bluuebunny/crossref_metadata_2025 huggingface dataset:
Pedro Infante and the Mexican Imagination
Authors: Acosta Sal
Published: April 2018

Pedro Infante (1917–1957) remains one of Mexico’s most beloved entertainers of all time. His films and songs, his life story and his charm, but also his death and funeral and the contestation over his patrimony have combined to sustain his popularity to this day. In part, his contemporaneous and posthumous representation as a common man, a man of el pueblo (the people), cemented a prominence that was already unparalleled during his lifetime. An overview of his life, career, and legacy provides a viable lens to understand his enduring fame, locating him within the Mexican imagination. That is, important events in his life make more sense when seen as specific images that Infante has represented: the humble carpenter, charro (cowboy), singer, boxer, and tragic figure. He has even represented Mexico itself for the Mexican community of the United States. The man and his characters seem to blend into an array of personas that consistently convey humility and charisma. Therefore, one can see why people around him have tried to appropriate his image and his story—efforts that began while he was still alive. Notably, his funeral marked the birth of the Infante who has reverberated among several generations of fans, but one that does not always match the Infante that his contemporaneous audiences admired. All versions of Infante, including the actual person and the characters that he played, have garnered attention and admiration since he began his career in the 1930s.
Luiz Inácio Lula da Silva and the Brazilian Workers’ Party (PT)
Authors: Goertzel Ted
Published: April 2018

Luiz Inácio Lula da Silva (b. Caetés, Pernambuco, Brazil, October 27, 1945) was born in severe poverty in the Brazilian northeast. “Lula” was a nickname which he legalized as an adult so that it could be listed on election ballots. He is universally referred to as Lula in Brazil. When he was seven years old his mother took the family on the back of a truck to the state of São Paulo in the hope of joining Lula’s father, who had abandoned the family. With her help, and without Lula’s illiterate and abusive father’s encouragement, he went to school to become a lathe mechanic. He then became a union activist and a leader of massive strikes in the industrial suburbs of São Paulo during the last years of Brazil’s military regime.

In 1980, Lula joined with progressive union leaders, activists, and intellectuals in organizing the Partido dos Trabalhadores (PT), or Workers’ Party. The PT was distinguished by its internal democracy and intellectual openness, and many on the left, in Brazil and elsewhere, believed it had great potential for reconciling socialist economics with political democracy. It initiated participatory budgeting practices in an effort to go beyond formal electoral democracy. Lula da Silva’s charisma made him the Party’s most popular leader. Lula won a seat in Congress in 1986, then was defeated in presidential campaigns in 1989, 1994, and 1998. In 2002, he adopted a more moderate campaign platform and was elected president of Brazil. He was re-elected in 2006 and passed the presidency on to his chief of staff, Dilma Rousseff, at the end of his second term.

As president of Brazil, Lula followed moderate economic and social policies, building on the accomplishments of his predecessor rather than making the radical changes many Workers’ Party activists and supporters wanted. The economy grew during his presidency, and he was able to increase funding for income redistribution programs that helped the poorest Brazilians. His administration was tarnished, however, by a massive corruption scandal involving illegal payments to members of Congress. Brazil went into a recession after Dilma Rousseff’s re-election in 2014, and there was an even larger corruption scandal involving the national oil company. Rousseff was impeached in 2016, and the Workers’ Party lost control of the Brazilian government and fared badly in municipal elections. Lula da Silva was convicted on corruption charges. If his conviction is not reversed on appeal, or if he is convicted on other pending indictments, he will not be allowed to compete for the presidency in the 2018 elections.
Revolutionary Influences on Genre Cinema in Mexico
Authors: Jenkins Jennifer L.
Published: April 2018

The visual and technical culture of the Mexican Revolution shaped and was shaped by cinematic innovation in newsreel and fiction filmmaking, which evolved simultaneously with those social changes, presenting the image of those changes for the first time to Mexican audiences. While Russian Sergei Eisenstein has been (wrongly) credited with inventing Mexican cinema, a strong tradition of family-based production units existed long before Eisenstein’s visit and persists to this day. From the earliest newsreels of the conflict to the melodramas and historical epics of the epoca de oro, the Revolution infused cinematic narrative in the first half of the 20th century. As such, distinctive visual tropes and film language evolved in response and counterdistinction to Revolutionary ideals. Moving toward midcentury, cinema developed genres and narratives that continually revisioned the Revolution, creating the epoca de oro films. In this period, the film industry developed in direct correlation to the agendas of the sitting presidents, Lázaro Cárdenas (1934–1940), Manuel Ávila Camacho (1940–1946), and Miguel Alemán Valdés (1946–1952). Influential directors Fernándo de Fuentes, Emilio Fernández, and Spanish immigrant Luis Buñuel, along with cinematographer Gabriel Figueroa, shaped the charter myths of modern Mexico though their cinematic works. At midcentury, with the advent of television and a postwar economic boom, Revolution-themed films appeared in near-continuous playback on television, while Buñuel inaugurated a cinema of realism that explored the harsher realities of the failure of Revolutionary ideals for the urban underclasses. The cultural imaginary that is cinema continued this exploration up to and after the tragedies of 1968.
The Mexican Son , Past and Present
Authors: Paraíso Raquel G.
Published: April 2018

