bluuebunny/crossref_metadata_2025 huggingface dataset:
Notes on Chinese species of the genus Tautoneura Anufriev (Hemiptera: Cicadellidae: Typhlocybinae), with descriptions of two new species
Authors: SONG YUEHUA , LI ZIZHONG
Published: May 2019

In this paper, two new species are added to the genus Tautoneura Anufriev, 1969 (Hemiptera: Cicadellidae: Typhlocybinae) from Southwest China, T. multimaculata sp. n. and T. longiprocessa sp. n. A key to species recorded from China is provided.
A new species of Goniurosaurus from Cat Ba Island, Hai Phong, northern Vietnam (Squamata: Eublepharidae)
Authors: ZIEGLER THOMAS , TRUONG NGUYEN QUANG , SCHMITZ ANDREAS , STENKE ROSWITHA , RÖSLER HERBERT
Published: May 2019

A new species of the gekkonid genus Goniurosaurus is described from Cat Ba Island, Hai Phong, northern Vietnam. G. catbaensis sp. n. is, by its gracile body and limbs, the thin, posteriorly protracted nuchal loop, the three (or four) thin immaculate dorsal body bands between limb insertions, without dark spotting and with dark, narrow border surrounding the body bands, the lack of postrostral (internasal) scales, the presence of a greatly enlarged row of supraorbital tubercles, the outer surface of the upper eyelid being composed of granular scales of about the same size of those on top of head and with a longish row of 6–9 enlarged tubercles, granular body scales, with 8–11 granular scales surrounding the dorsal tubercles, deep axillary pockets, claws being sheathed by four scales, and 16–21 precloacal pores. The new taxon is known only from Cat Ba Island and is the eleventh Goniurosaurus species known and the fourth known species from Vietnam. We provide first data on its natural history and a key to the currently recognized Goniurosaurus species.
Beyond time-binds: Rethinking work–family dynamics for a mobile world
Authors: Hughes Karen D , Silver William A
Published: May 2019

Contemporary work is increasingly mobile, sparking new challenges for scholars of work and organizations. In this review article, we argue that a ‘mobilities lens’ offers strong potential for rethinking established approaches, focusing on one important sub-field: work–family studies. Drawing on a ‘problematization’ approach (Sandberg and Alvesson, 2011) and a systematic literature review (SLR) of work–family research published from 1995 to 2015, we show how theoretical assumptions about time, space, and place have narrowed the scope of work–family studies, focusing attention on ‘time’ and ‘time-binds’, and a limited subset of mobilities (e.g. telework, commuting). We argue that a mobilities lens can help us ‘think differently’ about work–family dynamics, prompting theoretical and methodological reorientations that recognize the inextricable connection of time and space (as ‘time–space’) and the need for a more encompassing excavation of the power, practice, and meaning of employment-related mobility (ERM) in work–family life. We sketch out a ‘mobilities inspired’ agenda to illustrate how ideas from mobilities studies can enrich work–family inquiry. We also discuss how mobilities studies can benefit, in turn, from greater engagement with work–family and organizational research.
Hands-on undergraduate course based on software-defined radio and Matlab/Simulink
Authors: Bykhovsky Dima
Published: May 2019

Recent breakthroughs lowering the costs of software-defined radio devices have made them very attractive for teaching wireless communication. This paper provides an example of an undergraduate course that incorporates the use of low-cost software-defined radio and Matlab/Simulink software to illustrate the basic principles of practical digital communication systems. This course targets senior level undergraduate electrical engineering students with a background in the fields of communication and signal processing. The course comprises two parts: software-defined radio introductory studies and implementation of a basic digital modem. The second part of this course may also be taught as project-based learning or in a hackathon-style event. Finally, a list of additional project-based learning/hackathon projects is provided.
Mental Health Inventory: Sensitivity and Specificity of the Portuguese Version of the MHI-38 and MHI-5
Authors: Santos Ana M. S. , Novo Rosa F.
Published: May 2019

Detection of mental distress cases is essential in clinical practice, especially in primary care. Screening instruments could be useful and effective tools to help identify them. This study sought to evaluate the utility and capability of the Mental Health Inventory (MHI)-38 and MHI-5 in identifying cases suffering from mental distress from those who do not. The validity and accuracy of these MHI versions were tested using as gold standards: two samples of adults, one with clinical complaints ( n = 33) and another without clinical complaints ( n = 31); and the scores in Scales of Psychological Well-Being and in a psychopathology inventory (Minnesota Multiphasic Personality Inventory 2). Receiver operating characteristic curves were used to define cutpoints, which is the Youden’s index for the optimization criteria. The data analysis indicated an optimal cutpoint of 7.19 for MHI-38TOTAL and of 53 (recoded to a 0–100 scale) for MHI-5TOTAL to differentiate clinical cases from those who are not. These results indicate cutpoint values similar to those of previous studies in the case of MHI-5 and provide useful reference values for MHI-38. The need to replicate this study with larger samples and with controlled clinical conditions and type of pathology is also discussed.
Breakdown in the Smart City: Exploring Workarounds with Urban-sensing Practices and Technologies
Authors: Houston Lara , Gabrys Jennifer , Pritchard Helen
Published: May 2019

