bluuebunny/crossref_metadata_2025 huggingface dataset:
Beat vibration mechanism of a sluice pier under high-speed flood discharge excitation
Authors: Li Huo-Kun , Zhong Yi-Wei , Wei Bo-Wen , Du Lei , Wang Gang
Published: March 2019

The sluice pier prototype vibration test conducted in China Shuhe Hydropower Station shows that the vibration response of the measuring points exhibits a special form of vibration, which demonstrates intermittency and impact under high-speed flood discharge excitation. The waveform envelope increases or decreases sharply with time and shows the formation of beat vibration. Research on the mechanism of this type of vibration is rare. To analyze the characteristics and causes of the obvious beat phenomenon in the testing of the sluice pier prototype, we conduct research in the following manner. First, mathematical models of synthetic signals are built to analyze the influences of initial phase difference, frequency ratio, and amplitude ratio and determine the beat vibration formation condition. Second, the stochastic subspace identification method is used to identify the operational modal parameters (including the vibration order, frequency, damping ratio, and mode of vibration) on the basis of the measured prototype dynamic response. Last, the internal causes of the beat vibration phenomenon are analyzed based on the combination of the formation conditions of apparent beat vibration. Results show that the vibration of Shuhe sluice pier is dominated by the first two frequency components. The vibration frequency ratio is between 0.928 and 0.962 and satisfies the necessary conditions of beat vibration. The amplitude ratio is between 0.66 and 1.63 and thus makes the waveforms of beat vibration highly evident.
Closed-loop control of a dual-fuel engine working with different combustion modes using in-cylinder pressure feedback
Authors: Guardiola Carlos , Pla Benjamín , Bares Pau , Barbier Alvin
Published: March 2019

This work presents a closed-loop combustion control concept using in-cylinder pressure as a feedback in a dual-fuel combustion engine. At low load, reactivity controlled compression ignition combustion was used while a diffusive dual-fuel combustion was performed at higher loads. The aim of the presented controller is to maintain the indicated mean effective pressure and the combustion phasing at a target value, and to keep the maximum pressure derivative under a limit to avoid engine damage in all the combustion modes by cyclically adapting the injection settings. Various tests were performed at steady-state conditions showing good abilities to fulfil the expected operating conditions but also to reject disturbances such as intake pressure or exhaust gas recirculation variations. Finally, the proposed control strategy was tested during a load transient resulting in a combustion switching-mode and the results exhibited the closed-loop potential for controlling such combustion concept.
The invention of a mountain tourism destination: An exploration of Trevinca-A Veiga (Galicia, Spain)
Authors: Paül Valerià , Trillo-Santamaría Juan-Manuel , Haslam-Mckenzie Fiona
Published: March 2019

The literature on the development of tourism destinations neglects to question their precise origins. Thus, it makes sense to research the when, how and why a particular place attracts tourists to the point of being considered an up-and-coming destination. The case of Trevinca-A Veiga (Galicia, Spain), a mountain area which is emerging as a tourism destination, is analysed through 28 semi-structured interviews with stakeholders regarding the initial phases of tourism development. Six different narratives (rather than simply one), regarding the emergence of Trevinca-A Veiga as a tourism destination, are identified. These are not mutually exclusive stories, rather, they appear interwoven and in dialogue with each other, complementing and sometimes even contradicting each other. The article shows that the origin of a destination has to be understood not only in its materiality but also through its intangible dimensions. This includes discussing the place name used by a destination and its spatial coverage and scale, and negotiating the dimension and type of demand that is desired. Therefore, the origin of a destination is a process with multiple interpretations sustained by a complex social net. The conclusions include a set of recommendations for tourism destination development in a mountain area with no previous development.
Caregivers of older adults with dementia and multiple chronic conditions: Exploring their experiences with significant changes
Authors: Ploeg Jenny , Northwood Melissa , Duggleby Wendy , McAiney Carrie A , Chambers Tracey , Peacock Shelley , Fisher Kathryn , Ghosh Sunita , Markle-Reid Maureen , Swindle Jennifer , Williams Allison , Triscott Jean AC
Published: March 2019

Family caregiving is considered a social transition as changes in the health of the care recipient create a process of transition for the caregiver when they are more vulnerable to threats to their own health. Family and friend caregivers take on many responsibilities and experience high levels of burden when caring for community-dwelling older adults living with dementia and multiple chronic conditions. However, little is known about the changes they experience in their caring roles or how they cope with these changes. This qualitative descriptive study was part of a larger mixed methods randomized controlled trial evaluating a web-based caregiver support toolkit. Multiple semi-structured phone interviews were conducted with caregivers of older adults with dementia and multiple chronic conditions. Content analysis was used to generate thematic descriptions. Six themes were generated and grouped into two categories. Significant changes experienced by caregivers are described by the following themes: ‘everything falls on you – all of the responsibilities,’ ‘too many feelings’ and ‘no time for me.’ The themes describing how caregivers coped with these changes include: seeking support, self-caring, and adapting their caregiving approach. Study results indicate that caregivers of older adults with dementia and multiple chronic conditions experienced many changes in their caregiving journey resulting in increasing complexity as they tended to the care recipients’ declining health and well-being. These caregivers used several creative strategies to cope with these changes. Health care providers should consider both the caregiver and care recipient as clients in the circle of care, and facilitate their linkage with health and community support services to help address the increasing complexity of care needs.
Sound absorption property of PVA/PEO/GO nanofiber membrane and non-woven composite material
Authors: Liu Huan , Zuo Baoqi
Published: March 2019

