bluuebunny/crossref_metadata_2025 huggingface dataset:
Benign and Malignant Thyroid Incidentalomas Are Rare in Routine Clinical Practice: A Review of 97,908 Imaging Studies
Authors: Uppal Abhineet , White Michael G. , Nagar Sapna , Aschebrook-Kilfoy Briseis , Chang Paul J. , Angelos Peter , Kaplan Edwin L. , Grogan Raymon H.
Published: July 2015

Purpose: Thyroid nodules incidentally identified on imaging are thought to contribute to the increasing incidence of thyroid cancer. We aim to determine the true rate of incidental thyroid nodule reporting, malignancy rates of these nodules, and to compare these findings with rates of detection by dedicated radiology review.

Methods: A cross-sectional analysis was done to determine the prevalence of thyroid nodules in radiologist reports by analyzing all reports for CT, PET, and MRI scans of the head, neck, and chest as well as neck ultrasounds performed at a tertiary care center from 2007 to 2012. Retrospective chart review was performed on patients with a reported thyroid nodule to determine clinical outcomes of these nodules. Radiology reports were compared with dedicated radiology review of 500 randomly selected CT scans from the study group to determine the difference between clinical reporting and actual prevalence of thyroid nodules.

Results: 97,908 imaging studies met inclusion criteria, and 387 (0.4%) thyroid incidentalomas were identified on radiology report. One hundred and sixty three (42.1%) of these nodules were worked up with fine-needle aspiration, diagnosing 27 thyroid cancers (0.03% of all studies, 7.0% of reported incidentalomas). The prevalence of incidentalomas clinically reported was 142/100,000 CT scans, 638/100,000 MRIs, 358/100,000 PET scans, and 6,594/100,000 ultrasounds. In contrast, review of CT scans screening for thyroid nodules had a prevalence of 10%.

Conclusion: Routine clinical reporting of incidental thyroid nodules is far less common than on dedicated review.

Impact: These data contradict the notion that incidentalomas contribute significantly to rising thyroid cancer rates. Cancer Epidemiol Biomarkers Prev; 24(9); 1327–31. ©2015 AACR.
Leukoplakia, Oral Cavity Cancer Risk, and Cancer Survival in the U.S. Elderly
Authors: Yanik Elizabeth L. , Katki Hormuzd A. , Silverberg Michael J. , Manos M. Michele , Engels Eric A. , Chaturvedi Anil K.
Published: July 2015

Screening for oral leukoplakia, an oral cavity cancer (OCC) precursor, could lead to earlier detection of OCC. However, the progression rate from leukoplakia to OCC and the benefits of leukoplakia screening for improving OCC outcomes are currently unclear. We conducted a case–cohort study of U.S. adults ages ≥65 years in the Surveillance, Epidemiology, and End Results (SEER)-Medicare linkage. We identified leukoplakia diagnoses through Medicare claims, and OCC diagnoses through SEER cancer registries. Weighted Cox regression was used to estimate leukoplakia associations with OCC incidence, and the absolute OCC risk following leukoplakia diagnosis was calculated. Among OCC cases, we compared OCC stage and OCC survival between cases with a prior leukoplakia diagnosis versus those without prior leukoplakia. Among 470,266 individuals in the SEER-Medicare subcohort, 1,526 (0.3%) had a leukoplakia diagnosis. Among people with leukoplakia, the cumulative OCC incidence was 0.7% at 3 months and 2.5% at 5 years. OCC risk was most increased <3 months after leukoplakia diagnosis (HR, 115), likely representing the diagnosis of prevalent cancers. Nonetheless, risk remained substantially increased in subsequent follow-up [HR ≥ 3 months, 24; 95% confidence interval (CI), 22–27; HR ≥ 12 months, 22, 95% CI, 20–25]. Among OCC cases (N = 8,927), those with prior leukoplakia were less likely to be diagnosed at regional/distant stage (OR, 0.36; 95% CI, 0.30–0.43), and had lower mortality (HR, 0.74; 95% CI, 0.65–0.84) when compared with OCC cases without a prior leukoplakia. Individuals with leukoplakia have substantially elevated risk of OCC. Lower stage and better survival after OCC diagnosis suggest that leukoplakia identification can lead to earlier OCC detection and reduced mortality. Cancer Prev Res; 8(9); 857–63. ©2015 AACR.
Non-Coding RNAs in Cardiac Aging
Authors: Wang Hui , Bei Yihua , Shi Jing , Xiao Junjie , Kong Xiangqing
Published: July 2015

Aging has a remarkable impact on the function of the heart, and is independently associated with increased risk for cardiovascular diseases. Cardiac aging is an intrinsic physiological process that results in impaired cardiac function, along with lots of cellular and molecular changes. Non-coding RNAs include small transcripts, such as microRNAs and a wide range of long non-coding RNAs (lncRNAs). Emerging evidence has revealed that non-coding RNAs acted as powerful and dynamic modifiers of cardiac aging. This review aims to provide a general overview of non-coding RNAs implicated in cardiac aging, and the underlying mechanisms involved in maintaining homeo-stasis and retarding aging.
Human Dental Pulp Stem Cells via the NF-κB Pathway
Authors: Gu Shensheng , Ran Shujun , Qin Feng , Cao Dong , Wang Jia , Liu Bin , Liang Jingping
Published: July 2015