Smart cities are now an established area of technological development and theoretical inquiry. Research on smart cities spans from investigations into its technological infrastructures and design scenarios, to critiques of its proposals for citizenship and sustainability. This article builds on this growing field, while at the same time accounting for expanded urban-sensing practices that take hold through citizen-sensing technologies. Detailing practice-based and participatory research that developed urban-sensing technologies for use in Southeast London, this article considers how the smart city as a large-scale and monolithic version of urban systems breaks down in practice to reveal much different concretizations of sensors, cities, and people. By working through the specific instances where sensor technologies required inventive workarounds to be setup and continue to operate, as well as moments of breakdown and maintenance where sensors required fixes or adjustments, this article argues that urban sensing can produce much different encounters with urban technologies through lived experiences. Rather than propose a “grassroots” approach to the smart city, however, this article instead suggests that the smart city as a figure for urban development be contested and even surpassed by attending to workarounds that account more fully for digital urban practices and technologies as they are formed and situated within urban projects and community initiatives.
Preparation and optimization of a gelatin-based biomimetic three-layered vascular scaffold
Authors: Hu Qingxi , Wu Chuang , Zhang Haiguang
Published: May 2019

Electrospinning is promising approach for producing biomimetic vascular scaffolds. In particular, gelatin-based electrospun scaffolds offer excellent biocompatibility. However, gelatin-based vascular scaffolds are difficult to remove from the collector after electrospinning and cross-linking agents such as glutaraldehyde, which is commonly used to improve the strength of water-soluble electrospun gelatin, are highly toxic. Herein, we present a novel electrospinning method for preparing three-layered vascular scaffolds. First, Tween 80 was added to 2,2,2-trifluoroethanol as the polymer electrospinning solution and the gelatin electrospinning solution was mixed with polylactic acid and polycaprolactone, respectively. The three-layered vascular scaffold was fabricated by electrospinning an inner layer of gelatin, a middle layer of polyester, and another outer layer of gelatin. Finally, the electrospun scaffolds were cross-linked with microbial transglutaminase and vacuum dried. Biomechanical properties of the scaffold were determined by tensile testing. Furthermore, the structure and biocompatibility of the scaffolds were assessed by hydrophilicity tests, scanning electron microscopy, and cell seeding experiments. Our results suggest the proposed electrospinning method is suitable for preparing biomimetic vascular scaffolds for cardiovascular tissue engineering applications. Moreover, this paper provides a useful reference for the preparation and optimization of vascular scaffolds.
Assessment of replicate numbers for titrating avian influenza virus using dose-response models
Authors: Spackman Erica , Malladi Sasidhar , Ssematimba Amos , Stephens Christopher B.
Published: May 2019

Embryonating chicken eggs (ECEs) are among the most sensitive laboratory host systems for avian influenza virus (AIV) titration, but ECEs are expensive and require space for storage and incubation. Therefore, reducing ECE use would conserve resources. We utilized statistical modeling to evaluate the accuracy and precision of AIV titration with 3 instead of 5 ECEs for each dilution by the Reed–Muench method for 50% endpoint calculation. Beta-Poisson and exponential dose-response models were used in a simulation study to evaluate observations from actual titration data from 18 AIV isolates. The reproducibility among replicates of a titration was evaluated with one AIV isolate titrated in 3 replicates with the beta-Poisson, exponential, and Weibull dose-response models. The standard deviation (SD) of the error between input and estimated virus titers was estimated with Monte Carlo simulations using the fitted dose-response models. Good fit was observed with all models that were utilized. Reducing the number of ECEs per dilution from 5 to 3 resulted in the width of the 95% confidence interval increasing from ±0.64 to ±0.75 log10 50% ECE infectious doses (EID50) and the SD of the error increased by 0.03 log10 EID50. Our study suggests that using fewer ECEs per dilution is a viable approach that will allow laboratories to reduce costs and improve efficiency.
Children and the ‘Right to be Forgotten’: what the right to erasure means for European children, and why Australian children should be afforded a similar right
Authors: Bunn Anna
Published: May 2019

This article provides an overview of the right to erasure, or the right to be forgotten, in the General Data Protection Regulation (GDPR) and how it is likely to impact on children. It contrasts the position of Australian children and their European counterparts. The article considers the benefits for children of a right to erasure, as well as some of its limitations, and recommends that Australia should introduce such a right.
Predictions of vertical train-bridge response using artificial neural network-based surrogate model
Authors: Han Xu , Xiang Huoyue , Li Yongle , Wang Yichao
Published: May 2019

To improve the efficiency of reliability calculations for vehicle-bridge systems, we present a surrogate modeling method based on a nonlinear autoregressive with exogenous input artificial neural network model and an important sample, which can forecast responses of dynamic systems, such as vehicle-bridge systems, subjected to stochastic excitations. We also propose a process to analyze the method. A quarter-vehicle model is used to verify the proposed method’s precision, and the nonlinear autoregressive with exogenous input artificial neural network model is used to predict responses of vertical vehicle-bridge systems. The results show that, compared to other training samples, the nonlinear autoregressive with exogenous input artificial neural network model has better prediction accuracy when the sample with the maximum response is considered as an important sample and is used to train the nonlinear autoregressive with exogenous input artificial neural network model, and it requires only two-time numerical simulation (or Monte Carlo simulation) at most, which is used in the training of the nonlinear autoregressive with exogenous input artificial neural network model.
Improved global stability condition analysis for time-delay fast active queue management scalable transmission control protocol
Authors: Huang Jinfeng , Zeng Lingjing , Chen Xiaolong
Published: May 2019

