bluuebunny/crossref_metadata_2025 huggingface dataset:
Public spending on agricultural productivity and rural commercialization: A comparison of impacts using an economy‐wide approach
Authors: Aragie Emerta , Balié Jean
Published: June 2019

Motivation

Many developing countries have identified a set of strategic objectives and a longlist of investment areas to promote agricultural production and ensure food security. However, most of these countries lack the financial and technical capacity to execute all of the strategic objectives and investment areas, calling for a robust comparison of their effects.

Purpose

Taking the case of Ethiopia as an example, this study employs an economy‐wide model and assesses the relative efficiency of alternative investment options on agricultural performance and household welfare. These agricultural investment policies are evaluated under three alternative funding modalities: budget reallocation, donor financing and tax revenue.

Approach and methods

To account for the linkage, and direct and indirect impacts of alternative public expenditure policies, this study adapts an economy‐wide general equilibrium model for Ethiopia calibrated to a well disaggregated social accounting matrix representing the economic structure in 2010.

Findings

Results show that the public expenditure options examined could cause significantly different production and welfare responses. Productivity‐enhancing interventions such as input subsidy and irrigation development have superior output and welfare consequences, while policies aimed at smallholder commercialization such as infrastructural development aimed at cutting marketing margins have the least effect, suggesting a need to first prioritize relaxing supply constraints. This ranking of the agricultural policies is robust to the investment financing modalities considered. We, however, observe that financing these projects through income tax could be detrimental to the welfare of urban households.

Policy implications

Results show that in a supply‐constrained economy like that of Ethiopia, governments should focus on agricultural production and productivity‐enhancing interventions (at least in the short run). Reallocation of public funds towards the policies examined should be a principal funding source as this results in superior outcomes. On the other hand, governments should avoid using income tax as a source of finance since this can be highly detrimental to the welfare of urban households.
Doing business or leading care work? Intersections of gender, ethnicity and profession in home care entrepreneurship in Sweden
Authors: Brodin Helene , Peterson Elin
Published: June 2019

This article critically explores assumptions underpinning Swedish elder care policies that the introduction of market practices in publicly funded eldercare services advances women's entrepreneurship. We argue that gendered privileges and disadvantages are being recreated on tax‐funded home care markets; furthermore, gendered inequalities intersect with ethnicity and profession in the management of small‐scale care companies' dealings with authorities governing home care services and standards for home care work. However, we find that the salience of categories depends on the context in which they emerge. While gender and profession are dominant in management, gender and ethnicity influence interactions with authorities. Only in standards for home care work do all categories simultaneously shape the business approaches of care entrepreneurs. Our analysis, based on data on size and growth of home care companies and interviews with small‐scale care entrepreneurs, suggests that regulations and practices privilege big companies and care entrepreneurs who echo the white, masculine gendering of entrepreneurship as ‘doing business' and disadvantage small‐scale entrepreneurs focusing on leading care work to produce quality care.
Hemostatic function in hyperfibrinolytic disseminated intravascular coagulation
Authors: Ishihara Takashi , Nogami Keiji , Onishi Tomoko , Ogiwara Kenichi , Ochi Satoshi , Yamazaki Masaharu , Shima Midori
Published: June 2019

Background

Global hemostatic mechanism(s) in patients with disseminated intravascular coagulation (DIC) are poorly understood. There are few diagnostic criteria of DIC based on overall or global hemostatic mechanisms.

Methods

We have assessed in detailed the dynamic global hemostatic changes using thrombin and plasmin generation assay (T/P‐GA), clot fibrinolytic waveform analysis (CFWA) and not‐activated rotational thromboelastometry (NATEM), in a young girl with DIC associated with acute myeloid leukemia (AML). The ratios of endogenous thrombin potential (T‐EP) and plasmin lag time (P‐LT) relative to normal plasma was sourced from pooled normal plasma from healthy volunteers on T/P‐GA.

Results

The inverse P‐LT ratio prior to tranexamic acid (TXA) treatment was greater than the T‐EP ratio (1.1–2.8 and 0.83–1.2, respectively). Significant reduction in inverse P‐LT ratio (0.084–1.3) was observed after TXA treatment. The interval from clotting to the initiation of fibrinolysis (fibrinolysis lag time: FLT) in CFWA was significantly shorter than the control at onset (74.2–91.6 s vs 109 s), indicating enhanced fibrinolysis. Data from an adult with acute promyelocytic leukemia‐associated DIC also supportively showed a high inverse P‐LT ratio (2.1) and shortened FLT (83.7 s). The clotting time in patient whole blood using NATEM‐mode during an episode of severe epistaxis markedly shortened beyond control, but returned to normal after the addition of an anti‐tissue factor (TF) monoclonal antibody.

