bluuebunny/crossref_metadata_2025 huggingface dataset:
Deployment of Analytics into the Healthcare Safety Net: Lessons Learned
Authors: Hartzband David , Jacobs Feygele
Published: January 2017

To better understand existing capacity and help organizations plan for the strategic and expanded uses of data, a project was initiated that deployed contemporary, Hadoop-based, analytic technology into several multi-site community health centers (CHCs) and a primary care association (PCA). An initial data quality exercise was carried out after deployment, in which a number of analytic queries were executed using both the existing electronic health record (EHR) applications and in parallel, the analytic stack. Each organization carried out the EHR analysis using the definitions typically applied for routine reporting. The analysis using the analytic stack was carried out using those common definitions established for the Uniform Data System (UDS) by the Health Resources and Service Administration.  In addition, interviews with health center leadership and staff were completed to understand the context for the findings.The analysis uncovered many challenges and inconsistencies with respect to the definition of core terms (patient, encounter, etc.), data formatting, and missing, incorrect and unavailable data. At a population level, apparent underreporting of a number of diagnoses, specifically obesity and heart disease, was also evident in the results of the data quality exercise, for both the EHR-derived and stack analytic results.Data awareness, that is, an appreciation of the importance of data integrity, data hygiene and the potential uses of data, needs to be prioritized and developed by health centers and other healthcare organizations if analytics are to be used in an effective manner to support strategic objectives. While this analysis was conducted exclusively with community health center organizations, its conclusions and recommendations may be more broadly applicable.
Twitter Influenza Surveillance: Quantifying Seasonal Misdiagnosis Patterns
Authors: Mowery Jared
Published: January 2017

Background: Influenza (flu) surveillance using Twitter data can potentially save lives and increase efficiency by providing governments and healthcare organizations with greater situational awareness. However, research is needed to determine the impact of Twitter users’ misdiagnoses on surveillance accuracy. Objective: This study establishes the importance of Twitter users’ misdiagnoses by showing that Twitter flu surveillance in the United States failed during the 2011-2012 flu season, estimates the extent of misdiagnoses, and tests several methods for reducing the adverse effects of misdiagnoses.Methods: Metrics representing flu prevalence, seasonal misdiagnosis patterns, diagnosis uncertainty, flu symptoms, and noise were produced using Twitter data in conjunction with OpenSextant for geo-inferencing, and a maximum entropy classifier for identifying tweets related to illness. These metrics were tested for correlations with World Health Organization (WHO) positive specimen counts of flu from 2011 to 2014.Results: Twitter flu surveillance erroneously indicated a typical flu season during 2011-2012, even though the flu season peaked three months late, and erroneously indicated plateaus of flu tweets before the 2012-2013 and 2013-2014 flu seasons. Enhancements based on estimates of misdiagnoses removed the erroneous plateaus and increased the Pearson correlation coefficients by .04 and .23, but failed to correct the 2011-2012 flu season estimate. A rough estimate indicates that approximately 40% of flu tweets reflected misdiagnoses.Conclusions: Further research into factors affecting Twitter users’ misdiagnoses, in conjunction with data from additional atypical flu seasons, is needed to enable Twitter flu surveillance systems to produce reliable estimates during atypical flu seasons.
PROCEDURE FOR ESTIMATING OIL THREE-DIMENSIONAL SOLUBILITY PARAMETERS
Authors: Larson Brent K. , Hess Julie M. , Williams Jeffrey M.
Published: January 2017

Process oils make important contributions to nearly every compound in a tire, and oil–polymer interactions have effects on compound processing and performance. One way to predict oil–polymer interactions is to determine the three-dimensional (3-D) Hansen solubility parameters (HSPs) for both oil and polymer, and the polymer solubility sphere (PSS) radius. Favorable oil–polymer interactions occur when an oil's HSPs are located within a PSS. Interactions are stronger when an oil's HSPs are located closer to the center of the PSS. If an oil's HSPs are located outside a polymer's solubility sphere, then the polymer is not soluble in the oil as a result of insufficient favorable interactions. A polymer characterization technique for determining the HSPs is the bitumen solubility model. However, no simple procedure has previously been documented for estimating the 3-D HSPs for an oil. A labor-intensive method has been described by Levin and Redelius. The oil solubility parameters estimation procedure (OSPEP) has been developed to meet the need for a relatively simple characterization technique. This procedure can provide an estimation of oil HSPs by running two titrations and a dynamic scanning calorimetry test. Analysis involves an iterative procedure to estimate the three HSPs for the oil. OSPEP represents a step forward to easily obtain insight into oil–polymer interactions.
Performance Comparison of NextSeq and Ion Proton Platforms for Molecular Diagnosis of Clinical Oncology
Authors: Cao Fei , Gao Lianju , Wei Longgang , Chen Zhanni , Wang Yan , Ran Xia , Meng Xuehong , Tao Ji
Published: January 2017

Purpose

Next-generation sequencing is a powerful approach to detect genetic mutations with which cancer diagnosis and treatment can be tailored to the individual patient in the era of personalized and precision medicine. Ion Torrent Systems Ion Proton and Illumina NextSeq are 2 major targeted sequencing platforms; however, not much work has been done to compare these platforms’ performance for mutation detection in formalin-fixed paraffin-embedded (FFPE) materials.