Blend films based on polyvinyl alcohol/polyethylene oxide (70/30 wt%) undoped and doped with different concentration of graphene oxide were prepared by spiral vane electrospinning. Characteristic properties of the blend films were investigated by using X-ray diffraction and scanning electron microscopy. The sound absorption performance of the compositions (nanofiber membranes and needle punched non-woven fabric) was tested by an impedance tube. The sound absorption performance of non-woven fabric has greatly improved after combining with thin nanofiber membranes. With addition of graphene oxide, the fibers were intertwined in a loop and form a network, the areal density and surface roughness of the nanofiber membrane are reduced. Composites containing polyvinyl alcohol/polyethylene oxide nanofiber membranes and composites containing polyvinyl alcohol/polyethylene oxide/graphene oxide nanofiber membranes exhibited different sound absorption properties in different frequency bands. When the fiber coefficient of variation was small, the average sound absorption coefficient of the composite material was high. However, composites containing both polyvinyl alcohol/polyethylene oxide and polyvinyl alcohol/polyethylene oxide/graphene oxide nanofiber membranes had similar sound absorption properties, and the average sound absorption coefficient was greater than that of polyvinyl alcohol/polyethylene oxide composites.
Traps of Racial Residential Segregation
Authors: Gilbert Keon L. , Goodman Melody S.
Published: March 2019

Exploring residential segregation in the Gateway City with photographer Bryan Travis.
Aortic Valve Replacement in Elderly Patients With Small Aortic Annulus: Results With Three Different Bioprostheses
Authors: Chiariello Giovanni A. , Bruno Piergiorgio , Villa Emmanuel , Pasquini Annalisa , Pavone Natalia , Cammertoni Federico , Mazza Andrea , Colizzi Christian , Nesta Marialisa , Iafrancesco Mauro , Perri Gianluigi , Messina Antonio , Troise Giovanni , Massetti Massimo
Published: March 2019

Objectives

Aortic valve replacement (AVR) in patients with small aortic annulus (diameter ≤21 mm) is considered a challenging scenario because of technical aspects and the high risk of patient-prosthesis mismatch (PPM). The choice of the appropriate prosthesis is crucial, and at the moment, an ideal device has yet to be identified. We compare clinical and hemodynamic results after AVR with three bioprostheses with different design and characteristics.

Methods

We retrospectively evaluated 76 consecutive patients from two cardiac surgery centers who underwent AVR (Trifecta = 24; Edwards INTUITY Elite valve system = 26, and Perceval = 26) for severe aortic stenosis between 2013 and 2017. Patients selected were older than 75 years and with an annulus diameter ≤21 mm at preoperative echocardiogram. Reinterventions and combined procedures were excluded. Minimally invasive AVR was performed in 44 (57.8%) patients. Telephonic interview was obtained at 2.9 ± 0.5 years and echocardiographic follow-up at 2.2 ± 0.8 years.

Results

Clinical outcome was similar in the three groups. At follow-up, Trifecta patients presented significantly higher peak and mean transprosthetic pressure gradients ( P = 0.04 and 0.01). Effective orifice area and left ventricular mass regression were comparable, although an advantage was observed in Perceval patients without reaching the statistical significance. Incidence of moderate ( P = 0.2) and severe PPM ( P = 0.7) was comparable.

Conclusions

Despite higher postoperative pressure gradients observed with the Trifecta valve, all three prostheses (Trifecta, Edwards INTUITY Elite, and Perceval) have proven to be reliable when implanted in small aortic annuli, with good clinical outcome and favorable left ventricular mass regression.
Investigating the CEO of a MAT: Examining practices and positions on ‘the street’
Authors: Hughes Belinda C
Published: March 2019

The emergence of Chief Executive Officers as leaders of educational service providers is positioned in multi academy trusts, the preferred structure of schooling in England. Within this structure, the Chief Executive Officer position is distinct and different from previous constructs of headteachers, since the Chief Executive operates at both street level, that is within the MAT, and beyond ‘the street’. In this article, I argue that a new conceptualisation of the headteacher is needed to explain the emerging position and practices of the Chief Executive Officer. These include the interface with the market, adopting entrepreneurial dispositions and constructing professional and business networks. I typologise these practices and positioning through the analysis of empirical data gathered from the Leadership of the Lawrence Trust Project and its Chief Executive Officer, KT Edwards.
Thermal performance optimization of building floors under air-conditioning intermittent operation by numerical simulation
Authors: Meng Xi , Du Junfei , Wang Yating , Gao Yanna
Published: March 2019

