bluuebunny/crossref_metadata_2025 huggingface dataset:
The interaction effect of health insurance reimbursement and health workforce on health care‐seeking behaviour in China
Authors: Jin Yinzi , Yuan Beibei , Zhu Weiming , Zhang Yaoguang , Xu Ling , Meng Qingyue
Published: July 2019

Objective

In China, patients generally seek health care at high‐level hospitals, which is leading to escalating medical costs and overloaded hospitals. Some studies have suggested that the health system is an important factor influencing individuals' health care‐seeking behaviour; however, this association has not been studied in much depth. We therefore examined the impact of the health system (in terms of the interaction between health insurance reimbursement and health workforce) on health care‐seeking behaviour.

Methods

Drawing on national survey data from 2008 and 2013, we linked individual‐level data on choice of health care providers (our index of health care‐seeking behaviour) with county‐level data on the health workforce and health insurance. We then constructed a multilevel multinomial logistic model to examine the impacts of health insurance reimbursement (indexed as average reimbursement rate [ARR]) and the health workforce (number of registered physicians per 1000 population) at county hospitals and primary health care institutions (PHCs) on choice of inpatient care providers.

Results

Increases in ARR at county hospitals were associated with a greater probability of visiting such hospitals (relative risk ratio [RRR] = 1.23), and this positive impact was even greater in county hospitals with higher physician densities (RRR = 2.76). Greater ARR in PHCs was associated with a 73% lower probability of visiting municipal‐ and higher‐level hospitals; increasing ARR was associated with an even lower probability when physician density in PHCs was considered (RRR = 0.09).

Conclusion

Increases in the health insurance reimbursement and health workforce are necessary to improve health care access and thereby health care‐seeking behaviour. Thus, comprehensive health system reform is necessary.
Determining the cause of stillbirth in Kumasi, Ghana
Authors: Angell Jennifer N. , Abdul‐Mumin Abdul‐Razak S. , Gold Katherine J.
Published: July 2019

Objective

To classify cause‐of‐death (COD) for stillbirths occurring in a major referral hospital in Kumasi, Ghana.

Methods

In a retrospective review conducted between June 8, 2011, and June 12, 2012, detailed information was collected on all stillbirths delivered at Komfo Anokye Teaching Hospital in Kumasi, Ghana. Patient records were independently reviewed by investigators using the Perinatal Society of Australia and New Zealand's Perinatal Death Classification system to determine COD for each case.

Results

COD was analyzed in 465 stillbirth cases. The leading causes of death were hypoxic interpartum death (105, 22.6%), antepartum hemorrhage (67, 14.4%), hypertension (52, 11.2%), and perinatal infection (32, 6.9%). One hundred and fifty seven (33.8%) stillbirths were classified as unexplained antepartum deaths.

Conclusions

This evaluation of stillbirth in a busy, tertiary care hospital in Kumasi, Ghana provides crucial insight into the high volume of stillbirth in Ghana as well as its medical causes. The study demonstrated the high rate of stillbirth attributed to hypoxic intrapartum events, placental abruption, pre‐eclampsia, and unspecified bacterial infections. Yet, our rate of unexplained stillbirths underscores the need for a stillbirth classification system that thoughtfully integrates the needs and limitations of low‐resource settings as unexplained stillbirth rates are a common indicator of the effectiveness of a classification system.
Comparison of the AV Magnivisualizer device with colposcopy to detect cervical intraepithelial neoplasia using the Swede scoring system
Authors: Dayal Utkarsh , Gupta Bindiya , Hariprasad Roopa , Shriya Rashmi , Rajaram Shalini , Prasad Bhavya , Mehrotra Ravi
Published: July 2019

Objective

To compare the AV Magnivisualizer with colposcopy to detect cervical intraepithelial neoplasia (CIN) using the Swede scoring system.

Methods

Cross‐sectional study conducted in a tertiary care hospital from May 2017 to March 2018. One hundred women with positive results at visual inspection with acetic acid underwent cervical inspection using the Magnivisualizer followed by a colposcope. Biopsies were taken if the Swede score was greater than 4. Pregnant women, women with an obvious cervical growth, acute cervicitis, or prior cervical surgery were excluded. Diagnostic accuracy of the Magnivisualizer and colposcope was calculated for high‐grade lesions (CIN 2/CIN 2+) and agreement was compared between the two modalities.

Results

The sensitivity, specificity, and positive and negative predictive values of the Magnivisualizer were 88.2%, 70.0%, 50.0%, and 94.6%, respectively, to detect high‐grade lesions at a Swede score cutoff of 5 or more. The area under the curve for the Magnivisualizer was 0.80 (95% CI, 0.67–0.92), which was comparable with colposcopy (AUC 0.86; 95% CI, 0.76–0.96). There was very good agreement between the Magnivisualizer and colposcopy (κ=0.865, P<0.001) for high‐grade lesions.

Conclusion

The Magnivisualizer had high diagnostic accuracy to detect high‐grade CIN in screen‐positive women, which was comparable with colposcopy.
Anal prevalence of HPV in women with pre‐malignant lesion or cancer in the cervix and anal canal simultaneously: cross‐sectional study
Authors: Heráclio Sandra A. , de Souza Alex S.R. , Silveira Raquel K. , Torres Leuridan C. , Nunes Maria J.G. , Amorim Melania M.R.
Published: July 2019

Objective

To determine the prevalence of anal HPV genotypes and associated factors in women with pre‐malignant lesion or cancer in the cervix and anal canal.

