bluuebunny/crossref_metadata_2025 huggingface dataset:
Short-Time Antibacterial Effects of Dimethylaminododecyl Methacrylate on Oral Multispecies Biofilm In Vitro
Authors: Zhou Yujie , Wang Suping , Zhou Xuedong , Zou Yiran , Li Mingyun , Peng Xian , Ren Biao , Xu Hockin H. K. , Weir Michael D. , Cheng Lei , Chen Yu , Han Qi
Published: January 2019

Quaternary ammonium compounds constitute a large group of antibacterial chemicals with a potential for inhibiting dental plaque. The aims of this study were to evaluate short-time antibacterial and regulating effects of dimethylaminododecyl methacrylate (DMADDM) on multispecies biofilm viability, reformation, and bacterial composition in vitro. DMADDM, chlorhexidine (CHX), and sodium fluoride (NaF) were chosen in the present study. Streptococcus mutans, Streptococcus sanguinis, and Streptococcus gordonii were used to form multispecies biofilm. Cytotoxicity assay was used to determine the optimal tested concentration. 3-(4,5-dimethyl-thiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay and resazurin test of biofilm were conducted to study the biomass changes and metabolic changes of controlled multispecies biofilm. Scanning electron microscopy (SEM) was used to observe biofilm images. TaqMan real-time polymerase chain reaction was performed to evaluate the proportion change in multispecies biofilm of different groups. Cytotoxicity assay showed that there existed a certain concentration application range for DMADDM, CHX, and NaF. MTT assay and resazurin test results showed that DMADDM and CHX groups decreased multispecies biofilm growth and metabolic activity (p < 0.05), no matter after 1 min or 5 min direct contact killing or after 24 h regrowth. The proportion of S. mutans decreased steadily in DMADDM and CHX groups after 1 min and 5 min direct contact killing and 24 h regrowth, compared to control groups. A novel DMADDM-containing solution was developed, achieving effective short-time antibacterial effects and regulation ability of biofilm formation.
Asymptomatic Right Ventricular Hypoplasia in Twin Siblings: A Normal Variant or Cause of Early Mortality?
Authors: Qasim Amna , Dasgupta Soham , Aly Ashraf M.
Published: January 2019

Right ventricular (RV) hypoplasia may develop secondary to pulmonary or tricuspid valve atresia. These patients are usually symptomatic early in life and need prompt intervention. Isolated RV hypoplasia is a rare congenital heart disease. We report a case of 23-year-old twins who have been monitored for the last 14 years for isolated right ventricular hypoplasia. ECHO and MRI studies showed a small, heavily trabeculated, nonapex-forming RV and mild tricuspid valve insufficiency. The girl has a patent foramen ovale (PFO). Otherwise, the cardiac anatomy and function was normal. They have both been completely asymptomatic from the cardiac standpoint. The family history is remarkable for death of father at the age of 30 years with autopsy suggestive of a hypoplastic RV. The paternal uncle also died at the age of 46 years, and his son has an unidentified congenital heart disease. The family history appears to suggest an autosomal dominant pattern of inheritance with variable expressivity. However, the chromosome microarray analysis of the twins did not identify any variations of clinical significance.
Actual Temperature Evolution of Thick Raft Concrete Foundations and Cracking Risk Analysis
Authors: Ju Yuwen , Lei Honggang
Published: January 2019

Heat of the hydration-induced temperature evolution of a 3.30 m thick raft concrete foundation for wind turbines at the early ages was monitored in situ through a temperature sensor testing system. The temperature variation patterns and risk of cracking were studied. Finite element analysis (FEA) conducted on the temperature fields determined the lower thickness threshold requiring temperature control. A comprehensive temperature control approach suitable for thick raft foundations was proposed based on a practical engineering project. Temperature monitoring and analysis results showed that the early temperature field evolution featured two characteristic phases: heat accumulation and heat release. A remarkable temperature gradient was observed along the vertical direction of the foundation. The maximum temperature difference between the concrete core and the top surface was approximately 35°C, indicating a risk of cracking. The accuracy of the FEA was ensured by adopting the concrete heat generation rate obtained from the adiabatic temperature rise test. A further FEA performed on foundations with various thicknesses demonstrated that a thicker foundation corresponded to a higher vertical temperature gradient. Moreover, a raft thickness larger than 2.50 m corresponded to a maximum temperature difference between the concrete core and the surface higher than 25°C, above which cracking prevention measures should be taken. Field test results proved the applicability of a suite of temperature feedback regulation measures proposed herein, including layered pouring, thermal insulation, and in situ real-time temperature monitoring, to thick raft mass concrete structures with relatively small volumes. Good control of temperature difference was achieved using this approach.
Brucella Shunt Infection as a Rare Presentation of Neurobrucellosis
Authors: Mehrabian Fatemeh , Abdi Layaee Zahra , Ahmadinejad Zahra
Published: January 2019