Background/Aims: Odontogenic differentiation of human dental pulp stem cells (HDPSCs) is regulated by multiple factors and signaling molecules. However, their regulatory mechanisms are not completely understood. In this study, we investigated the role of Zinc finger and BTB domain-containing 20 (ZBTB20) in odontoblastic differentiation of HDPSCs. Methods: HDPSCs were obtained from human third molars and ZBTB20 expression was examined by qRT-PCR and western blot. Their osteo/odontogenic differentiation and the involvement of NF-κB pathway were subsequently investigated. Results: The expression of ZBTB20 is upregulated in a time-dependent manner during odontogenic differentiation of hDPSCs. Inhibition of ZBTB20 reduced osteogenic medium (OM)-induced odontogenic differentiation, reflected in decreased alkaline phosphatase (ALP) activity, mineralized nodule formation and mRNA expression of odonto/osteogenic marker genes. In contrast, overexpression of ZBTB20 enhanced ALP activity, mineralization and the expression of differentiation marker genes. Furthermore, the expression of IκBa was increased by ZBTB20 silencing in HDPSCs, whereas ZBTB20 overexpression decreased IκBa and enhanced nuclear NF-κB p65. Inhibition of the NF-κB pathway significantly suppressed the odontogenic differentiation of HDPSCs induced by ZBTB20. Conclusion: This study shows for the first time that ZBTB20 plays an important role during odontoblastic differentiation of HDPSCs and may have clinical implications for regenerative endodontics.
Dehydroepiandrosterone-Regulated Testosterone Biosynthesis via Activation of the ERK1/2 Signaling Pathway in Primary Rat Leydig Cells
Authors: Liu Lin , Kang Jian , Ding Xiao , Chen Di , Zhou Yingqiao , Ma Haitian
Published: July 2015

Background: Dehydroepiandrosterone decreases with age and this reduction has been shown to be associated with physical health in human. Some studies have suggested that the effects of DHEA are exerted after it is biotransformed into more biologically-active hormones in peripheral target cells. This study investigated the effects of DHEA on the testosterone biosynthesis and possible signaling pathway mechanism underlying these DHEA effects were also explored in primary rat Leydig cells. Methods: Primary Leydig cells were treated with DHEA and then detected testosterone content by RIA and steroidogenic enzymes, ERK1/2 signal pathway factors protein expression level by Western blot. Results: Incubation of primary Leydig cells with DHEA significantly increased testosterone content and 3β-HSD and 17β-HSD protein expression levels, while aromatase protein expression levels were decreased. Compared with the control group, p-ERK1/2 and p-CREB protein levels were significantly increased in DHEA-treated groups. Testosterone content was significantly decreased in the DHEA-treated group pre-incubated with U0126 (p-ERK1/2 inhibitor). Additionally, the rise in p-ERK1/2, 3β-HSD and 17β-HSD protein levels induced by DHEA was reversed when cells were pre-incubated with U0126. Interestingly, no significant difference was found in aromatase protein expression level in cells pretreated with U0126. Conclusion: These findings demonstrate that (a) exogenous DHEA might preferentially convert to testosterone rather than estradiol due to the up-regulation of 3β-HSD and 17β-HSD protein levels and the down-regulation of aromatase protein level in primary Leydig cells, and (b) the action of DHEA is at least partly associated with the elevation of p-ERK1/2 and p-CREB protein levels.
Adiponectin and Endometrial Cancer: A Systematic Review and Meta-Analysis
Authors: Zeng Fangxin , Shi Jinyu , Long Yang , Tian Haoming , Li Xiaoxi , Zhao Allan Z. , Li Rose Fanghong , Chen Tao
Published: July 2015

Objective: This study evaluates the association between serum adiponectin concentrations and the risk of endometrial cancer through a comprehensive meta-analysis of currently available clinical data. Methods: PubMed, Embase, the Chinese Biomedical Literature Database and the Science Citation Index (ISI Web of Science) were searched for studies that examined the association between blood adiponectin concentrations and the risk of endometrial cancer. Data from studies that met the inclusion criteria were systematically reviewed, and pooled analyses were performed according to the guidelines of Meta-Analysis of Observational Studies in Epidemiology and PRIMSA. Results: Eight case-control studies (including 1257 endometrial cancer patients and 2008 controls) and four nested case-control studies (including 659 endometrial cancer patients and 1398 controls) were included. We found that serum adiponectin level was inversely correlated with the risk of endometrial cancer development after pooling the case-control studies (OR = 0.50, 95% CI: 0.39-0.60; P < 0.001). However, meta-analysis of nested case-control studies thus far did not support a broad linkage between serum adiponectin level and endometrial cancer, although a correlation may exist in the subgroup of postmenopausal women (OR=0.81, 95%CI: 0.65-1.00; P=0.060), particularly in postmenopausal women without current hormone replacement therapy (OR = 0.62, 95% CI: 0.44-0.86; P = 0.004). Conclusions: Meta-analysis of currently available clinical evidence supports the association between high serum adiponectin concentration and reduced risk of endometrial cancer development, particularly in the group of postmenopausal women without current hormone replacement therapy. However, additional studies with prospective design are required to fully support this linkage.
The RoPE Score and Right-to-Left Shunt Severity by Transcranial Doppler in the CODICIA Study
Authors: Wessler Benjamin S. , Kent David M. , Thaler David E. , Ruthazer Robin , Lutz Jennifer S. , Serena Joaquín
Published: July 2015