Methods

We benchmarked the performance by using a collection of FFPE samples from 23 patients with different cancers for NextSeq and Ion Proton platforms. We report analysis of sequencing in terms of average coverage depth, read length, and variant detection.

Results

Sequencing results by NextSeq and Ion Proton displayed near perfect coverage behavior (>99%) on target region. We analyzed the ability to call variants from each platform and found that Ion Proton sequencing can identify 89% of single nucleotide variants (SNVs) whose mutant allele frequency (MAF) is greater than or equal to 5% detected by the NextSeq pipeline in common analytical regions. The correlation coefficient of MAF for those common SNVs was 1.0046 (R2 = 0.973) between the 2 platforms. To call lower mutant frequency (5%-10%) mutations for NextSeq sequencing, coverage depth should be improved. The concordance of small insertions and deletions between these 2 pipelines was up to 100%.

Conclusions

The 2 sequencing pipelines evaluated were able to generate usable sequence and had high concordance. They are proper for mutation detection in clinical application.
SÍNDROME MÃO-PÉ INDUZIDA POR CAPECITABINA: RELATO DE CASO
Authors: Bispo Júnior Walfrido , Tomaz Anna Cláudia de Andrade , Vieira Larissa Fernanda de Araújo , Silva Patrícia Magalhães Xavier , Oliveira Silvana Maria Barros , Lima Monik Kelly Santos
Published: January 2017

A capecitabina é um agente quimioterápico indicado, dentre outros casos, como monoterapia no câncer de mama metastático. A síndrome mão-pé consiste numa das reações adversas associadas ao seu uso e caracteriza-se por eritema doloroso, edema, disestesia, descamação, bolhas e úlceras nas regiões palmar e plantar. Objetivou-se descrever o caso de uma paciente portadora de carcinoma de mama esquerda com metástase hepática que apresentou síndrome mão-pé decorrente do tratamento com capecitabina. Trata-se de um relato de caso ocorrido num hospital universitário de um estado do nordeste do Brasil em 2016. Foi necessária a suspensão do protocolo antineoplásico utilizado. Observou-se remissão parcial dos sintomas após o uso do gel de Aloe vera para o tratamento das áreas afetadas. Ressalta-se a importância do relato para conhecimento dessa reação adversa, facilitando sua identificação e manejo, para promover melhora da qualidade de vida do paciente oncológico.
The Role of Premiums and Discounts in Business Valuation: Evidence from the Italian Context
Authors: Ferraro Olga , Rubino Franco Ernesto
Published: January 2017

The valuation of a (non-totalitarian) shareholding in capital stock is characterized by some critical conditions, which are mainly related to the fact that the transfer or acquisition of the same can determine the transfer of control from one subject to another. It follows that the value of the investment can not simply be equal to the proportional value of the share capital, but should include premiums or discounts. Discounts and premiums do not just affect the value of a company; they play a crucial role in influencing a host of other factors and conditions that can make or break a deal. When it comes to business valuations, it is the business appraiser’s responsibility to be intimately knowledgeable with every aspect of discounts and premiums: the different types, the situations when they may or may not apply, and how to quantify them. The paper has a twofold approach: on the one hand, it analyzes the main reference literature on the definition and characteristics of premiums and discounts and the recognition and quantification of the same; on the other, subsequently, it examines the behavior adopted by the Italian professional practice in recognition and appreciation of prizes and discounts.
Fossil Fuel Price Shocks and CO2 Emissions: The Case of Spain
Authors: Blazquez Jorge , Martin-Moreno Jose Maria , Perez Rafaela , Ruiz Jesus
Published: January 2017

ABSTRACT

This paper focuses on the impact of oil, natural gas and coal price shocks on the Spanish business cycle from 1969 to 2013. It uses Bayesian procedures to estimate a Dynamic Stochastic General Equilibrium (DSGE) model for a small open economy. The paper shows that natural gas and coal shocks are relevant sources of macroeconomic disruption in addition to oil price shocks. The three fossil fuel prices have an impact on the economic activity and explain the evolution of the energy mix. However, we find that oil price shocks have a significantly larger impact on economic volatility. Finally, we assess the impact of hydrocarbon price shocks on carbon emissions given that different price shocks result in a different fossil fuel mix and, thus, in different CO2 emissions.
Data Processing Methodology for Experimental Modeling of Ocean Waves
Authors: Gatz Maria , Łuksza Andrzej , Studański Ryszard
Published: January 2017

This paper presents the data processing methodology for the physical modeling of ocean waves in wave flumes which was developed for the purpose of conducting hydrodynamics research in laboratory conditions. It includes the description of the research cycle, applied wave theory and the measured data processing methods. A significant achievement presented in this paper is the originally developed data analysis algorithm for the practical improvement of the wave generation process.
Evaluation of the Impact of Breathing Air Contamination on Safe Performance of Hyperbaric Exposure
Authors: Woźniak Arkadiusz
Published: January 2017