Brucellosis, as a systemic infection with potential to involving virtually all organ systems, is an endemic zoonosis in Iran. This is the history of a 17-year-old boy with a ventriculoperitoneal (VP) shunt who presented with prolonged fever, constipation, and abdominal pain. Laboratory studies, including cerebrospinal fluid (CSF) and blood tests, revealed a VP shunt infection with Brucella spp. We treated the patient with rifampicin, trimethoprim-sulfamethoxazole (cotrimoxazole), and ceftriaxone. Also, the shunt was temporarily replaced with an extraventricular drain until the CSF culture was sterile and a new permanent VP shunt could be inserted. We report this case to underline the diagnostic possibility of brucellosis in every case of protracted fever of unknown origin (FUO), irrespective of accompanying signs and symptoms.
Functional and Respiratory Capacity of Patients with Chronic Kidney Disease Undergoing Cycle Ergometer Training during Hemodialysis Sessions: A Randomized Clinical Trial
Authors: Fernandes Antonio de Olival , Sens Yvoty Alves dos Santos , Xavier Vivian Bertoni , Miorin Luiz Antonio , Alves Vera Lúcia dos Santos
Published: January 2019

Purpose. Exercise is recommended for patients undergoing hemodialysis, to reduce the decrease in functional capacity secondary to the progression of chronic kidney disease. A cycle ergometer can be easily added to an exercise routine during hemodialysis sessions. The purpose of this article was to assess the results of a training protocol with the cycle ergometer during hemodialysis sessions on the respiratory function and functional capacity of patients with chronic kidney disease on hemodialysis. Method. In this randomized clinical trial (NCT no. 02834026), 39 patients undergoing hemodialysis were randomly allocated into two groups: the treatment group (TG, n = 20), who underwent a cycle ergometer protocol training, and the control group (GC, n = 19), not trained. The TG attended 24 training sessions, three times a week, during the intradialytic period. Training intensity was aimed at keeping the heart rate between 50 and 70% of its maximum. All participants were evaluated before and after the eight consecutive weeks of follow-up and had biochemicals data, anthropometric, functional, and respiratory outcomes evaluated. Results. A significant difference was observed between groups in forced vital capacity, forced expiratory volume in the first second, peak expiratory flow, maximal inspiratory and expiratory pressure, and Borg score and distance covered in the six-minute walk test. Improvement was also observed in biochemical and Kt/V test results for the TG. Conclusion. The systematic training regimen with a cycle ergometer resulted in benefits in the respiratory function and functional capacity in patients with chronic kidney disease undergoing hemodialysis.
Analysis of Changes in the Micromorphology of Sandstone Joint Surface under Dry-Wet Cycling
Authors: Fang Jingcheng , Deng Huafeng , Qi Yu , Xiao Yao , Zhang Hengbin , Li Jianlin
Published: January 2019

Changes in the micromorphology of joint surface under dry-wet cycling have a direct effect on the mechanical properties of the jointed rock masses, which in turn affects the deformation stability of the bank slope of a reservoir. In this study, we design and carry out a test that aims to quantity the effects of repeated rise and fall of a reservoir on the properties of a jointed rock masses. The results are as follows: first, the roughness, local gradient, and undulation of the joint surface gradually decreased under repeated dry-wet cycling. In addition, the height parameters and texture parameters showed a steep decrease followed by a slow decline. The deterioration was particularly obvious over the first 5 dry-wet cycles. Second, the roughness coefficient of the joint surface, the compressive strength of the face wall, and the basic friction angle were gradually reduced under dry-wet cycling. The shear strength of the jointed rock masses (obtained both quantitatively and experimentally) showed a deteriorating trend controlled by the deterioration of the micromorphology, the strength of the face wall, and the frictional properties of the joint surface. Finally, the dry-wet cycling process determined trends of changes in the microstructure parameters and mechanical properties of the joint surface. Our research results provide a good basis for the analysis of the deterioration and failure of rock masses within the hydrofluctuation belt of a bank slope.
Shared Medical and Environmental Risk Factors in Dry Eye Syndrome, Sjogren’s Syndrome, and B-Cell Non-Hodgkin Lymphoma: A Case-Control Study
Authors: Ben-Eli Hadas , Aframian Doron J. , Ben-Chetrit Eldad , Mevorach Dror , Kleinstern Geffen , Paltiel Ora , Solomon Abraham
Published: January 2019

