bluuebunny/crossref_metadata_2025 huggingface dataset:
Associations of Pre-Transplant Prescription Narcotic Use with Clinical Complications after Kidney Transplantation
Authors: Lentine Krista L. , Lam Ngan N. , Xiao Huiling , Tuttle-Newhall Janet E. , Axelrod David , Brennan Daniel C. , Dharnidharka Vikas R. , Yuan Hui , Nazzal Mustafa , Zheng Jie , Schnitzler Mark A.
Published: April 2015

Background: The impact of narcotic use before kidney transplantation on post-transplant clinical outcomes is not well described. Methods: We examined integrated national transplant registry, pharmacy records, and Medicare billing claims to follow 16,322 kidney transplant recipients, of whom 28.3% filled a narcotic prescription in the year before transplantation. Opioid analgesic fills were normalized to morphine equivalents (ME) and expressed as mg/kg exposures (approximate quartiles: 0.1-1.7, 1.8-5.4, 5.5-23.7, and ≥23.8 mg/kg, respectively). Post-transplant cardiovascular, respiratory, neurological, accidents, substance abuse, and noncompliance events were identified using diagnosis codes on Medicare billing claims. Adjusted associations of ME level with post-transplant complications were quantified by multivariate Cox regression. Results: The incidence of complications at 3 years post-transplant among those with the highest pre-transplant ME exposure compared to no use included: ventricular arrhythmias, 1.1 vs. 0.2% (p < 0.001); cardiac arrest, 4.7 vs. 2.7% (p < 0.05); hypotension, 14 vs. 8% (p < 0.0001); hypercapnia, 1.6 vs. 0.9% (p < 0.05); mental status changes, 5.3 vs. 2.7% (p < 0.001); drug abuse/dependence, 7.0 vs. 1.7% (p < 0.0001); alcohol abuse, 1.8 vs. 0.6% (p = 0.0001); accidents, 0.9 vs. 0.3% (p < 0.05); and noncompliance, 3.5 vs. 2.3% (p < 0.05). In multivariate analyses, transplant recipients with the highest level of pre-transplant narcotic use had approximately 2 to 4 times the risks of post-transplant ventricular arrhythmias, mental status changes, drug abuse, alcohol abuse, and accidents compared with non-users, and 35-45% higher risks of cardiac arrest and hypotension. Conclusion: Although associations may reflect underlying conditions or behaviors, high-level prescription narcotic use before kidney transplantation predicts increased risk of clinical complications after transplantation.
A Rare Case of Medulloblastoma Coexisting with Multiple Spinal Intramedullary Tumors
Authors: Rege Shrikant , Gupta Rakesh , Awasthi Rahul
Published: April 2015

Medulloblastoma is the most common primary central nervous system tumor of childhood. Medulloblastoma can metastasize along the neuraxis and to extraneural locations, but multiple intramedullary spinal metastases are very rare. The usual presenting clinical features are related to posterior fossa syndrome and/or hydrocephalus. We describe a unique case of medulloblastoma with multiple intramedullary lesions at the D-7 and D-12 levels.
Therapeutic Alliance in Antidepressant Treatment: Cause or Effect of Symptomatic Levels?
Authors: Zilcha-Mano Sigal , Roose Steven P. , Barber Jacques P. , Rutherford Bret R.
Published: April 2015

Background: Previous studies have shown that in psychotherapy alliance is a predictor of symptomatic change, even while accounting for the temporal precedence between alliance and symptoms. However, the extent to which alliance predicts outcomes in psychopharmacology is yet to be fully investigated considering the fact that alliance can be the result, rather than the cause, of symptomatic change. The current prospective study examined whether the alliance predicts outcomes in psychopharmacology, while controlling for previous symptomatic change throughout the course of treatment. Methods: Data from a psychopharmacological randomized controlled trial for the treatment of adult major depression (n = 42), including the patients' rating of the alliance with the physicians, were analyzed. Multilevel models controlling for autoregressive lag of the dependent variable were used in all analyses to examine the effect of alliance on outcome. Results: The effect of alliance on outcome, while controlling for prior symptomatic levels, was significant and restricted to the middle phase of treatment (week 4, p = 0.005), when most of the reductions in symptoms were observed. Exploratory analyses of the differences between placebo and medication conditions suggest that the differences between the patients in their average alliance levels predicted a greater reduction in symptoms in the placebo compared to the medication conditions (p = 0.008). The main limitation is the small cohort size. Conclusions: The findings suggest an effect of alliance on outcome in psychopharmacology, which is not merely the result of previous symptomatic levels. This effect may be more robust in conditions that do not include active treatment (placebo), possibly serving as a compensatory effect.
Plasma Neutrophil Gelatinase-Associated Lipocalin and Kidney Function Decline and Kidney Disease-Related Clinical Events in Older Women
Authors: Lim Wai H. , Lewis Joshua R. , Wong Germaine , Teo Rachel , Lim Ee M. , Byrnes Elizabeth , Prince Richard L.
Published: April 2015