Among the many musical traditions of Mexico, the son is one of the most representative of the richness and diversity of Mexican culture. Son (or sones) is a generic term that describes both a complex of genres and the various regional subgenres that make up that complex. Son is a type of traditional music performed by small ensembles, with or without singing, and danced. It serves to entertain, but is also performed at celebratory occasions and festivals as well as in rituals. Although sones appear throughout Mexico marked by regional differences in both instrumentation and performance styles, they share common characteristics that define the genre as a whole, musically (i.e., their rhythmic, melodic, and harmonic structures), lyrically, and choreographically. Because of the particular cultural traits and sociocultural contexts that each son subgenre encompasses, it can be argued that regional sones are a powerful expression of Mexican regional musics, cultures, and social identities.

Born as a hybrid genre out of the intermixing of European, American Indian, African, and Afro-Caribbean musical elements and contexts, Mexican sones have moved through time defined by many as a symbol of Mexican identity, even if the very concept of that “Mexican identity” has changed over time. What might be called the son’s “Golden Age” lasted from the 1890s until the middle of the 20th century. By the 1960s, sones were in serious decline all around Mexico: they had lost the favor of their audiences, old performers had passed away, and new generations did not engage with these musical traditions. Cultural politics contributed to selective processes through which some son subgenres faded away. Sociopolitical processes from the 1930s to the 1980s contributed to the re-contextualization of the Mexican son through modified versions of sones staged and broadcast in theatres, radio stations, and film productions. Post-revolutionary nationalism, the music industry, and folkloric ballets created these new versions and exercised an ideological control that both affected popular musical expressions and shaped musical tastes. Changes in urbanization and life conditions transformed social relationships and furthered this intense transformation.

With fewer performance occasions and little support from either the government or private patrons, several regional son subgenres became thin and isolated, with minimal projection outside their regions. In the 1980s, some of the son subgenres underwent a renaissance owing to various private and official initiatives that infused new life to the music. This article provides an overview of the son, past and present, connecting the relevance of this musical style with the social history of the country.
The Mexico that Spain Encountered
Authors: Schroeder Susan
Published: April 2018

The Spaniards had little idea of what to expect when they set foot in North America. Mexico, as the region is known today, was in the 16th century a vast territory with a grand history. Inhabited by diverse peoples for millennia, great civilizations had risen and then fallen, only to be supplanted by others.

The term “Mesoamerican” aptly describes the majority of peoples who lived in or near Mexico, for they shared many culture traits that depended not only on local resources but also on their ingenuity in exploiting all that was available. Food, technology, ball courts, monumental architecture, calendars, and record keeping are practices that characterize Mesoamerica. And in most instances, trade, whether local or long distance or by foot or canoe, served to join different groups across the land through an exchange of commodities, ideas, and the people themselves. Best known, and it might be said the first among many, are the Maya and the Aztecs.
Linguistic Landscape of Ethiopia
Authors: Lanza Elizabeth , Woldemariam Hirut
Published: April 2018

The linguistic landscape (henceforth LL) has proven to be a fruitful approach for investigating various societal dimensions of written language use in the public sphere. First introduced in the context of bilingual Canada as a gauge for measuring ethnolinguistic vitality, in the 21st century it is the focus of a thriving field of inquiry with its own conference series, an increasing number of publications, and an international journal dedicated exclusively to investigating language and other semiotic resources used in the public arena. The scholarship in this domain has centered on European and North American geographical sites; however, an increasingly voluminous share of studies addresses the LL of sites across the world through both books and articles. African contributions have added an important dimension to this knowledge base as southern multilingualisms bring into question the very concept of language in that speakers and writers draw on their rich linguistic repertoires, avoiding any compartmentalization or separation of what is traditionally conceived of as languages. The LL of Ethiopia has contributed to this growing base of empirical studies in the exploration of language policy issues, identity constructions, language contact, and the sociolinguistics of globalization. A new language policy of ethnic federalism was introduced to the country in the 1990s following a civil war and through a new constitution. This policy was set to recognize the various ethnolinguistic groups in the country and the official use of ethnic/regional languages to satisfy local political and educational needs. Through this, languages previously unwritten required a script in order for speakers to communicate in them in written texts. And many regions have chosen the Latin script above the Ethiopic script. Nonetheless, some languages remain invisible in the public sphere. These events create an exciting laboratory for studying the LL. Given the change of language policy since the late 20th century and the fast-growing economy of Ethiopia (one of the poorest countries on the continent) the manifest and increasingly visible display of languages in the LL provides an excellent lens for studying various sociolinguistic phenomena.
Romance in Contact With Semitic
Authors: Baglioni Daniele
Published: April 2018