Conclusion

The release of intravascular TF contributed to sustained activation of coagulation and subsequent fibrinolytic activity in this patient with AML‐associated DIC, and T/P‐GA could provide better quantitative data than conventional assays in these circumstances.
Nonlinear relations between post‐traumatic stress symptoms and electrocortical reactivity during emotional face processing in combat‐exposed veterans
Authors: Macatee Richard J. , Burkhouse Katie L. , Afshar Kaveh , Schroth Christopher , Aase Darren M. , Greenstein Justin E. , Proescher Eric , Phan K. Luan
Published: June 2019

Combat‐related post‐traumatic stress symptoms (PTSS) are prevalent among recently deployed veterans, making identification of biomarkers of PTSS in this population a public health priority. Given the link between threat processing neurobiology and PTSS, the threat‐related late positive potential (LPP), an ERP reflective of attentional processing sensitive to emotion and its regulation, may have utility as a cost‐effective biomarker. Existing PTSS/threat‐related LPP findings are mixed, possibly due to variability in PTSS across samples, but this has never been explicitly tested. To address this gap, LPP amplitudes to angry, fearful, and happy emotional face stimuli were recorded among 81 combat‐exposed veterans at a VA hospital. A quadratic relationship between self‐reported PTSS and LPP amplitude modulation by angry faces emerged such that greater PTSS was related to a decreased LPP response to angry faces among veterans with subthreshold PTSD and an enhanced LPP response to angry faces among veterans with probable PTSD. These results suggest that prior mixed findings may be due to variability in PTSS severity. In addition, exploratory moderation analysis revealed that PTSS was positively associated with late LPP modulation for veterans reporting low cognitive reappraisal use and negatively associated with late LPP modulation for veterans reporting high cognitive reappraisal use. All results were specific to the 1,000–3,000 ms LPP time window. Thus, the functional nature of LPP modulation by direct threat cues may depend upon PTSS severity and/or related variables (e.g., cognitive reappraisal utilization).
Hemolytic anemia, spherocytosis, and thrombocytopenia associated with honey bee envenomation in a dog
Authors: Nair Rajeev , Riddle Emily A. , Thrall Mary Anna
Published: June 2019

This case report describes a massive honey bee envenomation in a 14‐month‐old male Belgian Malinois dog from St. Kitts, West Indies. Acute and delayed onsets of hemolytic anemia, echinocytosis, spherocytosis, thrombocytopenia, hemoglobinemia, and hemoglobinuria developed following envenomation. The dog recovered after treatment with glucocorticoids and supportive therapy. Spherocytosis, hemolysis, and thrombocytopenia in patients with massive bee envenomation are likely due to the direct toxic effects of the primary components of bee venom, melittin and phospholipase A2(PLA2). Mellitin causes hemolysis by forming large pores in erythrocytes resulting in leakage of hemoglobin and also causes spectrin stiffening and resultant echinocyte and spherocyte formation. Melittin also stimulates PLA2, a hydrolase that causes echinocytosis and spherocytosis, in vivo and in vitro, and mitochondrial breakdown in platelets. However, delayed manifestations could be attributed to immune‐mediated mechanisms from the generation of antibodies against damaged erythrocytes and platelet membrane proteins.
Methadone, Pierre Robin sequence and other congenital anomalies: case–control study
Authors: Cleary Brian , Loane Maria , Addor Marie-Claude , Barisic Ingeborg , de Walle Hermien E K , Matias Dias Carlos , Gatt Miriam , Klungsoyr Kari , McDonnell Bob , Neville Amanda , Pierini Anna , Rissmann Anke , Tucker David F , Zurriaga Oscar , Dolk Helen
Published: June 2019

Objective

Methadone is a vital treatment for women with opioid use disorder in pregnancy. Previous reports suggested an association between methadone exposure and Pierre Robin sequence (PRS), a rare craniofacial anomaly. We assessed the association between gestational methadone exposure and PRS.

Design/setting

This case-malformed control study used European Surveillance of Congenital Anomalies population-based registries in Ireland, the Netherlands, Italy, Switzerland, Croatia, Malta, Portugal, Germany, Wales, Norway and Spain, 1995–2011.

Patients

Cases included PRS based on International Classification of Disease (ICD), Ninth Edition-British Paediatric Association (BPA) code 75 603 or ICD, Tenth Edition-BPA code Q8708. Malformed controls were all non-PRS anomalies, excluding genetic conditions, among live births, fetal deaths from 20 weeks’ gestation and terminations of pregnancy for fetal anomalies. An exploratory analysis assessed the association between methadone exposure and other congenital anomalies (CAs) excluding PRS. Methadone exposure was ascertained from medical records and maternal interview.

Results

Among 87 979 CA registrations, there were 127 methadone-exposed pregnancies and 336 PRS cases. There was an association between methadone exposure and PRS (OR adjusted for registry 12.3, 95% CI 5.7 to 26.8). In absolute terms, this association reflects a risk increase from approximately 1–12 cases per 10 000 births. A raised OR was found for cleft palate (adjusted OR 5.0, 95% CI 2.7 to 9.2).

Conclusions

These findings suggest that gestational methadone exposure is associated with PRS. The association may be explained by unmeasured confounding factors. The small increased risk of PRS in itself does not alter the risk–benefit balance for gestational methadone use. The association with cleft palate, a more common CA, should be assessed with independent data.
Extrahepatic bile duct injury caused by a horse kicking injury
Authors: Pereira Ryan , Slater Kellee
Published: June 2019