Background: It is still unclear whether serum neutrophil gelatinase-associated lipocalin (NGAL), a biomarker of renal tubular injury, is a prognostic marker for the progression of chronic kidney disease (CKD) in the general population. Methods: A prospective-cohort study of 1,245 women aged ≥70 from the general population. Associations between plasma NGAL and change in 5-year estimated glomerular filtration rate (eGFR), rapid renal decline and 10-year risk of acute or chronic renal disease-related hospitalisations and/or mortality were examined. Results: Compared to women with above-median plasma NGAL of 76.5 ng/l, women with below-median plasma NGAL had a 9.3% reduction in eGFR over a 5-year period. Among women with above-median plasma NGAL, there was over a 1.7-fold increased risk of rapid renal decline (eGFR decline of >3 ml/min/year) (adjusted odds ratio 1.76, 95% CI 1.003, 3.102, p = 0.049). Compared to women with baseline eGFR of <60 ml/min/1.73 m2, women with above-median plasma NGAL experienced over a 2.5-fold increased risk of renal disease events at 10 years (hazard ratio 2.55, 95% CI 1.13, 5.78, p = 0.025) after adjustment of age, hypertension and diabetes. Addition of plasma NGAL in participants with eGFR of <60 ml/min/1.73 m2 significantly improved the accuracy in predicting the 10-year risk of renal disease events (adjusted area-under-curve receiver operator characteristics without and with NGAL 0.64 and 0.71, respectively; p = 0.027) and reclassified 13% of women who experienced renal disease events into the higher risk categories (p = 0.03). Conclusion: Plasma NGAL is of modest clinical utility in predicting the renal function decline and risk of renal disease-related clinical events, particularly those with mild to moderate CKD.
Efficacy of RetroNectin-Activated Cytokine-Induced Killer Cell Therapy in Metastatic Brain Tumor Patients
Authors: Li Wei , Wang Yaomei , Zhao Lingdi , Xu Linping , Zhang Yong , Mai Ling , Gao Quanli
Published: April 2015

Background: The aim of this study was to investigate the clinical efficacy of RetroNectin-activated cytokine-induced killer cell (R-CIK) therapy following conventional therapies in patients with metastatic brain tumors. Methods: This study included 20 patients with metastatic brain tumors. Patients received R-CIK therapy following conventional therapies (including chemotherapy and target therapy). Progression-free survival (PFS), overall survival (OS), and prognostic factors were evaluated. Results: Of the 4 breast cancer patients in our cohort, 2 remained alive and 2 died. Of the 14 non-small cell lung cancer (all adenocarcinoma) patients, 3 had a partial response, 8 had stable disease, and 3 had progressive disease after receiving R-CIKs. The overall response rate was 21.4% (3/14), and the disease control rate was 78.6% (11/14). The median PFS and OS were 7.7 months (95% confidence interval (CI) 3-16.5 months) and 12.6 months (95% CI 6-21 months), respectively. Conclusion: R-CIKs combined with conventional therapies could improve the prognosis of metastatic brain tumor patients, especially of those with adenocarcinoma of the lung.
Acute and Chronic Performance Evaluation of a Novel Epicardial Pacing Lead Placed by Percutaneous Subxiphoid Approach in a Canine Model
Authors: John Roy M. , Morgan Kevin , Brennecke Lucas H. , Benser Michael E. , Jais Pierre
Published: April 2015

Background—

Endovascularly implanted leads risk vascular injury and endocarditis, and can be difficult to locate in desired positions for LV pacing. We evaluated the acute and long-term stability, electric performance and histopathology of a percutaneously placed intrapericardial lead (IPL).

Methods and Results—

Twelve adult mongrel dogs underwent defibrillator implants incorporating IPLs. Successful uncomplicated percutaneous implantation of an IPL was achieved in all. Early fluoroscopic shift noted with 3 of 6 of the initial version IPL-1 was not seen with the modified IPL-2. Mean±95% confidence interval bipolar capture threshold at 0.5-ms pulse width for the IPL increased from 0.69±0.14 V at implant to 1.50±0.34 V (
P
=0.003) at 12 weeks. The 12-week thresholds were higher for IPL compared with right ventricular endocardial leads (0.75±0.33 V;
P
=0.001) but not different compared with coronary sinus leads (1.33±0.58 V;
P
=0.994). IPL impedance increased from 742±46 Ω at implant to 1066±207 Ω at 12 weeks (
P
=0.007). R-wave amplitude at 12 weeks was 8.37±1.52 mV. There was no important phrenic nerve stimulation from IPL pacing. Histopathology in 8 animals showed adequate adhesion of the electrodes or mesh to the epicardium without damage to underlying vasculature. There was no evidence for late pericardial inflammation or effusion.

Conclusions—

The IPL demonstrated adequate stability of position and acceptable electric parameters without chronic pericardial inflammation in this canine model and offers a potential alternative to endocardial pacing leads.
Feasibility of Combined Unipolar and Bipolar Voltage Maps to Improve Sensitivity of Endomyocardial Biopsy
Authors: Casella Michela , Pizzamiglio Francesca , Dello Russo Antonio , Carbucicchio Corrado , Al-Mohani Ghaliah , Russo Eleonora , Notarstefano Pasquale , Pieroni Maurizio , D’Amati Giulia , Sommariva Elena , Giovannardi Marta , Carnevali Andrea , Riva Stefania , Fassini Gaetano , Tundo Fabrizio , Santangeli Pasquale , Di Biase Luigi , Bolognese Leonardo , Natale Andrea , Tondo Claudio
Published: April 2015

Background—

Endomyocardial biopsy (EMB) has a low sensitivity. Electroanatomic voltage mapping (EVM) is effective in guiding EMB thanks to its ability in identifying and locating low-voltage regions. The analysis of unipolar EVM can correlate with epicardial pathological involvement. We evaluated the unipolar EVM in EMB areas to determine whether it can increase EMB sensitivity in diagnosing epicardial diseases.