All through their history, Romance languages have been variously influenced by Arabic and Hebrew. The most relevant influence has been exerted by Arabic on Ibero-Romance and Sicilian in the Middle Ages, from, respectively, the Umayyad conquest of al-Andalus (711–716) and the Aghlabid attack on Sicily (827). Significant factors favoring Romance–Arabic contact have also been trade in the medieval Mediterranean (especially between Italy and the Crusader States), scientific translations from Arabic into Latin (notably those made in 13th-century Castilia), and medieval and early modern travelogues and pilgrimages, whereas of lesser importance are more recent lexical exchanges due to colonialism in North Africa and immigration, which have had a considerable impact on French. As for Hebrew, its influence has been quantitatively less relevant and mostly mediated through other languages (Greek and Latin, the Judeo-Romance languages, English). Still, it is of capital importance on a cultural level, at least as far as biblical loanwords shared by all Romance languages are concerned.

Effects of Semitic influence on Romance are almost exclusively limited to lexical borrowing, in the form of both loanwords and loan translations, regarding several semantic fields, such as agriculture, architecture, clothing, medicine, natural sciences, and seafaring (Arabic); religion and liturgy (Hebrew); and anthroponomy (Hebrew and Arabic). Only in individual dialects does structural interference occur, as is the case with pantesco, the Sicilian variety of Pantelleria, which shows traces of both phonological and syntactic contact-induced changes. Finally, though not belonging to the Romance linguistic family, a very peculiar case is represented by Maltese, the Semitic language of Malta that, throughout its history, has been strongly influenced by Sicilian and—to a lesser extent—by Italian both in its lexicon and in its grammar.
The Playful Lexicon in the Romance Languages: Prosodic Templates, Onomatopoeia, Reduplication, Clipping, Blending
Authors: Pharies David
Published: April 2018

A lexical item is described as “playful” or “ludic” when it shows evidence of manipulation of the relation that inheres between its form (signifier) and its meaning (signified). The playful lexicon of any given language, therefore, is the sum total of its lexical items that show signs of such manipulation. Linguists have long recognized that the only necessary link between a word’s form and its meaning is the arbitrary social convention that binds them. However, nothing prevents speakers from creating additional, unnecessary and therefore essentially “playful” links, associating forms with meanings in a symbolic, hence non-arbitrary way. This semantic effect is most evident in the case of onomatopoeia, through which the phonetic form of words that designate sounds is designed to be conventionally imitative of the sound. A second group of playful words combines repeated sequences of sounds with meanings that are themselves suggestive of repetition or related concepts such as collectivity, continuity, or actions in sequence, as well as repeated, back-and-forth, or uncontrolled movements, or even, more abstractly, intensity and hesitation. The playfulness of truncated forms such as clips and blends is based on a still more abstract connection between forms and meanings. In the case of clipping, the truncation of the full form of a word triggers a corresponding connotative truncation or diminution of the meaning, that is, a suggestion that the referent is small—either endearingly, humorously, or contemptuously so. In blending, truncation is often accompanied by overlapping, which symbolically highlights the interrelatedness or juxtaposition of the constituents’ individual meanings. Prosodic templates do not constitute a separate category per se; instead, they may play a part in the formation or alteration of words in any of the other categories discussed here.
Morphology and Phonotactics
Authors: Gouskova Maria
Published: April 2018

Phonotactics is the study of restrictions on possible sound sequences in a language. In any language, some phonotactic constraints can be stated without reference to morphology, but many of the more nuanced phonotactic generalizations do make use of morphosyntactic and lexical information. At the most basic level, many languages mark edges of words in some phonological way. Different phonotactic constraints hold of sounds that belong to the same morpheme as opposed to sounds that are separated by a morpheme boundary. Different phonotactic constraints may apply to morphemes of different types (such as roots versus affixes). There are also correlations between phonotactic shapes and following certain morphosyntactic and phonological rules, which may correlate to syntactic category, declension class, or etymological origins.

Approaches to the interaction between phonotactics and morphology address two questions: (1) how to account for rules that are sensitive to morpheme boundaries and structure and (2) determining the status of phonotactic constraints associated with only some morphemes. Theories differ as to how much morphological information phonology is allowed to access. In some theories of phonology, any reference to the specific identities or subclasses of morphemes would exclude a rule from the domain of phonology proper. These rules are either part of the morphology or are not given the status of a rule at all. Other theories allow the phonological grammar to refer to detailed morphological and lexical information. Depending on the theory, phonotactic differences between morphemes may receive direct explanations or be seen as the residue of historical change and not something that constitutes grammatical knowledge in the speaker’s mind.
The Morphology of Yam Languages
Authors: Carroll Matthew J.
Published: April 2018

The Yam languages are a primary language family spoken in southern New Guinea across an area spanning around 180km west to east across both the Indonesian province of Papua and Papua New Guinea.

The Yam languages are morphologically remarkable for their complex verbal inflection characterized by a tendency to distribute inflectional exponence across multiple sites on the verb. Under this pattern of distributed exponence, segmental formatives, that is, affixes, are identifiable but assigning any coherent semantics to these elements is often difficult and instead the inflectional meanings can only be determined once multiple formatives have been combined. Despite their complex inflectional morphology, Yam languages display comparatively impoverished word formation or derivational morphology.