Background: For patients with cryptogenic stroke (CS) and patent foramen ovale (PFO), it is unknown whether the magnitude of right-to-left shunt (RLSh) measured by contrast transcranial Doppler (c-TCD) is correlated with the likelihood an identified PFO is related to CS as determined by the Risk of Paradoxical Embolism (RoPE) score. Additionally, for patients with CS, it is unknown whether PFO assessment by c-TCD is more sensitive for identifying RLSh compared with transesophageal echocardiography (TEE). Our aim was to determine the significance of RLSh grade by c-TCD in patients with PFO and CS. Methods: We evaluated patients with CS who had RLSh quantified by c-TCD in the Multicenter Study into RLSh in Cryptogenic Stroke (CODICIA) to determine whether there is an association between c-TCD shunt grade and the RoPE Score. For patients who underwent c-TCD and TEE, we determined whether there is agreement in identifying and grading RLSh between these two modalities. Results: The RoPE score predicted the presence versus the absence of RLSh documented by c-TCD (c-statistic = 0.66). For patients with documented RLSh by c-TCD, shunt severity was correlated with increasing RoPE score (rank correlation (r) = 0.15, p = 0.01). Among 293 patients who had both c-TCD and TEE performed, c-TCD was more sensitive (98.7%) for detecting RLSh. Of the 97 patients with no PFO identified on TEE, 28 (29%) had a large amount of RLSh seen on c-TCD. Conclusions: For patients with CS, severity of RLSh by c-TCD is positively correlated with the RoPE score, indicating that this technique for shunt grading identifies patients more likely to have pathogenic rather than incidental PFOs. c-TCD is also more sensitive in detecting RLSh than TEE. These findings suggest an important role for c-TCD in the evaluation of PFO in the setting of CS.
MRI Susceptibility Changes Suggestive of Iron Deposition in the Thalamus after Ischemic Stroke
Authors: van Etten Ellis S. , van der Grond Jeroen , Dumas Eve M. , van den Bogaard Simon J.A. , van Buchem Mark A. , Wermer Marieke J.H.
Published: July 2015

Background: Iron accumulation has been linked to neuronal injury following cerebral ischemia. In animals, a hypointense signal on T2*-weighted (T2*-w) MRI correlated with iron deposits in remote brain regions following ischemic stroke. We aim to assess whether such signal changes are present in remote brain structures following ischemic stroke in humans. Methods: We analyzed T2*-w images of 36 patients with unilateral ischemic stroke and 36 healthy controls. Regions of interest (ROIs) consisted of the thalamus, putamen, globus pallidus, caudate nucleus and white matter. To quantify signal intensity in ROIs ipsilateral to the infarct, signal intensity was measured in the ROIs in both hemispheres and a ratio of signal intensity was calculated. Signal asymmetry was compared between patients and controls and its relation with time after stroke onset was assessed. Results: In 34 (94%) patients, the thalamus ipsilateral to the infarct was hypointense compared to the contralateral thalamus. Ipsilateral thalamic signal hypointensity was significantly different between patients and controls (p < 0.001) and was present as early as 1 day after stroke onset. In other ROIs, no difference was found between patients and controls. No association was found between intensity asymmetry and time. Conclusion: We demonstrated that, as early as days after ischemic stroke, T2*-w signal intensity was decreased in the ipsilateral thalamus. This finding might indicate pathophysiologic changes in regions outside the infarcted area, possibly reflecting toxic iron accumulation.
Serum Vitamin D Status as a Predictor of Prognosis in Patients with Acute Ischemic Stroke
Authors: Park Kwang-Yeol , Chung Pil-Wook , Kim Yong Bum , Moon Heui-Soo , Suh Bum-Chun , Won Yu Sam , Kim Jeong-Min , Youn Young Chul , Kwon Oh-Sang
Published: July 2015