Under air-conditioning intermittent operation, there may be the large difference of air temperatures in two adjacent rooms due to different operation behavior, and thereby, interior envelops may cause great heat loss. Under this condition, floors may become the most vulnerable spot of the room heat preservation due to their large proportion in interior envelops and poor thermal insulation. To optimize the thermal performance of floors, three floor models were built to compare their thermal performance characteristics under air-conditioning intermittent operation, while a heat transfer model was built by the finite volume method and verified by experimental data. The results showed that an expanded polystyrene layer located close to the upper surface can improve the thermal performance of the bottom floor, while the continuous integration of an air space ceiling placed close to the lower surface can improve the thermal performance of the top floor obviously. The daily cooling load formed by the cast-in-place-reinforced concrete floor integrated with the expanded polystyrene layer and the air space ceiling can reduce the daily cooling load by 53.27% and 47.00%, compared with the cast-in-place-reinforced concrete floor and the cast-in-place-reinforced concrete floor only integrated with the expanded polystyrene layer.
The monoclonal antibody GNbAC1: targeting human endogenous retroviruses in multiple sclerosis
Authors: Diebold Martin , Derfuss Tobias
Published: March 2019

Background:

Multiple sclerosis (MS) is an autoimmune demyelinating disorder of the central nervous system (CNS). Despite improvements of immunomodulatory therapies in relapsing–remitting MS, the pathomechanisms of progressive disease are poorly understood and therapeutically addressed to date. A pathophysiological role for proteins encoded by human endogenous retroviruses (HERVs) has been proposed. GNbAC1 is a monoclonal antibody directed against the envelope protein of a HERV with postulated involvement in MS.

Methods:

This review addresses the treatment concept of GNbAC1, the design, preclinical and clinical development of the antibody, as published by November 2018. All four in-human trials (of which two addressed MS) are discussed.

Conclusion:

The treatment concept of GNbAC1 is appealing but remains controversial due to conflicting results regarding the hypothesized underlying pathomechanism. Anticipated immunomodulatory effects were not observed in clinical or pharmacodynamic analyses of the currently available data. However, a magnetic resonance imaging sign compatible with the remyelinating potential of GNbAC1 encouraged further development of this antibody in progressive MS. No relevant issues with tolerability or safety have been described to date.
A Case of Tolosa-Hunt Syndrome With Discoid Lupus Erythematosus
Authors: Yu Amy W. , Finkelsztein Eli J. , Cheng Natalie T.
Published: March 2019

The occurrence of Tolosa-Hunt syndrome (THS) in the setting of discoid lupus erythematosus (DLE) has not been previously reported. We report a case of a 55-year-old Chinese man with established cutaneous lupus who presented with 1 week of worsening blurry vision and ptosis of the left eye with severe headache 2 weeks prior to presentation. His cranial nerve examination was significant for left afferent pupillary defect, red desaturation, ptosis, and oculomotor nerve palsy. He also presented with active DLE lesions. Magnetic resonance imaging brain demonstrated asymmetric thickening and enhancement of the left cavernous sinus consistent with THS. After a 4-week gradual steroid taper his ophthalmoplegia resolved. The unusual occurrence of THS and DLE prompts consideration of nonsystemic autoimmune disorders in diagnosis of THS.
Early childhood education quality indicators: Exploring the landscape of an African community perspective
Authors: Ejuu Godfrey , Apolot Josephine Matha , Serpell Robert
Published: March 2019

While more effort is being geared toward implementation of quality early childhood education programs, there is still debate on what quality entails. While the education officers believe they are providing quality education, some communities who are the target beneficiaries see it as meaningless and keep away from it, affecting the “Education for All” slogan. If education has to be meaningful in a manner that addresses Sustainable Development Goals 4, quality must be addressed in the perspective of the beneficiaries. This study focuses on a local community perspective of quality indicators for early childhood education and provides advice for implementers.
High efficacy of interferon‐free therapy for acute hepatitis C in HIV‐positive patients
Authors: Chromy David , Mandorfer Mattias , Bucsics Theresa , Schwabl Philipp , Scheiner Bernhard , Schmidbauer Caroline , Aichelburg MC , Ferenci Peter , Trauner Michael , Peck-Radosavljevic Markus , Reiberger Thomas
Published: March 2019

Background

The treatment of acute hepatitis C (AHC) with direct‐acting antiviral agents (DAAs) is considered a cornerstone of hepatitis C virus (HCV) elimination strategies, especially in human immunodeficiency virus (HIV)‐infected individuals at high risk of onward transmission.

Objective

Optimal treatment regimens and duration for AHC in HIV‐coinfected patients remain to be established. Thus, we aimed to evaluate the efficacy and safety of DAA treatment regimens in the setting of AHC.

Methods

All HIV‐positive patients with a diagnosis of AHC according to the European AIDS Treatment Network (NEAT) consensus attending our clinic after 2014 were included. DAA treatment regimens and duration were based on current recommendations for chronic hepatitis C (CHC) at treatment initiation.

Results

Thirty‐eight HIV/AHC patients (median age 42.0 years), mostly men who have sex with men (92%), were started on interferon‐free regimens. HCV‐genotype (GT) was predominately GT‐1a (65%). The following DAA regimens were prescribed: ombitasvir/paritaprevir/ritonavir/dasabuvir (42%; 16/38), glecaprevir/pibrentasvir (29%; 11/38), sofosbuvir/ledipasvir (13%; 5/38), ombitasvir/paritaprevir/ritonavir (5%; 2/38), grazoprevir/elbasvir (5%; 2/38) and sofosbuvir/velpatasvir (5%; 2/38). All HIV/AHC patients achieved sustained virologic response 12 weeks after end of treatment (SVR12) (100%; 38/38). DAA‐related adverse events were rare.