A 35-year-old man presented to a regional hospital after being kicked by a horse in the right upper quadrant. He was transferred to our hepatobiliary unit with bile peritonitis 8 days post trauma. Laparoscopic cholecystectomy and intraoperative cholangiography were performed, demonstrating distal common bile duct (CBD) obstruction with contrast extravasation from the distal duct. The CBD was drained with a T-tube via laparotomy. On postoperative day 14, T-tube cholangiography demonstrated no extravasation of contrast from the distal CBD and minor stricturing with eventual duodenal drainage. The T-tube was clamped and 5 weeks later, the patient represented with peri-T-tube bile leakage and right upper quadrant pain. A T-tube cholangiogram confirmed a complex distal CBD stricture. Two attempts at ERCP with intent of stenting the stricture were unsuccessful. The patient underwent an end to side Roux-en-Y choledochojejunostomy and was discharged home 4 days postoperatively on simple analgesia.
Drug-resistant epilepsy, early-onset hypertension and white matter lesions: a hidden paraganglioma
Authors: Silvennoinen Katri , Waghorn Alison J , Balestrini Simona , Sisodiya Sanjay M
Published: June 2019

We describe the case of a 35-year-old man with focal epilepsy since age 16. Due to a refractory course, several treatments were tried over the years, including insertion of a deep brain stimulator. At the time of his first assessment at our unit, he had recently been diagnosed with hypertension. An MR scan of brain revealed multiple T2 hyperintense white matter lesions, and evidence of previous haemorrhage in the left basal ganglia and pons. On follow-up imaging, the changes were considered to be in keeping with hypertensive arteriopathy. He was referred for further assessment of his hypertension and was found to have a para-aortic paraganglioma. This was excised 16 months after his initial presentation to us. The surgery was associated with an improvement in his seizure control. This case serves as a reminder of the need to be vigilant about the possibility of coexisting conditions in people with epilepsy.
Postpartum ovarian vein thrombosis and venous anatomical variation
Authors: Abrantes João , Teixeira Eliana , Gomes Fernanda , Fernandes Clara
Published: June 2019

A 34-year-old multipara presented 72 hours postpartum with acute right-sided abdominal pain. The investigation revealed mild leucocytosis with positive D-dimer and elevated C reactive protein. Abdominal ultrasound and abdominopelvic CT demonstrated an enlarged right ovarian vein with endoluminal thrombus, representing postpartum ovarian vein thrombosis. The patient became asymptomatic 48 hours after starting broad-spectrum antibiotic treatment and anticoagulant therapy. She completed the treatment in ambulatory regimen and control abdominopelvic CT imaging was performed and revealed a duplicated right ovarian vein and a small residual subacute thrombus in the lumen of the distal right ovarian vein. The patient remained asymptomatic in the clinical follow-up.
Rare primary abdominal ectopic pregnancy in the pouch of Douglas
Authors: Thomas Joshua Baji
Published: June 2019

A 35-year-old Nepalese woman, referred by her general practitioner for per vaginal spotting and abdominal pain for the past 12 days with a background history of 5 weeks of amenorrhoea and a quantifiable beta-human chorionic gonadotrophin of 18 900 IU/L. Subsequent pelvic ultrasound revealed a cystic lesion with peripheral vascularity in the pouch of Douglas indicating possible ectopic pregnancy with no intrauterine gestational sac seen. Subsequent to that, she underwent a diagnostic laparoscopy that revealed 150 mL of blood in the pouch of Douglas with no other obvious evidence of tubal or ovarian ectopic pregnancy seen. There was, however, a resemblance of trophoblastic tissue noted on the wall of the pouch of Douglas that was further investigated to reveal a primary ectopic pregnancy of the pouch of Douglas with no trophoblastic infiltration.
Successful osimertinib treatment in a patient who exhibited intramedullary spinal cord metastases of lung adenocarcinoma with an acquired EGFR T790M mutation
Authors: Horiuchi Kohei , Asakura Takanori , Sakaguchi Shinji , Saito Fumitake
Published: June 2019

Intramedullary spinal cord metastases (ISCMs) of non-small cell lung cancer (NSCLC) constitute a serious if infrequent complication, characterised by rapid progression of neurological deficits, with poor prognosis. We describe a 52-year-old man with ISCMs secondary to lung adenocarcinoma who acquired the T790M mutation of the epidermal growth factor receptor (EGFR) after previous use of a first-generation EGFR tyrosine kinase inhibitor (TKI); he was successfully treated with osimertinib. This is the first report of the use of osimertinib in ISCMs: due to its high central nervous system activity, osimertinib could be useful for treating ISCMs secondary to NSCLC in patients who exhibit the T790M mutation.
Rare and unusual case of hepatic and disseminated tuberculosis in an immunocompetent patient
Authors: Eshiwe Celestine , Shahi Farah , Gordon Neil , Lillie Patrick
Published: June 2019

Mycobacterium tuberculosiscomplex disease (tuberculosis (TB)) of the liver is rare and liver abscesses as a result are even rarer. In an immunocompetent individual, the disease tends to be localised. To the best of our knowledge, we report one of the most severe TB involvements of the liver in an immunocompetent individual. A young woman with a history of previous TB infection, presented in septic shock. Scans showed a liver filled with possible abscesses, one of which was aspirated and confirmed TB. Multiple HIV tests were negative but she remained lymphopaenic. Although she improved substantially with anti-tuberculous treatment, she later developed non-tuberculous central nervous system disease that we were unable to fully explain. Despite a stormy recovery period, she continues to do well.
Diaphragmatic eventration unusual presentation: a novel thoracoabdominal compartment syndrome case
Authors: Shaher Abdulaziz , Alqahtani Abdulrahman Mohmmed , Sinnah Khalid N , Al Bakheet Shaher Mousa
Published: June 2019