Background: Low 25-hydroxyvitamin D (25(OH)D) concentrations have been shown to predict risk of cardiovascular disease and all-cause mortality. Although the prevalence of 25(OH)D deficiency is high in patients with acute stroke, the prognostic value of 25(OH)D in stroke has not been clearly established. The purpose of this study was to determine whether the baseline serum 25(OH)D level was associated with the functional outcome in patients with acute ischemic stroke. Methods: From June 2011 to January 2014, consecutive patients with acute ischemic stroke within 7 days of symptom onset were enrolled in this study from a prospectively maintained stroke registry. Serum 25(OH)D level was measured at admission. Clinical and laboratory data including stroke severity using the National Institute of Health Stroke Scale (NIHSS) score were collected during admission, and the functional outcome at 3 months was assessed by modified Rankin scale (mRS). The association between the baseline 25(OH)D level and a good functional outcome (mRS 0-2) at 3 months was analyzed by multiple logistic regression models. Results: A total of 818 patients were enrolled in this study. Mean age was 66.2 (±12.9) years, and 40.5% were female. The mean 25(OH)D level was 47.2 ± 31.7 nmol/l, and the majority of patients met vitamin D deficient status (<50 nmol/l; 68.8%), while an optimal vitamin D level (≥75 nmol/l) was present in only 13.6% of the patients, and 436 (53.3%) patients showed good functional outcome at 3 months. Serum 25(OH)D levels in patients with good outcomes were significantly higher than those with poor outcome (50.2 ± 32.7 vs. 43.9 ± 30.0 nmol/l, p = 0.007). The 3-month functional outcome was significantly associated with month-specific 25(OH)D quartiles in multivariable logistic regression analysis. After adjustment for age and sex, the highest 25(OH)D quartile group had higher tendency for good functional outcome at 3 months (odds ratio (OR) = 1.68, 95% confidence interval (CI) = 1.13-2.51). After fully adjusting for other potential confounders, such as stroke severity and vascular risk factors, the association was further strengthened with an OR (95% CI) of 1.90 (1.14-3.16). Other factors associated with good functional outcome in multivariable analysis were younger age, lower initial NIHSS score and absence of diabetes. Conclusions: This study suggests that serum 25(OH)D level is an independent predictor of functional outcome in patients with acute ischemic stroke. Further studies are required to determine whether vitamin D supplementation could improve functional outcome in patients with ischemic stroke.
Maternal Colonization with Group B Streptococcus Is Associated with an Increased Rate of Infants Transferred to the Neonatal Intensive Care Unit
Authors: Brigtsen Anne Karin , Jacobsen Anne Flem , Dedi Lumnije , Melby Kjetil K. , Fugelseth Drude , Whitelaw Andrew
Published: July 2015

Background:Streptococcus agalactiae (group B Streptococcus, GBS) is the most common cause of early neonatal infection, but restricting the diagnosis to culture-positive infants may underestimate the burden of GBS disease. Our objective was to determine whether maternal GBS colonization was associated with an increased risk of transfer of term infants to the neonatal intensive care unit (NICU) and, if so, to estimate the incidence of probable early-onset GBS disease. Methods: We conducted a prospective cohort study of 1,694 term infants whose mothers had vaginal-rectal swabs collected at delivery. Data collected on each mother and infant included demographics, clinical findings and laboratory investigations. The medical staff were unaware of the maternal GBS colonization status. Results: A total of 26% of the mothers were colonized. Infants born to colonized mothers did not differ from infants born to non-colonized mothers with respect to birth weight or Apgar score. Altogether, 30 (1.8%) of the term infants were transferred to the NICU. Only 1 infant born to a colonized mother had culture-positive early-onset GBS disease. Infants born to colonized mothers were more than 3 times as likely to be transferred to the NICU compared to infants of non-colonized mothers (3.6 vs. 1.1%; OR 3.4, 95% CI 1.6-6.9, p = 0.001); 5 infants of colonized mothers had probable GBS disease with tachypnoea and raised C-reactive protein (3.0/1,000 live term births). Conclusions: Maternal GBS colonization is associated with increased risk of transfer to the NICU in term infants. The burden of neonatal GBS disease may be greater than indicated by the number of culture-positive cases.
Pancreatic and Gastric Heterotopia with Associated Submucosal Lipoma Presenting as a 7-cm Obstructive Tumor of the Ileum: Resection with Double Balloon Enteroscopy
Authors: Jiang Kun , Stephen F. Otis , Jeong Daniel , Pimiento Jose M.
Published: July 2015

Pancreatic and gastric heterotopias are rare clinical entities which have been identified throughout the entire length of the gastrointestinal tract. Combined gastric and pancreatic heterotopias, although unusual, have been described in the duodenum and jejunum, and in other structures, including Meckel's diverticulum and the ampulla of Vater. We report a novel case of pancreatic and gastric heterotopia with an associated submucosal lipoma in a 38-year-old female with a recent history of rectal cancer and chronic crampy abdominal pain. On computed tomography, a 7-cm luminal polypoid mass extending into the distal ileum was discovered. The mass was successfully resected using retrograde double balloon enteroscopy. We believe this is the first report of all three histological entities co-existing in an obstructive ileal lesion in an adult. It highlights endoscopic resection trough double enteroscopy as a safe alternative to more invasive surgical approaches for this type of lesion.
Water Security in a Changing World
Authors: Briscoe John
Published: July 2015

This essay defines the concept of water security and explores the implications of the eternal pursuit of it. I will describe how water security is perceived by wealthy and by poorer nations, the tensions that arise from these differing views, and how these tensions are being resolved in a world in which the geography of economics and power is changing rapidly. I outline a few iconic cases of how societies have built institutions and infrastructure to deal with both floods and droughts. The essay assesses the effects of changes in climate and land use systems, and the differing reactions to the new perception of “nonstationarity”: the idea that these systems are less predictable than they have historically been. The essay concludes with some reflections on the challenges of educating young people seized with passion for the issues of their generation but who may have difficulty taking a long view of water security. Many have been taught about the environmental ravages wrought by water infrastructure, but few understand how these same infrastructure and institutions underpin the water security that the United States has achieved. 1 Similarly, we teach the next generation too little about the remarkable contributions of “thinking practitioners”: experts who are also involved in policy-making and planning–whose work underpins the food, water, and energy security of their societies.
Adaptation in the Water Sector: Science & Institutions
Authors: Jacobs Katharine L. , Snow Lester
Published: July 2015