Methods

A prospective, cross‐sectional study analyzed DNA samples taken from women with cervical pre‐malignant lesions or cancer to identify anal HPV by polymerase chain reaction (PCR). The prevalence of high‐risk HPV (HR‐HPV) in women with intraepithelial neoplasia and anal cancer was calculated; sociodemographic and clinical risk factors were identified using multivariate analysis.

Results

A total of 152 patients were included (mean age 37.8 ± 10.01 years), of whom 101 (66.4%) had anal HR‐HPV. Fourteen different anal HPV types were identified. HPV 16 and 18 were found in 30 (52.6%) anal high‐grade squamous intraepithelial lesions (HSIL), and HPV 31 and 33 in 21 (36.8%) lesions. In the logistic regression analysis, the factors that remained associated with HR‐HPV types were: an anal histopathology report of HSIL or invasive carcinoma (odds ratio [OR] 8.96, 95% confidence interval [CI] 3.40–23.57; P<0.0001) and alcohol consumption (OR 2.20, 95% CI 1.01–4.80; P=0.04).

Conclusion

Prevalence of HR‐HPV is high in the anal canal of women with cervical and anal pre‐malignant lesions simultaneously or cancer of the cervix and/or anal canal. HPV 16, 31, 33, and 18 were the four major genotypes identified.
STATISTICAL DATA COLLECTION METHODOLOGIES OF IRRIGATED AREAS AND THEIR LIMITATIONS: A REVIEW
Authors: Ajaz Ali , Karimi Poolad , Cai Xueliang , De Fraiture Charlotte , Akhter Muhammad Saleem
Published: July 2019

Inconsistencies in the statistical data sets of irrigated areas at the national level could have considerable implications for policies developed for food and water security. Remote sensing can address this issue; however, doubts about its reliability inhibit its protagonist role. Methods that integrate both remote sensing based and statistical data sets seem expedient, and they are more likely to be acknowledged by policymakers. Therefore, it is important for scientists to know the basis and limitations of statistical data sets which originate at the country level. Data collection methodologies of irrigated areas have been reviewed for seven Asian countries, namely China, India, Pakistan, Bangladesh, Nepal, Indonesia and Thailand. Factors causing the uncertainties in data, and the limitations of data collection methodologies, were highlighted. Also, an irrigation density distribution analysis was conducted to understand the relation of spatial spread pattern of irrigated areas and uncertainty in their statistical records. It was found that irrigated area statistics are mostly based on information originating from water user associations and farmers, which is either self‐reported or collected through interviews during surveys and censuses. The main causes of discrepancy were lack of resources to frequently enumerate the irrigated land, inconsistency in data collection methodologies, unaccounted secondary crops, illegal and unregulated water use, and bureaucratic and political constraints. Irrigation density distribution analysis showed that largely scattered irrigated areas might be prone to a lack of comprehensive and frequent enumeration. Furthermore, dense irrigation regions might have potentially unrecorded irrigated areas where temporary or supplementary irrigation arrangements are made by marginal farmers. © 2019 John Wiley & Sons, Ltd.
Nanoscale zerovalent iron particles induce differential cytotoxicity, genotoxicity, oxidative stress and hemolytic responses in human lymphocytes and erythrocytes in vitro
Authors: Ghosh Ilika , Mukherjee Amitava , Mukherjee Anita
Published: July 2019

The growing usage of nanoscale zerovalent iron particles (nZVI) in the remediation of soil, ground/surface water has elicited large‐scale environmental release triggering human exposure. The size of nanomaterials is a key regulator of toxicity. However, the effect of a variable size of nZVI on genotoxicity is unexplored in human cells. To the best of our knowledge, in this study, the cytotoxic, genotoxic and hemolytic potential of nZVI‐1 (15 nm) and nZVI‐2 (50 nm) at concentrations of 5, 10 and 20 μg/mL was evaluated for the first time in human lymphocytes and erythrocytes treated for 3 hours. In erythrocytes, spherocytosis and echinocytosis occurred upon exposure to nZVI‐1 and nZVI‐2, respectively, leading to hemolysis. Lymphocytes treated with 20 μg/mL nZVI‐2 and 10 μg/mL nZVI‐1, incurred maximum DNA damage, although nZVI‐2 induced higher cyto‐genotoxicity than nZVI‐1. This can be attributed to higher Fe ion dissolution and time/concentration‐dependent colloidal destabilization (lower zeta potential) of nZVI‐2. Although nZVI‐1 showed higher uptake, its lower genotoxicity can be due to lesser Fe content, Fe ion dissolution and superior colloidal stability (higher zeta potential) compared with nZVI‐2. Substantial accumulation of Ca2+, superoxide anions, hydroxyl radicals and H2O2 leading to mitochondrial impairment and altered antioxidant enzyme activity was noted at the same concentrations. Pre‐treatment with N‐acetyl‐cysteine modulated these parameters indicating the indirect action of reactive oxygen species in nZVI‐induced DNA damage. The morphology of diffused nuclei implied the possible onset of apoptotic cell death. These results validate the synergistic role of size, ion dissolution, colloidal stability and reactive oxygen species on cyto‐genotoxicity of nZVI and unlock further prospects in its environmental nano‐safety evaluation.
Respiratory exposure to nano‐TiO2 induces pulmonary toxicity in mice involving reactive free radical‐activated TGF‐β/Smad/p38MAPK/Wnt pathways
Authors: Zhou Yingjun , Ji Jianhui , Ji Li , Wang Ling , Hong Fashui
Published: July 2019