The nonlinear time-delay fast active queue management scalable transmission control protocol model was studied in this article. By analyzing the boundedness properties for solution trajectory of the fast active queue management scalable transmission control protocol model, the iterative relations of fast active queue management scalable transmission control protocol trajectory bounds were obtained. Furthermore, we calculated the maximum growth direction of the delay term in the integral interval and applied the backward method to calculate the lower conservative bound corresponding to each time of the delay term. Therefore, the global stability parameter condition of fast active queue management scalable transmission control protocol, which was less conservative than the existing global stability conditions, was obtained in this article. The validity of the stability conditions obtained in this article was verified by NS-2 simulation experiment.
From Moving Beyond Compliance to Quality to Moving Beyond Quality to Effectiveness: Realities and Challenges
Authors: Tsan Min-Fu
Published: May 2019

In 2007, Taylor proposed to move beyond compliance to develop measures for assessing the ethical quality of institutional review board (IRB) reviews. To date, no such tool has been developed. In 2018, Lynch et al. proposed to move beyond quality to advance effective research ethics oversight. Instead of providing a set of measures, they proposed to define and specify ways to measure the effectiveness of IRBs in protecting human subjects. They further claimed that any attempts to measure the quality and performance of IRBs without using such measures, to be developed by them in the unforeseeable future, were not helpful. The realities are that nearly 50 years after its establishment, there has been no systematic assessment of the quality and performance of IRBs, and that nearly two decades after the deaths of Jesse Gelsinger and Ellen Roche and the implementation of reform processes to improve our system of protecting human subjects, there is still plenty of room for improvement. The challenges today are for Taylor to come up with a tool to measure the ethical quality of IRB reviews, for Lynch et al. to develop measures for assessing the effectiveness of IRBs in protecting human subjects, and for the IRB community to decide whether to continue to wait for Taylor and Lynch et al. to develop their promised tools or to start taking advantage of performance measurements to improve the quality and performance of IRBs by using existing IRB performance metrics or to improve those existing performance metrics.
Determinants of hand hygiene behaviour based on the Theory of Interpersonal Behaviour
Authors: Kupfer Tom R , Wyles Kayleigh J , Watson Fraje , La Ragione Roberto Marcello , Chambers Mark A , Macdonald Alastair S
Published: May 2019

Background:

Many investigations into the determinants of hand hygiene (HH) behaviour have explored only individual predictors or were designed according to arguably overly simplistic models of behaviour. Consequently, important influences on HH behaviour, including habit and emotion, are sometimes neglected. This study is the first to employ the Theory of Interpersonal Behaviour as a comprehensive model for understanding the determinants of HH behaviour.

Method:

A self-report questionnaire was conducted with staff from two large UK veterinary referral practices. Participants ( n = 75) reported their HH behaviour and responded to statements rating the importance of social norms, self-protection, patient protection, time pressures, access to equipment, habit and disgust, to their HH behaviour.

Results:

Regression analysis showed that, overall, determinants explained 46% of variance ( p < .001) in self-reported HH behaviour, with time constraints being the strongest predictor ( β = −.47, p < .001) followed by difficulty finding equipment ( β = −.21, p = .05).

Discussion:

Time constraints may be the most important influence on HH adherence among the determinants investigated. Future researchers should consider employing theoretical models to aid a more comprehensive understanding of the psychology underlying HH adherence and HH interventions.
A Review of Continuous Glucose Monitoring Data Interpretation in the Age of Automated Insulin Delivery
Authors: Ekhlaspour Laya , Tabatabai Ideen , Buckingham Bruce
Published: May 2019

Using a continuous glucose monitor (CGM) improves glycemic control in patients with type 1 diabetes. The ambulatory glucose profile (AGP) has been recommended as a standard method for reporting CGM data. However, in recently developed automated insulin delivery (AID) systems, a standard format for reporting data has not yet been developed. Instead, reports are specific to each system being used. Currently, the only FDA approved AID system is a hybrid closed-loop insulin pump. In these systems, the patient is still required to announce a meal, respond to alerts, and keep the system in automated insulin delivery. The integrated pump and sensor information provides insights into how the system is performing, and how to make changes to tunable parameters, such as carbohydrate to insulin ratios. The reports also offer a window into human behavior related to performing diabetes tasks, responding to alarms, reasons for exiting HCL, and how glycemic goals are being met. This article reviews the pump and CGM data provided by several of the current closed-loop systems with a focus on systems that are currently approved in the United States (MiniMed™ 670G, Tandem Basal:IQ) and those used by patients using do-it-yourself systems. A step-wise approach to reviewing the nuances of these systems is provided. The comparison may reinforce the importance of the continued need for streamlining a standard report for providers to be able to interpret the CGM data of these systems.
Spatially Resolved STD-NMR Applied to the Study of Solute Transport in Biphasic Systems: Application to Protein-Ligand Interactions
Authors: Nepravishta Ridvan , Monaco Serena , Muñoz-García Juan C. , Khimyak Yaroslav Z. , Angulo Jesus
Published: May 2019