The evaluation of the impact of contamination in breathing air intended for hyperbaric purposes is essential both for practical and theoretical reasons. The quality of breathing air and the breathing mixes obtained on its basis is of crucial importance with regard to divers’ safety in the course of underwater works. The existing contaminants, as well as substandard quality gases have an adverse impact on divers’ health and life, both in terms of the physiological impact on the body, and fire hazards in hyperbaric complexes. In the process of breathing air production we deal with a few sources of potential contaminants stemming from technical measures. The human body is also responsible for the release of contaminants in hyperbaric conditions. The article presents the above issues and provides insight into existing threats.
Philippine mossy forest stick insects: first record of the genus Otraleus Günther, 1935 in the country, with four new species, and the new genus Capuyanus gen. nov. (Phasmida, Diapheromeridae, Necrosciinae)
Authors: Bresseel Joachim , Constant Jérôme
Published: January 2017

The genus Otraleus Günther, 1935 is recorded from the Philippines for the first time. Four new species, Otraleus bellemansae sp. nov., O. applai sp. nov., O. christianae sp. nov. and O. elizabethae sp. nov., are described from the highlands of Northwestern Luzon. The characters allowing separation from O. hypsimelathrus Günther, 1935 and O. labanrataensis Soew-Choen, 2016, are given. A new genus closely related to Otraleus, Capuyanus gen. nov., is described with a single species, C. magwilangi sp. nov., as type-species. An identification key and distribution maps are provided for all species.
Evolution of Classification of Thymic Epithelial Tumors in the Era of Dr Thomas V. Colby
Authors: Roden Anja C.
Published: January 2017

Context.—Numerous histomorphologic and staging classifications of thymic epithelial tumors (TETs) have been proposed during the last century, suggesting that the classification of these tumors is challenging and controversial. Difficulties of classifying TETs include various combinations of epithelial cells and lymphocytes and the paucity of these tumors. The prognostic significance, specifically of the histomorphologic classifications, has been debated. Early classifications were also challenged by the uncertainty of the neoplastic component(s) of the tumor.

Objective.—To discuss the evolution of the histomorphologic classification and the staging system of TET. Controversies and problems of some classifications and their importance for therapeutic management and prognosis will be reviewed. Classifications that incorporated new concepts and approaches at the time or outcome studies will be highlighted. Current classifications will be discussed and the staging system that was recently proposed for the upcoming eighth American Joint Committee on Cancer staging will be described.

Data Sources.—Search of literature database (PubMed) and current (2015) World Health Organization classification.

Conclusions.—Histomorphologic and staging classifications of TET have evolved during the last century and especially during the era of Thomas V. Colby, MD. Evidence supports that the staging system has prognostic implications independent of and superior to the histomorphologic classification. Histomorphology appears to be important for biologic features of TET.
Pathology of Antineutrophil Cytoplasmic Antibody–Associated Pulmonary and Renal Disease
Authors: Smith Maxwell L.
Published: January 2017

Context.—Antineutrophil cytoplasmic antibody (ANCA)–associated vasculitis commonly presents with pulmonary and renal involvement that may present diagnostic challenges.

Objectives.—To highlight the updates in the classification of small vessel vasculitis, present the patterns of pulmonary and renal pathology in which ANCA-associated vasculitis is included in the differential diagnosis, analyze the screening and specific antineutrophil cytoplasmic antibody testing methods in the clinical laboratory, compare and contrast the 3 major ANCA-associated vasculitis diseases, and review the pathophysiologic mechanisms of tissue injury in this setting.

Data Sources.—Data are derived from published literature and clinical experience.

Conclusions.—Although rare, ANCA-associated vasculitis diseases are often considered in the differential diagnosis of many pathologic patterns of pulmonary and renal disease. Histopathologic diagnosis of specific entities in this context nearly always requires correlation of the pathology with clinical and serologic data.
Enriching Divisibility: Multiple Proofs and Generalizations
Authors: Dickman Benjamin
Published: January 2017

One technique to create rich mathematical tasks is to require routine propositions to be proved in a variety of ways.
Creating Mathematical Lessons Using TED-Ed
Authors: Lehner Rachael
Published: January 2017

TED-Ed is a free web-based video service tied to the well-known TED Talks. TED-Ed allows instructors to use videos on the website for students to view as homework assignments. It also has options for educators to build lessons around videos and include their own questions, resources, notes, and discussion board posts. Because the lessons have four sections—Watch, Think, Dig Deeper, and Discuss—students are given multiple opportunities to interact with the content and to reflect on their understanding. In the Discuss section, for example, students are able to respond to a question posted on a discussion board. TED-Ed gives educators the freedom to create personal lessons that can be used for homework, extension assignments, make-up quiz assignments, or projectbased instruction.
A New Look at an Old Triangle Counting Problem
Authors: McDevitt Tim , Sutcliffe Kathryn
Published: January 2017

The Matchstick problem of counting equilateral triangles is modified to allow for additional side lengths and summation formulas, which lead to a result represented with combinatorics.
Distribution of Breast Cancer Biomarkers by Age in Iran
Authors: Hassan Akbari  , Farzad Taghizadeh Hesary  , Laya Rahnar Nikoukar
Published: January 2017