Methods and Results—

We performed endocardial bipolar EVM-guided EMBs in 29 patients and we analyzed unipolar EVM at withdrawal sites. Eighty myocardial samples were collected (mean, 2.8±0.9; median, 3 fragments per patient) and 60 were suitable for histological analysis. Ten specimens (17%) were collected from an area with discordant normal bipolar/low-voltage unipolar EVM and they were diagnostic or suggestive for arrhythmogenic right ventricular dysplasia/cardiomyopathy in 6 patients, for myocarditis and sarcoidosis in 1 patient each. Six samples (10%) were collected from an area with discordant low-voltage bipolar/normal unipolar EVM and they showed nonspecific features. The sensitivity of unipolar EVMs for a diagnostic biopsy finding EMB was significantly higher compared with bipolar EVMs analyzed according to samples (
P
<0.01) and patients (
P
=0.008). The specificity of unipolar EMB was better than bipolar EMB when analyzed for all samples (
P
=0.0014) but the difference did not reach statistical significance when analyzed by patient (
P
=0.083). The diagnostic yield was 63.3% for the bipolar and 83.3% for the unipolar EVM.

Conclusions—

These findings suggest that use of a combined bipolar/unipolar map may be able to improve the diagnostic yield of endomyocardial ventricular biopsy.
Access and Non–Access Site Bleeding After Percutaneous Coronary Intervention and Risk of Subsequent Mortality and Major Adverse Cardiovascular Events
Authors: Kwok Chun Shing , Khan Muhammad A. , Rao Sunil V. , Kinnaird Tim , Sperrin Matt , Buchan Iain , de Belder Mark A. , Ludman Peter F. , Nolan James , Loke Yoon K. , Mamas Mamas A.
Published: April 2015

Background—

The prognostic impact of site-specific major bleeding complications after percutaneous coronary intervention (PCI) has yielded conflicting data. The aim of this study is to provide an overview of site-specific major bleeding events in contemporary PCI and study their impact on mortality and major adverse cardiovascular event outcomes.

Methods and Results—

We conducted a meta-analysis of PCI studies that evaluated site-specific periprocedural bleeding complications and their impact on major adverse cardiovascular events and mortality outcomes. A systematic search of MEDLINE and Embase was conducted to identify relevant studies and random effects meta-analysis was used to estimate the risk of adverse outcomes with site-specific bleeding complications. Twenty-five relevant studies including 2 400 645 patients that underwent PCI were identified. Both non–access site (risk ratio [RR], 4.06; 95% confidence interval [CI], 3.21–5.14) and access site (RR, 1.71; 95% CI, 1.37–2.13) related bleeding complications were independently associated with an increased risk of periprocedural mortality. The prognostic impact of non–access site–related bleeding events on mortality related to the source of anatomic bleeding, for example, gastrointestinal RR, 2.78; 95% CI, 1.25 to 6.18; retroperitoneal RR, 5.87; 95% CI, 1.63 to 21.12; and intracranial RR, 22.71; 95% CI, 12.53 to 41.15.

Conclusions—

The prognostic impact of bleeding complications after PCI varies according to anatomic source and severity. Non–access site-related bleeding complications have a similar prevalence to those from the access site but are associated with a significantly worse prognosis partly related to the severity of the bleed. Clinicians should minimize the risk of major bleeding complications during PCI through judicious use of bleeding avoidance strategies irrespective of the access site used.
High-Sensitivity Cardiac Troponin I and B-Type Natriuretic Peptide as Predictors of Vascular Events in Primary Prevention
Authors: Everett Brendan M. , Zeller Tanja , Glynn Robert J. , Ridker Paul M , Blankenberg Stefan
Published: April 2015

Background—

Cardiac troponin and B-type natriuretic peptide (BNP) concentrations are associated with adverse cardiovascular outcome in primary prevention populations. Whether statin therapy modifies this association is poorly understood.

Methods and Results—

We measured high-sensitivity cardiac troponin I (hsTnI) in 12 956 and BNP in 11 076 participants without cardiovascular disease in the Justification for the Use of Statins in Prevention: An Intervention Trial Evaluating Rosuvastatin (JUPITER) trial before randomization to rosuvastatin 20 mg/d or placebo. Nearly 92% of participants had detectable circulating hsTnI, and 2.9% of men and 4.1% of women had levels above proposed sex-specific reference limits of 36 and 15 ng/L, respectively. hsTnI concentrations in the highest tertile were associated with a first major cardiovascular event (adjusted hazard ratio [aHR], 2.19; 95% confidence interval, 1.56–3.06;
P
for trend <0.001). BNP levels in the highest tertile were also associated a first cardiovascular event (aHR, 1.94; 95% confidence interval, 1.41–2.68;
P
for trend <0.001). The risk of all-cause mortality was elevated for the highest versus the lowest tertiles of hsTnI (aHR, 2.61; 95% confidence interval, 1.81–3.78;
P
for trend <0.001) and BNP (aHR, 1.45; 95% confidence interval, 1.03–2.04;
P
for trend 0.02). Rosuvastatin was equally effective in preventing a first cardiovascular event across categories of hsTnI (aHR range, 0.50–0.60) and BNP (aHR range, 0.42–0.67) with no statistically significant evidence of interaction (
P
for interaction=0.53 and 0.20, respectively).

Conclusions—

In a contemporary primary prevention population, baseline cardiac troponin I and BNP were associated with the risk of vascular events and all-cause mortality. The benefits of rosuvastatin were substantial and consistent regardless of baseline hsTnI or BNP concentrations.