Water management activities involve a complex and interconnected web of science, infrastructure considerations, societal expectations, and institutional limitations that has evolved over time. Much of the water management system's current complexity developed in response to the interests of local water users and land owners, historical water supply and demand issues, political demands, and water quality and environmental considerations. Climate change poses a new set of questions for water managers and may require more flexible solutions than those that have evolved historically. Although the implications of changes in the climate on water supply and demand are recognized (if not well quantified), ongoing changes in temperature and precipitation, as well as the linkages between environmental and societal factors, lead to major uncertainties in future conditions. New tools, techniques, and institutions will be needed to sustain water supplies for communities and watersheds in the future.
Impair-then-Repair: A Brief History & Global-Scale Hypothesis Regarding Human-Water Interactions in the Anthropocene
Authors: Vörösmarty Charles J. , Meybeck Michel , Pastore Christopher L.
Published: July 2015

Water is an essential building block of the Earth system and a nonsubstitutable resource upon which humankind must depend. But a growing body of evidence shows that freshwater faces a pandemic array of challenges. Today we can observe a globally significant but collectively unorganized approach to addressing them. Under modern water management schemes, impairment accumulates with increasing wealth but is then remedied by costly, after-the-fact technological investments. This strategy of treating symptoms rather than underlying causes is practiced widely across rich countries but leaves poor nations and many of the world's freshwater life-forms at risk. The seeds of this modern “impair-then-repair” mentality for water management were planted long ago, yet the wisdom of our “water traditions” may be ill-suited to an increasingly crowded planet. Focusing on rivers, which collectively satisfy the bulk of the world's freshwater needs, this essay explores the past, present, and possible future of human-water interactions. We conclude by presenting the impair-then-repair paradigm as a testable, global-scale hypothesis with the aim of stimulating not only systematic study of the impairment process but also the search for innovative solutions. Such an endeavor must unite and cobalance perspectives from the natural sciences and the humanities.
Fusion of Scores in a Detection Context Based on Alpha Integration
Authors: Soriano Antonio , Vergara Luis , Ahmed Bouziane , Salazar Addisson
Published: July 2015

We present a new method for fusing scores corresponding to different detectors (two-hypotheses case). It is based on alpha integration, which we have adapted to the detection context. Three optimization methods are presented: least mean square error, maximization of the area under the ROC curve, and minimization of the probability of error. Gradient algorithms are proposed for the three methods. Different experiments with simulated and real data are included. Simulated data consider the two-detector case to illustrate the factors influencing alpha integration and demonstrate the improvements obtained by score fusion with respect to individual detector performance. Two real data cases have been considered. In the first, multimodal biometric data have been processed. This case is representative of scenarios in which the probability of detection is to be maximized for a given probability of false alarm. The second case is the automatic analysis of electroencephalogram and electrocardiogram records with the aim of reproducing the medical expert detections of arousal during sleeping. This case is representative of scenarios in which probability of error is to be minimized. The general superior performance of alpha integration verifies the interest of optimizing the fusing parameters.
New genus and species names for the Eocene lizard Cadurcogekko rugosus Augé, 2005
Authors: BOLET ARNAU , DAZA JUAN D. , AUGÉ MARC , BAUER AARON M.
Published: July 2015

Cadurcogekko rugosus Augé, 2005 was described as a gekkotan lizard from the Eocene of France. A revision of the material has revealed that the holotype, a nearly complete dentary, actually belongs to a scincid lizard, for which we erect the new genus Gekkomimus. The rest of material originally referred to C. rugosus is of undoubted gekkotan nature and is included in the new species Cadurcogekko verus, with the exception of a partial left dentary belonging to the iguanid lizard Cadurciguana hoffstetteri.
Cross-Seasonal Influence of the December–February Southern Hemisphere Annular Mode on March–May Meridional Circulation and Precipitation
Authors: Zheng Fei , Li Jianping , Wang Lei , Xie Fei , Li Xiaofeng
Published: July 2015

New evidence suggests that interannual variability in zonal-mean meridional circulation and precipitation can be partially attributed to the Southern Hemisphere annular mode (SAM), the dominant mode of climate variability in the Southern Hemisphere (SH) extratropics. A cross-seasonal correlation exists between the December–February (DJF) SAM and March–May (MAM) zonal-mean meridional circulation and precipitation. This correlation is not confined to the SH: it also extends to the Northern Hemisphere (NH) subtropics. When the preceding DJF SAM is positive, counterclockwise, and clockwise meridional cells, accompanied by less and more precipitation, occur alternately between the SH middle latitudes and NH subtropics in MAM. In particular, less precipitation occurs in the SH middle latitudes, the SH tropics, and the NH subtropics, but more precipitation occurs in the SH subtropics and the NH tropics. A framework is built to explain the cross-seasonal impact of SAM-related SST anomalies. Evidence indicates that the DJF SAM tends to lead to dipolelike SST anomalies in the SH extratropics, which are referred to in this study as the SH ocean dipole (SOD). The DJF SOD can persist until the following MAM when it begins to modulate MAM meridional circulation and large-scale precipitation. Atmospheric general circulation model simulations further verify that MAM meridional circulation between the SH middle latitudes and the northern subtropics responds to the MAM SOD.
A Multiscale Variational Data Assimilation Scheme: Formulation and Illustration
Authors: Li Zhijin , McWilliams James C. , Ide Kayo , Farrara John D.
Published: July 2015