Objectives. To assess whether there are shared exposures associated with Sjogren’s syndrome (SS), dry eye syndrome (DES), and B-cell non-Hodgkin lymphoma (B-NHL), in order to determine whether they are etiologically related. Methods. In a clinic-based case-control study, 702 participants (91 SS, 120 DES, 211 (age and sex frequency-matched) controls, and 280 B-NHL cases) were recruited and interviewed regarding exposures, medical history, and family history. Results. Female predominance was noted in SS (ratio 9.2 : 1). Eye dryness was severest in SS compared to DES and controls (P<0.001). Compared to controls, alcohol consumption was inversely associated with NHL, DES, and SS (odds ratio OR=0.47, 95% confidence interval (CI): 0.31-0.71; OR=0.54, 95% CI: 0.33-0.88; and OR=0.26, 95% CI: 0.14-0.49, respectively), while a previous history of infection requiring hospitalization was positively associated with all three conditions: NHL (OR=1.92; 95% CI: 1.23-2.99), DES (OR=3.29; 95% CI: 1.97-5.47), and SS (OR=4.74; 95% CI: 2.66-8.44). NHL patients were more likely to report first-degree relatives with hematologic cancer, while having first-degree relatives with an autoimmune disease (AID) was associated with SS (OR=5.25; 95% CI: 2.59-10.63) and DES (OR=3.55; 95% CI: 1.83-6.91) compared to controls. Conclusions. Some exposures are associated with all three conditions (such as an inverse association with alcohol consumption and a positive association with serious past infection), while a family history of AID appears to be shared by DES and SS, but not NHL subjects. Shared risk factors for all three conditions indicate possible mutual etiological pathways.
Lymphomatoid Granulomatosis in a Patient with Chronic Lymphocytic Leukemia and Rapidly Progressing Peribronchovascular Pulmonary Infiltrates
Authors: Rezvani Shahab , Tominna Marie , Al-Katib Sayf , Smith Marc D. , Cousineau Craig , Al-Katib Ayad
Published: January 2019

Lymphomatoid granulomatosis (LG) is an EBV-associated angiodestructive lymphoproliferative disease with multiorgan involvement that predominantly affects the lungs. We present a case of a 72-year-old man with a history of chronic lymphocytic leukemia who presented with upper respiratory symptoms and multiple erythematous skin papules. Chest CT showed ill-defined, irregular solid pulmonary nodules with peripheral ground-glass opacities in a peribronchovascular distribution. The differential for this pattern of lung disease is vast which includes but is not limited to infection, vasculitis, sarcoidosis, lymphoma, and Kaposi sarcoma. Subsequent PET/CT showed rapid progression of lung opacities and marked FDG uptake of pulmonary opacities and skin nodules, which raised the question of Richter syndrome. Wedge biopsy under video-assisted thoracoscopic surgery was performed. Pathology showed an extensive lymphoid infiltrate involving lymphatic and bronchovascular bundles and consisting of a mixture of large lymphocytes and inflammatory cells. Special stains showed that the large lymphocytes expressed B-cell markers and EBV virus. Overall, the findings were consistent with LG.
Promising Combination Therapy with Bevacizumab and Erlotinib in an EGFR-Mutated NSCLC Patient with MET Amplification Who Showed Intrinsic Resistance to Initial EGFR-TKI Therapy
Authors: Seki Nobuhiko , Natsume Maika , Ochiai Ryosuke , Haruyama Terunobu , Ishihara Masashi , Fukasawa Yoko , Sakamoto Takahiko , Tanzawa Shigeru , Usui Ryo , Honda Takeshi , Ota Shuji , Ichikawa Yasuko , Watanabe Kiyotaka
Published: January 2019