Clinical Trial Registration—

URL:
http://www.clinicaltrials.gov
. Unique identifier: NCT00239681.
Growth Hormone–Releasing Hormone Agonists Reduce Myocardial Infarct Scar in Swine With Subacute Ischemic Cardiomyopathy
Authors: Bagno Luiza L. , Kanashiro‐Takeuchi Rosemeire M. , Suncion Viky Y. , Golpanian Samuel , Karantalis Vasileios , Wolf Ariel , Wang Bo , Premer Courtney , Balkan Wayne , Rodriguez Jose , Valdes David , Rosado Marcos , Block Norman L. , Goldstein Peter , Morales Azorides , Cai Ren‐Zhi , Sha Wei , Schally Andrew V. , Hare Joshua M.
Published: April 2015

Background

Growth hormone–releasing hormone agonists (
GHRH
‐As) stimulate cardiac repair following myocardial infarction (
MI
) in rats through the activation of the
GHRH
signaling pathway within the heart. We tested the hypothesis that the administration of
GHRH
‐As prevents ventricular remodeling in a swine subacute
MI
model.

Methods and Results

Twelve female Yorkshire swine (25 to 30 kg) underwent transient occlusion of the left anterior descending coronary artery (
MI
). Two weeks post
MI
, swine were randomized to receive injections of either 30 μg/kg
GHRH
‐A (
MR
‐409) (
GHRH
‐A group; n=6) or vehicle (placebo group; n=6). Cardiac magnetic resonance imaging and pressure–volume loops were obtained at multiple time points. Infarct, border, and remote (noninfarcted) zones were assessed for GHRH receptor by immunohistochemistry. Four weeks of
GHRH
‐A treatment resulted in reduced scar mass (
GHRH
‐A: −21.9±6.42%;
P
=0.02; placebo: 10.9±5.88%;
P
=0.25; 2‐way
ANOVA
;
P
=0.003), and scar size (percentage of left ventricular mass) (
GHRH
‐A: −38.38±4.63;
P
=0.0002; placebo: −14.56±6.92;
P
=0.16; 2‐way
ANOVA
;
P
=0.02). This was accompanied by improved diastolic strain. Unlike in rats, this reduced infarct size in swine was not accompanied by improved cardiac function as measured by serial hemodynamic pressure–volume analysis.
GHRH
receptors were abundant in cardiac tissue, with a greater density in the border zone of the
GHRH
‐A group compared with the placebo group.

Conclusions

Daily subcutaneous administration of
GHRH
‐A is feasible and safe in a large animal model of subacute ischemic cardiomyopathy. Furthermore,
GHRH
‐A therapy significantly reduced infarct size and improved diastolic strain, suggesting a local activation of the
GHRH
pathway leading to the reparative process.
Trends in Door-to-Thrombolysis Time in the Safe Implementation of Stroke Thrombolysis Registry
Authors: Strbian Daniel , Ahmed Niaz , Wahlgren Nils , Lees Kennedy R. , Toni Danilo , Roffe Christine , Surakka Ida L. , Tatlisumak Turgut
Published: April 2015

Background and Purpose—

Shorter delays between symptom onset and treatment translate into better outcomes after ischemic stroke thrombolysis. There are considerable intercenter variations in treatment delivery. We analyzed the trends of door-to-needle times (DNTs) in the Safe Implementation of Thrombolysis in Stroke registry between 2003 and 2011.

Methods—

We extracted from the Safe Implementation of Thrombolysis in Stroke registry (n=45 079) year of treatment, center code, DNT, sex, age, National Institutes of Health Stroke Scale, and comorbidity. For each center, the year they joined the registry and the annual volume of patients were determined (<5, 5–24, 25–49, 50–74, 75–99, and ≥100 patients/y).

Results—

DNT was not available for 720 (1.6%) patients. The overall mean (SD) DNT was 73 (37) minutes with a median (interquartile range) of 67 (47–91) minutes. The DNT was 65 (46–90), 68 (50–92), and 72 (51–98) minutes for centers joined early (2003–2005), later (2006–2009), and recently (2009–2011), respectively. Center volume had more robust effect on DNT than year of treatment, and the shortest DNTs were seen in centers with volumes ≥100 patients/y. Earlier enrollment period was also associated with shorter delays.

Conclusions—

Centers that joined the registry earlier and those with high annual volume achieved shorter DNT than centers that joined later and low-volume centers. However, in most of the centers, DNT did not change much during the registry period. A multicenter project aiming to reduce DNT is warranted.
Effect of Public Awareness Campaigns on Calls to Ambulance Across Australia
Authors: Bray Janet E. , Straney Lahn , Barger Bill , Finn Judith
Published: April 2015

Background and Purpose—

The National Stroke Foundation of Australia has run 12 public awareness campaigns since 2004. Campaign exposure and funding has varied annually and regionally during this time. The aim of this study was to measure the effect of campaigns on calls to ambulance for stroke across Australia in exposed regions (paid or pro bono advertising).

Methods—

All ambulance services in Australia provided monthly ambulance dispatch data between January 2003 and June 2014. We performed multivariable regression to measure the effect of campaign exposure on the volume of stroke-related emergency calls, after controlling for confounders.

Results—

The final model indicated that 11 of the 12 National Stroke Foundation campaigns were associated with increases in the volume of stroke-related calls (varying between 1% and 9.9%) in regions with exposure to advertising. This increase lasted ≈3 months, with an additional 10.2% relative increase in the volume of the calls in regions with paid advertising. We found no significant additional effect of the campaigns on stroke calls where ambulance services are publicly funded.