A multiscale data assimilation (MS-DA) scheme is formulated for fine-resolution models. A decomposition of the cost function is derived for a set of distinct spatial scales. The decomposed cost function allows for the background error covariance to be estimated separately for the distinct spatial scales, and multi-decorrelation scales to be explicitly incorporated in the background error covariance. MS-DA minimizes the partitioned cost functions sequentially from large to small scales. The multi-decorrelation length scale background error covariance enhances the spreading of sparse observations and prevents fine structures in high-resolution observations from being overly smoothed. The decomposition of the cost function also provides an avenue for mitigating the effects of scale aliasing and representativeness errors that inherently exist in a multiscale system, thus further improving the effectiveness of the assimilation of high-resolution observations. A set of one-dimensional experiments is performed to examine the properties of the MS-DA scheme. Emphasis is placed on the assimilation of patchy high-resolution observations representing radar and satellite measurements, alongside sparse observations representing those from conventional in situ platforms. The results illustrate how MS-DA improves the effectiveness of the assimilation of both these types of observations simultaneously.
Judicial Influence on Policy Outputs? The Political Constraints of Legal Integration in the European Union
Authors: Martinsen Dorte Sindbjerg
Published: July 2015

The ability of courts to generate political change has long been debated in national, comparative, and international politics. In the examination of the interaction between judicial and legislative politics, scholars have disagreed on the degree of judicial power and the ability of politics to override unwanted jurisprudence. In this debate, the Court of Justice of the European Union (CJEU) has become famous for its central and occasionally controversial role in European integration. This article examines to what extent and under which conditions judicial decisions influence European Union (EU) social policy outputs. A taxonomy of judicial influence is constructed, and expectations of institutional and political conditions on judicial influence are presented. The analysis draws on an extensive novel data set and examines judicial influence on EU social policies over time, that is, between 1958 and 2014, as well as for case studies of working-time regulations and patients’ rights. The findings demonstrate that both the codification and overriding of judicial decisions are unlikely in the contemporary EU-28 of fragmented politics. However, modification and nonadoption constitute other political responses to attenuate unwelcome jurisprudence and constrain the legislative effect of judicial decisions.
Society, steward or security actor? Three visions of the Arctic Council
Authors: Wilson Page
Published: July 2015

While a long-term decrease in overall Arctic sea ice extent has been recorded by the US National Snow and Ice Data Center (2014) since the late 1970s, the unprecedented levels of ice melting and thinning experienced in the region in 2007, and subsequently in 2012, have brought the Arctic once again to the forefront of international affairs. Much popular and academic attention has focused on whether the Arctic is likely to remain a zone of cooperation, or descend into conflict. However, less attention has been paid to examining the evolution and role of fora in the region, such as the Arctic Council. In this paper, it is argued that three visions are presently shaping ways of thinking about the Council: the first envisages the Council as a society for Arctic states; the second sees the Council as a steward for the Arctic; and the third imagines the Council as a fully-fledged security actor. The extent to which each vision is manifested in the practices of the Council and its members is also examined. Finally, the paper considers what the ongoing tensions within and among these three ways of conceptualising the Council means for its future prospects, and for Arctic politics more generally.
Impacts of Unionization on Quality and Productivity
Authors: Sojourner Aaron J. , Frandsen Brigham R. , Town Robert J. , Grabowski David C. , Chen Min M.
Published: July 2015

Using a regression discontinuity design, the authors of this article examine the effects of nursing home unionization on several labor, establishment, and consumer outcomes. They find negative effects of unionization on staffing levels and no decline in care quality, suggesting positive labor productivity effects. Some evidence suggests that nursing homes in less competitive local product markets and those with lower union density at the time of election experienced stronger union employment effects. Unionization appears to raise wages for a given worker while also shifting the composition of the workforce away from higher-earning workers. By combining credible identification of union effects and firm- and worker-level outcomes over time with measures of market-level characteristics, this study provides important new evidence on many controversial questions in the economics of unions. It also generates evidence from the service sector, which has grown in importance and where evidence has been thin.
Distributional Orientation and Health Outcomes in OECD Countries
Authors: Safaei Jalil
Published: July 2015

This study uses data from the Organisation for Economic Co-operation and Development countries over the 2008–2010 period to construct indicators of “pro-primary” and “pro-secondary” distributions. The former is concerned with the original distribution of income through the market, whereas the latter is concerned with the redistribution efforts of the government. The study ranks these countries along these dimensions to create a distributional orientation map for such countries. It finds that the Scandinavian countries occupy the top rankings in terms of equity in pro-primary distribution, followed by countries with a Bismarckian welfare state regime. The Scandinavian countries also rank very high on equity in pro-secondary distribution, along with some of the top-ranking Bismarckian countries. More significantly, the study finds that the countries’ health outcomes are associated more strongly with the pro-primary distributional stance than with the pro-secondary distributional stance. A key policy implication is that to achieve better and more equitable health, it is more effective to design a level playing field for market participants in the first place, than to try to mend inequities after the fact through remedial social policy.
A combined numerical and experimental study for characterizing interfacial properties of polyoxymethylene–calcium carbonate nanocomposites in tensile state
Authors: Zamani Zakaria Afshin , Soltanzadeh F Mohsen , Shelesh-Nezhad Karim
Published: July 2015