Numerous studies have shown that lung injury can be caused by respiratory exposure to nanoparticulate titanium dioxide (nano‐TiO2), but whether pulmonary inflammation and fibrosis are related to the activation of the TGF‐β/Smad/p38MAPK/Wnt pathways remains unclear. In this study, mice were administrated nano‐TiO2 by nasal instillation for nine consecutive months, and the molecular mechanisms of nano‐TiO2 on the pulmonary toxicity of mice were examined. The findings suggested that nano‐TiO2 caused pneumonia and pulmonary fibrosis. Furthermore, the results also showed that an overproduction of reactive free radicals occurred in mouse lungs, and that the expression of TGF‐β/p38MAPK/Wnt pathway‐related factors, including hypoxia‐inducible factor 1α (HIF‐1α), transforming growth factor‐β1 (TGF‐β1), phosphorylated p38 mitogen activated protein kinases (p‐p38MAPK), small mothers against decapentaplegic homolog 2 (Smad2), extracellular matrix (ECM), Wingless/Integrated 3 (Wnt3), Wingless/Integrated 4 (Wnt4), integrin‐linked kinase (ILK), β‐catenin, nuclear factor‐κB (NF‐κB), α‐smooth muscle actin (α‐SMA), c‐Myc, Type I collage (collagen I), and Type collage III (collagen III) were remarkably elevated, while phosphorylated glycogen synthase kinase‐3β (p‐GSK‐3β) expression was decreased. Those data implied that the pulmonary inflammation and fibrosis caused by nano‐TiO2 exposure may be involved in reactive free radical‐mediated activation of the TGF‐β/Smad/p38MAPK/Wnt pathways.
Bisphosphonate Use and Fractures in Adults with Hypophosphatasia
Authors: Rassie Kate , Dray Michael , Michigami Toshimi , Cundy Tim
Published: July 2019

Adults with hypophosphatasia (HPP) may suffer femoral fractures resembling the atypical femoral fractures that can occur with long‐term bisphosphonate treatment, and there is an emerging consensus that bisphosphonates should not be used in adults with HPP and low bone mass. However, the spectrum of HPP in adults is wide: ranging from the severely affected—who commonly have osteomalacia—through to the minimally affected. The former typically have biallelic and the latter, heterozygous ALPL mutations. We have reviewed reports of fractures in adults with genetically proven HPP which suggest that the risk of fracture is at least 200‐fold greater in those with biallelic mutations. We also discuss two cases of postmenopausal women with heterozygous ALPL mutations. One had fractures and severe osteoporosis, but histology revealed no evidence of osteomalacia. The second had taken alendronate for 8 years, but despite profound suppression of bone turnover, histology again revealed no evidence of osteomalacia. The management of adults with HPP who have coexisting osteoporosis is challenging. More data are clearly needed, but we suggest that the risks of bisphosphonate therapy may be relatively low in patients who have heterozygous mutations and no histological evidence of osteomalacia. © 2019 The Authors. JBMR Plus published by Wiley Periodicals, Inc. on behalf of American Society for Bone and Mineral Research © 2019 The Authors. JBMR Plus published by Wiley Periodicals, Inc. on behalf of American Society for Bone and Mineral Research.
siRNA‐mediated NCAM1 gene silencing suppresses oxidative stress in pre‐eclampsia by inhibiting the p38MAPK signaling pathway
Authors: Zhang Xiao‐Lin , Xu Feng‐Xian , Han Xiao‐Yun
Published: July 2019

Pre‐eclampsia (PE), whose pathophysiology and etiology remain undefined, represents a leading consequence of fetal and maternal mortality and morbidity. Oxidative stress (OS) is recognized to involve in this disorder. In this study, we hypothesized that neural cell adhesion molecule 1 (NCAM1) gene silencing would suppress the OS in the pregnancy complicated by PE. Initially, clinical samples were collected for determination of NCAM1 expression in placental tissues and levels of OS products in blood. To assess the regulatory mechanism of NCAM1 knockdown on OS, we used small interfering RNA (siRNA) to silence NCAM1 expression in human umbilical vein endothelial cells (HUVECs). Next, cells were treated with or without hypoxia/reoxygenation to observe the level changes of OS products and p38 mitogen‐activated protein kinase (p38MAPK) pathway‐related genes. Finally, an evaluation of HUVEC migration and invasion abilities was conducted by wound‐healing and transwell assays. Placenta of pregnancy with PE presented significantly increased NCAM1 expression in comparison to placenta of normal pregnancy. Meanwhile, enhanced OS in blood of pregnant women with PE was observed relative to women with normal pregnancy. siRNA‐mediated knockdown of NCAM1 gene could inhibit the p38MAPK signaling pathway, repress OS, and promote cell migration and invasion in HUVECs, indicating that NCAM1 inhibition could reduce the influence of PE. Importantly, blocking the p38MAPK signaling pathway reversed the inhibitory role of NCAM1 gene silencing on PE. Collectively, this study defines potential role of NCAM1 gene silencing as a therapeutic target in PE through inhibiting OS and enhancing HUVEC migration and invasion by disrupting the p38MAPK signaling pathway.
Effect of Lercanidipine on the Pharmacokinetics‐Pharmacodynamics of Carvedilol Enantiomers in Patients With Chronic Kidney Disease
Authors: Hanauer Schaab Estela , Lanchote Vera Lucia , Balthazar Nardotto Glauco Henrique , Marques Pereira Maria Paula , Dantas Márcio , Paiva Carlos Eduardo , Barbosa Coelho Eduardo
Published: July 2019