Conclusions—

The National Stroke Foundation stroke awareness campaigns are associated with increases to calls to ambulance for stroke in regions receiving advertising and promotion. Research is now required to examine whether this increased use in ambulance is for appropriate emergencies.
Hispanic Older Adult Health & Longevity in the United States: Current Patterns & Concerns for the Future
Authors: Hummer Robert A. , Hayward Mark D.
Published: April 2015

The Hispanic population aged sixty-five and over – the most socioeconomically disadvantaged subset of America's elderly – is projected to quintuple between 2012 and 2050. While current longevity patterns for Hispanics relative to whites are favorable, old-age functioning and disability patterns for Hispanics are unfavorable and have serious implications for caregivers; families; and local, state, and federal governments. Troubling signs for the future Hispanic population (which are shared to varying degrees with other vulnerable groups) include the unresolved legal status of unauthorized immigrants, continued low levels of insurance coverage even after health care reform, some unfavorable trends in health behaviors, and continued disadvantages in educational attainment and income relative to whites. We urge policy-makers to deal with these potentially problematic health and well-being issues. Not doing so could have detrimental consequences for the future of the Hispanic population as well as other at-risk groups and, by extension, the U.S. elderly population as a whole.
Labor-Force Participation, Policies & Practices in an Aging America: Adaptation Essential for a Healthy & Resilient Population
Authors: Berkman Lisa F. , Boersch-Supan Axel , Avendano Mauricio
Published: April 2015

Population aging in the United States poses challenges to societal institutions while simultaneously creating opportunities to build a more resilient, successful, and cohesive society. Work organization and labor-force participation are central to both the opportunities and challenges posed by our aging society. We argue that expectations about old age have not sufficiently adapted to the reality of aging today. Our institutions need more adaptation in order to successfully face the consequences of demographic change. Although this adaptation needs to focus especially on work patterns among the “younger elderly,” our society has to change its general attitudes toward work organization and labor-force participation, which will have implications for education and health care. We also show that work's beneficial effects on well-being in older ages are often neglected, while the idea that older workers displace younger workers is a misconception emerging from the “lump-of-labor” fallacy. We conclude, therefore, that working at older ages can lead to better quality of life for older people and to a more productive and resilient society overall.
Productivity & Engagement in an Aging America: The Role of Volunteerism
Authors: Carr Dawn C. , Fried Linda P. , Rowe John W.
Published: April 2015

Volunteering in late life is associated with health benefits such as reduced risk of hypertension, improved self-related health and well-being, delayed physical disability, enhanced cognition, and lower mortality. Although the mechanisms of these correlations are not clear, increases in physical activity, cognitive engagement, and social interactions likely play contributing roles. Volunteers are typically thought to represent a select group, often possessing higher levels of education and income, good health, and strong social networks. However, group evidence indicates that there are many members of groups of lower socioeconomic status (SES), including elderly adults, who serve their communities on a regular basis and in high-priority programs. We propose that the impact of volunteering in an aging population be recognized and invested into, and that effective programs harness social capital of older adults to address critical societal needs and also improve the well-being of older adults. While members of low-SES groups are less likely to volunteer, they exhibit disproportionately great benefits. The Experience Corps represents a model of an effective volunteerism program, in which elders work with young schoolchildren. Existing federal initiatives, in cluding the Foster Grandparent Program and Senior Companion Program – which target low-income elders – have had low participation with long waiting lists. Given the proven benefits and relatively low proportion of older persons who volunteer, enhancement of elder volunteerism presents a significant opportunity for health promotion and deserves consideration as a national public health priority.
Global Population Aging: Facts, Challenges, Solutions & Perspectives
Authors: Bloom David E. , Canning David , Lubet Alyssa
Published: April 2015

The rapid aging of populations around the world presents an unprecedented set of challenges: shifting disease burden, increased expenditure on health and long-term care, labor-force shortages, dissaving, and potential problems with old-age income security. We view longer life spans, particularly longer healthy life spans, as an enormous gain for human welfare. The challenges come from the fact that our current institutional and social arrangements are unsuited for aging populations and shifting demographics; our proposed solution is therefore to change our institutions and social arrangements. The first section of this essay provides a statistical overview of global population aging and its contributing factors. The second section outlines some of the major challenges associated with widespread population aging. Finally, the third section of the essay describes various responses to these challenges, both current and prospective, facing individuals, businesses, institutions, and governments.
Motion Tracking of a Fish as a Novel Way to Control Electronic Music Performance
Authors: Eloul Shaltiel , Zissu Gil , Amo Yehiel H. , Jacoby Nori
Published: April 2015

The authors have mapped the three-dimensional motion of a fish onto various electronic music performance gestures, including loops, melodies, arpeggio and DJ-like interventions. They combine an element of visualization, using an LED screen installed on the back of an aquarium, to create a link between the fish’s motion and the sonified music. This visual addition provides extra information about the fish’s role in the music, enabling the perception of versatile and developing auditory structures during the performance that extend beyond the sonification of the momentary motion of objects.
Timescale Separation in Recurrent Neural Networks
Authors: Flynn Thomas
Published: April 2015

Supervised learning in recurrent neural networks involves two processes: the neuron activity from which gradients are estimated and the process on connection parameters induced by these measurements. A problem such algorithms must address is how to balance the relative rates of these activities so that accurate sensitivity estimates are obtained while still allowing synaptic modification to take place at a rate sufficient for learning. We show how to calculate a sufficient timescale separation between these two processes for a class of contracting neural networks.
Theodore Abū Qurra and the Instability of “Heresy”
Authors: Mugler Joshua
Published: April 2015