Nominal inflection is characterized by moderately large case inventories, the largest displaying 16 cases. Nouns are occasionally marked for number although this is typically restricted to certain case values. Verbal paradigms are much larger than nominal paradigms. Verbs mark agreement with up to two arguments in person, number, and natural gender. Verbs also mark complex tense, aspect, and mood values; in all languages this involves at least two aspect values, multiple past tense values, and some level of grammatical mood marking. Verbs may also be marked for diathesis, direction, and/or pluractionality.

The overall morphological pattern is that of fusional or inflectional languages. Nominal inflection is rather straightforward with nominals taking case suffixes or clitics with little to no inflectional classes. The true complexity lies in the organization of the verbal inflectional system, about which, despite individual variation across the family, a number of architectural generalizations can be made. The family displays a fairly uniform verbal inflectional template and all languages make a distinction between prefixing and ambifixing verbs. Prefixing verbs show agreement via a prefix only while ambifixing verbs via agreement with a suffix, for monovalent clauses, or with both a prefix and a suffix for bivalent verbs. These agreement affixes are also involved in the distributed exponence of tense, aspect, and mood.
Valuing the Benefits of Green Stormwater Infrastructure
Authors: Ando Amy W. , Netusil Noelwah R.
Published: April 2018

Green stormwater infrastructure (GSI), a decentralized approach for managing stormwater that uses natural systems or engineered systems mimicking the natural environment, is being adopted by cities around the world to manage stormwater runoff. The primary benefits of such systems include reduced flooding and improved water quality. GSI projects, such as green roofs, urban tree planting, rain gardens and bioswales, rain barrels, and green streets may also generate cobenefits such as aesthetic improvement, reduced net CO2 emissions, reduced air pollution, and habitat improvement. GSI adoption has been fueled by the promise of environmental benefits along with evidence that GSI is a cost-effective stormwater management strategy, and methods have been developed by economists to quantify those benefits to support GSI planning and policy efforts. A body of multidisciplinary research has quantified significant net benefits from GSI, with particularly robust evidence regarding green roofs, urban trees, and green streets. While many GSI projects generate positive benefits through ecosystem service provision, those benefits can vary with details of the location and the type and scale of GSI installation. Previous work reveals several pitfalls in estimating the benefits of GSI that scientists should avoid, such as double counting values, counting transfer payments as benefits, and using values for benefits like avoided carbon emissions that are biased. Important gaps remain in current knowledge regarding the benefits of GSI, including benefit estimates for some types of GSI elements and outcomes, understanding how GSI benefits last over time, and the distribution of GSI benefits among different groups in urban areas.
The Global Groundwater Revolution
Authors: van der Gun Jac
Published: April 2018

Human behavior in relation to groundwater has remained relatively unchanged from ancient times until the early 20th century. Intercepting water from springs or exploiting shallow aquifers by means of wells or qanats was common practice worldwide, but only modest quantities of groundwater were abstracted. In general, the resource was taken for granted in absence of any knowledge regarding groundwater systems and their vulnerability. During the 20th century, however, an unprecedent change started spreading globally—a change so drastic that it could be called the Global Groundwater Revolution. It did not surface simultaneously everywhere but rather encroached into different regions as waves of change, with varied timing, depending on local conditions. This Global Groundwater Revolution has three main components: (1) rapid intensification of the exploitation of groundwater, (2) fundamentally changing views on groundwater, and (3) the emergence of integrated groundwater management and governance. These three components are mostly interdependent, although their emergence and development tend to be somewhat asynchronous. The Global Groundwater Revolution marks a radical historical change in the relation between human society and groundwater. It has taken benefits produced by groundwater to an unprecedented level, but their sustainability is assured only if there is good groundwater governance.
Improving the annotation of the Heterorhabditis bacteriophora genome
Authors: McLean Florence , Berger Duncan , Laetsch Dominik R , Schwartz Hillel T , Blaxter Mark
Published: April 2018

Background

Genome assembly and annotation remain exacting tasks. As the tools available for these tasks improve, it is useful to return to data produced with earlier techniques to assess their credibility and correctness. The entomopathogenic nematode Heterorhabditis bacteriophora is widely used to control insect pests in horticulture. The genome sequence for this species was reported to encode an unusually high proportion of unique proteins and a paucity of secreted proteins compared to other related nematodes.

Findings

We revisited the H. bacteriophora genome assembly and gene predictions to determine whether these unusual characteristics were biological or methodological in origin. We mapped an independent resequencing dataset to the genome and used the blobtools pipeline to identify potential contaminants. While present (0.2% of the genome span, 0.4% of predicted proteins), assembly contamination was not significant.