This study evaluates the carvedilol‐lercanidipine drug interaction, and the influence of chronic kidney disease (CKD) on both drugs. Patients with high blood pressure (8 with normal renal function [control] and 8 with CKD with estimated glomerular filtration rate categories of G3b to G5 [12‐38 mL/min/1.73 m2]) were included and prescribed 3 different treatment regimens, a single oral dose of racemic carvedilol 25 mg (CAR), a single oral dose of racemic lercanidipine 20 mg (LER), and single oral doses of CAR plus LER. Blood samples were collected and variations in heart rate were assessed (using isometric exercise with handgrip) for up to 32 hours. Lercanidipine pharmacokinetics were not enantioselective, and were not affected by carvedilol and CKD. Carvedilol pharmacokinetics (data presented as median) were enantioselective with higher plasma exposure of (R)‐(+)‐carvedilol in both control (103.5 vs 46.0 ng ∙ h/mL) and CKD (190.6 vs 98.9 ng ∙ h/mL) groups. Lercanidipine increased the area under the plasma concentration–time curve of only (R)‐(+)‐carvedilol in the CKD group (190.6 vs 242.2 ng ∙ h/mL) but not in the control group (103.5 vs 98.7 ng ∙ h/mL). CKD increased plasma exposure (46.0 vs 98.9 ng ∙ h/mL) and effect‐compartment exposure (5.5 vs 20.9 ng ∙ h/mL) to (S)‐(–)‐carvedilol, resulting in higher β‐adrenergic inhibition (10.0 vs 6.1 bpm). Therefore, carvedilol dose titration in CKD patients with estimated glomerular filtration rate categories of G3b to G5 should be initiated, with no more than half the dose used for patients with normal renal function.
Efficient Synthesis and Antimicrobial Evaluation of New Azolopyrimidines‐Bearing Pyrazole Moiety
Authors: Abdelhamid Abdou O. , Gomha Sobhi M. , El‐Enany Waleed A. M. A.
Published: July 2019

Sodium salt of 3‐hydroxy‐1‐(1‐aryl‐5‐methylpyrazolyl)propenone derivatives was used as a precursor for synthesis of various fused azolopyrimidine ring systems as pyrazolopyrimidines, triazolopyrimidines, and pyrimidobenzimidazoles following many procedures. The identity of the prepared compounds was elucidated by their spectral data and elemental analyses. The in vitro antimicrobial activity of 13 new compounds was evaluated, and many derivatives showed good to moderate activity.
Assessing risk for HIV infection among adolescent girls in South Africa: an evaluation of the VOICE risk score (HPTN 068)
Authors: Giovenco Danielle , Pettifor Audrey , MacPhail Catherine , Kahn Kathleen , Wagner Ryan , Piwowar‐Manning Estelle , Wang Jing , Hughes James P
Published: July 2019

Introduction

To maximize impact and minimize costs, antiretroviral pre‐exposure prophylaxis (PrEP) interventions should be offered to those at highest risk for HIV infection. The risk score derived from the VOICE trial is one tool currently being utilized to determine eligibility in adolescent PrEP trials in sub‐Saharan Africa. This study is aimed at evaluating the utility of the risk score in predicting HIV incidence among a cohort of adolescent girls in rural South Africa.

Methods

We utilized data from HIV Prevention Trials Network (HPTN) 068, a phase III randomized controlled trial conducted in rural Mpumalanga province, South Africa. School‐attending young women aged 13 to 20 years were enrolled into the trial from 2011 to 2012 and followed for up to three years. A risk score based on individual‐level risk factors measured at enrolment was calculated for HPTN 068 participants who completed a one‐year follow‐up visit and were HIV seronegative at enrolment. Possible scores ranged from 0 to 10. A proportional hazards model was then used to determine if risk score at enrolment was predictive of incident HIV infection at follow‐up and an area under the curve analysis was used to examine the predictive ability of the score.

Results and Discussion

The risk score had limited variability in the HPTN 068 sample. Scores ≥5 identified 85% of incident infections from 94% of the sample, compared to the VOICE sample in which scores ≥5 identified 91% of incident infections from only 64% of participants. The risk score did not predict HIV incidence after one year of follow‐up (hazard ratio = 1.029; 95% confidence interval (CI): 0.704, 1.503, p = .884) and showed poor predictive ability (area under the curve = 0.55; 95% CI: 0.44, 0.65). Certain individual risk factors that comprise the risk score may be context specific or not relevant for adolescent populations. Additional factors should be considered when assessing risk for the purposes of determining PrEP eligibility.

Conclusions

The VOICE risk score demonstrated low utility to predict HIV incidence in the HPTN 068 sample. Findings highlight the need for an age and developmentally appropriate tool for assessing risk for HIV infection among adolescents. Use of the VOICE risk score for determining PrEP eligibility in younger populations should be carefully considered.
Profiling the interaction of 1‐phenylbenzimidazoles to cyclooxygenases
Authors: Gómez‐Castro Carlos Z. , López‐Martínez Margarita , Hernández‐Pineda Jessica , Trujillo‐Ferrara José G. , Padilla‐Martínez Itzia I.
Published: July 2019