Conclusion

Interferon‐free DAA regimens (including 34% pan‐genotypic regimens) yielded 100% SVR12 in HIV/AHC individuals if treatment durations similar to CHC are applied.
Vitamin D serum levels in children with vernal keratoconjunctivitis and disease control
Authors: Ghiglioni Daniele Giovanni , Bruschi Gaia , Gandini Sara , Osnaghi Silvia , Peroni Diego , Marchisio Paola
Published: March 2019

The aim of this study was to evaluate whether the control of ocular symptoms with cyclosporine or with tacrolimus in eye drops allows to improve sun exposure and therefore serum level of vitamin D (VD; 25OHD), in the more severe forms of vernal keratoconjunctivitis (VKC). Out of 242 children followed for active VKC, 94 were treated with 1% cyclosporine or 0.1% tacrolimus eye drops, while the other 148 with mild VKC did not need to be treated with immunomodulators. VD serum levels were measured in spring and autumn in 71 children. In total, 60 of them were treated with cyclosporine eye drops (first group) and 11 (not responding to cyclosporine therapy previously) with 0.1% tacrolimus eye drops (second group) between March and November 2016. Pre-treatment median values of VD were 23.7 ng/mL in the first group and 23.8 in the second group, and post-treatment values increased up to 32.8 and 32.9 ng/mL, respectively. Before treatment, 33% presented a deficiency (25OHD < 20 ng/mL), and at the end of summer, only 4% were deficient. The overweight children had lower improvement in VD serum levels than children with a body mass index (BMI) lower than 85th percentile. Children in therapy with cyclosporine, but requiring the administration of local steroid therapy during the summer for control of the symptoms, showed a greater improvement in 25OHD serum levels in ng/mL (23–37 ng/mL) than children who did not require steroid therapy (24–35 ng/mL). Furthermore, there was a significant difference in change of 25OHD in children presenting limbal VKC (21–41 ng/mL) versus tarsal VKC (24–35 ng/mL) ( P = 0.04). Our study suggests that ocular treatment carried out with immunomodulator eye drops could allow for an improvement in 25OHD serum levels. In children with active VKC and at risk of 25OHD deficiency, likely due to avoidance of sun exposure, the role of other risk factors (BMI, phototype and treatment) on 25OHD serum levels should be considered.
Therapeutic effects of combination environmental enrichment with necrostatin-1 on cognition following vascular cognitive impairment in mice
Authors: Zhang Shehong , Si Wen , Yu Qing , Wang Yuyang , Wu Yi
Published: March 2019

Cognitive dysfunction resulting from the reduction of cerebral blood flow has been defined as “vascular cognitive impairment” (VCI) which has become the second cause of dementia only after Alzheimer’s disease (AD) and arouses great concerns. There is accumulating evidence that environmental enrichment (EE) can induce functional and anatomical alterations and then bring about overt improvement in memory and learning tasks in many injury paradigms, including ischemic brain injury. Moreover, necrostatin-1 (Nec-1), the special inhibitor of necroptosis, improved functional outcomes following ischemic brain injury and AD. The question of whether and what effect EE and EE + Nec-1 could bring about on cognitive performance and microenvironment and histopathological consequences in the mice suffering from VCI is still unclear. In this study, we investigated this question using the bilateral common carotid artery stenosis (BCAS) mouse model. A week after surgical operation for BCAS, mice were reared for 3 weeks either in standard housing condition or in an EE consisting of special cage filling with various stimulatory items. The results found that the mice in the BCAS + EE and BCAS + EE + Nec-1 groups showed significantly shorter latencies and distances to reach the platform in behavioral tests versus untreated mice at 4 weeks after BCAS surgery. However, three injured groups showed significant deficits compared with the sham group ( P < 0.05). In addition, there were no differences between the EE-reared mice and EE + Nec-1-treated mice except in the level of expression of inflammation cytokines. Our results indicated that noninvasive environmental stimulation is beneficial in ameliorating cognitive deficits and inflammation response in mice following VCI and that Nec-1 enhanced the inhibitory effect of EE on inflammation response.
Single Ventricle Palliation in a Developing Sub-Saharan African Country: What Should be Improved?
Authors: Manuel Valdano , Morais Humberto , Turquetto Aida L. R. , Miguel Gade , Miana Leonardo A. , Pedro Albino , Nunes Maria A. S. , Leon Gilberto , Magalhães Manuel Pedro , Martins Telmo , Júnior António P. F.
Published: March 2019

Introduction:

Single ventricle physiology management is challenging, especially in low-income countries.

Objective:

To report the palliation outcomes of single ventricle patients in a developing African country.

Methods:

We retrospectively studied 83 consecutive patients subjected to single ventricle palliation in a single center between March 2011 and December 2017. Preoperative data, surgical factors, postoperative results, and survival outcomes were analyzed. The patients were divided by palliation stage: I (pulmonary artery banding [PAB] or Blalock–Taussig shunt [BTS]), II (Glenn procedure), or III (Fontan procedure).