Conclusions

Re-prediction of the gene set using BRAKER1 and published transcriptome data generated a predicted proteome that was very different from the published one. The new gene set had a much reduced complement of unique proteins, better completeness values that were in line with other related species' genomes, and an increased number of proteins predicted to be secreted. It is thus likely that methodological issues drove the apparent uniqueness of the initial H. bacteriophora genome annotation and that similar contamination and misannotation issues affect other published genome assemblies.
Tissue Metabolic Changes Drive Cytokine Responses to Mycobacterium tuberculosis
Authors: Lachmandas Ekta , Rios-Miguel Ana B , Koeken Valerie A C M , van der Pasch Eva , Kumar Vinod , Matzaraki Vasiliki , Li Yang , Oosting Marije , Joosten Leo A B , Notebaart Richard A , Noursadeghi Mahdad , Netea Mihai G , van Crevel Reinout , Pollara Gabriele
Published: April 2018

Our study reveals that human tissue challenged with mycobacterial antigens induces differential expression of genes that regulate multiple metabolic pathways. We demonstrate that variable expression of these metabolic genes influences the cytokine response of immune cells stimulated by Mycobacterium tuberculosis.
Oral food challenge using different target doses and time intervals between doses
Authors: Yanagida Noriyuki , Sato Sakura , Nagakura Ken-ichi , Asaumi Tomoyuki , Ebisawa Motohiro
Published: April 2018

Purpose of review

The oral food challenge (OFC) is a specific and vital tool used in clinical practice to identify the level of tolerance a person exhibits toward certain foods while diagnosing food-related allergies. OFC methods differ among countries. The aim of this review is to evaluate different target doses and determine the time interval between doses used for OFC.

Recent findings

We analyzed recent articles on target doses and time between doses, and noted that some papers reported low target doses and less time between doses. A low-dose OFC appears to be a useful strategy; a time interval of 15 min between doses is short and that of at least 1 h is appropriate.

Low-dose OFCs appear to be well tolerated and effective to avoid complete elimination of the consumption of foods causing allergies. For the safety of the OFC method, the time interval between doses should be more than 30 min.
His Bundle Pacing
Authors: Patel Brijesh , Garg Jalaj , Chaudhary Rahul , Sablani Naveen , Gupta Rahul , Shah Mahek , Nazir Talha , Bozorgnia Babak , Natale Andrea
Published: April 2018

From 1993 to 2009, nearly 2.9 million pacemakers were implanted in the United States; the majority of which were dual-chamber pacemakers. One of the major physiologic advantages of dual-chamber pacing over single-chamber ventricular pacing is atrioventricular synchrony, which prevents the pacemaker syndrome. However, patients who are pacemaker dependent or use right ventricle (RV) apical pacing more than 40% of the time are at a risk of developing heart failure from electromechanical dyssynchrony. Studies have also shown that RV pacing results in nonphysiological activation of the left ventricle, leading to adverse clinical outcomes. Hence, alternative pacing sites, including the RV outflow tract, the high-RV septal region, bi-ventricular pacing, or His bundle pacing, have been explored for a better physiological electromechanical coupling of the ventricles. Although His bundle pacing has gained attention due to favorable data and clinical outcomes, it has not gained widespread acceptance into clinical practice. Hence, we aim to review the current experience with His bundle pacing and its clinical implications in this article.
Diagnosis, Treatment, and Management of Orthotopic Liver Transplant Candidates With Portopulmonary Hypertension
Authors: Koulava Anna , Sannani Abdallah , Levine Avi , Gupta Chhaya Aggarwal , Khanal Sarina , Frishman William , Bodin Roxana , Wolf David C. , Aronow Wilbert S. , Lanier Gregg M.
Published: April 2018

Portopulmonary hypertension (POPH) is seen in 5–8% of orthotopic liver transplantation (OLT) candidates and has significant implications for clinical outcomes. POPH is characterized by vasoconstriction and remodeling of the pulmonary vasculature. It is exacerbated by the hyperdynamic circulation that is common in advanced liver disease. Screening all OLT candidates with transthoracic echocardiography to assess pulmonary pressures and right ventricular function is crucial, as clinical symptoms alone are not reliable. Any significant right ventricular dysfunction or dilatation along with an elevation in estimated pulmonary pressures usually triggers further investigation with right heart catheterization. The mainstays of therapy of POPH are vasodilators that are used in pulmonary arterial hypertension. They include monotherapy or combination therapy with prostanoids, endothelin receptor antagonists, and phosphodiesterase-5 inhibitors/guanylate cyclase stimulator. Limited evidence from smaller studies and case series suggests that a timely diagnosis of POPH and the early initiation of treatment improve patient outcomes, whether or not OLT is ultimately undertaken. Given the historically high perioperative mortality rate of more than 35%, POPH remains a contraindication to OLT unless it is treated and responsive to vasodilator therapy. We review the current literature and International Liver Transplant Society practice guidelines (2016) for the latest in understanding POPH, its pathogenesis, diagnosis, modern pharmacological treatment, indications, and contraindications for OLT, as well as perioperative management.
Interatrial Shunting, a Novel Device-Based Therapy for Patients With Heart Failure
Authors: Yum Brian K.W. , Frishman William H.
Published: April 2018