In lung cancer, several potential mechanisms of intrinsic and acquired resistance to epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors (TKIs) have been explored, including mesenchymal-epithelial transition factor (MET) signaling pathway activation. On the other hand, vascular endothelial growth factor (VEGF) production of EGFR-mutated lung cancer cells is stimulated by predominantly activated MET signaling pathway. Therefore, the inhibition of VEGF axis as the downstream target of MET signaling pathway seems promising. Here, for the first time, we report the potential efficacy of combination therapy with bevacizumab and erlotinib in an EGFR-mutated NSCLC patient with MET amplification who showed intrinsic resistance to initial EGFR-TKI therapy. The patient was a 60-year-old male smoker, showing performance status (PS) 2, who presented with stage IV lung adenocarcinoma (cT4N2M1a) harboring the EGFR exon 19 deletion mutation. He was started on gefitinib at 250 mg/day. However, by 28 days, his symptoms further deteriorated along with the increased tumor size, resulting in PS 3. Then, repeat biopsy was performed, showing the positive MET amplification and the preserved EGFR exon 19 deletion mutation. Therefore, on the basis of the potential efficacy for activated MET signaling pathway as well as the confirmed safety by the known phase II trial for EGFR-mutated patients, the patient was started on combination therapy with bevacizumab at 15 mg/kg every 3 weeks plus erlotinib at 150 mg/day. By 21 days, his symptoms gradually improved along with the decreased tumor size, resulting in better PS with no severe toxicities.
Need for Flexible Adjustment of the Treatment Schedule for Aprepitant Administration against Erlotinib-Induced Refractory Pruritus and Skin Rush
Authors: Seki Nobuhiko , Ochiai Ryosuke , Haruyama Terunobu , Ishihara Masashi , Natsume Maika , Fukasawa Yoko , Sakamoto Takahiko , Tanzawa Shigeru , Usui Ryo , Honda Takeshi , Ota Shuji , Ichikawa Yasuko , Watanabe Kiyotaka
Published: January 2019

Common dermatological side-effects associated with erlotinib, epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor (TKI), include pruritus and skin rash, which are mediated by substance P, leading to the occasional discontinuation of cancer treatment. Aprepitant is an antagonist of neurokinin-1 receptor, through which substance P activates the pruritogens. Thus, aprepitant is expected to offer a promising option for the treatment of erlotinib-induced pruritus. However, the appropriate treatment schedule for aprepitant administration is under consideration. Here, we discuss the need for flexible adjustment of the treatment schedule for aprepitant administration against erlotinib-induced refractory pruritus and skin rush. A 71-year-old female smoker presented with stage IV EGFR-mutated lung adenocarcinoma. She was started on erlotinib at 150 mg/day. However, by 28 days, severe pruritus and acneiform skin rush resistant to standard therapies occurred, resulting in the interruption of erlotinib therapy. After recovery, she was restarted on erlotinib at 100 mg/day. However, severe pruritus and skin rush developed again within 2 weeks. Then, we started the first 3-day dose of aprepitant (125 mg on day 1, 80 mg on day 3, and 80 mg on day 5) based on the results of the previous prospective study, which showed the success rate of 100% with at least the second dose of aprepitant. However, the pruritus and skin rush exacerbated again within 4 weeks. Therefore, we started the second 3-day dose of aprepitant, but in vain. At this point, as the patient-centered medicine, bi-weekly schedule of the 3-day dose of aprepitant was considered and, then, adopted. As the results, the pruritus and skin rush remained well-controlled throughout the subsequent treatment with erlotinib.
Long-Term Follow-Up after Surgical Management for Atypical Endometriosis: A Series of Nine Cases
Authors: Tanase Yasuhito , Kawaguchi Ryuji , Uchiyama Tomoko , Kobayashi Hiroshi
Published: January 2019

Background and Objective: Atypical endometriosis is reported to possess a precancerous potential attributed to premalignant changes characterized by cytological atypia and architecture proliferation. Although the coexistence of atypical endometriosis and neoplasms has been reported, cases of atypical endometriosis transformation to carcinoma are rarely reported. The purpose of this case series was to evaluate the prognosis of atypical endometriosis. Subjects and Methods: Data from nine women who underwent surgical treatment including cystectomy and salpingo-oophorectomy with or without hysterectomy and diagnosed with atypical endometriosis was analyzed. Between January 2006 and January 2018, the clinical characteristics and prognosis of atypical endometriosis were evaluated. Results: During the follow-up period, eight of nine patients with atypical endometriosis did not develop malignant epithelial tumors, although one patient developed endometrioid carcinoma, grade 1, 48 months after her right laparoscopic cystectomy. The median overall survival period for all patients was 68 (range 13–131) months. Conclusion: When we encounter the cases of atypical endometriosis, it is necessary to consider the possibility of ovarian cancer and carefully follow those cases for long periods.
Co-Occurrence of Leber Congenital Amaurosis and Meckel Syndrome Type 1 in a Fetus: Is There a Lesson to Be Learned
Authors: Tallapaka Karthik , Aggarwal Shagun , Bhattacherjee Amrita , Das Bhowmik Aneek , Dalal Ashwin
Published: January 2019