Background and Objectives: Breast cancer is the leading cause of cancer related death globally and presents as the most common female malignancy in Iran. Multiple factors are associated with an increased risk of developing breast cancer; for example first degree family history of breast cancer, BRCA1, 2 mutation and history of atypical hyperplasia on biopsy are the most important risk factors for developing breast cancer. Some prognostic factors are classically used that it would help us to either choosing recommended optimal treatment or recognizing the prognosis. In several studies it is shown that these factors have different patterns in age groups or histopathologic types. The aim of this study was to determine the age distribution of hormone receptors and biomarkers and determine their relation to the histopathologic types. Methods: Data were gathered from the medical records of Baqiyatallah hospital, Tehran, Iran. Breast cancer patients whose disease was confirmed by pathologic studies and had immunohistochemical profile, were included. Estrogen receptor (ER), Progesterone receptors (PR), HER2/neu and p53 were selected as biomarkers of this study. Results: Mean age of patients was 49.47±12.50 years (range 20 to 86). The most common histopathologic type was invasive ductal carcinoma. Distribution of ER and PR against age detected similar; ER positivity increased with age and it peaked in fifth decade of life, and PR positivity showed more regular pattern and it also peaked in fifth decade of life (p <0.05) HER2/neu positivity also had trend to increase with age and it peaked in sixth decade of life, but P53 had trend to show unimodal distribution pattern that peaked in sixth decade of life, but this findings were not statistically significant (p>0.05). Conclusions: Our breast cancer patients were generally younger than patients round the world. The different distribution pattern of biomarkers in our studies in comparison with similar studies, may suggest different biologic behavior of breast cancer in our patients. Further studies will help illuminate this point.
Angular Variation of Applicators in LDR-ICBT
Authors: A.S. Kirthi Koushik  , Ram Alva  , M.G. Janaki  , Arul Ponni
Published: January 2017

Effect of angular variation to dose received and its clinical correlation was studied in 36 ca.cervix patients. Angular variation results in dose variation but its impact needs to be studied.
Local Staging of Prostate Cancer Using Three Dimensional (3D) Transrectal Ultrasound Assisted with Power Doppler Capability
Authors: Ashraf Talaat Youssef
Published: January 2017

Introduction: The ability to differentiate between carcinoma confined to the prostate and the extra-capsular extension (ECE) of the tumor is the key point for management. ECE of prostate cancer can lead to failure of radical prostatectomy and every attempt should be made to localize the tumor and assess its extensions preoperatively. The study aimed to evaluate the value of three dimensional (3D) Transrectal ultrasound (TRUS) assisted with power Doppler in local staging of prostate cancer. Methodology: -3D TRUS assisted with the power Doppler capability was performed for 120 patients were complaining of burning urination, difficult urination or blood in urine, among them 95 patients were subjected to 3D TRUS guided biopsies. Results: 33 patients showed prostatic carcinomas, 2 patients showed prostatic sarcoma. In patients with proven prostate cancer 3D TRUS showed an estimated sensitivity 85.7% and specificity 90% with a positive predictive value 83.3%, negative predictive value 91.5% and total accuracy 90.9%. 77% of our cancer patients (27/35) showed hypervascularity by power Doppler ultrasonography while 8 patients (23%) showed no abnormal high vascularity. Power Doppler increased the sensitivity of 3D TRUS in the detection of prostate cancer from 85.7% to 88.5% 3D TRUS clearly identified the extra-prostatic spread in 15 out of 18 patients of an estimated sensitivity (83%). Conclusion: 3D TRUS aided with power Doppler is a valuable tool in local staging of prostate cancer .The expected benefits in local staging of prostate cancer from the combination of 3D TRUS, power Doppler and 3D TRUS guided biopsy as one sitting exam, will be highly promising.
A Climate of Inaction: Limitations of a Relational Understanding of Morality
Authors: Butron Juliana
Published: January 2017

Reducing greenhouse gas emissions is the only way to mitigate the consequences of climate change. In spite of this knowledge, curing the world’s addiction to fossil fuels has proven to be A herculean task. International agreements are limited in scope, and National governments have failed to enact laws that would sufficiently reduce domestic emissions. in addition, most individuals are hesitant to make THE necessary sacrifices that would reduce personal emissions. While political, economic, and technological factors are the most apparent barr iers to reform, climate change can also be understood as a moral failure. Fr om a psychological standpoint, morality is an emotional belief that stems from Interpersonal relationships. The unprecedented scope of climate change has exposed the limits of the relational understanding of morality. We have been unable to frame our relationship with the biosphere in a manner that elicits a strong enough moral response to lead to decisive action. This paper does not attempt to offer a solution, but hopes instead to reveal the moral implications of climate inaction.
Two Separate Persons: Ethnicity and Identity in Trollope's Phineas Finn
Authors: Heine Jennifer
Published: January 2017

This essay explores Anthony Trollope’s decision to identify Phineas Finn, of his various “Palliser Novels,” as Irish. Many Victorian readers questioned Phineas’s ethnicity and lack of stereotypically Irish characteristics, and Trollope himself renounced this decision in his autobiography. The character’s Irishness, however, seems to be more than a gimm ick to differentiate the novel from similar tales of aspiring members of Parliament; in Phineas Finn, the author uses ethnicity to invert the national marriage trope. Trollope employs gendered ethnic stereotypes, casting his title character as feminine in his romantic entanglements and even his political behavior, while the English ladies he meets are described as masculine. But the character of Phineas emerges as more complicated than a feminine or emasculated one; in his tenuous loyalty to his docile Irish sweetheart, Phineas becomes a conventional male lead. His Irishness, then, lends a duality to his character that encompasses more than merely two national identities; it embodies two entirely different kinds of men: one masculine and the other feminine, one a philanderer and the other loyal, one English and the other Irish.
Divisions Dissected: A Deconstruction of Boston College's "Asian Bubble"
Authors: Park Daniel , Lee Yoon-Shin (Clara)
Published: January 2017