Heart failure (HF) patients with either reduced ejection fraction or preserved ejection fraction experience a high mortality rate. The most recent pharmacologic advance for treating patients with HF with reduced ejection fraction has been with sacubitril/valsartan. Along with pharmaceutical research, there has been interest in device-based therapies as another treatment approach. One novel interventional device therapy that has shown promise in early tests and trials is the interatrial shunt device developed by Corvia Medical Inc. and the V-Wave device by V-Wave Ltd. Inserted between the atria in the atrial septum, both devices create a left-to-right unidirectional shunt. The aim is to decompress the left atrium, thereby, possibly reducing symptoms related to pulmonary congestion. With encouraging initial results and a favorable safety profile in non-randomized studies involving less than 100 patients, interatrial shunting may be a viable therapeutic approach for HF patients who remain symptomatic despite optimal medical therapy. It is hoped that these devices will be especially effective in HF with preserved ejection fraction, which has seen very few successful treatments in the past decade. To solidify its place as a successful treatment option, however, the results from randomized controlled trials, which are currently underway, will be crucial.
Risk-Adjusted Overall Mortality as a Quality Measure in the Cardiovascular Intensive Care Unit
Authors: Goldfarb Michael
Published: April 2018

Risk-adjusted mortality has been proposed as a quality of care indicator to gauge cardiovascular intensive care Unit (CICU) performance. Mortality is easily measured, readily understandable, and a meaningful outcome for the patient, provider, administrative agencies, and other key stakeholders. Disease-specific risk-adjusted mortality is commonly used in cardiovascular medicine as an indicator of care quality, for external accreditation, and to determine payer reimbursement. However, the evidence base for overall risk-adjusted mortality in the CICU is limited, with most available data coming from the general critical care literature. In addition, existing risk-adjusted mortality models vary considerably in terms of approach and composition, and there is no nationally recognized standard. Thus, the objective of this study was to review the use of risk-adjusted mortality as a measure of overall unit performance and quality of care in the CICU. We found a considerable variability in the risk-adjustment methodology for cardiovascular disease. Although predictive models for disease-specific risk-adjusted mortality in cardiovascular disease have been developed, there are limited published data on overall risk-adjusted mortality for the CICU. Without standardization of risk-adjustment methodology, researchers are often required to use existing risk-adjustment models developed in noncardiac patient populations. Further studies are needed to establish whether risk-adjusted overall CICU mortality is a valid performance measure and whether it reflects care quality.
Do Dads Make a Difference? Family Feeding Dynamics and Child Fussy Eating
Authors: Harris Holly A. , Jansen Elena , Mallan Kimberley M. , Daniels Lynne , Thorpe Karen
Published: April 2018

Objective:

Few studies on child feeding have focused on family dynamics or disadvantaged families, yet feeding occurs in the complex social, economic, and relational context of the family. We examined how the level (high vs low) and concordance (concordant vs discordant) of nonresponsive feeding practices of mothers and fathers are associated with child fussy eating, in a socioeconomically disadvantaged Australian sample.

Methods:

Mother-father pairs (N = 208) of children aged 2 to 5 years old independently completed validated questionnaires reporting their “persuasive feeding,” “reward for eating,” “reward for behavior,” and child's “food fussiness.” The fussiness scores did not differ between mother-father pairs and were averaged to derive a single dependent variable. K-means cluster analyses were used to assign mother-father pairs to clusters for each feeding practice, based on mean scores. Three ANCOVAs, corresponding to each feeding practice, tested differences in child fussiness across clusters while controlling for covariates.

Results:

Four clusters were identified for each feeding practice—concordant: (1) high (MHi/FHi) for both parents and (2) low (MLo/FLo) for both parents; and discordant: (3) high for mother but low for father (MHi/FLo); and (4) low for mother but high for father (MLo/FHi). For “persuasive feeding,” MLo/FLo reported lower levels of fussiness compared with MHi/FLo, MHi/FHi, and MLo/FHi (p values < 0.05). For “reward for eating,” MLo/FLo reported lower levels of fussiness than did MHi/FHi (p < 0.05). Child fussiness did not differ across “reward for behavior” clusters.

Conclusion:

In socioeconomically disadvantaged families, when parents are concordant in avoiding nonresponsive feeding practices, less child “food fussiness” is reported. Findings suggest that feeding interventions should consider inclusion of both parents in 2-parent households.
Ready, Set, Go: How Patients and Caregivers Are Prepared for Self-Management of an Implantable Ventricular Assist Device
Authors: Casida Jesus M. , Combs Pamela , Pavol MaryKay , Hickey Kathleen T.
Published: April 2018