Diaphragmatic eventration is a rare entity in the adult population, and usually asymptomatic1; our case is a young man with severe right-sided diaphragmatic eventration with huge dilated colon that has compromised the right hemithorax and caused complete lung collapse and mediastinal shift similar to tension pneumothorax picture with haemodynamic alteration. A single similar case report had been published but did not shed the light on the accurate description of the pathophysiological mechanism of the disease. We believe that such a high abdominal pressure that has transmitted to the thoracic cavity due to the pliable diaphragm causing such a derangment in both the anatomy and the physiology deserves reporting and we think that the term ‘thoracoabdominal compartment syndrome’ describes it accurately, so we discuss some learning points from our case and things that could have been done better.
Delayed complication of tracheocutaneous fistula closure with severe compromising subcutaneous emphysema
Authors: Lewis Robert J , Mandler Ari G , Perez Geovanny , Mudd Pamela A
Published: June 2019

We report a significant complication after tracheocutaneous fistula (TCF) excision with closure by secondary intention in a 4-year-old boy who had been tracheostomy dependent since infancy. He had a persistent 3 mm TCF one year after decannulation. On postoperative day 2 the patient developed profound subcutaneous emphysema and pneumomediastinum. He was extubated after 2 days and discharged from the hospital on postoperative day 7. At follow up he had complete resolution of subcutaneous emphysema and complete closure of the TCF. The main methods of TCF closure and management of subcutaneous emphysema are discussed along with the lessons learned from this case.
Jejunojejunal intussusception secondary to metastatic uveal melanoma after 11 years of remission
Authors: Butt Hifza Waheed , Soin Sarthak , Ali Faisal , Wojtkowski Antoni
Published: June 2019

Malignant cutaneous melanoma frequently metastasises to gastrointestinal tract, small bowel being the most common site likely due to its rich vascular supply. However, most common sites for metastatic uveal melanoma are the liver (93%), lung (24%), bone (16%), skin/subcutaneous tissue (11%) and lymph nodes (10%).1We present a case of 46-year-old man with jejunojejunal intussusception secondary to metastatic uveal melanoma status postbrachytherapy after 11 years of remission. We aim to highlight the rare occurrence of adult intussusception secondary to uveal melanoma after a prolonged period of remission.
BMPR1A mutation–positive juvenile polyposis syndrome and atrial septal defect: coincidence or association?
Authors: Harris Rachel E , Russell Richard K
Published: June 2019

We describe the case of a 16-year-old male patient with BMPR1A mutation and incidentally detected atrial septal defect (ASD). This patient was diagnosed with BMPR1A mutation through genetic testing and was attending for routine surveillance endoscopy when ASD was incidentally diagnosed. He was referred to cardiology outpatient clinic with plans for elective ASD closure. Through this case report we aim to discuss the pathophysiology of juvenile polyposis syndrome (JPS), highlight what we believe to be a novel presentation of comorbid BMPR1A mutation and ASD and hypothesise that patients with BMPR1A mutation and JPS may be at risk of previously unrecognised cardiovascular complications analogous to the previous association of SMAD4 JPS and cardiac abnormalities.
Beyond the building blocks: integrating community roles into health systems frameworks to achieve health for all
Authors: Sacks Emma , Morrow Melanie , Story William T , Shelley Katharine D , Shanklin D , Rahimtoola Minal , Rosales Alfonso , Ibe Ochiawunma , Sarriot Eric
Published: June 2019

Achieving ambitious health goals—from the Every Woman Every Child strategy to the health targets of the sustainable development goals to the renewed promise of Alma-Ata of ‘health for all’—necessitates strong, functional and inclusive health systems. Improving and sustaining community health is integral to overall health systems strengthening efforts. However, while health systems and community health are conceptually and operationally related, the guidance informing health systems policymakers and financiers—particularly the well-known WHO ‘building blocks’ framework—only indirectly addresses the foundational elements necessary for effective community health. Although community-inclusive and community-led strategies may be more difficult, complex, and require more widespread resources than facility-based strategies, their exclusion from health systems frameworks leads to insufficient attention to elements that need ex-ante efforts and investments to set community health effectively within systems. This paper suggests an expansion of the WHO building blocks, starting with the recognition of the essential determinants of the production of health. It presents an expanded framework that articulates the need for dedicated human resources and quality services at the community level; it places strategies for organising and mobilising social resources in communities in the context of systems for health; it situates health information as one ingredient of a larger block dedicated to information, learning and accountability; and it recognises societal partnerships as critical links to the public health sector. This framework makes explicit the oft-neglected investment needs for community health and aims to inform efforts to situate community health within national health systems and global guidance to achieve health for all.
Antihyperalgesia effect of AMP-activated protein kinase (AMPK) activators in a mouse model of postoperative pain
Authors: Das Vaskar , Kroin Jeffrey S , Moric Mario , McCarthy Robert J , Buvanendran Asokumar
Published: June 2019

Background and objectives

AMP-activated protein kinase (AMPK) activator drugs decrease hypersensitivity in mice with pain. This study examines if postsurgery treatment with the prototype AMPK activator metformin and a new mechanism-specific AMPK activator, O304, after plantar hindpaw incision in mice, would reduce mechanical hypersensitivity and produce changes in the AMPK pathway in the dorsal root ganglion (DRG).