In the design of 1‐phenylbenzimidazoles as model cyclooxygenase (COX) inhibitors, docking to a series of crystallographic COX structures was performed to evaluate their potential for high‐affinity binding and to reproduce the interaction profile of well‐known COX inhibitors. The effect of ligand‐specific induced fit on the calculations was also studied. To quantitatively compare the pattern of interactions of model compounds to the profile of several cocrystallized COX inhibitors, a geometric parameter, denominated ligand‐receptor contact distance (LRCD), was developed. The interaction profile of several model complexes showed similarity to the profile of COX complexes with inhibitors such as iodosuprofen, iodoindomethacin, diclofenac, and flurbiprofen. Shaping of high‐affinity binding sites upon ligand‐specific induced fit mostly determined both the affinity and the binding mode of the ligands in the docking calculations. The results suggest potential of 1‐phenylbenzimidazole derivatives as COX inhibitors on the basis of their predicted affinity and interaction profile to COX enzymes. The analyses also provided insights into the role of induced fit in COX enzymes. While inhibitors produce different local structural changes at the COX ligand binding site, induced fit allows inhibitors in diverse chemical classes to share characteristic interaction patterns that ensure key contacts to be achieved. Different interaction patterns may also be associated with different inhibitory mechanisms.
Identification and evaluation of quercetin as a potential inhibitor of naphthoate synthase from Enterococcus faecalis
Authors: Das Satyajeet , Batra Sagar , Gupta Pramodkumar P. , Kumar Mukesh , Srivastava Vijay Kumar , Jyoti Anupam , Singh Nagendra , Kaushik Sanket
Published: July 2019

Enterococcus faecalis is a gram‐positive, rod‐shape bacteria responsible for around 65% to 80% of all enterococcal nosocomial infections. It is multidrug resistant (MDR) bacterium resistant to most of the first‐line antibiotics. Due to the emergence of MDR strains, there is an urgent need to find novel targets to develop new antibacterial drugs against E. faecalis. In this regard, we have identified naphthoate synthase (1,4‐dihydroxy‐2‐naphthoyl‐CoA synthase, EC: 4.1.3.36; DHNS) as an anti‐E. faecalis target, as it is an essential enzyme for menaquinone (vitamin K2) synthetic pathway in the bacterium. Thus, inhibiting naphtholate synthase may consequently inhibit the bacteria's growth. In this regard, we report here cloning, expression, purification, and preliminary structural studies of naphthoate synthase along with in silico modeling, molecular dynamic simulation of the model and docking studies of naphthoate synthase with quercetin, a plant alkaloid. Biochemical studies have indicated quercetin, a plant flavonoid as the potential lead compound to inhibit catalytic activity of EfDHNS. Quercetin binding has also been validated by spectrofluorimetric studies in order to confirm the bindings of the ligand compound with EfDHNS at ultralow concentrations. Reported studies may provide a base for structure‐based drug development of antimicrobial compounds against E. faecalis.
Characterization of the full‐length human Grb7 protein and a phosphorylation representative mutant
Authors: Bradford Andrew M. , Koirala Rajan , Park Chad K. , Lyons Barbara A.
Published: July 2019

It is well known the dimerization state of receptor tyrosine kinases (RTKs), in conjunction with binding partners such as the growth factor receptor bound protein 7 (Grb7) protein, plays an important role in cell signaling regulation. Previously, we proposed, downstream of RTKs, that the phosphorylation state of Grb7SH2 domain tyrosine residues could control Grb7 dimerization, and dimerization may be an important regulatory step in Grb7 binding to RTKs. In this manner, additional dimerization‐dependent regulation could occur downstream of the membrane‐bound kinase in RTK‐mediated signaling pathways. Extrapolation to the full‐length (FL) Grb7 protein, and the ability to test this hypothesis further, has been hampered by the availability of large quantities of pure and stable FL protein. Here, we report the biophysical characterization of the FL Grb7 protein and also a mutant representing a tyrosine‐phosphorylated Grb7 protein form. Through size exclusion chromatography and analytical ultracentrifugation, we show the phosphorylated‐tyrosine‐mimic Y492E‐FL‐Grb7 protein (Y492E‐FL‐Grb7) is essentially monomeric at expected physiological concentrations. It has been shown previously the wild‐type FL Grb7(WT‐FLGrb7) protein is dimeric with a dissociation constant (Kd) of approximately 11μM. Our studies here measure a FL protein dimerization Kd of WT‐FL‐Grb7 within one order of magnitude at approximately 1μM. The approximate size and shape of the WT‐FL‐Grb7 in comparison the tyrosine‐phosphorylation mimic Y492E‐FL‐Grb7 protein was determined by dynamic light scattering methods. In vitro phosphorylation of the Grb7SH2 domain indicates only one of the available tyrosine residues is phosphorylated, suggesting the same phosphorylation pattern could be relevant in the FL protein. The biophysical characterization studies in total are interpreted with a view towards understanding the functionally active Grb7 protein conformation.
Trends in precipitation days in the United States
Authors: Bartels Rudy J. , Black Alan W. , Keim Barry D.
Published: July 2019

Changes in precipitation frequency can have a major impact on many different sectors including agriculture, tourism, and recreation. This study investigates trends in precipitation days at first‐order weather stations across the conterminous United States from 1951 to 2015. The Mann‐Kendall test and sliding window correlation analysis are used to examine trends over time. Future precipitation days are forecasted via usage of a stepwise auto‐regressive model. The Mann‐Kendall test found that the majority of the Northeast and Midwestern states show upward trends in precipitation days, while negative trends are located in the Southeast and in clusters throughout the Northwest. Sliding window correlation analysis was used to detect the decade when most of the change in precipitation days occurred. The northeastern United States had more significant changes during the earlier decades whereas the centre part of the country had more significant changes in the later decades. Most stations saw more decades with positive (increasing) trends in precipitation days. Precipitation days are expected to increase for most of the United States into the future.
Associations of electronic and conventional cigarette use with periodontal disease in South Korean adults
Authors: Jeong Wonjeong , Choi Dong‐Woo , Kim Yun Kyung , Lee Hyeon Ji , Lee Sang Ah , Park Eun‐Cheol , Jang Sung‐In
Published: July 2019

Background

The aim of this study was to examine the association of conventional cigarette smoking and electronic cigarette vaping with periodontal disease in South Korean adults.