Results:

Of the 83 patients who underwent palliation (stages I-III), 38 deaths were observed (31 after stage I, six after stage II, and one after stage III) for an overall mortality of 45.7%. The main causes of operative mortality were multiple organ dysfunction due to sepsis, shunt occlusion, and cardiogenic shock. Twenty-eight survivors were lost to follow-up (22 after stage I, six after stage II). Thirteen stage II survivors are still waiting for stage III. The mean follow-up was 366 ± 369 days. Five-year survival was 28.4 % for PAB and 30.1% for BTS, while that for stage II and III was 49.8% and 57.1%, respectively. Age (hazard ratio, 0.61; 95% confidence interval: 0.47-0.7; P = .000) and weight at surgery (hazard ratio, 0.45; 95% confidence interval: 0.31-0.64; P = .002) impacted survival.

Conclusion:

A high-mortality rate was observed in this initial experience, mainly in stage I patients. A large number of patients were lost to follow-up. A task force to improve outcomes is urgently required.
Hip-Hop and Spoken Word Therapy in Urban School Counseling
Authors: Levy Ian P.
Published: March 2019

This study involved a secondary analysis of data collected across the 2016–2017 academic year to determine the impact on students’ social and emotional well-being of a new hip-hop lyricism course implemented by a school counselor. The new course introduced hip-hop and spoken word therapy into a specially designed classroom curriculum to meet the emotional and stress-coping needs of youth, allowing for improvements in the development of coping skills, emotional self-awareness, and self-image.
Districtwide Initiative to Improve Tier 1 With Evidence-Based Classroom Lessons
Authors: McCormac Mary E. , Snyder Sarah
Published: March 2019

Evidence-based social/emotional learning (SEL) programs have been shown to have many benefits and are considered best practice in helping students apply the knowledge, attitudes, and skills necessary to understand and manage emotions. One school district undertook a multiyear process to move to a common school counseling core curriculum in the social/emotional domain. The process included curriculum selection, development, implementation, assessment, and revision. Preliminary results indicate that school counselors are delivering the standardized curriculum across schools, and most report that the program has a positive impact on students.
Who Benefits? Adding Inclusive Innovation into the Evidence-Based School Counseling Research Agenda
Authors: McMahon H. George , Patel Shruti
Published: March 2019

Inclusive innovation is a research framework used to assess the degree to which innovations are accessible to and useful within communities experiencing high need. We describe the tenets of inclusive innovation research and outline how the model could be added to the current evidence-based school counseling research agenda to begin to answer questions of access and equity in the distribution of effective practices.
English Language Learners and School Belonging: Implications for School Counselor Practice
Authors: Shi Qi , Watkinson Jennifer
Published: March 2019

Using an evidence-based framework in a mixed-method study, we examined the needs of English Language Learners (ELLs) in a middle school in the eastern United States and identified strategic intervention approaches to enhance ELL students’ sense of school belonging to promote academic success. We illustrate how describing a problem as part of an evidence-based framework can lead to a targeted intervention for ELLs. When describing the problem, we considered intersectional social identity factors of ELL students. Problem description revealed how ELLs perceived their relationships with teachers, how school personnel viewed ELL student needs, obstacles to meeting ELL student needs, and current solutions. Suggested interventions focus on a culturally responsive bibliotherapy approach.
Selections From the ABC 2018 Annual Conference, Miami, Florida: Bridging Teaching Ideas From the Innovator to the Classroom
Authors: Whalen D. Joel
Published: March 2019

This article offers readers 13 My Favorite Assignments that were presented at the Association for Business Communication’s 83rd annual conference held in Miami, Florida, in 2018. The teaching innovations offered include assignments that present quick, fun icebreaker exercises; visual communication and diversity; rhetoric; email; and informational interviews. Additional assignment support materials—instructions to students, stimulus materials, slides, grading rubrics, frequently asked questions, and sample student projects—are posted on the Association for Business Communication and DePaul University Center for Sales Leadership websites: https://www.businesscommunication.org/page/assignments and https://salesleadershipcenter.com/research/business-professional-communication-quarterly-my-favorite-assignment
Hepatitis B Infection: A Mixed Methods of Disclosure Pattern and Social Problems in the Nigerian Family
Authors: Adekanle Olusegun , Komolafe Akinwumi Oluwole , Olowookere Samuel A , Ijarotimi Oluwasegun , Ndububa Dennis Amajuoyi
Published: March 2019

Background:

Hepatitis B virus (HBV) infection has a high prevalence rate in Nigeria. Disclosure of infection status to close partner and the public attracts support for infected people. This study looks at disclosure and social challenges of infected persons.

Methods:

Mixed methods of patients’ administered questionnaire and an in-depth interview conducted on HBV-infected respondents in a hospital in Nigeria were used. The study recruited all participants who satisfied the inclusion criteria. Data were entered into SPSS version 20 and analyzed using simple and inferential statistics and content analysis for the in-depth interview.