Since the first use of an implantable ventricular assist device (VAD) nearly 3 decades ago, many VAD Centers in the United States expect patients and caregivers to manage the device and related care following hospital discharge. Despite this customary practice and the rapid advancements in VAD technology, no research data about the patient and caregiver preparations exist for self-management of VAD. This study explored the process of preparing patients and caregivers for VAD care before hospital discharge along with their perceived experiences of the discharge process. Using an exploratory research design, we collected the data with self-administered demographics and VAD Hospital Discharge Survey questionnaires. We analyzed the data provided by 102 patients and 116 caregivers from different regions in the United States. Patients’ mean age was 51.4 ± 13.8 years; they were predominantly White (78%); male (66%); and duration of device between 2 and 74 months. Caregivers were predominantly White (80%); female (81%); and had a mean of age 48.9 ± 12.7 years. Participants reported that their VAD care preparations, a crucial component of hospital discharge, were extensive and intensive processes comprising education, training, competency validation, and provision of resources for VAD self-management in home settings. Participants were satisfied with the process and felt prepared for discharge. Further research is needed to rectify the study limitations, advance the science of VAD self-management, and develop evidenced-based VAD self-management guidelines that are aimed at optimizing longevity of the VAD, patients’ health, and quality of life.
Left Ventricular Distension in Veno-arterial Extracorporeal Membrane Oxygenation: From Mechanics to Therapies
Authors: Rajagopal Keshava
Published: April 2018

Veno-arterial (V-A) extracorporeal membrane oxygenation (ECMO) is increasingly commonly used to treat acute cardiac or pulmonary failure because of a wide range of etiologies. However, despite progressively improving outcomes, the mortality associated with V-A ECMO, particularly when used to treat cardiac failure (its most common indication), continues to be high. Consistent with this, V-A ECMO is associated with numerous morbid complications. Left ventricular (LV) distension is a major complication of V-A ECMO, and is challenging both to treat and diagnose. The author review the pathophysiology underlying LV distension, and construct a systematic diagnostic and therapeutic approach.
Comparison of Outpatient and Inpatient Pediatric Rhinoplasty: Results From National Surgical Quality Improvement Program–Pediatric, 2012–2014
Authors: Garg Ravi K. , Garland Catharine B. , Mount Delora L. , Babchenko Oksana , Leverson Glen J. , Afifi Ahmed M.
Published: April 2018

Introduction:

Outpatient management of patients undergoing elective surgical procedures has been associated with significantly decreased health care costs compared with inpatient management. This study investigates current practices in outpatient versus inpatient management of pediatric rhinoplasty patients.

Methods:

A query was performed of the 2012 to 2014 National Surgical Quality Improvement Program–Pediatric data sets. Patients age 17 or younger undergoing rhinoplasty as the primary surgical procedure were included. Clinical characteristics and complications were compared among patients managed as inpatients versus outpatients using both univariate and multivariate logistic regression analyses.

Results:

Among 938 pediatric rhinoplasty patients, 199 (21.2%) were managed as inpatients. Multivariate analysis revealed multiple variables significantly associated with an increased odds of inpatient management, including young patient age, presence of a congenital malformation, neurologic or nutritional disease, lengthy procedure time, management by a plastic surgeon compared with an otolaryngologist, and certain procedure types including cleft septorhinoplasty, secondary rhinoplasty with intermediate or major revision, and rib cartilage grafting. Complications among both inpatients and outpatients were rare, with the most common complication being readmission among 15 patients (1.6%).

Conclusions:

This study indicates that multiple subgroups of pediatric patients undergoing rhinoplasty procedures have a significantly increased likelihood of inpatient management without any significantly increased likelihood of a complication or need for readmission. Future efforts to manage appropriately selected children on an ambulatory basis may be safe, while improving costs and quality of care.
How to feed patients with gastrointestinal mucositis
Authors: Arends Jann
Published: April 2018

Purpose of review

Gastrointestinal mucositis is a frequent side effect of systemic anticancer treatment and radiotherapy. The occurrence endangers body resources by decreasing food intake and absorption. This review highlights new developments in treatment and prevention.

Recent findings

Recent clinical practice guidelines recommend supplying adequate amounts of energy and nutrients to cancer patients undergoing anticancer treatments. This requires repeated screening for risk of malnutrition and in at-risk patients, assessment of food intake and nutritional status, followed by nutritional interventions targeted at individual deficiencies and tolerance to oral, enteral or parenteral feeding. Recent preclinical data report beneficial effects of stimulating the sensor for cell damage signals TRPA1, blocking histamine H2 receptors or supplying probiotics. In a recent clinical trial, amifostine reduced gastrointestinal symptoms and was well tolerated. Probiotics are studied in ongoing clinical trials and glucagon-like peptide 2 analogues are considered for future trials. Due to limited options available today, it has been suggested to also consider several plant-based complementary therapies.