Methods

For this study, data from 13,551 participants, a subset derived from the Korean National Health and Nutrition Examination Survey conducted between 2013 and 2015, were examined. Participants were divided into four categories: electronic cigarettes vapers, conventional cigarettes smokers, ex‐users, and non‐users. Periodontal status was measured by the Community Periodontal Index. Multiple logistic regression analysis was performed to examine the association of periodontal disease with smoking and vaping individually.

Results

Out of 187 men and 35 women who vape electronic cigarette, 67 (35.8%) men and 10 (28.6%) women had periodontal diseases. Out of 1,957 men and 363 women who smoke conventional cigarettes, 861 (44.0%) men and 121 (35.3%) women had periodontal diseases. Periodontal disease was more prevalent in each vapers and smokers than non‐users in men (electronic cigarettes: odds ratio [OR] = 2.34, 95% confidence interval [CI] = 1.52 to 3.59, conventional cigarettes: OR = 2.17, 95% CI = 1.76 to 2.68). Furthermore, both vaping and smoking had significant relation to dental caries, toothache, and dental damages.

Conclusions

Electronic and conventional cigarette use was each significantly associated with increased periodontal disease rates. After adjusting for demographic, socioeconomic, and health‐related characteristics, both vaping and smoking each had significant association with periodontal diseases. Therefore, this study suggests that vaping may not be a safe alternative to smoking. Cessation of both types of cigarettes is necessary for maintaining oral health.
Topographic controls on plateau icefield recession: insights from the Younger Dryas Monadhliath Icefield, Scotland
Authors: Boston Clare M. , Lukas Sven
Published: July 2019

Plateau icefields are a common form of mountain ice mass, frequently found in mid‐latitude to high‐arctic regions and increasingly recognized in the Quaternary record. Their top‐heavy hypsometry makes them highly sensitive to changes in climate when the equilibriaum line altitude (ELA) lies above the plateau edge, allowing ice to expand significantly as regional ELAs decrease, and causing rapid recession as climate warms. With respect to future climate warming, it is important to understand the controls on plateau icefield response to climate change in order to better predict recession rates, with implications for water resources and sea‐level rise. Improving knowledge of the controls on glacier recession may also enable further palaeoclimatic information to be extracted from the Quaternary glacial record. We use the distribution of moraines to examine topographic controls on Younger Dryas icefield recession in Scotland. We find that overall valley morphology influences the style of recession, through microclimatic and geometric controls, with bed gradient affecting moraine spacing. Ice mass reconfiguration may occur as recession progresses because ice divide migration could alter the expected response based on hypsometric distribution. These results add to a growing body of research examining controls on glacier recession and offer a step towards unravelling non‐linear ice mass behaviour. Copyright © 2019 John Wiley & Sons, Ltd.
Fabrication of Ag‐modified nanocone frustum arrays with controlled shape as active substrates for surface‐enhanced Raman scattering
Authors: Mehrvar Leila , Sadeghipari Mehrnoosh , Tavassoli Seyed Hassan , Mohajerzadeh Shamsoddin , Fathipour Morteza , Hajihosseini Hamid reza
Published: July 2019

Surface‐enhanced Raman scattering (SERS) substrates utilizing the interparticle nanogaps as hot spots can provide ultrasensitive and geometry‐dependent enhancement factors in analyte detection. Here, we report theoretical and experimental studies on the optical properties of Ag nanoparticles‐decorated Si‐nanocone frustum (NCF) arrays with various geometrical dimensions to enable engineering of the most effective SERS substrate. Our fabrication steps include electron beam lithography, deep reactive‐ion etching, and metallization. In this regard, the effect of geometrical parameters including height, diameter, and slant angle, associated with Si‐NCF arrays, on optical properties and SERS effect are investigated. Results show that the NCF array with larger height and slant angle exhibit higher antireflection property and excellent performance for low‐concentration analyte molecules detection. Furthermore, our results show that the excitation of Mie resonances in NCF arrays leads to formation of near electric field distributions and enhancement of Si Raman lines. It is demonstrated that the strength of Si Raman line follows the trend of the integrated near electric fields in the excitation volume.
Morbidity, mortality and temporal trends in the surgical management of retroperitoneal sarcoma: An ACS‐NSQIP follow up analysis
Authors: Judge Sean J. , Lata‐Arias Kathleen , Yanagisawa Mio , Darrow Morgan A. , Monjazeb Arta M. , Kirane Amanda R. , Bold Richard J. , Canter Robert J. , Canter Daniel J.
Published: July 2019

Background

Calls for multivisceral resection (MVR) of retroperitoneal sarcoma (RPS) are increasing, although the risks and benefits remain controversial. We sought to analyze current 30‐day morbidity and mortality rates, and trends in utilization of MVR in a national database.

Methods

Overall morbidity, severe morbidity, mortality rates, and temporal trends were analyzed utilizing the American College of Surgeons National Surgical Quality Improvement Program (ACS‐NSQIP).