Results:

A total of 205 participants completed the questionnaire study. Mean (standard deviation) age was 35.3 (±11.0) years. There were 121 married, 37 singles with noncohabiting partners and 47 singles without partners with disclosure rates being 96.7% versus 97.9% versus 89.2%, respectively. Singles disclosed infection more to their parents while married respondents disclosed infection more to their spouses. Singles had high rate of denial of sexual relationship (22.6%), emotional trauma (34.5%), broken relationships (11.4%), and surreptitious use of contraception for protection (67.6%). Married respondents had the highest rate of HBV vaccination of their family members (40.1%). Infection prevention and allaying fears of family members were their counseling needs. In-depth interview revealed that infected respondents usually expressed shock and depression at a positive test leading to fear and deception that put close associates at risk.

Conclusion:

Hepatitis B virus–infected respondents have high rate of disclosure. Family problems of these people can therefore be solved through public enlightenment and individual counseling.
Dental Fluorosis Trends in US Oral Health Surveys: 1986 to 2012
Authors: Neurath C. , Limeback H. , Osmunson B. , Connett M. , Kanter V. , Wells C.R.
Published: March 2019

Introduction:

Dental fluorosis has been assessed only 3 times in nationally representative oral health surveys in the United States. The first survey was conducted by the National Institute of Dental Research from 1986 to 1987. Subsequently, the National Health and Nutrition Examination Survey (NHANES) conducted fluorosis assessments from 1999 to 2004 and more recently from 2011 to 2012. A large increase in prevalence and severity of fluorosis occurred between the 1986–1987 and 1999–2004 surveys.

Objectives:

To determine whether the trend of increasing fluorosis continued in the 2011–2012 survey.

Methods:

We analyzed publicly available data from the 2011–2012 NHANES, calculating fluorosis prevalence and severity using 3 measures: person-level Dean’s Index score, total prevalence of those with Dean’s Index of very mild degree and greater, and Dean’s Community Fluorosis Index. We examined these fluorosis measures by several sociodemographic factors and compared results with the 2 previous surveys. Analyses accounted for the complex design of the surveys to provide nationally representative estimates.

Results:

Large increases in severity and prevalence were found in the 2011–2012 NHANES as compared with the previous surveys, for all sociodemographic categories. For ages 12 to 15 y—an age range displaying fluorosis most clearly—total prevalence increased from 22% to 41% to 65% in the 1986–1987, 1999–2004, and 2011–2012 surveys, respectively. The rate of combined moderate and severe degrees increased the most, from 1.2% to 3.7% to 30.4%. The Community Fluorosis Index increased from 0.44 to 0.67 to 1.47. No clear differences were found in fluorosis rates among categories for most of the sociodemographic variables in the 2011–2012 survey.

Conclusion:

Large increases in fluorosis prevalence and severity occurred. We considered several possible spurious explanations for these increases but largely ruled them out based on counterevidence. We suggest several possible real explanations for the increases.

Knowledge Transfer Statement:

The results of this study greatly increase the evidence base indicating that objectionable dental fluorosis has increased in the United States. Dental fluorosis is an undesirable side effect of too much fluoride ingestion during the early years of life. Policy makers and professionals can use the presented evidence to weigh the risks and benefits of water fluoridation and early exposure to fluoridated toothpaste.
Fixing the ecosystem: Conservation, crisis and capital in Rwanda's Gishwati Forest
Authors: Clay Nathan
Published: March 2019

Conservation-development projects are increasingly enacted across large expanses of land where human livelihoods hang in the balance. Recent initiatives–often called ‘landscape approaches’ or ‘ecosystem-based’ conservation–aim to achieve economic development and conservation goals through managing hybrid spaces. I argue that the landscape/ecosystem approach is a socioecological fix: an effort to resolve social-environmental crises through sinking capital (financial, natural, and social) into an imagined ecosystem. Rwanda’s Gishwati Forest has been the locus of diverse crises and fixes over the past 40 years, including an industrial forestry and dairy project, a refugee settlement, a privately managed chimpanzee sanctuary, a carbon sequestration platform, and, most recently, an “integrated silvo-pastoral conservation landscape.” This paper considers how these governance schemes have intersected with broader processes of agrarian change to generate crises that subsequent conservation/development projects then attempt to resolve. I demonstrate how visions for ecosystems privilege certain forms of governance around which imagined socioecological histories are mobilized to frame problems and legitimize certain solutions, technologies, and actors. The Gishwati ecosystem and its fixes are repeatedly defined through an imaginary of crisis and degradation that engenders large-scale landscape modification while foreclosing reflection about root causes of crises or how these might be addressed. Thus, even while conservation/development paradigms have shifted over the past 40 years (from separating people and nature to integrating them in conservation landscapes), this crisis-fix metabolism has consistently generated livelihood insecurity for the tens of thousands of people living in and around Gishwati. Imagining and enacting more just and inclusive social-environmental landscapes will require making space for diverse voices to define ecosystem form and function as well as addressing deeply rooted power imbalances that are at the heart of recurrent crises.
Inactivation of platelet-derived TGF-β1 attenuates aortic stenosis progression in a robust murine model
Authors: Varshney Rohan , Murphy Brennah , Woolington Sean , Ghafoory Shahrouz , Chen Sixia , Robison Tyler , Ahamed Jasimuddin
Published: March 2019

