More exposure opportunities for promoting freshwater conservation

Freshwater ecosystems have a higher percentage of threatened and extinct species than terrestrial or marine realms, but remain under-represented in conservation research and actions arguably as a consequence of less popularity and promotion. Cover images of conservation journals were used as a proxy of exposure and potential promotion opportunities provided for different ecosystems and species. To examine whether articles related to cover images received more attention, citations and Altmetric scores of cover-featured articles were compared with non-featured ones within the same host journal issue. Freshwater ecosystems (10.4%) were featured less often than marine (15.2%) or terrestrial (74.4%) ecosystems on covers of 18 conservation journals from 1997 to 2016. All 15 most featured species are from terrestrial or marine ecosystems. In addition, cover-featured studies showed higher citations and Altmetric scores than non-featured ones within the same host journal issue, indicating that cover-featured articles received more attention. Further investigations are needed to examine the relationship (i.e. whether there is a true causality) between being featured on the cover, and citations and Altmetric scores received by articles, as well as potentially resulting in greater conservation efforts. Nevertheless, we believe that providing exposure opportunities is likely to better inform the public about the continuing degradation of freshwater ecosystems and its impacts on human well-being, including economic loss and danger to public health. Journal editors can contribute by balancing their selection of featured ecosystems and species when opportunities arise. Increasing exposure opportunities for freshwater ecosystems through various channels seems a promising approach to raise public awareness and appreciation of freshwater biodiversity. Scientists can play an active role and form an alliance with journal editors, conservation organizations, and media, to increase momentum in society for fresh waters to be experienced as essential ecosystems and prevent further degradation of freshwater habitats and biodiversity loss. © 2021 The Authors. Aquatic Conservation: Marine and Freshwater Ecosystems published by John Wiley & Sons Ltd.This work has been carried out within the SMART Joint Doctorate (Science for the MAnagement of Rivers and their Tidal systems), funded with the support of the Erasmus Mundus programme of Education, Audiovisual and Culture Executive Agency of the European Union and is a contribution to the Leibniz Competition project ‘Freshwater Megafauna Futures’ funded by the Leibniz Association. S.C.J. and F.H. acknowledge the support of German Federal Ministry of Education and Research (BMBF; 033W034A). S.D.L. was supported through the Spanish Governmen

Sleep assessment by patients and nurses in the intensive care: An exploratory descriptive study

© 2016. Background: Sleep disruption is common in intensive care unit (ICU) patients, with reports indicating reduced quality and quantity of sleep in many patients. There is growing evidence that sleep in this setting may be improved. Aim: To describe ICU patients' self-report assessment of sleep, examine the relationship between patients' self-reported sleep and their reported sleep by the bedside nurse, and describe the strategies suggested by patients to promote sleep. Methods: An exploratory descriptive study was undertaken with communicative adult patients consecutively recruited in 2014-2015. Patients reported sleep using the Richards-Campbell Sleep Questionnaire (score range 0-100. mm; higher score indicates better sleep quality), with nursing assessment of sleep documented across a five level ordinal variable. Patients were asked daily to describe strategies that helped or hindered their sleep. Ethical approval for the study was gained. Descriptive statistical analysis was performed [median (interquartile range)]; relationships were tested using Spearman's rank correlation and differences assessed using the Kruskal-Wallis test; . p . <. 0.05 was considered significant. Results: Participants (n = 151) were recruited [age: 60 (46-71) years; ICU length of stay 4 (2-9) days] with 356 self-reports of sleep. Median perceived sleep quality was 46 (26-65) mm. A moderate relationship existed between patients' self-assessment and nurses' assessment of sleep (Spearman's rank correlation coefficient 0.39-0.50; . p . <. 0.001). Strategies identified by patients to improve sleep included adequate pain relief and sedative medication, a peaceful and comfortable environment and physical interventions, e.g. clustering care, ear plugs. Conclusion: Patients reported on their sleep a median of 2 (1-3) days during their ICU stay, suggesting that routine use of self-report was feasible. These reports revealed low sleep quality. Patients reported multiple facilitators and barriers for sleep, with environmental and patient comfort factors being most common. Interventions that target these factors to improve patient sleep should be implemented