Asian American discrimination is often associated with the concept of the “Asian Bubb le.” This discrimination is no different in the Boston College (BC) community than in much of society at large. A serious consideration of the Asian Bubb le and the impact of this lababel on the asian community is necessary to obtain a full understanding of this complex issue and facilitate the search for a permanent solution. This research project is babased upon a survey of 236 BC students that was conducted to gauge respondent perceptions of the Asian community, involvements on campus, and connections with Asian American identity. results of the study reveal that students agree ababout the existence of negative perceptions of the Asian community. Nevertheless, the study also shows that the Asian community is not as exclusive as many perceive it to be, which offers hope for further research and action in the future.
The Blindspot: Asian Misrepresentation In Orange Is The New Black
Authors: Kim Clare
Published: January 2017

As our nation and society attempt to introduce the notion of post-raciality in the twenty-first century, it becomes clear that this idealistic view of race relations in the United States can only be seen as valid when whiteness is considered to be “normal” or “neutral.” This prioritization of whiteness can be easily identified throughout popular culture, especially with the tendency of mainstream film and television to whitewash casts. However, one of the most prominent shows of the current age, Orange is the New Black (OITNB), has a cast that challenges the blindly accepted hegemonic standards by bringing marginalized communities to the center of attention. While it shatters many preconceived stereotypes dealing with race, class, and gender through its diverse array of characters, the show’s handling of its Asian characters seems only to perpetuate racist tropes. This essay examines why we have developed a blindspot for Asians when dealing with race and race relations by using OITNB as a quintessential microcosm of society at large
Extra Point Under Review: Machine Learning And The NFL Field Goal
Authors: LeDoux James
Published: January 2017

The new NFL extra point rule first implemented in the 2015 season requires a kicker to attempt his extra point with the ball snapped from the 15-yard line. This attempt stretches an extra point to the equivalent of a 32-yard field goal attempt, 13 yards longer than under the previous rule. Though a 32-yard attempt is still a chip shot to any professional kicker, many NFL analysts were surprised to see the number of extra points that were missed. Should this really have been a surprise, though? Beginning with a replication of a study by Clark et. al, this study aims to explore the world of NFL kicking from a statistical perspective, applying econometric and machine learning models to display a deeper perspective on what exactly makes some field goal attempts more difficult than others. Ultimately, the goal is to go beyond the previous research on this topic, providing an improved predictive model of field goal success and a better metric for evaluating placekicker ability.
L’espace judiciaire pénal CEMAC : regard sur la déterritorialisation du droit pénal
Authors: Gatsi Éric-Adol T
Published: January 2017

Les enjeux liés à la lutte contre la criminalité transfrontalière et le raffermissement du Marché commun ont amené le législateur communautaire à jeter les bases d’un espace pénal commun dans la Communauté économique et monétaire des États de l’Afrique centrale (CEMAC). Intervenant dans un domaine où la souveraineté de l’État a longtemps été considérée comme un obstacle à toute harmonisation, la construction de l’espace pénal communautaire est perceptible sur les plans matériel et procédural. Sur le plan matériel, elle se manifeste par une communautarisation des règles pénales au moyen de l’institution d’infractions communautaires assorties de sanctions. Sur le plan procédural, la construction de l’espace pénal commun procède de la consécration, bien qu’imparfaite, du principe de la reconnaissance et de l’exécution mutuelles des décisions judiciaires en matière pénale, d’une part, et d’une procédure de coopération judiciaire qui emprunte progressivement la voie des organes communautaires, d’autre part.
Le fédéralisme coopératif entre territorialité et fonctionnalité : le cas des valeurs mobilières
Authors: Karazivan Noura
Published: January 2017

L’histoire constitutionnelle canadienne, et le fédéralisme en particulier, oscillent traditionnellement entre deux horizons analytiques contrastés : le premier, issu d’une approche territoriale ou dualiste, considère les compétences exclusives comme un terrain à morceler; le second repose sur une interprétation fonctionnelle des chefs de compétence et rejette l’étanchéité du partage des compétences que suppose le dualisme. Celui-ci alimente les écrits de juristes soucieux de préserver une fédération centralisée, où le palier fédéral aurait les coudées franches pour adopter des politiques législatives uniformes et efficaces à travers le pays. De ces deux visions contrastées, le fédéralisme coopératif est l’héritier, un peu désorienté, un peu en quête d’identité. Même s’il est fréquemment associé à une conception plus fonctionnelle du partage des compétences, il demeure balisé, voire astreint, par les limites imposées par le dualisme.

