; Janssen: Honoraria.

Epidemiology, management, and graft outcomes after West Nile virus encephalitis in kidney transplant recipients.

Minimal data exist describing the epidemiology, management, and long-term graft outcomes after West Nile viral disease in kidney transplant recipients (KTRs). Single-center observational cohort study of patients who received a kidney transplant between 1/1/1994 and 12/31/2018 and developed WNV at any time point after transplantation. During the 24-year study period, 11 patients had documented WNV infection. Seven patients were recipients of a kidney transplant alone, and four had a simultaneous kidney and pancreas transplant. The mean age at the time of transplant was 44.7±17.1years, and the mean age at the time of WNV infection was 48±17.2years. All patients received lymphocyte depleting induction at transplant (alemtuzumab (n=2), OKT3 (n=1), or anti-thymocyte globulin (n=8)). The mean time from transplant to WNV infection was 3.4±5.4years, and none was suspected of having a donor-derived infection. Three patients were treated for rejection in the 6months before infection. The most common presenting symptom was altered mental status (n=7), followed by a combination of fever and headache (n=4). All patients had detectable serum WNV IgM antibodies at the time of diagnosis. All patients had a reduction in their immunosuppression and received supportive care; only two patients were treated with intravenous immunoglobulins. Nine patients recovered with no residual deficit; however, two suffered permanent neurologic damage. The mean estimated glomerular filtration rate drop at 1year after the infection was 8.4±13mL/min/1.73m2 . Three patients suffered acute rejection within 1year after the infection episode, likely attributable to aggressive immunosuppressive reduction. The mean follow-up after the infection was 5.1±4.3years. At last follow-up, two patients lost their kidney allograft, and five patients died. None of the graft losses or deaths occurred within a year of the WNV or were directly attributable to WNV. The majority of patients with WNV infection after KTR recovered fully with supportive care and immunosuppressive adjustment without residual neurologic sequelae. Additionally, WNV infection was associated with relatively small reductions in eGFR at 1year.

An Analysis of Urban Land Use/Land Cover Changes in Blantyre City, Southern Malawi (1994–2018)

Rapid and unplanned urban growth has adverse environmental and social consequences. This is prominent in sub-Saharan Africa where the urbanisation rate is high and characterised by the proliferation of informal settlements. It is, therefore, crucial that urban land use/land cover (LULC) changes be investigated in order to enhance effective planning and sustainable growth. In this paper, the spatial and temporal LULC changes in Blantyre city were studied using the integration of remotely sensed Landsat imageries of 1994, 2007 and 2018, and a geographic information system (GIS). The supervised classification method using the support vector machine algorithm was applied to generate the LULC maps. The study also analysed the transition matrices derived from the classified map to identify prominent processes of changes for planning prioritisation. The results showed that the built-up class, which included urban structures such as residential, industrial, commercial and public installations, increased in the 24-year study period. On the contrary, bare land, which included vacant lands, open spaces with little or no vegetation, hilly clear-cut areas and other fallow land, declined over the study period. This was also the case with the vegetation class (i.e., forests, parks, permanent tree-covered areas and shrubs). The post-classification results revealed that the LULC changes during the second period (2007–2018) were faster compared to the first period (1994–2007). Furthermore, the results revealed that the increase in built-up areas systematically targeted the bare land and avoided the vegetated areas, and that the vegetated areas were systematically cleared to bare land during the study period (1994–2018). The findings of this study have revealed the pressure of human activities on the land and natural environment in Blantyre and provided the basis for sustainable urban planning and development in Blantyre city.