Theodore Abū Qurra, a Chalcedonian bishop in late eighth- and early ninth-century Harran, attempts to defend Christianity rationally against the new intellectual power of Islam. However, in his classification of the world’s religions, he places non-Chalcedonian Christians in a strange category called “heresy.” They are both within Christianity and without, sitting precariously on the border between Theodore’s Christianity, the “one true religion,” and its false counterparts. Nevertheless, Theodore reserves some of his harshest rhetoric for these heretics, viewing them as a sickness infecting the Church; he even implies that it is acceptable for the emperor to persecute them, though he elsewhere writes that Christianity is never spread by power or force. This paper addresses this odd term, “heresy,” and its ability to destabilize Theodore’s neat classification of religions. Perhaps this destabilization itself leads to his harsh attacks, as he seeks for stability in a world newly destabilized by the advent of Islam.
Glossae ad ALCHORAN LATINUM Roberti Ketenensis translatoris, fortasse a Petro Pictauiense redactae: An Edition of the Glosses to the Latin Qurʾān in bnf ms Arsenal 1162
Authors: Martínez-Gázquez José
Published: April 2015

Robert of Ketton completed his translation of the Qurʾān in Latin in 1143 at the behest of Peter the Venerable. This translation, the first into any Western language, was highly influential on later encounters with the Qurʾān by Western Christians, being published in 1543 and used extensively in polemical writing on Islam and by future translators of the Qurʾān. The oldest manuscript of Ketton’s Qurʾān, Bibliothèque National de France, ms. Arsenal 1162, contains numerous Latin glosses to the text, both polemical and philological, only some of which have been properly studied. This article offers the first full edition of the Latin glosses to Ketton’s Latin Qurʾān in ms. Arsenal 1162, facilitating the further study of the history of Latin Qurʾāns and of Christian–Muslim relations in the Middle Ages.
Taxonomic notes on Encephalartos ferox (Cycadales: Zamiaceae), with the description of a new subspecies from Mozambique
Authors: Rousseau Philip , Vorster Pieter Johannes , Afonso Abilio , Van Wyk Abraham Erasmus
Published: April 2015

Continued work on the systematics of the genus Encephalartos has been conducted over a large area along the Mozambican coast to determine the infraspecific variation and taxonomic status of Encephalartos ferox populations. The northern extent of the species was also investigated based on anecdotal information that it might represent a new taxon. Several (45) vegetative and reproductive (ca. 40) characters were analysed and used to re-circumscribe E. ferox. Literature and iconographic citations are included, as is information on ecology, cytology and conservation as available. No specimens of E. ferox were located north of the Save River in the Sofala Province, Mozambique, and the northernmost population of the species was found to be anomalous. Accordingly a new subspecies, E. ferox subsp. emersus, is recognised based on its invariably emergent stems, shorter unarmed petiole length, shorter leaves, greater number and narrower leaflets (in seedlings as well) which are more closely spaced. Strobili and peduncles in subsp. emersus are shorter and narrower with strobili having a propensity towards yellow, while internally the megasporophylls are green, grading to white away from the outer surface. The IUCN Red List status is suggested as Critically Endangered A4d + B1a,b(v) + B2a,b(v), with the threat of illegal over-collection highlighted.
Luzula effusa var. chinensis (Juncaceae): the first record for the wood-rush genus in Vietnam
Authors: Ford Bruce Austin , Vu Anh Tai , Nguyen Kim Thanh , Starr Julian Richard
Published: April 2015

Mount Fansipan, situated in the Hoang Lien Son Range, supports a rich subtropical and temperate flora of over 1700 species, including 25% of Vietnam’s endemic plant taxa (Nguyen & Harder 1996, Sterling et al. 2006). At elevations above 2000 m, Mount Fansipan contains numerous temperate genera including Acer Linnaeus (19 spp., Sapindaceae Jussieu), Alnus Miller (A. nepalensis, Betulaceae Gray), Betula Linnaeus (B. alnoides Buchanan-Hamilton, Betulaceae), Carex Linnaeus (36 spp., Cyperaceae Jussieu), Clematis Linnaeus (9 spp., Ranunculaceae Jussieu), Lithocarpus Blume (13 spp., Fagaceae Dumortier), Quercus Linnaeus (9 spp., Fagaceae), Rhododendron Linnaeus (40 spp., Ericaceae Jussieu), Rubus Linnaeus (36 spp., Rosaceae Jussieu), Tsuga Carrière (T. dumosa Eichler, Pinaceae Sprengel ex F. Rudolphi), Ulmus Linnaeus (U. lancifolia Roxburgh, Ulmaceae Mirbel), Vaccinium Linnaeus (12 spp., Ericaceae), and Viola Linnaeus (12 spp., Violaceae Batsch) (Vietnam Plant Data Center 2015, Nguyen & Harder 1996) with many of these genera being both species-rich and locally common (Nguyen & Harder 1996, pers. obs.). In April 2012, a collection of a specimen, representing the temperate genus Luzula de Candolle (1805: 158), was made while conducting botanical studies on the Carex flora of Mount Fansipan, Lao Cai Province, Vietnam, which is about 30 km south of the border with Yunnan Province, China. While the specimen was immediately recognized as a Luzula, a new genus to the flora of Vietnam (Vietnam Plant Data Center 2015), it was not until our collection was identified using the keys in Wu & Clements (2000) and Kirschner (2002) that it was determined to be Luzula effusa Buchenau (1879: 88) (Figs. 1, 2). A Basic Alignment Search Tool (BLAST) search of an internal transcribed spacer region (ITS1+5.8S+ITS2) sequence obtained from our specimen (KM612280) showed a 100% match with an existing sequence for L. effusa var. chinensis (Brown 1903: 161) Wu (1992: 92) (AY727778.1, see Drábková & Vlcek 2010) in GenBank (National Center for Biotechnology Information 2014), supporting our identification based on morphology (Table 1). Eighteen other Luzula accessions, representing species placed in two different subgenera and four different sections, were found to have 100% coverage and 99% identity with the sequence from our specimen (National Center for Biotechnology Information 2014) (Table 1). In all cases, these sequences came from taxa that occur in regions that are more geographically disparate from Vietnam than the previously known closest location for L. effusa (see below). These taxa are also morphologically dissimilar to our specimen (see text below and Table 1).
Taxonomy of the genus Ptomaphaginus Portevin (Coleoptera: Leiodidae:
Cholevinae: Ptomaphagini) from China, with description of eleven new species
Authors: WANG CHENG-BIN , ZHOU HONG-ZHANG
Published: April 2015