In this research, experimental and numerical approaches used simultaneously to discover the mechanical properties of interphase region formed in polyoxymethylene (POM)/calcium carbonate (CaCO3) nanocomposites. For acquiring interphase thickness, differential scanning calorimetry thermo-analytical data were incorporated by assuming that the whole crystallization of polymer matrix developed only in the interphase region. An inverse mode of a micromechanical equation known as effective interface model was used to acquire the interphase stiffness tensor. To obtain tensile strength of interphase region, a parametric study was designed and proceeded using finite element analysis method. The formations of interphase regions in POM/CaCO3 nanocomposites, which had 25–85% higher modulus and 10–50% higher strength than matrix led to as high as 40% and 14% improvements in the nanocomposite Young’s modulus and tensile strength, respectively. The proposed method provides further accuracy in obtaining interphase properties of crystalline polymers reinforced by mineral nanoparticles.
Not All Transitions Are Equal: The Relationship Between Effects on Passing Steps in a Sequential Process and Effects on the Final Outcome
Authors: Buis Maarten L.
Published: July 2015

This article deals with a model for describing a sequence of events, for example, education is typically attained by a set of transitions from one level of education to the next. In particular, this article tries to reconcile measures describing the effect of a variable on each of these transitions, with measures describing the effect of this variable on the final outcome of that process. Such a relationship has been known to exist within a sequential logit model, but it has hardly been used in empirical research mainly because of an absence of a practical way of giving it a substantive interpretation. This article tries to provide such an interpretation by showing that the effect on the final outcome is a weighted sum of the effects on each transition, such that a transition gets more weight if more people are at risk of passing that transition, passing the transition is more differentiating, and people gain more from passing.
Neurobrucellosis: an often forgotten cause of chronic meningitis
Authors: Mahajan Sanjay K , Sharma Arindam , Kaushik Madan , Raina Rajiv , Sharma Sudhir , Banyal Vikas
Published: July 2015

We report a 26-year-old man of neurobrucellosis who presented with intermittent fever and headache for 2 years, sensori-neural hearing loss with cerebellar ataxia. He responded well to a combination of antimicrobials with significant clinical improvement.
Traversing between transnationalism and integration: Dual embeddedness of new Chinese immigrant entrepreneurs in Singapore
Authors: Ren Na , Liu Hong
Published: July 2015

Transnationalism was initially proposed as an alternative perspective to the assimilation and integration frameworks, which tend to prioritize the nation-state over transnational mobility. Policy-makers in host societies usually regard transnational migrants’ close linkages with the homeland as a sign of social and political detachment, thus reducing their contributions to the host land. Findings from our research on Chinese new immigrant entrepreneurs in Singapore suggest the simultaneous embeddedness of immigrants into two or more nation-states and geopolitical spheres. However, integration in Singapore and transnational ties with China are not necessarily a zero-sum game. Our evidence suggests that transnationalism and integration have been construed as a mutually reinforcing strategy in new immigrants’ efforts to accumulate economic and social resources in both the host land and the homeland. The formations, characteristics and mechanisms of the dual embeddedness process of new Chinese immigrant entrepreneurs in Singapore are detailed in the article.
Voluntary Organizations and Community Groups as New Partners in Diabetes Self-management and Education
Authors: Portillo Mari Carmen , Regaira Elena , Pumar-Méndez María J. , Mujika Agurtzane , Vassilev Ivaylo , Rogers Anne , Wensing Michel , Foss Christina , Knutsen Ingrid Ruud , Todorova Elka , Roukova Poli , Kennedy Anne , Serrano Manuel , Lionis Christos , Angelaki Agapi , Patelarou Evridiki , Koetsenruijter Jan
Published: July 2015

Purpose

The purpose of this study is to critically review the literature on the role and work of voluntary organizations and community groups and volunteers in diabetes self-management programs. It seeks to explain how these organizations are located and could be integrated further within a broader system of support.

Methods

A critical interpretative synthesis of the literature was undertaken as part of the conceptual development of a European research project. Evidence (2000-November 2014) was searched in databases, with the use of key terms, and limited to the languages of the participating countries. This was supplemented by an additional hand search and snowballing technique. A total of 21 articles were included in the review.

Results

Evidence regarding the involvement of voluntary organizations in diabetes self-management programs mainly related to: the nature and remit of their work, responsibilities, and attributes; key strategies of programs accounting for success; motivations/barriers for engaging in volunteering participation; relationships between volunteers and users; and connections/tensions with formal services.