Methods

To create postoperative pain, an incision was made in the left plantar hindpaw. Animals were randomized into four oral gavage drug treatment groups (n=8/group): (1) vehicle, (2) metformin 200 mg/kg, (3) O304 200 mg/kg and (4) O304 200 mg/kg plus metformin 200 mg/kg. Drug gavages were performed 4 hours postsurgery and were repeated for 3 days. Mechanical hypersensitivity was measured with von Frey filaments. Changes in phosphorylated AMP-activated protein kinase alpha subunit, phosphorylated mechanistic target of rapamycin and phosphorylated eukaryotic initiation factor 2 alpha in DRG neurons were examined by immunohistochemistry.

Results

O304 or metformin increased von Frey thresholds (reduced mechanical hypersensitivity) in plantar incision mice versus vehicle-treated incision mice between days 1 and 4 (difference of mean area under the curve, O304: 2.24 g*day; 95% CI of the difference 0.28 to 4.21, p=0.011; metformin: 2.56 g*day; 95% CI of the difference 1.71 to 3.41, p<0.001). The drug combination further elevated von Frey thresholds. In the vehicle-treated group, the AMP-activated protein kinase alpha subunit was downregulated and mechanistic target of rapamycin and eukaryotic initiation factor 2 alpha were upregulated in DRG neurons; these deficits were reversed by the AMPK activator treatments.

Conclusions

Early treatment with the mechanism-specific AMPK activator O304 or the prototype AMPK activator metformin reduces mechanical hypersensitivity in a postoperative pain model in mice. These drugs also normalize the AMPK pathway in the DRG.
Cost‐Effectiveness of Left Atrial Appendage Closure for Stroke Reduction in Atrial Fibrillation: Analysis of Pooled, 5‐Year, Long‐Term Data
Authors: Reddy Vivek Y. , Akehurst Ronald L. , Gavaghan Meghan B. , Amorosi Stacey L. , Holmes David R.
Published: June 2019

Background

Recent publications reached conflicting conclusions about the cost‐effectiveness of left atrial appendage closure (LAAC) with the Watchman device (Boston Scientific, Marlborough, MA) for stroke risk reduction in nonvalvular atrial fibrillation (AF). This analysis sought to assess the cost‐effectiveness of LAAC relative to both warfarin and nonwarfarin oral anticoagulants (NOACs) using pooled, long‐term data from the randomized PROTECT AF (Watchman Left Atrial Appendage System for Embolic Protection in Patients With Atrial Fibrillation) and PREVAIL (Prospective Randomized Evaluation of the Watchman LAA Closure Device in Patients With Atrial Fibrillation Versus Long‐Term Warfarin) trials.

Methods and Results

A Markov model was constructed from a US payer perspective with a lifetime (20‐year) horizon. LAAC clinical event rates and stroke outcomes were from pooled PROTECT AF and PREVAIL trial 5‐year data. Warfarin and NOAC inputs were derived from published meta‐analyses. The model was populated with a cohort of 10 000 patients, aged 70 years, at moderate stroke and bleeding risk. Sensitivity analyses were performed. LAAC was cost‐effective relative to warfarin by year 7 ($48 674/quality‐adjusted life‐year) and dominant (more effective and less costly) by year 10. LAAC became cost‐effective and dominant compared with NOACs by year 5. Over a lifetime, LAAC provided 0.60 more quality‐adjusted life‐years than warfarin and 0.29 more than NOACs. In sensitivity analyses, LAAC was cost‐effective relative to warfarin and NOACs in 98% and 95% of simulations, respectively.

Conclusions

Using pooled, 5‐year PROTECT AF and PREVAIL trial data, LAAC proved to be not only cost‐effective, but cost saving relative to warfarin and NOACs. LAAC with the Watchman device is an economically viable stroke risk reduction strategy for patients with AF seeking an alternative to lifelong anticoagulation.
Impact of Sex on Ventricular‐Vascular Stiffness and Long‐Term Outcomes in Heart Failure With Preserved Ejection Fraction: TOPCAT Trial Substudy
Authors: Beale Anna L. , Nanayakkara Shane , Kaye David M.
Published: June 2019

Background

Women have higher vascular stiffness with aging. The aim of this study was to characterize sex differences in vascular and ventricular structure and function, and to investigate the impact on the primary outcome in the TOPCAT trial (Treatment of Preserved Cardiac Function Heart Failure With an Aldosterone Antagonist Trial).

Methods and Results

Data from the Americas cohort of the
TOPCAT
trial were analyzed. Patients with echocardiography (n=654) were compared according to sex, and achievement of the primary end point (a composite of death from cardiovascular causes and heart failure hospitalization) assessed. Echocardiography revealed higher arterial, systolic, and diastolic ventricular elastance and worse ventricular‐vascular coupling in women. Women had better overall survival and heart failure hospitalization outcomes (hazard ratio 0.74, 95%
CI
0.57–0.98,
P
=0.034), however, determinants of achievement of the primary outcome differed between the sexes. Pulse pressure was a key determinant of outcome in women (hazard ratio 1.04, 95%
CI
1–1.09,
P
=0.034) whereas in men heart rate (hazard ratio 1.61, 95%
CI
1.02–2.52 per 10 mm Hg increase,
P
=0.04) and B‐type natriuretic peptide (hazard ratio 1.01, 95%
CI
1–1.02 per 10 ng/mL increase
P
=0.02) were associated with poorer outcome.

Conclusions

Outcomes in patients with heart failure with preserved ejection fraction appear to be differentially influenced by key physiological factors that vary according to sex. In women, ventricular‐vascular stiffening was the most significant determinant of outcome, whereas in men overall survival was influenced by heart rate and B‐type natriuretic peptide; this highlights key sex differences in the pathophysiology and outcomes of heart failure with preserved ejection fraction and warrants further exploration.