Fluid biphasic systems are one of the most interesting dynamic systems in chemistry and biochemistry. In nuclear magnetic resonance (NMR) spectroscopy, the study of the solute dynamics across fluid biphasic systems requires the introduction of dedicated NMR methods, due to their intrinsic heterogeneity. Diffusion and spatially resolved NMR techniques represent a useful approach for dealing with the study of solutes in biphasic systems and have been applied lately with success. Nevertheless, other potential applications of NMR spectroscopy for biphasic systems remain to be explored. In this proof-of-concept communication, we specifically aimed to investigate whether solute exchange between two immiscible phases can be followed by NMR experiments involving transfer of magnetization. To that aim, we have used spatially resolved saturation transfer difference NMR (SR-STD NMR) experiments to analyze solute exchange by transfer of saturation from one phase to the other in a biphasic system and have explored which are the underlying mechanisms leading to the transfer of magnetization between phases and the limits of the approach. We hereby demonstrate that SR-STD NMR is feasible and that it might be implemented in pharmacological screening for binders of biological receptors or in the study of chemical and biochemical reactions occurring at interfaces.
Pharmaceutical intervention after evaluation of the risk of ictus in elderly patients institutionalized with atrial fibrillation
Authors: Pérez-Surio Alberto Frutos , Ortiz Roberto Lozano , Crespo Alejandro Martínez
Published: May 2019

Objectives

To evaluate the risk of having a stroke and the risk of bleeding in institutionalized patients with atrial fibrillation. Atrial fibrillation is a common cardiac arrhythmia associated with increased morbidity and mortality. It is necessary to develop pharmacotherapy plans to minimize the risk.

Design

A prospective study.

Setting

Institutionalized patients.

Participants

Inclusion criteria were: patients diagnosed with atrial fibrillation, with or without treatment for the prevention of stroke.

Main outcome measures

The evaluation of the CHA2DS2-VASc criteria was performed. The risk of hemorrhage was assessed using the HAS-BLED scale, based on the risk factors associated with the probability of bleeding.

Results

We included 53 patients (86.4 ± 6.4 years, 30.2% men). Of these, 37 (69.8%) were correctly anticoagulated. Of the remaining, 5 patients (31.2%) did not have any type of anticoagulant or antiaggregant treatment and 11 (68.7%) were treated with antiaggregant alone. The pharmaceutical intervention was performed in patients who did not meet stroke criteria. Of the untreated patients: two died before the intervention, two were recommended to be referred to cardiology and in one there was no intervention because of very advanced age. In the antiaggregant patients, it was decided not to modify the treatment. The reasons were: high risk of bleeding, very advanced age, advanced dementia or terminal illness, moderate risk of stroke, and clotting factor deficiency.

Conclusions

The risk of stroke in elderly patients with atrial fibrillation is high, so it is important to control the risk factors.
Serum Apolipoprotein B and A1 Concentrations Predict Late-Onset Posttransplant Diabetes Mellitus in Prevalent Adult Kidney Transplant Recipients
Authors: Malyala Rohit , Rapi Lindita , Nash Michelle M. , Prasad G. V. Ramesh
Published: May 2019

Background:

Glucose metabolism links closely to cholesterol metabolism. Posttransplant diabetes mellitus (PTDM) adversely affects posttransplant outcomes, but its risk factors in relation to cholesterol metabolism have not been fully delineated. The apolipoprotein B/A1 (Apo B/A1) ratio, which is associated with insulin resistance, has not been evaluated in kidney transplant recipients as a risk factor for PTDM.

Objective:

The objective of this study was to determine whether serum apolipoprotein profiles predict late PTDM, defined as a new onset diabetes occurring greater than 3 months posttransplant.

Design:

Retrospective chart review of a prevalent population of kidney transplant recipients.

Setting:

Large transplant center in Ontario, Canada.

Patients:

We identified 1104 previously nondiabetic adults who received a kidney transplant between January 1, 1998, and December 1, 2015, and were followed at 1 transplant center.

Measurements:

Recipients provided testing for serum apolipoprotein B (Apo B) and apolipoprotein A1 (Apo A1) concentrations from 2010, either at 3 months posttransplant for new transplant recipients or the next clinic visit for prevalent recipients. Late PTDM defined using Canadian Diabetes Association criteria as occurring ≥3 months posttransplant was recorded until May 1, 2016.

Methods:

All analyses were conducted with R, version 3.4.0 (The R Foundation for Statistical Computing). Comparisons were made using Student t test, Fisher exact test or chi-square test, Kaplan-Meier methodology with the logrank test, or Cox proportional hazards analysis as appropriate. Covariates for the multivariate Cox proportional hazards models of PTDM as the outcome variable were selected based on significance of the univariate associations and biological plausibility.

Results:

There were 53 incident late PTDM cases, or 1.71 cases per 100 patient-years. Incident late PTDM differed between the highest and lowest quartiles for Apo B/A1 ratio, 2.47 per 100 patient-years vs 0.88 per 100 patient-years ( P = .005 for difference). In multiple Cox regression analysis, first measured serum Apo B/A1 concentration better predicted subsequent PTDM than low-density lipoprotein cholesterol (LDL-C; hazard ratio [HR] = 7.80 per unit increase, P = .039 vs HR = 1.05 per unit increase, P = .774). Non-high-density lipoprotein cholesterol (HDL-C) concentrations also did not predict PTDM ( P = .136). By contrast to Apo B, Apo A1 was protective against PTDM in statin users (HR = 0.17 per unit increase, P = .016).