Sea ice volume variability and water temperature in the Greenland Sea

Abstract. This study explores a link between the long-term variations in the integral sea ice volume (SIV) in the Greenland Sea and oceanic processes. Using the Pan-Arctic Ice Ocean Modeling and Assimilation System (PIOMAS, 1979–2016), we show that the increasing sea ice volume flux through Fram Strait goes in parallel with a decrease in SIV in the Greenland Sea. The overall SIV loss in the Greenland Sea is 113 km3 per decade, while the total SIV import through Fram Strait increases by 115 km3 per decade. An analysis of the ocean temperature and the mixed-layer depth (MLD) over the climatic mean area of the winter marginal sea ice zone (MIZ) revealed a doubling of the amount of the upper-ocean heat content available for the sea ice melt from 1993 to 2016. This increase alone can explain the SIV loss in the Greenland Sea over the 24-year study period, even when accounting for the increasing SIV flux from the Arctic. The increase in the oceanic heat content is found to be linked to an increase in temperature of the Atlantic Water along the main currents of the Nordic Seas, following an increase in the oceanic heat flux from the subtropical North Atlantic. We argue that the predominantly positive winter North Atlantic Oscillation (NAO) index during the 4 most recent decades, together with an intensification of the deep convection in the Greenland Sea, is responsible for the intensification of the cyclonic circulation pattern in the Nordic Seas, which results in the observed long-term variations in the SIV.

Evaluating a 24-year tuberculosis screening in first-grade elementary schoolers in a low-burden area.

Early diagnosis of tuberculosis infection can significantly contribute to the control of the disease. The aim of the present study was to describe the tuberculin skin test (TST) trends over a 24-year period (1990-2013) and explore the value of universal tuberculosis screening in a low-burden area. All first graders that underwent TST during the 24-year study period (1990-2013) on the island of Crete, Greece, were retrospectively included in the study. A total of 82402 children (92.3% of Greek nationality; 51.0% male) underwent TST, of whom 335 (0.41%, 95% CI 0.37-0.46) were found to have positive TST while 0.27% of the study population had a TST between 5 and 9mm. The tuberculin index declined significantly between 1990-1994 and 2010-2013 (0.67 vs 0.26; RR 2.73, 95% CI 1.82-4.09; p<0.0001). Positive TST result was significantly higher in the immigrant than the native group (0.66% vs 0.24%; RR 3.76 95%, CI 2.89-4.84; p<0.0001). In the last study years, 386 children (488 native; 153 immigrant) should be tested for one to be found TST positive. Our findings question the massive tuberculin testing in low-burden areas and point to selective screening of high-risk groups.

Slow Down of the Gulf Stream during 1993\u20132016

The Gulf Stream, the main heat-carrier from low to high latitudes in the North Atlantic Ocean, influences the climate and weather in the northern hemisphere. In this study we determine and analyze the position, speed, and width of the Gulf Stream (GS) from 80°W–50°W using satellite altimeter sea surface height (SSH) measurements to examine the possible link between changes in the strength of the GS and coastal sea levels along the U.S. East Coast. During our 24-year study period (1993–2016), the GS experienced a southward shift east of 65°W after passing the New England Seamount chain. This southward shift was accompanied by a weakening of the GS, associated with an increase in SSH to the north of the GS. West of 70°W, however, we found no statistically significant trends in the GS properties, consistent with results based on in situ measurements. This lack of a trend to the west fails to support a direct link between a long-term slowdown of the GS west of 70°W and sea level rise acceleration along the U.S. East Coast, though a slowdown of the GS east of 65°W may contribute to sea level rise. It is also possible that heat carried to the region by the GS may be responsible for these observed sea level changes.

Land-Use/Land-Cover Change Analysis and Urban Growth Modelling in the Greater Accra Metropolitan Area (GAMA), Ghana

A rapid increase in the world’s population over the last century has triggered the transformation of the earth surface, especially in urban areas, where more than half of the global population live. Ghana is no exception and a high population growth rate, coupled with economic development over the last three decades, has transformed the Greater Accra region into a hotspot for massive urban growth. The urban extent of the region has expanded extensively, mainly at the expense of the vegetative cover in the region. Although urbanization presents several opportunities, the environmental and social problems cannot be underestimated. Therefore, the need to estimate the rate and extent of land use/land cover changes in the region and the main drivers of these changes is imperative. Geographic Information Systems (GIS) and remote sensing techniques provide effective tools in studying and monitoring land-use/land-cover change over space and time. A post classification change detection of multiple Landsat images was conducted to map and analyse the extent and rate of land use/land cover change in the region between 1991 and 2015. Subsequently, the urban extent of the region was forecasted for the year 2025 using the Markov Chain and the Multi-Layer Perceptron neural network, together with drivers representing proximity, biophysical, and socio-economic variables. The results from the research revealed that built-up areas increased by 277% over the 24-year study period. However, forest areas experienced massive reduction, diminishing from 34% in 1991 to 6.5% in 2015. The 2025 projected land use map revealed that the urban extent will massively increase to cover 70% of the study area, as compared to 44% in 2015. The urban extent is also anticipated to spill into the adjoining districts mainly on the western and eastern sides of the region. The success of this research in generating a future land-use map for 2025, together with the other significant findings, demonstrates the usefulness of spatial models as tools for sustainable city planning and environmental management, especially for urban planners in developing countries.