Results

From 2012 to 2015, a total of 564 patients underwent RPS resection with 233 patients (41%) undergoing MVR. The MVR group had a higher rate of preoperative weight loss and larger tumors overall. When comparing MVR to non‐MVR, there was no significant difference in overall morbidity (22% vs 17%, P = .13), severe morbidity (11% vs 8%, P = .18), or mortality (<1% vs 2%, P = .25). On multivariate analysis, MVR was not associated with increased overall morbidity or severe morbidity. Mortality rates were too low for meaningful statistical analysis. Annual rates of MVR ranged from 37% to 46% with no significant change over time (P = .47).

Results

Short‐term morbidity and mortality rates after MVR for RPS remain acceptable, but rates of MVR show little change over time in NSQIP hospitals. Concerns about increased morbidity and mortality should not be viewed as a contraindication to wider implementation of MVR for RPS.
The impact of social determinants of health on laryngotracheal stenosis development and outcomes
Authors: Dang Sabina , Shinn Justin R. , Campbell Benjamin R. , Garrett Gaelyn , Wootten Christopher , Gelbard Alexander
Published: July 2019

Objectives

The social determinants of health affect a wide range of health outcomes and risks. To date, there have been no studies evaluating the impact of social determinants of health on laryngotracheal stenosis (LTS). We sought to describe the social determinants in a cohort of LTS patients and explore their association with treatment outcome.

Methods

Subjects diagnosed with LTS undergoing surgical procedures between 2013 and 2018 were identified. Matched controls were identified from intensive care unit (ICU) patients who underwent intubation for greater than 24 hours. Medical comorbidities, stenosis characteristics, and patient demographics were abstracted from the clinical record. Tracheostomy at last follow‐up was recorded from the medical record and phone calls. Socioeconomic data was obtained from the American Community Survey.

Results

One hundred twenty‐two cases met inclusion criteria. Cases had significantly lower education compared to Tennessee (P = .009) but similar education rates as ICU controls. Cases had significantly higher body mass index (odds ratio [OR]: 1.04, P = .035), duration of intubation (OR: 1.21, P < .001), and tobacco use (OR: 1.21, P = .006) in adjusted analysis when compared to controls. Tracheostomy dependence within the case cohort was significantly associated with public insurance (OR: 1.33, P = .016) and chronic obstructive pulmonary disease (OR: 1.34, P = .018) in adjusted analysis.

Conclusion

Intubation practices, medical comorbidities and social determinants of health may influence the development of LTS and tracheostomy dependence after treatment. Identification of at‐risk populations in ICUs may allow for prevention of tracheostomy dependence through the use of early tracheostomy and specialized follow‐up.

Level of Evidence

Level 3, retrospective review comparing cases and controls Laryngoscope, 130:1000–1006, 2020
Neutrally expandable models of arithmetic
Authors: Abdul‐Quader Athar , Kossak Roman
Published: July 2019

A subset of a model of is called neutral if it does not change the relation. A model with undefinable neutral classes is called neutrally expandable. We study the existence and non‐existence of neutral sets in various models of . We show that cofinal extensions of prime models are neutrally expandable, and ω1‐like neutrally expandable models exist, while no recursively saturated model is neutrally expandable. We also show that neutrality is not a first‐order property. In the last section, we study a local version of neutral expandability.
A variant of Shelah's characterization of Strong Chang's Conjecture
Authors: Cox Sean , Sakai Hiroshi
Published: July 2019

Shelah considered a certain version of Strong Chang's Conjecture which we denote , and proved that it is equivalent to several statements, including the assertion that Namba forcing is semiproper. We introduce an apparently weaker version, denoted , and prove an analogous characterization of it. In particular, is equivalent to the assertion that the the Friedman‐Krueger poset is semiproper. This strengthens and sharpens results by Cox and sheds some light on problems posed by Usuba, Torres‐Perez and Wu.
Mental health groups vow to fight judge's STLDI plan ruling
Authors: Canady Valerie A.
Published: July 2019

The decades‐long fight for parity continues as mental health and consumer groups vow to fight a recent ruling by a federal district judge that will allow for the expanded sale of short‐term, limited‐duration insurance (STLDI) plans, which they say are discriminatory and would harm people with mental illness.
Incorporating boundary conditions in a stochastic volatility model for the numerical approximation of bond prices
Authors: Gómez‐Valle Lourdes , López‐Marcos Miguel Ángel , Martínez‐Rodríguez Julia
Published: July 2019

In this paper, we consider a two‐factor interest rate model with stochastic volatility, and we assume that the instantaneous interest rate follows a jump‐diffusion process. In this kind of problems, a two‐dimensional partial integro‐differential equation is derived for the values of zero‐coupon bonds. To apply standard numerical methods to this equation, it is customary to consider a bounded domain and incorporate suitable boundary conditions. However, for these two‐dimensional interest rate models, there are not well‐known boundary conditions, in general. Here, in order to approximate bond prices, we propose new boundary conditions, which maintain the discount function property of the zero‐coupon bond price. Then, we illustrate the numerical approximation of the corresponding boundary value problem by means of an alternative direction implicit method, which has been already applied for pricing options. We test these boundary conditions with several interest rate pricing models.
Standard Assessments Reveal Context-Dependent Responses of Crappie Populations to a Length-Based Regulation in Ohio Reservoirs
Authors: Pritt Jeremy J. , Conroy Joseph D. , Page Kevin S. , Tyszko Stephen M. , Zweifel Richard D.
Published: July 2019