Conclusions

This review has uncovered a range of facets of voluntary organizations and community groups relevant for supporting diabetes self-management such as the context within which they act and the nature of relationships developed with community and health services. The principles of “assistance, support, sharing, and link” seem essential for this voluntary initiative in self-management to establish effective reciprocal collaboration with health professionals.
Of Caucasians, Asians, and Giraffes
Authors: Machunsky Maya , Walther Eva
Published: July 2015

Past research has indicated that social projection is moderated by categorization, with more projection onto ingroups than onto outgroups. However, a few studies have reported elevated levels of projection even onto outgroups. In line with recent evidence, we hypothesized that positive target valence is the key feature of conditions that elicit projection onto outgroups. The present research extends previous findings by testing whether the effect of valence occurs independent of categorization, with increased levels of projection onto positive ingroup and non-ingroup targets alike. We designed two experiments in which target valence was manipulated by means of evaluative conditioning. Category membership was varied by using faces of Caucasians, Asians, and giraffes. The results supported our valence hypothesis. Counter-intuitively, we also found higher levels of projection onto giraffes than onto humans. These findings suggest that current cognition-based models of projection are not sufficient to account for the whole range of projection phenomena.
Recognition of Future News in Earnings and Price Bubbles in Experimental Asset Markets
Authors: Ghosh Sudeep , Radhakrishnan Suresh , Srinidhi Bin , Su Lixin (Nancy)
Published: July 2015

In this article, we use an experimental approach to examine the effect of reporting regimes on asset prices. We examine four different reporting regimes: the no recognition (NR) regime where no expected future cash flows are recognized; the full recognition (FR) regime where both the expected good news and expected bad news pertaining to the next period cash flows are recognized in current earnings; the good news recognition (GR) regime where only the expected good news pertaining to the next period cash flows are recognized in current earnings; and the bad news recognition (BR) regime where only the expected bad news pertaining to the next period cash flows are recognized in current earnings. We find that the NR, BR, and GR regimes are associated with more intense asset price bubbles than the FR regime. We also find that between the BR and GR regimes, the BR regime is associated with more intense asset price bubbles than the GR regime. Our findings shed insights about how biased (non-neutral) reporting regimes could affect the price formation process.
Microfracture and Osteochondral Autograft Transplantation Are Cost-effective Treatments for Articular Cartilage Lesions of the Distal Femur
Authors: Miller D. Josh , Smith Matthew V. , Matava Matthew J. , Wright Rick W. , Brophy Robert H.
Published: July 2015

Background:

Multiple techniques have been suggested for the treatment of isolated knee articular cartilage injuries. For smaller lesions (<2-5 cm2), microfracture and osteochondral autograft transplantation (OAT) are commonly used options. With an increasing focus on health care efficiency, analyzing the cost-effectiveness of treatment modalities has become increasingly important.

Purpose/Hypothesis:

The purpose of this study was to analyze the costs and outcomes of microfracture and OAT to compare their cost-effectiveness. The hypothesis was that microfracture would be more cost-effective.

Study Design:

Economic and decision analysis; Level of evidence, 2.

Methods:

A literature search was performed to identify studies comparing microfracture and OAT for the treatment of articular cartilage lesions of the distal femur in an adult population. Data from these studies including surgical time, failure rates, revision surgeries, outcome scores, and return to athletics were then incorporated into a constructed cost model using standard accounting methodology. The model was based on actual 2013 cost figures (in US dollars) for all procedure, operating room, and instrumentation costs.

Results:

Three studies, with a mean follow-up of 8.7 years, met the inclusion criteria of having evidence level 1 or 2 comparing microfracture and OAT. There was a cumulative 28.6% reoperation rate among patients undergoing microfracture compared with 12.5% among patients undergoing OAT. While both groups demonstrated significant improvements compared with preoperative levels, the only significant differences in any outcome score reported between the 2 procedures were the International Cartilage Repair Society (ICRS) score and patient-reported return to their previous sports activity level. While microfracture had a lower initial cost ($3100), these savings lessened over 1 year ($1843) and 10 years ($996). Microfracture was more cost-effective when comparing Lysholm and Hospital for Special Surgery scores, whereas OAT was more cost-effective when comparing Tegner and ICRS scores. There was a significantly lower cost for return to play in athletes after OAT versus microfracture at 1 year ($11,428 vs $16,953, respectively), 3 years ($12,856 vs $38,000, respectively), and 10 years ($32,141 vs $60,799, respectively).

Conclusion:

Published level 1 and 2 clinical studies with a 10-year follow-up demonstrated that the net cost and cost-effectiveness of microfracture and OAT are comparable for the treatment of isolated articular cartilage lesions of the distal femur.

Clinical Relevance:

Given similar clinical outcomes, microfracture and OAT are both viable, cost-effective first-line treatment options for these injuries.
Feasibility study for retrofitting biogas cogeneration systems to district heating in South Korea
Authors: Chung Mo , Park Hwa-Choon
Published: July 2015

A feasibility study was performed to assess the technical and economic merits of retrofitting biogas-based cogeneration systems to district heating networks. Three district heating plants were selected as candidates for accommodating heat recovery from nearby waste treatment stations, where a massive amount of biogas can be produced on a regular basis. The scenario involves constructing cogeneration systems in each waste treatment station and producing electricity and heat. The amounts of biogas production for each station are estimated based on the monthly treatment capacities surveyed over the most recent years. Heat produced by the cogeneration system is first consumed on site by the waste treatment system to keep the operating temperature at a proper level. If surplus heat is available, it will be transported to the nearest district heating plant. The year-round operation of the cogeneration system was simulated to estimate the electricity and heat production. We considered cost associated with the installation of the cogeneration system and piping as initial investments. Profits from selling electricity and recovering heat are counted as income, while costs associated with buying biogas are expenses. Simple payback periods of 2–10 years were projected under the current economic conditions of South Korea. We found that most of the proposed scenarios can contribute to both energy savings and environmental protection.