GRAM-NEGATIVE BACTERIA FROM PATIENTS WITH ENDOPHTHALMITIS: DISTRIBUTION OF ISOLATES AND ANTIMICROBIAL SUSCEPTIBILITIES.

To study the distribution of isolates and antimicrobial susceptibility of gram-negative bacteria among culture-positive vitreous samples from patients with endophthalmitis. The records from culture-positive vitreous isolates (endophthalmitis cases) during a 24-year period (December 1990 to December 2014), at the Microbiology Department of Bascom Palmer Eye Institute were reviewed. In the current study, gram-negative bacteria were reported in 246 (11.5%) of 2,134 vitreous isolates from endophthalmitis patients during 24-year period (December 1990 to December 2014) from a University Referral Center. The antimicrobial susceptibility to fluoroquinolones, aminoglycosides, carbapenems, and ceftazidime remained stable among gram-negative bacteria during the study period. Antibiotic susceptibility pattern of gram-negative bacteria from vitreous isolates did not change significantly during the 24-year study period.

Trends in the Implementation of Active Surveillance for Low-Risk Papillary Thyroid Microcarcinomas at Kuma Hospital: Gradual Increase and Heterogeneity in the Acceptance of This New Management Option.

Background: Active surveillance (AS) of low-risk papillary thyroid microcarcinoma (PMC) was adopted as a management modality in both the Japanese guidelines in 2011 and the American Thyroid Association guidelines in 2015. AS was initiated at Kuma Hospital in 1993 but was not immediately accepted by all physicians. This study investigated the history of acceptance of AS at Kuma Hospital over time. The results should assist in the implementation of AS at other hospitals in Japan and other countries.Methods: This study included 4023 patients who were cytologically diagnosed with low-risk PMC at Kuma Hospital during the 24-year period between October 1993 and June 2016. The trend in the frequency of AS use over time was analyzed, dividing the 24-year study period into five parts based on the change in frequency of AS use: 1993–1997, 1998–2002, 2003–2006, 2007–2013, and 2014–2016.Results: The frequency of AS use in the present cohort was 65%. The frequency gradually increased from 30% in 1993–1997 to 88% in 2014–2016, with a slight decrease from 51% in 1998–2002 to 42% in 2003–2006. Until 2007, patients were mostly seen by surgeons, and the frequency of AS use varied remarkably among individual surgeons. Since 2007, the number of patients whose therapeutic strategies are determined by endocrinologists has increased, and the frequency of AS use for low-risk PMC by endocrinologists has been higher than that by surgeons.Conclusions: At Kuma Hospital, acceptance of AS for low-risk PMC gradually increased over the 24-year study period, but AS was not equally accepted by all physicians. Such variations in the acceptance of AS among individual physicians are also expected to exist in other hospitals. However, due to increasing evidence of the safety and superiority of AS over immediate surgery for this indolent disease, it is expected that AS will gain faster acceptance in other hospitals in Japan and around the world.

Mapping the evolution of entrepreneurship as a field of research (1990-2013): A scientometric analysis.

This article applies scientometric techniques to study the evolution of the field of entrepreneurship between 1990 and 2013. Using a combination of topic mapping, author and journal co-citation analyses, and overlay visualization of new and hot topics in the field, this article makes important contribution to the entrepreneurship research by identifying 46 topics in the 24-year history of entrepreneurship research and demonstrates how they appear, disappear, reappear and stabilize over time. It also identifies five topics that are persistent across the 24-year study period––institutions and institutional entrepreneurship, innovation and technology management, policy and development, entrepreneurial process and opportunity, and new ventures––which I labeled as The Pentagon of Entrepreneurship. Overall, the analyses revealed patterns of convergence and divergence and the diversity of topics, specialization, and interdisciplinary engagement in entrepreneurship research, thus offering the latest insights on the state of the art of the field.