Ptomaphaginus Portevin, 1914 is one of the most speciose genera in the tribe Ptomaphagini (Coleoptera: Leiodidae: Cholevinae). Its members are mainly soil dwellers and are almost all distributed in the Oriental Region. This paper reports eleven new species from China: P. guangxiensis sp. nov. (type locality: Napo, Guangxi autonomous region), P. gutianshanicus sp. nov. (type locality: Gutianshan, Zhejiang province), P. luoi sp. nov. (type locality: Shennongjia, Hubei province), P. newtoni sp. nov. (type locality: Wuzhishan, Hainan province), P. perreaui sp. nov. (type locality: Jinghong, Yunnan province), P. quadricalcarus sp. nov. (type locality: Xishuangbanna, Yunnan province), P. ruzickai sp. nov. (type locality: Baoxing, Sichuan province), P. shennongensis sp. nov. (type locality: Shennongjia, Hubei province), P. wenboi sp. nov. (type locality: Fushan, Taiwan province), P. wuzhishanicus sp. nov. (type locality: Wuzhishan, Hainan province) and P. yui sp. nov. (type locality: Lijiang, Yunnan province). Five other species known to occur in China were also reviewed and mostly redescribed to update the knowledge on their identification. The Chinese fauna of the genus Ptomaphaginus is thus increased to sixteen species. Important characters on the last two visible ventrites and aedeagus in the male as well as on the ventral side of the proleg are discussed, detailed line drawings are offered for each species, and a key to species from China is presented.
Brazilian Histerini (Coleoptera, Histeridae, Histerinae): a new species, key to the genera, and checklist of species
Authors: LEIVAS FERNANDO W. T. , MOURA DANIEL P. , CATERINO MICHAEL S.
Published: April 2015

A new species of the Hister coenosus group from southern Brazil is described. Hister lucia sp. nov. is the largest Hister sp. in the New World, and is also distinguished by its dorsally and laterally concave mandibles. The three genera of Histerini recorded from Brazil are keyed, and a checklist of species of the tribe recorded from Brazil is presented. In total, seventeen described species of Histerini are recorded from Brazil, including fifteen of Hister Linnaeus, one of Atholus C. Thomson, and one of Margarinotus Marseul.
A review of species of the genus Apalochrus Erichson (Coleoptera, Malachiidae)
Authors: TSHERNYSHEV SERGEI E.
Published: April 2015

The genus Apalochrus Erichson, 1840 (Coleoptera, Cleroidea, Malachiidae) is revised. All seven species and subspecies of the genus have been discussed and described, all materials studied have been listed and the known distributions reported. Figures of male habiti, genitalia, and distribution map are supplied; a determination key is also provided. One new status and two new synonymies are proposed: A. femoralis pallipes Motschulsky, 1860 stat. n.; A. flavicornis Abeille de Perrin, 1890 = A. femoralis pallipes Motschulsky, 1860 syn. n. and A. notatus mongolicus Evers, 1968 = A. notatus (Zoubkoff, 1833) syn. n.
The Amundsen Sea Low: Variability, Change, and Impact on Antarctic Climate
Authors: Raphael M. N. , Marshall G. J. , Turner J. , Fogt R. L. , Schneider D. , Dixon D. A. , Hosking J. S. , Jones J. M. , Hobbs W. R.
Published: April 2015

The Amundsen Sea low (ASL) is a climatological low pressure center that exerts considerable influence on the climate of West Antarctica. Its potential to explain important recent changes in Antarctic climate, for example, in temperature and sea ice extent, means that it has become the focus of an increasing number of studies. Here, the authors summarize the current understanding of the ASL, using reanalysis datasets to analyze recent variability and trends, as well as ice-core chemistry and climate model projections, to examine past and future changes in the ASL, respectively. The ASL has deepened in recent decades, affecting the climate through its influence on the regional meridional wind field, which controls the advection of moisture and heat into the continent. Deepening of the ASL in spring is consistent with observed West Antarctic warming and greater sea ice extent in the Ross Sea. Climate model simulations for recent decades indicate that this deepening is mediated by tropical variability while climate model projections through the twenty-first century suggest that the ASL will deepen in some seasons in response to greenhouse gas concentration increases.
Effects of Horizontal Geometrical Spreading on the Parameterization of Orographic Gravity Wave Drag. Part I: Numerical Transform Solutions
Authors: Eckermann Stephen D. , Ma Jun , Broutman Dave
Published: April 2015