Clinical Trial Registration

URL:
https://clinicaltrials.gov
. Unique identifier: NCT00094302.
‘Let them have it!’ A review of the retention and storage of, and access to, material post conviction in England and Wales
Authors: Shorter Louise , Madland Geir
Published: June 2019

Records kept, physical material seized, samples taken and extracts derived during a criminal investigation are retained post conviction in case they could assist a subsequent appeal against conviction. Forensic evidence is the application of scientific analysis to the law. Its presentation in court involves not just the material itself but a suitably learned scientist’s opinion of its significance, and that opinion may be called into question, scientific understanding being in constant flux. Scientific opinion presented in court today may be superseded tomorrow – a powerful argument for the retention of all material which could be subjected to new tests or interpretation in the light of new information. But are exhibits being retained appropriately? A Freedom of Information request to all police forces in England and Wales was undertaken to ascertain their retention practices. The far-from-uniform results are presented and discussed here, along with policy recommendations.
What Makes Hosts Trust Airbnb? Antecedents of Hosts’ Trust toward Airbnb and Its Impact on Continuance Intention
Authors: Wang Yichuan , Asaad Yousra , Filieri Raffaele
Published: June 2019

Sharing economy platforms are growing at an unprecedented rate. Travel and tourism scholars have been focusing on customers’ sharing intention, yet the literature has largely overlooked what makes sharing service providers trust a sharing economy platform and decide to continue using it. Drawing on sociotechnical theory and the information systems success model, in conjunction with privacy concerns and economic value perspectives, this study develops an integrated model of antecedents and consequences of trust toward sharing economy platforms. Data from 606 Airbnb hosts were analyzed through structural equation modeling. Our research documents the importance of social antecedents (i.e., social value orientation and social utility), technical antecedents (i.e., system quality, service quality, and information quality), economic antecedents (i.e., monetary rewards) and privacy assurance antecedents (i.e., perceived effectiveness of privacy policy) in shaping hosts’ trust toward Airbnb, thereby enhancing their continuance intention with regard to using the platform.
Facts and Fears in Public Reporting: Patients’ Information Needs and Priorities When Selecting a Hospital for Cancer Care
Authors: Chimonas Susan , Fortier Elizabeth , Li Diane G. , Lipitz-Snyderman Allison
Published: June 2019

Objective. Public reporting on the quality of provider care has the potential to empower patients to make evidence-based decisions. Yet patients seldom consult resources such as provider report cards in part because they perceive the information as irrelevant. To inform more effective public reporting, we investigated patients’ information priorities when selecting a hospital for cancer treatment. We hypothesized that patients would be most interested in data on clinical outcomes. Methods. An experienced moderator led a series of focus groups using a semistructured discussion guide. Separate sessions were held with patients aged 18 to 54 years and those older than 54 years in Philadelphia, Pennsylvania; Phoenix, Arizona; and Indianapolis, Indiana, in 2017. All 38 participants had received treatment for cancer within the past 2 years and had a choice of hospitals. Results. In selecting hospitals for cancer treatment, many participants reported that they considered factors such as reputation, quality of the facilities, and experiences of other patients. For most, however, decisions were guided by trusted advisors, with the majority agreeing that a physician’s opinion would sway them to disregard objective data about hospital quality. Nonetheless, nearly all expressed interest in having comparative data. Participants varied in selecting from a hypothetical list, “the top 3 things you would want to know when choosing a hospital for cancer care.” The most commonly preferred items were overall care quality, timeliness, and patient satisfaction. Contrary to our hypothesis, many preferred to avoid viewing comparative clinical outcomes, particularly survival. Conclusions. Patients’ information preferences are diverse. Fear or other emotional responses might deter patients from viewing outcomes data such as survival. Additional research should explore optimal ways to help patients incorporate comparative data on the components of quality they value into decision making.
Adapting National-Level Textbooks for Students With Disabilities in South Korea
Authors: Lee Okin , Shin Mikyung
Published: June 2019

Educators in South Korea have been adapting textbooks and related activities to meet the increasing need for national-level curricula for teachers of special and general education for students with disabilities at the elementary school level. The underlying aim is to create inclusive educational environments. There are four steps in adapting national-level textbooks to make education inclusive of students with disabilities in South Korea: (a) Step 1—Determine the need for textbook adaptation, (b) Step 2—Identify and adapt curricular goals and objectives, (c) Step 3—Create classroom materials and adapt textbooks, and (d) Step 4—Monitor the progress of the use of textbook adaptations. This column presents the process, using examples of topics in third-grade mathematics that are foundational for future learning.
Numerical investigation of aerodynamic noise generated by circular cylinders in cross-flow at Reynolds numbers in the upper subcritical and critical regimes
Authors: Liu Xiaowan , Thompson David J , Hu Zhiwei
Published: June 2019