Fisheries managers implement minimum length limits (MLLs) to improve the size structure of populations of crappie Pomoxis spp. throughout Midwestern and southeastern U.S. reservoirs. The success of these regulations has been mixed, with several implementations resulting in undesirable outcomes, including slow growth and stunting of crappies, and ultimately regulation removal. Consequently, it is unclear whether and where MLLs should be used to improve crappie size structure. Beginning in 2003, Ohio instituted a statewide standard sampling protocol to monitor reservoir crappie populations, and between 2003 and 2010 a 229-mm MLL was implemented at over 40 reservoirs throughout the state. Using these spatially and temporally extensive crappie population data, we sought to (1) test for the response of crappie population adult abundance, growth, and size structure to the MLL, (2) test whether reservoir surface area and/or productivity mediated this response, and (3) model fisheries outcomes at different reservoir sizes and productivities to predict where application of a MLL would be most appropriate. Using linear mixed-effects models and an information theoretic approach, we found that crappie population abundances generally increased, whereas growth decreased in small, unproductive reservoirs but increased in large, productive reservoirs. Overall, the MLL failed to produce increases in size structure, except in large reservoirs. Yield-per-recruit models predicted a decrease in angler yield in response to a 229-mm MLL in small reservoirs, whereas in large, productive reservoirs this regulation was predicted to increase angler yield. Consequently, the MLL could improve crappie fisheries in reservoirs larger than 1,000 ha with high productivity (total phosphorus concentrations > 50 μg/L) but could be counterproductive in small, unproductive reservoirs. Finally, our approach highlights the benefits of standard sampling as we were able to integrate data across years and reservoirs to make comparisons on a statewide scale.
A new versatile constitutive law for modelling the monotonic response of soft rocks and structured fine‐grained soils
Authors: Boldini Daniela , Palmieri Francesca , Amorosi Angelo
Published: July 2019

This paper deals with a new critical state–based constitutive model for soft rocks and fine‐grained soils. The model, formulated in the single‐surface plasticity framework, is characterised by the following main features: (i) a generalised three‐invariant yield surface capable of reproducing a wide set of well‐known criteria, (ii) the dependency of the elastic stiffness on the current stress state by means of a hyperelastic formulation, (iii) the ability of simulating the plastic strain–driven structure degradation processes by a set of appropriate isotropic hardening laws, and (iv) a nonassociate flow rule in the meridian plane. The adopted formulation is hierarchical, such that the various features of the model can be activated or excluded depending on the specific kind of geomaterial to be modelled and on the quality and quantity of the related available experimental results. The constitutive model was implemented in a commercial finite element code by means of an explicit modified Euler scheme with automatic substepping and error control. The procedure does not require any form of stress correction to prevent drift from the yield surface. The performance of the model is first analysed by means of a wide set of parametric analyses, in order to highlight the main features and to evaluate the sensitivity of the formulation with reference to the input parameters. The model is then adopted to simulate the experimental response observed on three different geomaterials, ranging from soft clays to soft rocks.
Robust topology optimization under load position uncertainty
Authors: Wang Dong , Gao Weifeng
Published: July 2019

The topology optimization problem of a continuum structure on the compliance minimization objective is investigated under consideration of the external load uncertainty in its application position with a nonprobabilistic approach. The load position is defined as the uncertain‐but‐bounded parameter and is represented by an interval variable with a nominal application point. The structural compliance due to the load position deviation is formulated with the quadratic Taylor series expansion. As a result, the objective gradient information to the topological variables can be evaluated efficiently in a quadratic expression. Based on the maximum design sensitivity value, which corresponds to the most sensitive compliance to the uncertain loading position, a single‐level optimization approach is suggested by using a popular gradient‐based optimality criteria method. The proposed optimization scheme is performed to gain the robust topology optimizations of three benchmark examples, and the final configuration designs are compared comprehensively with the conventional topology optimizations under the loading point fixation. It can be observed that the present method can provide remarkably different material layouts with auxiliary components to accommodate the load position disturbances. The numerical results of the representative examples also show that the structural performances of the robust topology optimizations appear less sensitive to the load position perturbations than the traditional designs.
Prevalence of human papillomavirus type 16 in persistent oral lesions arising in patients with tobacco, areca nut, and alcohol habits
Authors: Khowal Sapna , Jain Swatantra Kumar , Wajid Saima
Published: July 2019

Background and purpose

Human papillomavirus (HPV) has been shown to be associated with oral malignancies. The purpose of this study was to detect HPV and a high‐risk type HPV16 viral DNA in 24 cases with oral squamous cell carcinoma (OSCC) and 15 cases with non‐OSCC persistent oral lesions (POL) residing in North India. The diagnosis was determined by the histopathological characteristics of the oral biopsy.

Results

All oral lesions were HPV‐DNA positive, and the HPV16‐positive ratios of OSCC and non‐OSCC POLs were 50% and 53%, respectively. Approximately 62% of moderately differentiated OSCC and 36% of well‐differentiated OSCC were HPV16 positive. Evaluated odds and prevalence ratios >1 indicated a higher prevalence of HPV16 infection in patients with tobacco, areca nut, and/or alcohol habits, compared with nonaddicts. The obtained P‐values were higher than 0.05, indicating that the relationship is statistically insignificant, which may be due to lower number of POL cases. This study could not conclude that HPV16 infection plays an essential role in malignant transformation of the oral mucosa, raising a need for further experimental endeavors.

Conclusions

This study indicates that HPV16 infection in OSCC and non‐OSCC POLs frequently occurred in people with tobacco smoking, tobacco‐areca nut chewing, and alcohol intake. These fallacious habits may increase HPV16 infection in the oral cavity.