Limitations:

Posttransplant diabetes mellitus cases occurring before apolipoprotein testing was implemented were not included in the analysis.

Conclusions:

Apolipoproteins B and A1 better predict late PTDM than conventional markers of cholesterol metabolism.
Factors Motivating Customization and Echo Chamber Creation Within Digital News Environments
Authors: Auxier Brooke E. , Vitak Jessica
Published: May 2019

With the influx of content being shared through social media, mobile apps, and other digital sources—including fake news and misinformation—most news consumers experience some degree of information overload. To combat these feelings of unease associated with the sheer volume of news content, some consumers tailor their news ecosystems and purposefully include or exclude content from specific sources or individuals. This study explores customization on social media and news platforms through a survey ( N = 317) of adults regarding their digital news habits. Findings suggest that consumers who diversify their online news streams report lower levels of anxiety related to current events and highlight differences in reported anxiety levels and customization practices across the political spectrum. This study provides important insights into how perceived information overload, anxiety around current events, political affiliations and partisanship, and demographic characteristics may contribute to tailoring practices related to news consumption in social media environments. We discuss these findings in terms of their implications for industry, policy, and theory.
Coronal shear fracture of distal humerus associated with olecranon fracture: A case report and pathomechanism
Authors: Sun Yucheng , Thanomsingh Pachin , Jeon In-Ho
Published: May 2019

Distal humeral coronal shear fractures are rare and account for around 1% of all fractures at the elbow level and 6% of the distal humeral fractures. Many studies have reported on the associated injuries involving the lateral collateral ligament injuries and radial head fractures in up to 40% and 30% of humeral fractures, but this combination of coronal shear fracture of the trochlea and capitellum associated with olecranon fracture is unusual. Here, we report two cases of distal humerus coronal shear fracture with olecranon fracture treated surgically and establish and discuss the pathomechanisms, diagnosis, and therapeutic issues relating to this fracture.
The economic burden of health disparities related to socioeconomic status in Israel
Authors: Politzer Eran , Shmueli Amir , Avni Shlomit
Published: May 2019

Background

Low socioeconomic status (SES) is often associated with excess morbidity and premature mortality. Such health disparities claim a steep economic cost: Possibly-preventable poor health outcomes harm societal welfare, impair the domestic product, and increase health care expenditures. We estimate the economic costs of health inequalities associated with socioeconomic status in Israel.

Methods

The monetary cost of health inequalities is estimated relative to a counterfactual with a more equal outcome, in which the submedian SES group achieves the average health outcome of the above-median group. We use three SES measures: the socioeceonmic ranking of localities, individuals’ income, and individuals’ education level. We examine costs related to the often-worse health outcomes in submedian SES groups, mainly: The welfare and product loss from excess mortality, the product loss from excess morbidity among workers and working-age adults, the costs of excess medical care provided, and the excess government expenditure on disability benefits. We use data from the Central Bureau of Statistics’ (CBS) surveys and socio-health profile of localities, from the National Insurance Institute, from the Ministry of Health, and from the Israel Tax Authority. All costs are adjusted to 2014 terms.

Results

The annual welfare loss due to higher mortality in socioeconomically submedian localities is estimated at about 1.1–3.1 billion USD. Excess absenteeism and joblessness occasioned by illness among low-income and poorly educated workers are associated with 1.4 billion USD in lost product every year. Low SES is associated with overuse of inpatient care and underuse of community care, with a net annual cost of about 80 million USD a year. The government bears additional cost of 450 million USD a year, mainly due to extra outlays for disability benefits. We estimate the total cost of the estimated health disparities at a sum equal to 0.7–1.6% of Israel’s GDP.

Conclusions

Our estimates underline the substantial economic impact of SES-related health disparities in Israel. The descriptive evidence presented in this paper highlights possible benefits to the economy from policies that will improve health outcomes of low SES groups.
Controversies, Methods, Results
Authors: Crown Sidney , D'Ardenne Patricia
Published: May 2019

Background

The terminology of sexual dysfunction is ugly enough in all conscience—erectile impotence, orgasmic dysfunction and so on—but it has served a useful purpose by bringing these problems into clear focus rather than burying them within the general vagueness of terms such as impotence and frigidity.
Relationship Between Body Build and Mental Illness
Authors: Verghese Abraham , Large Pamela , Chiu Edmond
Published: May 2019

A study to test the relationship between body build and mental illness, conducted in Royal Park Psychiatric Hospital, Melbourne, is described. The Rees-Eysenck body index (REBI) and androgyny score (AGS) were determined for 225 male patients and 24 normals. As age increases, there is a decreasing trend in the scores for these two indices. There were no significant differences between the various diagnostic groups and the normal group for the AGS. But the difference between the non-paranoid schizophrenic group and paranoid schizophrenic group in REBI was significant.
Nortriptyline Plasma Levels and Subjective Side Effects*
Authors: Ziegler Vincent E. , Taylor John R. , Wetzel Richard D. , Biggs John T.
Published: May 2019