Chacune de ces visions sera explorée dans la première partie de cet article, à travers les écrits de deux figures de proue de l’histoire constitutionnelle canadienne, les juges, doyens et auteurs Jean Beetz et Bora Laskin. Une attention particulière sera portée à la manière dont chacun de ces auteurs a entrevu le fédéralisme coopératif, ses potentialités, ses risques. La seconde partie de ce texte étudie les divers usages du fédéralisme coopératif dans la jurisprudence constitutionnelle canadienne, en distinguant le recours au fédéralisme coopératif dans l’assouplissement de doctrines interprétatives, d’une part, et le recours à ce même principe en présence de régimes coopératifs intégrés, d’autre part. La troisième partie prend le litige des valeurs mobilières pour point d’ancrage, en effectuant, d’abord, un retour sur le Renvoi relatif à la Loi sur les valeurs mobilières, et en anticipant le rôle potentiel que le fédéralisme coopératif pourrait jouer dans le second renvoi, qui s’est amorcé, à l’automne 2016, devant la Cour d’appel du Québec.
Modeling susceptibility to drug-induced long QT with a panel of subject-specific induced pluripotent stem cells
Authors: Stillitano Francesca , Hansen Jens , Kong Chi-Wing , Karakikes Ioannis , Funck-Brentano Christian , Geng Lin , Scott Stuart , Reynier Stephan , Wu Ma , Valogne Yannick , Desseaux Carole , Salem Joe-Elie , Jeziorowska Dorota , Zahr Noël , Li Ronald , Iyengar Ravi , Hajjar Roger J , Hulot Jean-Sébastien
Published: January 2017

A large number of drugs can induce prolongation of cardiac repolarization and life-threatening cardiac arrhythmias. The prediction of this side effect is however challenging as it usually develops in some genetically predisposed individuals with normal cardiac repolarization at baseline. Here, we describe a platform based on a genetically diverse panel of induced pluripotent stem cells (iPSCs) that reproduces susceptibility to develop a cardiotoxic drug response. We generated iPSC-derived cardiomyocytes from patients presenting in vivo with extremely low or high changes in cardiac repolarization in response to a pharmacological challenge with sotalol. In vitro, the responses to sotalol were highly variable but strongly correlated to the inter-individual differences observed in vivo. Transcriptomic profiling identified dysregulation of genes (DLG2, KCNE4, PTRF, HTR2C, CAMKV) involved in downstream regulation of cardiac repolarization machinery as underlying high sensitivity to sotalol. Our findings offer novel insights for the development of iPSC-based screening assays for testing individual drug reactions.
Put to the test
Authors: Woon Marites T , Kamp Timothy J
Published: January 2017

Personalized heart muscle cells made from stem cells in the laboratory could be used to check an individual’s response to potential new drugs before clinical trials.
Use of Patient-Authored Prehistory to Improve Patient Experiences and Accommodate Federal Law
Authors: Warner Michael J. , Simunich Thomas J. , Warner Margaret K. , Dado Joseph
Published: January 2017

Context: Although federal law grants patients the right to view and amend their medical records, few studies have proposed a process for patients to coauthor their subjective history in their medical record. Allowing patients to fully disclose and document their medical history is an important step to improve the diagnostic process.

Objective: To evaluate patients’ office experience before and after they authored their subjective medical history for the electronic health record.

Methods: Patients were mailed a prehistory form and presurvey to be completed before their family medicine office visit. On arrival to the office, the prehistory form was scanned into the electronic health record while the content was transcribed by hospital staff into the appropriate fields in the history component of the encounter note. Postsurveys were given to patients to be completed after their visit. Pre- and postsurveys measured the patients’ perception of office visit quality as well as completeness and accuracy of their electronic health record documentation before and after their appointment. Medical staff surveys were collected weekly to measure the staff’s viewpoint of the federal law that allows patients to view and amend their medical records.

Results: Of 405 patients who were asked to participate, 263 patients aged 14 to 94 years completed a presurvey and a prehistory form. Of those 263 patients, 134 completed a postsurvey. The pre- and postsurveys showed improved patient satisfaction with the office visit and high scores for documentation accuracy and completeness. Before filling out the prehistory form, 116 of 249 patients (46.6%) agreed or strongly agreed that they felt more empowered in their health care by completing the prehistory form compared with 110 of 131 (84.0%) who agreed or strongly agreed after the visit (P<.001). Staff members agreed that patients should have the right to view and amend their medical records in accordance with federal law.

Conclusion: Empowering patients to contribute subjective information to their electronic health record has the potential to improve the diagnostic process. When conducting a medical encounter, the authors recommend having patients complete a prehistory form beforehand to improve the patient experience while accommodating federal law.
Somatic Dysfunction in the Diagnosis of Uncommon Ectopic Pregnancies: Surgical Correlation and Comparison With Related Pathologic Findings
Authors: Martingano Daniel , Canepa Hannah , Fararooy Setareh , Rybitskiy Dmitriy , Shahem Sam , Martingano Francis X. , Aglialoro George
Published: January 2017

Background: Ectopic pregnancies occur when the implantation of a fertilized ovum occurs outside the endometrial cavity. Such pregnancies occur in approximately 1.5% to 2.0% of all pregnancies and cause 6% of maternal deaths.

Objectives: To evaluate osteopathic structural examination (OSE) findings in patients with ectopic pregnancies of uncommon locations and to establish the utility of these findings in the diagnosis of these ectopic pregnancies.

Methods: In this prospective case series, a focused OSE was performed on each patient with an ectopic pregnancy at her initial presentation after the patient history but before other diagnostic or laboratory tests were performed and surgical treatment was initiated. Chapman reflex points (CRPs) were evaluated pre- and postoperatively. For comparison, patients who had otherwise normal first pregnancies, underwent elective postpartum bilateral tubal ligation, or had simple ovarian cysts were also included and received OSEs.