Although options for prevention and treatment of chemotherapy or radiotherapy-induced gastrointestinal mucositis today are still limited, inadequate energy and nutrient intake should trigger nutritional interventions, including counselling, oral nutritional supplements, tube feeding and parenteral nutrition. To prevent gastrointestinal mucositis, several new agents have shown promising results in preclinical trials.
Climate and development: enhancing impact through stronger linkages in the implementation of the Paris Agreement and the Sustainable Development Goals (SDGs)
Authors: Gomez-Echeverri Luis
Published: April 2018

One of the greatest achievements in the global negotiations of 2015 that delivered the 2030 Agenda for Sustainable Development or Sustainable Development Goals (SDGs) and the Paris Agreement on climate change is that, for the first time, the linkages between climate and development were enshrined in each of the documents. This was done in recognition that climate change and development need to be addressed together in order not only to avoid harmful trade-offs and high costs, particularly for poorer countries, but also to exploit the benefits that come from strengthening these linkages. This review presents some of the latest data that argue for stronger linkages as well as the challenges of implementation which are not only politically and economically related but also include issues such as knowledge gaps, finance and governance. Finally, the review also presents a glimpse at the pathways that will be required to reach the ambitious global temperature targets of the Paris Agreement of less than 2°C above pre-industrial levels with efforts to limit temperature rise even further to 1.5°C. This provides the context for some conclusions and recommendations for policy-makers, including on methodologies for assessing linkages and leveraging them for greater benefit.

This article is part of the theme issue ‘The Paris Agreement: understanding the physical and social challenges for a warming world of 1.5°C above pre-industrial levels’.
Phrank measures phenotype sets similarity to greatly improve Mendelian diagnostic disease prioritization
Authors: Jagadeesh Karthik A. , Birgmeier Johannes , Guturu Harendra , Deisseroth Cole A. , Wenger Aaron M. , Bernstein Jonathan A. , Bejerano Gill
Published: April 2018

Purpose

Exome sequencing and diagnosis is beginning to spread across the medical establishment. The most time-consuming part of genome based diagnosis is the manual step of matching the potentially long list of patient candidate genes to patient phenotypes to identify the causative disease.

Methods

We introduce Phrank (for phenotype ranking), an information-theory inspired method that utilizes a Bayesian Network to prioritize candidate diseases or genes, as a stand-alone module that can be run with any underlying knowledgebase and any variant filtering scheme.

Results

Phrank outperforms existing methods at ranking the causative disease or gene when applied to 169 real patient exomes with Mendelian diagnoses. Phrank’s greatest improvement is in disease space, where across all 169 patients it ranks only 3 diseases on average ahead of the true diagnosis, whereas Phenomizer ranks 32 diseases ahead of the causal one.

Conclusion

Using Phrank to rank all patient candidate genes or diseases, as they start working through a new case, will save the busy clinician much time in deriving a genetic diagnosis.
Constant conflict betweenGypsyLTR retrotransposons and CHH methylation within a stress-adapted mangrove genome
Authors: Wang Yushuai , Liang Weiqi , Tang Tian
Published: April 2018

Evolutionary dynamics of the conflict between transposable elements (TEs) and their host genome remain elusive. This conflict would be intense in stress-adapted plants as stress can often reactivate TEs. Mangroves reduce TE load convergently in their adaptation to intertidal environments and thus provide a unique opportunity to address the host-TE conflict and its interaction with stress adaptation.

Using the mangroveRhizophora apiculataas a model, we investigated methylation and short interfering RNA (siRNA) targeting patterns in relation to the abundance and age of long terminal repeat (LTR) retrotransposons. We also examined LTR retrotransposons’ distance to genes, impact on neighboring gene expression, and population frequencies.

We found differential accumulation among classes of LTR retrotransposons despite high overall methylation levels. This can be attributed to 24-nt siRNA-mediated CHH methylation preferentially targetingGypsyelements, particularly in their LTR regions. OldGypsyelements possess unusually abundant siRNAs which show cross-mapping to young copies.Gypsyelements appear to be closer to genes and under stronger purifying selection than other classes.

Our results suggest a continuous host-TE battle masked by the TE load reduction inR. apiculata. This conflict may enable mangroves likeR. apiculatato maintain genetic diversity and thus evolutionary potential during stress adaptation.
Plant odour and sex pheromone are integral elements of specific mate recognition in an insect herbivore
Authors: Borrero-Echeverry Felipe , Bengtsson Marie , Witzgall Peter
Published: April 2018

Specific mate recognition strongly relies on the chemical senses in many animals, and especially in nocturnal insects. Two signal types lend to premating olfactory communication in terrestrial habitats: sex signals blend into an atmosphere of habitat odorants, where plant volatiles prevail. We show for the first time that males of the African cotton leafwormSpodoptera littoralisperceive female sex pheromone and volatiles of its plant host cotton as a unit, rather than as independent messages. In clean air,S.littoralismales are attracted to flawed pheromone signals, such as single synthetic pheromone components or even the pheromone of a sibling species, Oriental leafwormS.litura. Presence of host plant volatiles, however, strongly reduces the male response to deficient or heterospecific pheromone signals. That plant cues enhance discrimination of sex pheromone quality confirms the idea that specific mate recognition in noctuid moths has evolved in concert with host plant adaptation. A participation of host plant odour in sexual communication suggests that mate recognition is under natural and sexual selection. Moreover, shifts in either female host preference or sex pheromone biosynthesis give rise to new communication channels that have the potential to initiate or contribute to reproductive isolation.