Nortriptyline plasma levels and the incidence and severity of the common subjective side effects of the tricyclic antidepressants were determined in 26 patients during six weeks of treatment with nortriptyline. The total corrected (treatment minus pre-treatment) score of the eight side effects most independent of the severity of depression correlated (0 · 60) with the nortriptyline plasma level. Increased perspiration (o · 59) and dry mouth (o · 54) were the individual corrected side effects which most consistently correlated with the plasma level. These subjective side effects may serve as clinically useful guides to dosage adjustments during treatment, though their value is limited by the magnitude of the correlations and the need to correct for their presence prior to treatment.
Chronic Schizophrenic Patients in the Community
Authors: Cheadle A. J. , Freeman H. L. , Korer J.
Published: May 2019

A sample of 190 patients, diagnosed as schizophrenic by the same psychiatrist, have been surveyed in an urban community and their clinical and social status assessed. Compared to the local population as a whole, a significantly greater proportion of the men had never married, and although the women had married at approximately the same rate as those in the general population, 25 per cent of them had been divorced by the time of the interview. Assessments of the subjects' clinical condition by the Present State Examination were analysed into four groups of syndromes. Only 27 patients showed schizophrenic or paranoid symptoms, whereas neurotic symptoms were not only prevalent but seemed to cause most of the reported personal problems. Twenty-eight patients were free of symptoms at the time of interview. The great majority of the sample (72 per cent) were being maintained on long-acting neuroleptics. These data will form the baseline to assess a monitoring system, designed to keep the local psychiatric services in touch with schizophrenic patients who might otherwise drop out of treatment.
Phenomenology of Obsessive-Compulsive Neurosis
Authors: Stern R. S. , Cobb J. P.
Published: May 2019

Forty-five patients with obsessive-compulsive neurosis were given a specially devised structured interview with the aim of elucidating aspects of the phenomenology. Four main kinds of ritual were found to predominate: cleaning, avoiding, repeating and checking. A surprisingly large number of patients had little or no resistance to carrying out their rituals. The recognition of senselessness of a ritual was a more important criterion than that of resistance, but patients with predominantly repeating rituals did demonstrate resistance. It is proposed that a redefinition of obsessive-compulsive neurosis with less emphasis on resistance as a necessary condition may be appropriate.
Suicide, Cancer and Depression
Authors: Whitlock F. A.
Published: May 2019

A comparison has been made between persons aged 50 and over dying from suicide and a matched control group of persons dying from other violent causes with respect to the incidence of malignant neoplasms and benign intracranial tumours found at autopsy. Significantly more of the suicide cases were found to have cancer, meningiomas and benign pituitary tumours. The implications of this finding and the relationship between depression and neoplasia are discussed.
Serum IL-6 and CRP as prognostic factors in melanoma patients receiving single agent and combination checkpoint inhibition.
Authors: Weber Jeffrey S. , Tang Hao , Hippeli Lauren , Qian Max , Wind-Rotolo Megan , Larkin James M.G. , Wolchok Jedd D. , Sznol Mario , Robert Caroline , Woods David Michael , Laino Andressa Sodre , Hodi F. Stephen
Published: May 2019

100

Background: Acute phase reactants including C-reactive protein (CRP), and chronic inflammatory proteins including IL-6, which induces production of CRP from the liver, have been associated with a poor outcome in a variety of cancers. Methods: Sera from the CheckMate 064, 066 and 067 studies were assessed at baseline and on treatment for levels of IL-6 and CRP by Luminex. Associations between IL-6 and/or CRP levels and response or survival were determined. Purified endotoxin- and azide-free CRP was also tested for its immune effects in vitro using human T cells. Results: In patients receiving sequential nivolumab then ipilimumab in CheckMate 064 (cohort A), baseline serum IL-6 was associated with response (p = 0.03); serum IL-6 at week 12 after nivolumab alone (cohort A) or ipilimumab alone (cohort B), was also associated with response (p = 0.004 and 0.006, respectively). Baseline IL-6 above the median was associated with shorter survival in cohort A (p = 0.003) and cohort B (p = 0.0001). Serum CRP above the median was associated with shorter survival in cohort A (p = 0.001). Baseline IL-6 and CRP in cohort A were associated with one another, rho = 0.71 and p < 0.0001 In the randomized CheckMate 067 study, higher baseline serum CRP above the median was associated with shorter survival for ipilimumab, nivolumab or the combination with p < 0.0001, p < 0.11, and p = 0.0034, respectively. In the randomized CheckMate 066 study, higher baseline serum CRP was associated with shorter survival for nivolumab or dacarbazine (p = 0.131 and P < 0.0001 respectively). CRP suppressed T cell immunity and function, and levels above 10 micrograms/mL suppressed T cell proliferation (p = 0.005) and altered T cell signaling as well as calcium flux (p = 0.01), suggesting that CRP affected the earliest steps in T cell signaling and activation. Conclusions: High levels of CRP and IL-6 at baseline were associated with a poor response and shorter survival after nivolumab alone, and CRP with ipilimumab alone or the combination of both drugs. High levels of CRP were also associated with shorter overall survival in the randomized CheckMate 066 study of chemotherapy compared to nivolumab. CRP and IL-6 are prognostic factors for checkpoint inhibition.
Effect of intensification of induction II chemotherapy and liberalization of stem cell donor source on outcome for children with high risk acute myeloid leukemia: A report from the Children’s Oncology Group.
Authors: Aplenc Richard , Sung Lillian , Pollard Jessica Anne , Brodersen Lisa , Loken Michael , Gerbing Robert B , Getz Kelly D. , Meshinchi Soheil , Woods William G. , Kolb E. Anders , Alonzo Todd Allen , Gamis Alan S.
Published: May 2019