Numerical transform solutions for hydrostatic gravity waves generated by both uniform and sheared flow over elliptical obstacles are used to quantify effects of horizontal geometrical spreading on amplitude evolution with height. Both vertical displacement and steepness amplitudes are considered because of their close connections to drag parameterizations in weather and climate models. Novel diagnostics quantify the location and value of the largest wavefield amplitudes most likely to break at each altitude. These horizontal locations do not stray far from the obstacle peak even at high altitudes. Resulting vertical profiles of wave amplitude are normalized to remove density and refraction effects, thereby quantifying the horizontal geometrical spreading contribution, currently absent from parameterizations. Horizontal geometrical spreading produces monotonic amplitude decreases with height through wave-action conservation as waves propagate into progressively larger horizontal areas. Accumulated amplitude reductions are appreciable for all but the most quasi-two-dimensional obstacles with long axes orthogonal to the flow, and even these are impacted appreciably if the obstacle is rotated by more than 20°–30°. Profiles are insensitive to the obstacle’s functional form but vary strongly in response to changes in its horizontal aspect ratio. Responses to background winds are captured by a vertical coordinate transformation that remaps profiles to a universal form for a given obstacle. These results show that horizontal geometrical spreading has comparable or larger effects on wave amplitudes as the refraction of vertical wavenumbers and thus is important for accurate parameterizations of wave breaking and drag.
Winter Extreme Flux Events in the Kuroshio and Gulf Stream Extension Regions and Relationship with Modes of North Pacific and Atlantic Variability
Authors: Ma Xiaohui , Chang Ping , Saravanan R. , Wu Dexing , Lin Xiaopei , Wu Lixin , Wan Xiuquan
Published: April 2015

Boreal winter (November–March) extreme flux events in the Kuroshio Extension region (KER) of the northwestern Pacific and the Gulf Stream region (GSR) of the northwestern Atlantic are analyzed and compared, based on NCEP Climate Forecast System Reanalysis (CFSR), NCEP–NCAR reanalysis, and NOAA Twentieth Century Reanalysis data, as well as the observationally derived OAFlux dataset. These extreme flux events, most of which last less than 3 days, are characterized by cold air outbreaks (CAOs) with an anomalous northerly wind that brings cold and dry air from the Eurasian and North American continents to the KER and GSR, respectively. A close relationship between the extreme flux events over KER (GSR) and the Aleutian low pattern (ALP) [east Atlantic pattern (EAP)] is found with more frequent occurrence of the extreme flux events during a positive ALP (EAP) phase and vice versa. A further lag-composite analysis suggests that the ALP (EAP) is associated with accumulated effects of the synoptic winter storms accompanied by the extreme flux events and shows that the event-day storms tend to have a preferred southeastward propagation path over the North Pacific (Atlantic), potentially contributing to the southward shift of the storm track over the eastern North Pacific (Atlantic) basin during the ALP (EAP) positive phase. Finally, lag-regression analyses indicate a potential positive influence of sea surface temperature (SST) anomalies along the KER (GSR) on the development of the extreme flux events in the North Pacific (Atlantic).
Spectral Transformation Using a Cubed-Sphere Grid for a Three-Dimensional Variational Data Assimilation System
Authors: Song Hyo-Jong , Kwon In-Hyuk
Published: April 2015

Atmospheric numerical models using the spectral element method with cubed-sphere grids (CSGs) are highly scalable in terms of parallelization. However, there are no data assimilation systems for spectral element numerical models. The authors devised a spectral transformation method applicable to the model data on a CSG (STCS) for a three-dimensional variational data assimilation system (3DVAR). To evaluate the 3DVAR system based on the STCS, the authors conducted observing system simulation experiments (OSSEs) using Community Atmosphere Model with Spectral Element dynamical core (CAM-SE). They observed root-mean-squared error reductions: 24% and 34% for zonal and meridional winds (U and V), respectively; 20% for temperature (T); 4% for specific humidity (Q); and 57% for surface pressure (Ps) in analysis and 28% and 27% for U and V, respectively; 25% for T; 21% for Q; and 31% for Ps in 72-h forecast fields. In this paper, under the premise that the same number of grid points is set, the authors show that the use of a greater polynomial degree, np, produces better performance than use of a greater element count, ne, on equiangular coordinates in terms of the wave representation.
Radiofrequency Coblation Versus Intramural Bipolar Cautery for the Treatment of Inferior Turbinate Hypertrophy
Authors: Shah Anil N. , Brewster Douglas , Mitzen Kelly , Mullin David
Published: April 2015

Objective:

Compare intramural bipolar electrocautery and radiofrequency coblation in the treatment of inferior turbinate hypertrophy with regards to objective and subjective improvement in nasal obstruction, rate and type of complications, experience during the procedure, and rate of recovery.

Study Design:

Prospective, single-blinded study.

Setting:

Single tertiary medical center from 2008 to 2010.

Subjects and Methods:

Forty-one adult patients with inferior turbinate hypertrophy refractory to medical management were treated with radiofrequency coblation in one nostril and intramural bipolar cautery in the other. Subjective and objective data, including use of a Visual Analog Scale (VAS) for subjective outcomes, acoustic rhinometry, and nasal endoscopy, were then obtained from each patient comparing the 2 techniques.

Results:

Radiofrequency coblation was significantly less painful than intramural bipolar cautery during the procedure ( P = .03) and during the early postoperative period ( P < .02) and produced less crusting at 3 weeks ( P = .009). Both interventions were similar in subjective and objective improvements in nasal obstruction as measured by acoustic rhinometry and subjective VAS outcomes.

Conclusion:

Radiofrequency coblation seems to offer an equivalent alternative to bipolar electrocautery for the treatment of inferior turbinate hypertrophy with less discomfort during the procedure and early post-operative period.