Cross-boundary subsidy cascades from oil palm degrade distant tropical forests

Native species that forage in farmland may increase their local abundances thereby affecting adjacent ecosystems within their landscape. We used two decades of ecological data from a protected primary rainforest in Malaysia to illutrate how subsidies from neighboring oil palm plantations triggered powerful secondary ‘cascading’ effects on natural habitats located >1.3 km away. We found (i) oil palm fruit drove 100-fold increases in crop-raiding native wild boar (Sus scrofa), (ii) wild boar used thousands of understory plants to construct birthing nests in the pristine forest interior, and (iii) nest building caused a 62% decline in forest tree sapling density over the 24-year study period. The long-term, landscape-scale indirect effects from agriculture suggest its full ecological footprint may be larger in extent than is currently recognized. Cross-boundary subsidy cascades may be widespread in both terrestrial and marine ecosystems and present significant conservation challenges.

Loneliness and friendships among eight-year-old children: time-trends over a 24-year period.

Loneliness in childhood has a wide range of negative consequences for well-being and mental health later in life. This study reports time-trends in children's loneliness and the association between children's loneliness and psychiatric symptoms over a 24-year period. Information on 3,749 eight-year-old Finnish-speaking children born in 1981, 1991, 1997, and 2004 was gathered at four time points from the area covered by Turku University Hospital in southwest Finland. The actual numbers of participants at these time points were 986 (1989), 891 (1999), 930 (2005), and 942 (2013), with participation rates of 86%-95%. The study design and methods were similar at every time point. Information on children's loneliness and friendships was obtained from the children and also parents and teachers evaluated how many friends children had and their psychiatric symptoms. Approximately 20% of the children reported loneliness at each time point, 5% always felt lonely, and 25% wished they had more friends. Conduct and emotional problems, and hyperactivity were independently associated with loneliness in the multiple-regression analysis. The strength of these associations remained at similar levels over the 24-year study period. Living in a nonnuclear family, parents with a lower level of vocational education, and negative life events among the girls in the study were all associated with loneliness. Loneliness was a common phenomenon in childhood, and no notable changes were found during the 24-year study period. Psychiatric symptoms were strongly associated with loneliness. It is important to pay attention to children's loneliness and make it an integral part of school health care. Further epidemiological research is needed.

Preventable diagnostic errors in fatal cervical spine injuries: a nationwide register-based study from 1987 to 2010

BackgroundFall-induced injuries in patients are increasing in number, and they often lead to serious consequences, such as cervical spine injuries (CSI). CSI diagnostics remain a challenge despite improved radiological services. PurposeOur aim is to define the incidence and risk factors for diagnostic errors among patients who died following a CSI. Study Design/SettingA retrospective death certificate-based study of the whole population of Finland was carried out. Patient sampleWe identified 2,041 patients whose death was, according to the death certificate, either directly or indirectly caused by a CSI. Outcome MeasuresDemographics, injury- and death-related data, and adverse event (AE)-related data were the outcome measures. MethodsAll death certificates between the years 1987 and 2010 from Statistics Finland that identified a CSI as a cause death were reviewed to identify preventable AEs with the emphasis on diagnostic errors. ResultsOf the 2,041 patients with CSI-related deaths, 36.5% (n=744) survived at least until the next day. Errors in CSI diagnostics were found in 13.8% (n=103) of those who died later than the day of injury. Those with diagnostic errors were significantly older (median age 79.4 years, 95% confidence interval 75.9–80.1 vs. 74.9, 95% confidence interval 70.2–72.9, p<.001) and the mechanism of injury was significantly more often a fall (86.4%, n=89 vs. 69.7%, n=447, p=.002) compared with those who did not have a diagnostic error. The incidence of diagnostic errors increased slightly during the 24-year study period. ConclusionsCervical spine injury diagnostics remain difficult despite improved radiological services. The majority of the patients subjected to diagnostic errors are fragile elderly people with reduced physical capacity. In our analysis, preventable AEs and diagnostic errors were most commonly associated with ground-level falls.