Aortic stenosis (AS) is a degenerative heart condition characterized by fibrosis and narrowing of aortic valves (AV), resulting in high wall shear stress (WSS) across valves. AS is associated with high plasma levels of transforming growth factor-β1 (TGF-β1), which can be activated by WSS to induce organ fibrosis, but the cellular source of TGF-β1 is not clear. Here, we show that platelet-derived TGF-β1 plays an important role in AS progression. We first established an aggressive and robust murine model of AS, using the existing Ldlr−/−Apob100/100 (LDLR) breed of mice, and accelerated AS progression by feeding them a high-fat diet (HFD). We then captured very high resolution images of AV movement and thickness and of blood flow velocity across the AV, using a modified ultrasound imaging technique, which revealed early evidence of AS and distinguished different stages of AS progression. More than 90% of LDLR animals developed AS within 6 months of HFD. Scanning electron microscopy and whole-mount immunostaining imaging of AV identified activated platelets physically attached to valvular endothelial cells (VEC) expressing high phosphorylated Smad2 (p-Smad2). To test the contribution of platelet-derived TGF-β1 in AS, we derived LDLR mice lacking platelet TGF-β1 (TGF-β1platelet-KO-LDLR) and showed reduced AS progression and lower p-Smad2 and myofibroblasts in their AV compared with littermate controls fed the HFD for 6 months. Our data suggest that platelet-derived TGF-β1 triggers AS progression by inducing signaling in VEC, and their subsequent transformation into collagen-producing-myofibroblasts. Thus, inhibiting platelet-derived TGF-β1 might attenuate or prevent fibrotic diseases characterized by platelet activation and high WSS, such as AS.
Inadequate assessment of adherence to maintenance medication leads to loss of power and increased costs in trials of severe asthma therapy: results from a systematic literature review and modelling study
Authors: Mokoka Matshediso C. , McDonnell Melissa J. , MacHale Elaine , Cushen Breda , Boland Fiona , Cormican Sarah , Doherty Christina , Doyle Frank , Costello Richard W. , Greene Garrett
Published: March 2019

Adherence to inhaled maintenance therapy in severe asthma is rarely adequately assessed, and its influence on trial outcomes is unknown. We systematically determined how adherence to maintenance therapy is assessed in clinical trials of “add-on” therapy for severe asthma. We model the improvement in trial power that could be achieved by accurately assessing adherence.

A systematic search of six major databases identified randomised trials of add-on therapy for severe asthma. The relationship between measuring adherence and study outcomes was assessed. An estimate of potential improvements in statistical power and sample size was derived using digitally recorded adherence trial data.

87 randomised controlled trials enrolling 22 173 participants were included. Adherence assessment was not reported in 67 trials (n=13 931, 63%). Studies that reported adherence used a range of self-report and subjective methods. None of the studies employed an objective assessment of adherence. Studies that reported adherence had a significantly reduced pooled variance in forced expiratory volume in 1 s (FEV1) compared to those that did not assess adherence: s2=0.144 L2versuss2=0.168 L2, p<0.0001. Power to detect clinically relevant changes in FEV1was significantly higher in trials that reported adherence assessment (mean power achieved 59%versus49%). Modelling suggests that up to 50% of variance in FEV1outcomes is attributable to undetected variations in adherence. Controlling for such variations could potentially halve the required sample size.

Few trials of add-on therapy monitor adherence to maintenance inhaled therapy, resulting in a greater variance in trial outcomes and inadequate power for determining efficacy.
Personalised medicine for nonsmall cell lung cancer
Authors: Mascaux Céline , Tomasini Pascale , Greillier Laurent , Barlesi Fabrice
Published: March 2019

After years of standard care prescribed to cancer patients without any selection except the primary site and histology of the tumour, the era of precision medicine has revolutionised cancer care. Personalised medicine refers to the selection of patients for specific treatment based on the presence of specific biomarkers which indicate sensitivity to corresponding targeted therapies and/or lower toxicity risk, such that patients will have the greatest chance of deriving benefit from the treatments. Here, we review personalised medicine for nonsmall cell lung cancer.
RETRACTED ARTICLE: Downregulation of CDKL1 suppresses neuroblastoma cell proliferation, migration and invasion
Authors: Li Weiyi , Cao Jing , Liu Jian , Chu Wenli , Zhang Congqing , Chen Shuiling , Kang Zefeng
Published: March 2019

Background

Cyclin-dependent kinase-like 1 (CDKL1) is a member of the cell division control protein 2-related serine–threonine protein kinase family. It is known to occur in various malignant tumors, but its role in neuroblastoma (NB) remains unclear.

Methods

We constructed a CDKL1-silenced NB cell strain (SH-SY5Y) and used real-time PCR and western blotting to confirm the silencing. Functional analyses were performed using the MTT, colony-formation, FACS, wound-healing and transwell invasion assays.

Results

The expression of CDKL1 was significantly upregulated in NB tissue as compared to the adjacent normal tissue. CDKL1 knockdown significantly suppressed cell viability and colony formation ability. It also induced cell cycle G0/G1 phase arrest and apoptosis, and suppressed the migration and invasion ability of SH-SY5Y cells. CDKL1 knockdown decreased the CDK4, cyclin D1 and vimentin expression levels, and increased the caspase-3, PARP and E-cadherin expression levels in SH-SY5Y cells.