Results: Seven cases with ectopic pregnancies outside the fallopian tube were included. Two primary ovarian pregnancies and 1 heterotopic pregnancy (uterine and ovarian) had somatic dysfunction at the T10-T11 spinal levels and CRPs posterior for the ovary, 1 primary omental pregnancy with somatic dysfunction at the T9-T12 spinal levels and CRPs anterior and posterior for the ileum and jejunum, and 1 tubal pregnancy with somatic dysfunction at the T10-L1 spinal levels and CRPs anterior and posterior for the fallopian tube. Two cornual ectopic pregnancies were not associated with unique findings. These somatic dysfunctions and CRP findings appear to be distinct from those of comparison cases, including first pregnancies at any trimester, simple ovarian cysts, and elective bilateral tubal ligation.

Conclusion: The OSE findings demonstrated in these cases aided in the final diagnosis and thus can potentially prove helpful in cases of ovarian, tubal, and omental pregnancies to provide clues to abnormal ectopic pregnancy locations where diagnostic imaging results are insufficient or equivocal. Osteopathic structural examinations may allow osteopathic physicians to better prepare for treatment approaches, including surgery.
Common Foot and Ankle Injuries: What Not to Miss and How Best to Manage
Authors: Reissig Jessica , Bitterman Adam , Lee Simon
Published: January 2017

Injuries to the foot and ankle are commonly encountered, especially among athletes, and can lead to morbidity if not managed appropriately. Health care professionals must have a firm understanding of injury anatomy, diagnoses, and management. This article provides a review of lateral talus process fractures, os trigonum injuries, Lisfranc injuries, turf toe, navicular stress fractures, and syndesmotic injuries.
Long Thoracic Nerve Injury Caused by Overhead Weight Lifting Leading to Scapular Dyskinesis and Medial Scapular Winging
Authors: Berthold Justin B. , Burg Timothy M. , Nussbaum Ryan Paul
Published: January 2017

Scapular winging represents a rare phenomenon that most commonly results from nerve damage to either the long thoracic nerve, spinal accessory nerve, or, less commonly, the dorsal scapular nerve. This injury results in an abnormal scapulohumeral interaction during kinetic motion known as scapular dyskinesis. In this case report, the patient presented with scapular dyskinesis and medial scapular winging caused by overhead weight-lifting exercises, and a long thoracic nerve injury was diagnosed. Physicians are encouraged to consider long thoracic nerve damage in a patient with a history of repetitive overhead movements who presents with scapular dyskinesis and the corresponding restriction of overhead arm motions. Potential mechanisms of injury and treatment options are also discussed.
Primary Mural Endocarditis Without Valvular Involvement
Authors: Tahara Mai , Nagai Tomoo , Takase Yoshiyuki , Takiguchi Shunichi , Tanaka Yoshiaki , Kunihara Takashi , Arakawa Junko , Nakaya Kazuhiro , Hamabe Akira , Gatate Youdou , Kujiraoka Takehiko , Tabata Hirotsugu , Katsushika Shuichi
Published: January 2017

Primary mural endocarditis is an extremely rare infection in which nonvalvular endocardial involvement is seen without any cardiac structural abnormalities such as ventricular septal defects. The rapid and precise diagnosis of this disease remains challenging. We present 2 cases (67‐ and 47‐year‐old male patients) of pathologically confirmed primary mural endocarditis that could have been detected by initial transthoracic echocardiography in the emergency department. Transthoracic echocardiography and transesophageal echocardiography play critical roles in the early recognition and confirmation of primary mural endocarditis.
Brief exposure to small molecules allows induction of mouse embryonic fibroblasts into neural crest‐like precursors
Authors: Takayama Yuzo , Wakabayashi Tamami , Kushige Hiroko , Saito Yutaka , Shibuya Yoichiro , Shibata Shinsuke , Akamatsu Wado , Okano Hideyuki , Kida Yasuyuki S.
Published: January 2017

In this study, we propose a novel method for inducing neuronal cells by briefly exposing them to small‐molecule cocktails in a step‐by‐step manner. Global gene expression analysis with immunohistochemical staining and calcium flux assays reveal the generation of neurons from mouse embryonic fibroblasts. In addition, time‐lapse imaging of neural precursor‐specific enhancer expression and global gene expression analyses show that the neurons are generated by passing through a neural crest‐like precursor stage. Consistent with these results, the neural crest‐like cells are able to differentiate into neural crest lineage cells, such as sympathetic neurons, adipocytes, osteocytes, and smooth muscle cells. Therefore, these results indicate that brief exposure to chemical compounds could expand and induce a substantial multipotent cell population without viral transduction.
Cloud droplet activation through oxidation of organic aerosol influenced by temperature and particle phase state
Authors: Slade Jonathan H. , Shiraiwa Manabu , Arangio Andrea , Su Hang , Pöschl Ulrich , Wang Jian , Knopf Daniel A.
Published: January 2017