A numerical investigation of the aeroacoustic characteristics of the flow past a circular cylinder is presented for Reynolds numbers in the range [Formula: see text], which falls within the upper subcritical and critical regimes. This is based on computational fluid dynamics simulations using a delayed detached-eddy simulation model for the aerodynamics of the near-field, which feeds the equivalent source terms into the Ffowcs Williams–Hawkings equation for far-field noise prediction. The accuracy of delayed detached-eddy simulation in predicting unsteady flow quantities is assessed from an engineering viewpoint through comparisons with experimental data. Good agreement is found for both the near-field flow quantities and the far-field noise spectra. The aerodynamic and aeroacoustic characteristics are investigated from two aspects: the effect of varying the Reynolds number and the sensitivity to the spanwise computational dimension. The results in terms of the vortex shedding frequency, hydrodynamic forces and far-field noise levels only show small variations in the subcritical range. However, in the critical range, the vortex shedding frequency increases and the noise level decreases considerably after allowing for the typical sixth power dependence. A spanwise length of 3 D is found to be sufficient for most Reynolds numbers in the critical range; but in the subcritical range, a longer spanwise length is needed, and the sound level may be under-predicted by up to around 4.5 dB by using 3 D.
Who will benefit more from low-dose alteplase in acute ischemic stroke?
Authors: Wang Xia , Lee Keon-Joo , Moullaali Tom J , Kim Beom Joon , Li Qiang , Bae Hee-Joon , Carcel Cheryl , Delcourt Candice , Arima Hisatomi , Sato Shoichiro , Robinson Thompson G , Song Lili , Chen Guofang , Yang Jie , Chalmers John , Anderson Craig S , Lindley Richard , Woodward Mark ,   for the ENCHANTED Investigators
Published: June 2019

Objectives

Controversy persists over the benefits of low-dose versus standard-dose intravenous alteplase for the treatment of acute ischemic stroke. We sought to determine individual patient factors that contribute to the risk–benefit balance of low-dose alteplase treatment.

Methods

Observational study using data from the Enhanced Control of Hypertension and Thrombolysis Stroke Study (ENCHANTED), an international, randomized, open-label, blinded-endpoint trial that assessed low-dose (0.6 mg/kg) versus standard-dose (0.9 mg/kg) intravenous alteplase in acute ischemic stroke patients. Logistic regression models were used to estimate the benefit of good functional outcome (scores 0 or 1 on the modified Rankin scale at 90 days) and risk (symptomatic intracerebral hemorrhage), under both regimens for individual patients. The net advantage for low-dose, relative to standard-dose, alteplase was calculated by dividing excess benefit by excess risk according to a combination of patient characteristics. The algorithms were externally validated in a nationwide acute stroke registry database in South Korea.

Results

Patients with an estimated net advantage from low-dose alteplase, compared with without, were younger (mean age of 66 vs. 75 years), had lower systolic blood pressure (148 vs. 160 mm Hg), lower National Institute of Health Stroke Scale score (median of 8 vs. 16), and no atrial fibrillation (10.3% vs. 97.4%), diabetes mellitus (19.2% vs. 22.4%), or premorbid symptoms (defined by modified Rankin scale = 1) (16.3% vs. 37.8%).

Conclusion

Use of low-dose alteplase may be preferable in acute ischemic stroke patients with a combination of favorable characteristics, including younger age, lower systolic blood pressure, mild neurological impairment, and no atrial fibrillation, diabetes mellitus, or premorbid symptoms.
Comparison of the inverse scattering series free-surface multiple elimination (ISS FSME) algorithm with the industry-standard surface-related multiple elimination (SRME): Defining the circumstances in which each method is the appropriate toolbox choice
Authors: Ma Chao , Fu Qiang , Weglein Arthur B.
Published: June 2019

The industry-standard surface-related multiple elimination (SRME) method provides an approximate predictor of the amplitude and phase of free-surface multiples. This approximate predictor then calls upon an energy-minimization adaptive subtraction step to bridge the difference between the SRME prediction and the actual free-surface multiple. For free-surface multiples that are proximal to other events, the criteria behind energy-minimization adaptive subtraction can be invalid. When applied under these circumstances, a proximal primary can often be damaged. To reduce the dependence on the adaptive process, a more accurate free-surface multiple prediction is required. The inverse scattering series (ISS) free-surface multiple elimination (FSME) method predicts free-surface multiples with accurate time and accurate amplitude of free-surface multiples for a multidimensional earth, directly and without any subsurface information. To quantify these differences, a comparison with analytic data was carried out, confirming that when a free-surface multiple interferes with a primary, applying SRME with adaptive subtraction can and will damage the primary, whereas ISS free-surface elimination will precisely remove the free-surface multiple without damaging the interfering primary. On the other hand, if the free-surface multiple is isolated, then SRME with adaptive subtraction can be a cost-effective toolbox choice. SRME and ISS FSME each have an important and distinct role to play in the seismic toolbox, and each method is the indicated choice under different circumstances.
Traveltime approximation for converted waves in elastic orthorhombic media
Authors: Xu Shibo , Stovas Alexey
Published: June 2019

The moveout approximations are commonly used in seismic data processing such as velocity analysis, modeling, and time migration. The anisotropic effect is very obvious for a converted wave when estimating the physical and processing parameters from the real data. To approximate the traveltime in an elastic orthorhombic (ORT) medium, we defined an explicit rational-form approximation for the traveltime of the converted [Formula: see text]-, [Formula: see text]-, and [Formula: see text]-waves. To obtain the expression of the coefficients, the Taylor-series approximation is applied in the corresponding vertical slowness for three pure-wave modes. By using the effective model parameters for [Formula: see text]-, [Formula: see text]-, and [Formula: see text]-waves, the coefficients in the converted-wave traveltime approximation can be represented by the anisotropy parameters defined in the elastic ORT model. The accuracy in the converted-wave traveltime for three ORT models is illustrated in numerical examples. One can see from the results that, for converted [Formula: see text]- and [Formula: see text]-waves, our rational-form approximation is very accurate regardless of the tested ORT model. For a converted [Formula: see text]-wave, due to the existence of cusps, triplications, and shear singularities, the error is relatively larger compared with PS-waves.
Enhancing subsurface imaging and reservoir characterization in the Marcellus Shale play, northeast Pennsylvania, through advanced reprocessing of wide-azimuth 3D seismic data
Authors: Zhu Jinming , Perll Chris , Coulman Trevor
Published: June 2019