10002

Background: Patients with residual acute myeloid leukemia (AML) after induction fare poorly. The recently completed AAML1031 Phase III clinical trial intensified Induction II chemotherapy, altered the stem cell transplant (SCT) conditioning regimen, and liberalized SCT donor source criteria. We sought to test whether these practice changes improved clinical outcomes. Methods: Patients on AAML0531 and AAML1031, sequential Phase III trials for AML with shared high risk features of both > 15% residual blasts by morphology and ≥ 0.1% minimal residual disease (MRD) by flow cytometry with uninformative cytogenetics or high risk cytogenetic features (-7 or -5/5q-) were included. Gemtuzmab exposed and patients with high allelic ratio FLT3 ITD were excluded. Patients were observed from the start of Induction II through last available follow up. Induction II chemotherapy (ADE or AraC/Mito) was the exposure of interest. Disease free and overall survival (DFS, OS) were the primary outcomes. Standard descriptive statistics were used to compare patient characteristics and secondary outcomes; Kaplan Meier analyses were used to evaluate DFS/OS. Results: A total of 47 patients from AAML0531 (ADE) and 95 patients from AAML1031 (AraC/Mito) were included and did not differ in baseline characteristics. Five year DFS ±2SE was 17.5 ± 11.4 for ADE and 23.9 ± 8.8 for AraC/Mito, p = 0.528. Five year OS was 38.1 ± 14.2 for ADE and 33.3 ± 10.7 for AraC/Mito, p = 0.364. End of Induction II disease response and MRD did not differ between ADE and AraC/Mito. Patients receiving ADE had a higher probability of neutrophil recovery (74% vs 53%, p = 0.019) and recovered neutrophils a median of 7 days more quickly (27 vs 34 days), p = < 0.001. ADE patients also had fewer inpatient hospital days (28 days versus 32 days, p = 0.002). The percentage of patients receiving SCT did not differ, 34% vs 44%, p = 0.253 and post-SCT outcomes did not differ. Conclusions: The intensification of Induction II chemotherapy, change in SCT conditioning regimen, and liberalization of SCT donor source was not associated with improved clinical outcomes. Intensification of Induction II was associated with increased hematologic toxicity and length of stay. These data do not support the intensification of Induction II chemotherapy with AraC/Mitoxantrone. Clinical trial information: NCT01371981.
A randomized trial of a mercaptopurine (6MP) adherence-enhancing intervention in children with acute lymphoblastic leukemia (ALL): A COG ACCL1033 study.
Authors: Bhatia Smita , Hageman Lindsey , Chen Yanjun , Wong Florence Lennie , Mascarenhas Leo , Freyer David Robert , Mba Nkechi , Aristizabal Paula , Walterhouse David , Lew Glen , Kempert Pamela , Russell Thomas , McNall-Knapp Rene , Jacobs Shana S. , Dang Ha , Raetz Elizabeth A. , Relling Mary V. , Landier Wendy
Published: May 2019

10007

Background: We previously reported that > 40% of children with ALL are non-adherent to 6MP, and > 52% of ALL relapses are attributable to 6MP non-adherence. The most common barrier is forgetting to take 6MP; the most common facilitator is parental vigilance. These observations informed a randomized trial to enhance 6MP adherence (COG-ACCL1033, #NCT01503632; 89 COG sites). Results are described here. Methods: The Intervention Package (IP) consisted of: i) Education; ii) 6MP schedules; iii) daily personalized text message reminders from physician to patient and caregiver, to prompt iv) directly supervised therapy (DST), with text back response by patient/caregiver. Baseline adherence was measured for 4 wks, followed by intervention for 16 wks to examine the impact of IP vs. Edu (education) on 6MP adherence (measured electronically by MEMs Cap) in all patients, ≥12yo, < 12yo. Longitudinal binomial logistic regression using generalized estimating equations was used. Missing data were handled by multiple imputation. Results: 444 patients were randomly assigned to IP (n = 230) or Edu (n = 214). Baseline characteristics (age at study: 8.6y vs 7.5y; males: 67% vs 69%; non-Hispanic whites: 40% vs 42%) and adherence rates (92% vs 94%) were comparable (except paternal education: 49% vs 38%, p = 0.04). No study arm*time interaction was found; thus, the 16-week overall mean fitted adherence rates were compared between IP and Edu, adjusting for baseline adherence, time on study, parental education. All patients: Adherence rates were marginally higher on IP (94% vs 92.5%, p = 0.09). On IP, for times with a record of text response, adherence rates were higher (94%) when compared with times with no response (89%), p = 0.002. < 12yo: Adherence rates were comparable (IP: 94.4% vs Edu: 93.7%, p = 0.5). ≥12yo: Adherence rates were significantly higher on IP (93.1% vs 90.0%, p = 0.037). ≥12yo with baseline adherence < 90%: IP had the highest impact for this subgroup (83.4% vs 74.6%, p = 0.008). Conclusions: A 16-week comprehensive intervention resulted in higher 6MP adherence rates in children with ALL who were 12y or older at study. IP was most impactful in adolescents with baseline non-adherence. Clinical trial information: #NCT01503632.
Comparing late mortality risks among childhood cancer survivors: A report from the Childhood Cancer Survivor Study and British Childhood Cancer Survivor Study.
Authors: Fidler Miranda Marie , Oeffinger Kevin C. , Yasui Yutaka , Winter David L , Leisenring Wendy , Robison Leslie L. , Reulen Raoul , Chen Yan , Armstrong Gregory T. , Hawkins Mike
Published: May 2019