Conclusions

Our findings suggest that CDKL1 plays an important role in NB cell proliferation, migration and invasion. It might serve as a potential target for NB therapy.
An enhanced procedure for the analysis of organic binders in Pompeian’s wall paintings from Insula Occidentalis
Authors: Gelzo Monica , Corso Gaetano , Pecce Rita , Arcari Ottavia , Piccioli Ciro , Dello Russo Antonio , Arcari Paolo
Published: March 2019

Quantitation of paint powders of ancient wall paintings is often hindered by the calcite contamination during samples withdrawal. To overcome this problem, a new approach was explored based on the mechanical pulverization of the paint powder followed by the evaluation of its true concentration, namely binders, pigments, and decaying compounds, from the comparison of the calcite FT-IR peak area at 2510 cm−1 with that of the corresponding underlying calcite used as calibrator. After extraction of the pulverized paint powder with polar and nonpolar solvents, liquid chromatography, gas chromatography with flame ionization detection, and gas chromatography–mass spectrometry were used to estimate the free amino acids, and fatty acids profiles. Compared to our previous investigation, the results obtained showed a better yield of the extracted organic materials as mg/kg of powder and also a qualitative improvement of the lipids profile.
Impact of testosterone replacement therapy after radical prostatectomy on prostate cancer outcomes.
Authors: Sarkar Reith , Parsons J Kellogg , Einck John Paul , Mundt Arno James , Kader A. Karim , Kane Christopher J. , Riviere Paul , McKay Rana R. , Murphy James Don , Rose Brent Shane
Published: March 2019

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Background: Currently there is little data to guide the use of post-radical prostatectomy (RP) testosterone replacement therapy in prostate cancer. We sought to evaluate the impact of post-RP testosterone replacement on prostate cancer outcomes in a large national cohort. Methods: We conducted a population-based cohort study using the Veterans Affairs Informatics and Computing Infrastructure. We identified node-negative and non-metastatic prostate cancer patients diagnosed between 2001-2015 treated with RP. We excluded patients for missing covariate and follow-up data. We then coded receipt of testosterone replacement after RP as a time-dependent covariate. Other covariates included: age, Charlson Comorbidity index, diagnosis year, body mass index, race, PSA, clinical T/N/M stage, Gleason score, and receipt of hormone therapy. Biochemical recurrence was defined as a post-RP PSA≥0.2. We evaluated prostate cancer-specific survival, overall survival, and biochemical recurrence free survival using multivariable Cox regression. Results: Our cohort included 28,651 patients, of whom 469 (1.6%) received testosterone replacement after RP. Median follow up was 7.4 years. There were no differences in clinical T stage, median post-RP PSA (testosterone: 0 non-testosterone: 0; p = 0.18), or hormone therapy use between treatment groups. Testosterone patients were more likely to be of younger age, have higher comorbidity, non-black, have a lower median pre-treatment PSA (5.0 vs 5.8; p < 0.001), and have higher BMI. The median time from RP to TRT was 3.0 years. After controlling for potential confounders, we found no difference in prostate cancer specific mortality (HR 0.73; 95% CI 0.32-1.62; p = 0.43), overall survival (HR 1.11; 95% CI 0.86-1.44; p = 0.43), non-cancer mortality (HR 1.17; 95% CI 0.89-1.55; p = 0.26) biochemical recurrence free survival (HR 1.07; 95% CI 0.84-1.36; p = 0.59) between testosterone users and non-users. Conclusions: Our results suggest that testosterone replacement is safe in prostate cancer patients who have undergone RP, though prospective data is necessary to confirm this finding.
External validation of prostatectomy incontinence nomogram (PIN).
Authors: Pinkhasov Rubin , Pinkhasov Alexandr M. , Attwood Kristopher , Abaev Michall , Underwood Willie
Published: March 2019

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Background: Using previously developed prostatectomy incontinence nomogram (PIN) we sought to externally validate the nomogram that predicts probability of incontinence at 6-, 12-, and 24-months after robot assisted radical prostatectomy (RARP). Methods: Prospective data from 663 men with prostate cancer that underwent RARP from 2010 to 2014 at two comprehensive cancer centers and three large group practices was queried. The performance of the previously developed model was evaluated using calibration plots (predicted continence rates versus observed continence rates with 95% CI obtained using Jeffrey’s prior method) and receiver operating curves (ROC). Using Expanded Prostate Cancer Index Composite (EPIC-50) Urinary Function questionnaire, perfect continence was defined as 0 pads, social continence was defined as 1 or 2 pads, and incontinence was defined as ≥ 3 pads used after RARP. Results: The 6-, 12-, and 24- month social continence rates were 77%, 88%, and 93%, respectively. Similar to the 6- and 12-month model development cohort, the external validation cohort has modest predictability with a 6- and 12- month AUC of 0.61, and 0.62, respectively. The 24-month AUC of 0.62 in the external validation cohort is worse than what was reported in the development cohort (AUC 0.80). Conclusions: The externally validated prostatectomy incontinence nomogram is generalizable but has modest 6-, 12-, and 12-month predictability in risk of incontinence after RARP.