The Marcellus Shale sits in a geologically complicated region, characterized by faults and salt-cored compressional folds. Large lateral velocity variations associated with this complex geology make seismic imaging difficult. Recently acquired 3D seismic with wide azimuthal coverage and long offsets have poorly imaged folds and faults within the Marcellus Shale. Wells drilled using the existing 3D seismic volumes often encounter incorrect bed dips and folds mistakenly interpreted as faults (or vice versa) because of the poor imaging quality. We carefully examined each processing step in the seismic processing and imaging workflow and identified a few key drivers that could potentially lead to improvements in subsurface imaging. Starting from field seismic records, we identified and corrected geometry errors. To improve signal-to-noise ratio, we applied advanced noise attenuation practices including land surface-related multiple elimination. We carefully tested and validated an extension patch in the 5D seismic data interpolation that improved the offset coverage in the crossline direction. Furthermore, we performed orthorhombic prestack time migration (PSTM). An orthorhombic velocity model fits the geology better than the traditional vertical transverse isotropic (VTI) model for layered subsurface because a dominant set of orthogonal fracture sets is present in the basin. We achieved a significant improvement of subsurface imaging by implementation of these processing steps as key drivers. The new orthorhombic PSTM correctly images steeply dipping (75° and above) faults that were elusive or absent on the previous VTI migration. Additionally, previously interpreted faults are now clearly imaged as folds, small and large in scale. These imaging improvements have enabled the accurate drilling of lateral wells in the target that otherwise would have been drilled out of zone. Some large faults, which pass through the Marcellus, Mahantango, and Tully Formations, are now well-imaged but were previously barely visible. Successful imaging of such large faults helps identify and avoid geohazards. The dramatic improvement in the subsurface imaging and amplitude-preserving processing enhance the reservoir description of the Marcellus Shale.
Family separation and emotional bonds: women of Chiapas and Yucatan, Mexico, facing male migration to Quebec, Canada
Authors: Rosales-Mendoza Adriana Leona , Campos-Flores Linamar
Published: June 2019

Scarce attention has been given to the social-emotional problem that men in the Canadian Seasonal Agricultural Workers Program undergo during the migratory process. Even less attention has been placed on their romantic partners. In this article, we inquire into the emotions felt among women from Yucatan and Chiapas, Mexico, while their partners are working in Canada. Our analysis is based on a postcolonial and intersectional perspective, as well as on a socio-anthropological and geographical approach to emotions. The strategy of inquiry is based on the qualitative approach, using a novel method of the evocation of emotion through images (photo-evoking), proposed by the authors.
Endoscopic Removal of Migrated Intrauterine Device: Case Report and Review of Literature and Technique
Authors: Lei Yang , Iablakov Vadim , Karmali Riaz J. , Forbes Nauzer
Published: June 2019

Intrauterine devices (IUDs) are commonly used contraceptive methods. Uterine perforation and device migration are rare but have been/are previously described as adverse events. Migration of the perforated IUD into the bowel is rare and generally requires surgical removal. We describe the endoscopic removal of an IUD embedded in the rectal wall in an otherwise healthy patient. Extraction of the IUD was uncomplicated, well tolerated, and followed by same-day hospital discharge. No prophylactic hemostasis or antimicrobial coverage was needed. We also present a comprehensive review of the reported endoscopic IUD removal. We recommend close investigation and follow-up when pregnancy or other potential signs of IUD migration occur. Endoscopic removal appears to be a safe and cost-effective technique for the extraction of IUDs that migrate into the bowel lumen.
Celiac Artery Portal Vein Fistula After Transjugular Intrahepatic Portosystemic Shunt Presenting as Heart Failure
Authors: Kathi Pradeep Reddy , Thammineni Nikhila , Dhillon Kunwardeep , Kundumadam Shankerdas , Goyal Sachin
Published: June 2019

Transjugular intrahepatic portosystemic shunt (TIPS) is an important therapeutic tool available to decrease portal vein pressure in patients with cirrhosis and portal hypertension. TIPS is associated with various complications, and fistula formation is an important one to be noted. We present an unusual and interesting case of a patient who developed right-sided heart failure 5 months after TIPS placement. Diagnostic workup revealed an uncommon fistula between the celiac artery trunk and portal vein that was successfully treated with angiography-guided embolization, resulting in clinical improvement.
On mixed Lp
John ellipsoids
Authors: Hu Jiaqi , Xiong Ge , Zou Du
Published: June 2019

A new family of ellipsoids associated with a pair of convex bodies in ℝ
n
is introduced, which extends the classical John ellipsoids and the evolved Lp
John ellipsoids in a distinctive way. Analogues of John’s inclusion and Ball’s volume-ratio inequality are established for these new ellipsoids.