10017

Background: It is unclear whether late-effect risks are comparable across international settings. We compared late mortality risks in the Childhood Cancer Survivor Study (CCSS) and British Childhood Cancer Survivor Study (BCCSS). Methods: 46,474 5-year survivors of childhood cancer diagnosed from 1970-1999 and < 15 years age were included: 28,248 from the CCSS and 18,226 from the BCCSS. Late mortality (death ≥5 years from diagnosis) was assessed by linking to national vital statistics records. Adjusted ratios of the standardized mortality ratio (RSMR) and cumulative mortality probabilities were used to compare risks between cohorts. Treatment exposures were not available for the BCCSS, precluding comparison. Results: The cumulative all-cause mortality at 10 years from diagnosis was significantly lower in the CCSS (4.8%;95%CI:4.6%-5.0%) compared to the BCCSS (6.9%;95%CI:6.5%-7.2%); this was due to a lower probability of death from recurrence/progression of the primary cancer (CCSS = 3.3% vs. BCCSS = 5.8%), with significant differences observed in survivors of leukemia (7.9% vs 4.0%), Hodgkin lymphoma (2.5% vs 1.3%), CNS tumors (6.4% vs 4.4%), and sarcoma (6.5% vs 4.0%). However, with increasing time from diagnosis, risks became more similar. The CCSS ultimately had a greater cumulative mortality at 40 years from diagnosis, attributable to a 2-fold higher mortality from subsequent neoplasms (SNs) (RSMR:2.0;95%CI:1.8-2.3), cardiac (RSMR:1.7;95%CI:1.4-2.3) and pulmonary (RSMR:1.9;95%CI:1.4-2.5) causes, and other health-related deaths (RSMR:2.4;95%CI:2.1-2.9). When assessed by follow-up interval, the differences between the CCSS and BCCSS increased significantly for deaths due to SNs, cardiac and pulmonary causes, and other health-related deaths as time increased. Among those diagnosed more recently, the gap in all-cause mortality widened, with CCSS survivors diagnosed 1990-1999 experiencing approximately half the excess (RSMR:0.5;95%CI:0.5-0.6) observed in the BCCSS; this widening was driven by declines in the RSMR for most non-recurrence/progression causes of death. Conclusions: Our findings suggest that North American survivors may have received more intensive regimens during this time period to achieve sustainable remission and cure. However, the cost of this approach was a higher risk of death from late-effects. Which approach confers a net survival advantage will depend critically on the magnitude of the excess risk of late-effect deaths as the cohorts age.
Real-time sharing of comprehensive clinical genomics sequencing data in St. Jude Cloud.
Authors: Newman Scott , McLeod Clay , Macias Michael , Birch Kirby , Gout Alexander , Foy Scott , Silkov Antonina , Kesserwan Chimene , Nakitandwe Joy , Shurtleff Sheila , Azzato Elizabeth M. , Wang Lu , Rusch Michael C , Nichols Kim , Gajjar Amar J. , Pappo Alberto S. , Mullighan Charles Grenfell , Ellison David W. , Zhang Jinghui , Downing James
Published: May 2019

10019

Background: As tumor and germline genomic data from pediatric cancer patients is scarce in existing genomic databases, there is an urgent need for more comprehensive datasets. Such data will allow us to fully assess the actionable pediatric cancer genome, facilitate biomarker discovery, and identify new clinical associations. Methods: We sequenced 1002 tumor/normal pairs as part of a real-time clinical genomics service including whole genome, exome and transcriptome for 775 and exome/transcriptome for 227 samples. Tumor types were representative of the common and rare diseases treated at our institution (37% hematological, 31% brain and 32% solid tumors). A multidisciplinary team assessed every case, and after clinical reporting was complete, genomics data and basic clinical information (primary diagnosis, age, sex, ethnicity, primary/relapse/metastasis status), was made securely available online through St. Jude Cloud (www.stjude.cloud). Results: Based on analysis of 253 initial cases from the Genomes for Kids study, our multi-platform sequencing approach uncovered diagnostic, prognostic and/or therapeutically relevant findings in 78% of patients. We estimate 11-16% of clinically-relevant gene mutations could be missed by less comprehensive sequencing approaches. One quarter of patients had a potentially druggable mutation. This surprisingly high proportion was driven, in part, by BRAF fused low-grade gliomas and diverse JAK/STAT pathway alterations in B-Cell acute lymphoblastic leukemias. Whole genome/transcriptome sequencing allowed us to detect rare and novel gene fusions in 8% of cases and facilitated discovery of a new recurrent fusion gene in pediatric melanoma. All data is available online for others to mine and it is likely that additional clinically-relevant mutations can be uncovered. Conclusions: These data demonstrate the value of incorporating comprehensive sequencing into clinical diagnostics and patient care. We endeavor to make this large and richly annotated dataset available to others in real time rather than holding it back for months or years until publication. We anticipate adding approximately 500 additional cases per year at regular intervals, and as the resource grows, expect users to identify new targetable alterations that may be incorporated into patient care.