In-situ study of growth of carbon nanotube forests on conductive CoSi₂ support

The growth of high density vertically aligned carbon nanotube forests on conductive CoSi2 substrate layers is characterized by in situ x-ray photoemission spectroscopy and x-ray diffraction. We use in situ silicidation to transform as loaded, low conductivity CoSi supports to highly conductive CoSi2 during nanotube growth. These cobalt silicide films are found to be stable against oxidation and carbide formation during growth and act as an excellent metallic support for growth of aligned nanotubes, resembling the growth on the insulating Fe/Al2O3 benchmark system. The good catalytic activity is attributed to interfacial reactions of the Fe catalyst particles with the underlying CoSi2 support. We obtain ohmic conduction from the support layer to the carbon nanotube forest

Branch Retinal Vein Occlusion: Pathogenesis, Visual Prognosis, and Treatment Modalities

In branch retinal vein occlusion (BRVO), abnormal arteriovenous crossing with vein compression, degenerative changes of the vessel wall and abnormal hematological factors constitute the primary mechanism of vessel occlusion. In general, BRVO has a good prognosis: 50–60% of eyes are reported to have a final visual acuity (VA) of 20/40 or better even without treatment. One important prognostic factor for final VA appears to be the initial VA. Grid laser photocoagulation is an established treatment for macular edema in a particular group of patients with BRVO, while promising results for this condition are shown by intravitreal application of steroids or new vascular endothelial growth factor inhibitors. Vitrectomy with or without arteriovenous sheathotomy combined with removal of the internal limiting membrane may improve vision in eyes with macular edema which are unresponsive to or ineligible for laser treatment

Effectiveness and cost-effectiveness of sentinel lymph node biopsy compared with axillary node dissection in patients with early-stage breast cancer: a decision model analysis

BACKGROUND: Sentinel lymph node biopsy (SLNB) is less invasive than axillary lymph node dissection (ALND) for staging early breast cancer, and has a lower risk of arm lymphoedema and similar rates of locoregional recurrence up to 8 years. This study estimates the longer-term effectiveness and cost-effectiveness of SLNB. METHODS: A Markov decision model was developed to estimate the incremental quality-adjusted life years (QALYs) and costs of an SLNB-based staging and management strategy compared with ALND over 20 years’ follow-up. The probability and quality-of-life weighting (utility) of outcomes were estimated from published data and population statistics. Costs were estimated from the perspective of the Australian health care system. The model was used to identify key factors affecting treatment decisions. RESULTS: The SLNB was more effective and less costly than the ALND over 20 years, with 8 QALYs gained and $883 000 saved per 1000 patients. The SLNB was less effective when: SLNB false negative (FN) rate >13%; 5-year incidence of axillary recurrence after an SLNB FN>19%; risk of an SLNB-positive result >48%; lymphoedema prevalence after ALND <14%; or lymphoedema utility decrement <0.012. CONCLUSION: The long-term advantage of SLNB over ALND was modest and sensitive to variations in key assumptions, indicating a need for reliable information on lymphoedema incidence and disutility following SLNB. In addition to awaiting longer-term trial data, risk models to better identify patients at high risk of axillary metastasis will be valuable to inform decision-making.H. Verry, S.J. Lord, A. Martin, G. Gill, C.K. Lee, K. Howard, N. Wetzig and J. Sime

Development of a Unifying Target and Consensus Indicators for Global Surgical Systems Strengthening: Proposed by the Global Alliance for Surgery, Obstetric, Trauma, and Anaesthesia Care (The G4 Alliance)

After decades on the margins of primary health care, surgical and anaesthesia care is gaining increasing priority within the global development arena. The 2015 publications of the Disease Control Priorities third edition on Essential Surgery and the Lancet Commission on Global Surgery created a compelling evidenced-based argument for the fundamental role of surgery and anaesthesia within cost-effective health systems strengthening global strategy. The launch of the Global Alliance for Surgical, Obstetric, Trauma, and Anaesthesia Care in 2015 has further coordinated efforts to build priority for surgical care and anaesthesia. These combined efforts culminated in the approval of a World Health Assembly resolution recognizing the role of surgical care and anaesthesia as part of universal health coverage. Momentum gained from these milestones highlights the need to identify consensus goals, targets and indicators to guide policy implementation and track progress at the national level. Through an open consultative process that incorporated input from stakeholders from around the globe, a global target calling for safe surgical and anaesthesia care for 80% of the world by 2030 was proposed. In order to achieve this target, we also propose 15 consensus indicators that build on existing surgical systems metrics and expand the ability to prioritize surgical systems strengthening around the world