Chemical aging of organic aerosol (OA) through multiphase oxidation reactions can alter their cloud condensation nuclei (CCN) activity and hygroscopicity. However, the oxidation kinetics and OA reactivity depend strongly on the particle phase state, potentially influencing the hydrophobic‐to‐hydrophilic conversion rate of carbonaceous aerosol. Here, amorphous Suwannee River fulvic acid (SRFA) aerosol particles, a surrogate humic‐like substance (HULIS) that contributes substantially to global OA mass, are oxidized by OH radicals at different temperatures and phase states. When oxidized at low temperature in a glassy solid state, the hygroscopicity of SRFA particles increased by almost a factor of two, whereas oxidation of liquid‐like SRFA particles at higher temperatures did not affect CCN activity. Low‐temperature oxidation appears to promote the formation of highly‐oxygenated particle‐bound fragmentation products with lower molar mass and greater CCN activity, underscoring the importance of chemical aging in the free troposphere and its influence on the CCN activity of OA.
Martian electron foreshock from MAVEN observations
Authors: Meziane K. , Mazelle C. X. , Romanelli N. , Mitchell D. L. , Espley J. R. , Connerney J. E. P. , Hamza A. M. , Halekas J. , McFadden J. P. , Jakosky B. M.
Published: January 2017

Flux enhancements of energetic electrons are always observed when the Mars Atmosphere and Volatile EvolutioN (MAVEN) spacecraft is magnetically connected to the shock. The observations indicate that the foreshock electrons consist of two populations. The most energetic (E≥237 eV) originate from a narrow region at the nearly perpendicular shock. They always appear as spikes, and their flux level reaches a maximum when the angle θBn approaches 90°. The other population emanates from the entire Martian bow shock surface, and the flux level decreases slightly from the quasi‐parallel to quasi‐perpendicular regions. A detailed examination of the pitch angle distribution shows that the enhanced fluxes are associated with electrons moving sunward. Annulus centered along the interplanetary magnetic field direction is the most stringent feature of the 3‐D angular distribution. The gyrotropic character is observed over the whole range of shock geometry. Although such signatures in the electron pitch angle distribution function strongly suggest that the reflection off the shock of a fraction of the solar wind electrons is the main mechanism for the production of Martian foreshock electrons, the decay of the flux of the second population on the other hand has yet to be understood.
Extreme daily precipitation in coastal western Norway and the link to atmospheric rivers
Authors: Azad Roohollah , Sorteberg Asgeir
Published: January 2017

This work investigates the link between the most extreme daily precipitation (EDP) events observed since 1900 on the west coast of Norway and the large‐scale moisture fluxes over the North Atlantic Ocean. Using station precipitation data, vertically integrated water vapor (IWV) from Special Sensors Microwave Imager/Sounder (SSMIS) satellite observations and the state of the art NOAA‐twentieth Century (NOAA‐20C) reanalysis, it is shown that 55 out of 58 EDPs are associated with narrow plumes of intense low‐level moisture defined as atmospheric rivers. Despite the high spatial correlation between IWV fields in the SSMIS and NOAA‐20C data sets, the significant positive relationship between the maximum amount of observed precipitation at all stations and the IWV content hitting the coastal terrain is only observed in the SSMIS data set. Further, the composite analyses of synoptic conditions show that the preferred circulation type consists of a mean sea level pressure (MSLP) dipole pattern where a high‐pressure system over central Europe and a series of low‐pressure systems to the east of Iceland and over the Norwegian Sea are present. The west coast of Norway is located in the exit region of the anticyclonically curved upper tropospheric polar jet stream implying that the coupling of upper troposphere and surface dynamics begins to weaken at the time of EDPs. It is also found that the primary synoptic‐scale precursors are persistent positive 500 hPa height geopotential and MSLP anomalies over central Europe up to 10 days before the occurrence of EDP events.
Impacts of precipitation and potential evapotranspiration patterns on downscaling soil moisture in regions with large topographic relief
Authors: Cowley Garret S. , Niemann Jeffrey D. , Green Timothy R. , Seyfried Mark S. , Jones Andrew S. , Grazaitis Peter J.
Published: January 2017

Soil moisture can be estimated at coarse resolutions (>1 km) using satellite remote sensing, but that resolution is poorly suited for many applications. The Equilibrium Moisture from Topography, Vegetation, and Soil (EMT+VS) model downscales coarse‐resolution soil moisture using fine‐resolution topographic, vegetation, and soil data to produce fine‐resolution (10–30 m) estimates of soil moisture. The EMT+VS model performs well at catchments with low topographic relief (≤124 m), but it has not been applied to regions with larger ranges of elevation. Large relief can produce substantial variations in precipitation and potential evapotranspiration (PET), which might affect the fine‐resolution patterns of soil moisture. In this research, simple methods to downscale temporal average precipitation and PET are developed and included in the EMT+VS model, and the effects of spatial variations in these variables on the surface soil moisture estimates are investigated. The methods are tested against ground truth data at the 239 km2 Reynolds Creek watershed in southern Idaho, which has 1145 m of relief. The precipitation and PET downscaling methods are able to capture the main features in the spatial patterns of both variables. The space‐time Nash‐Sutcliffe coefficients of efficiency of the fine‐resolution soil moisture estimates improve from 0.33 to 0.36 and 0.41 when the precipitation and PET downscaling methods are included, respectively. PET downscaling provides a larger improvement in the soil moisture estimates than precipitation downscaling likely because the PET pattern is more persistent through time, and thus more predictable, than the precipitation pattern.