A patient referred for prenatal diagnostics, after first-trimester ultrasound due to a previous child with Leber congenital amaurosis, was suggestive of a Meckel syndrome-like phenotype. Fetal autopsy confirmed the multiple anomalies, and whole-exome sequencing of the fetal DNA identified a pathogenic variant in the RPGRIP1 gene, previously identified in the elder sibling, and a variant causative of Meckel syndrome 1 in the MKS1 gene. Reporting the MKS1 mutation, which was present in heterozygous state in the elder sibling, as a secondary finding would have enabled the parents to be tested for carrier status of the same variant and appropriate counseling could have been provided prior to the onset of the pregnancy. Although the information may not be of great benefit in cases where the ultrasonographic changes can be recognized early, it would be of definitive help where diagnostic imaging in early pregnancy is not possible.
Expanding the Indication for Novel Theranostic 177Lu-Dotatate Peptide Receptor Radionuclide Therapy: Proof-of-Concept of PRRT in Merkel Cell Cancer
Authors: Kasi Pashtoon M. , Sharma Akash , Jain Manoj K.
Published: January 2019

The field of theranostics is a new nuclear medicine tool being utilized in the treatment of different types of cancers. It couples receptor-specific based imaging predicting and guiding response to receptor-specific based radionuclide therapies. For example, somatostatin-receptor based imaging (Gallium; 68Ga-dotatate scan) is now predicting and guiding the use of treatment with the somatostatin-receptor radiolabeled somatostatin analog (peptide receptor radionuclide therapy PRRT – Lutetium; 177Lu-Dotatate) for neuroendocrine tumors that express the somatostatin receptors. The United States Food and Drug Administration approved the use of 177Lu-Dotatate PRRT for somatostatin-receptor-positive gastroenteropancreatic neuroendocrine tumors only. Here we show proof of concept and results of an outstanding response to this novel therapy in conjunction with immunotherapy in a refractory cancer type where it has not been approved (Merkel Cell Cancer). Our results and data provide proof of principle for considering the use of this novel therapy in a tumor-agnostic approach; similar to approval of immunotherapy for mismatch repair deficient tumors. The response demonstrated has also been unprecedented, likely secondary to use of PRRT with immunotherapy. These observations have profound and broad implications on how to move this novel field of theranostics forward for treatment of many cancer-types.
Extreme Levels of Air Pollution Associated With Changes in Biomarkers of Atherosclerotic Plaque Vulnerability and Thrombogenicity in Healthy Adults
Authors: Xu Hongbing , Wang Tong , Liu Shengcong , Brook Robert D. , Feng Baihuan , Zhao Qian , Song Xiaoming , Yi Tieci , Chen Jie , Zhang Yi , Wang Yang , Zheng Lemin , Rajagopalan Sanjay , Li Jianping , Huang Wei
Published: January 2019

Rationale:

The pathophysiologic mechanisms of air pollution–associated exacerbation of cardiovascular events remain incompletely understood.

Objective:

To assess whether ambient air pollution can be a trigger of the vulnerable plaque and heightened thrombogenicity through systemic inflammatory pathways.

Methods and Results:

In Beijing AIRCHD study (Air Pollution and Cardiovascular Dysfunctions in Healthy Adults Living in Beijing), 73 healthy adults (mean±SD, 23.3±5.4 years) were followed up in 2014 to 2016. We estimated associations between air pollutants and biomarkers relevant to atherosclerotic plaque vulnerability, thrombogenicity, and inflammation using linear mixed-effects models and elucidated the biological pathways involved using mediation analyses. Receiver operating characteristic analyses were conducted to assess the ability of each biomarker to predict ambient air pollution exposures. High average concentrations of particulate matter in diameter <2.5 μm (91.8±63.8 µg/m
3
) were observed during the study period. Significant increases in circulating biomarkers of plaque vulnerability, namely MMPs (matrix metalloproteinases; MMP-1, 2, 3, 7, 8, and 9), of 8.6% (95% CI, 0.1–17.8) to 141.4% (95% CI, 111.8–171.0) were associated with interquartile range increases in moving averages of particulate matter in diameter <2.5 μm, number concentrations of particles in sizes of 5 to 560 nm and black carbon, during the last 1 to 7 days before each participant’s clinic visit. Higher air pollutant levels were also significantly associated with decreases in TIMP (tissue inhibitors of MMPs; TIMP-1 and 2), heightened thrombogenicity (shortened prothrombin time and increases in sCD40L [soluble CD40 ligand], sCD62P [soluble P-selectin], and fibrinogen/fibrin degradation products), and elevations in systemic inflammation (IL-1β [interleukin-1β], CRP [C-reactive protein], MIP-1α/β [macrophage inflammatory protein-1α/β], sRAGE [soluble receptor for advanced glycation end products], and IGFBP [insulin-like growth factor–binding protein]-1 and 3). Receiver operating characteristic curves showed that several biomarkers can serve as robust pollutant-specific predictors with high versus low black carbon exposure (area under the receiver operating characteristic curve of 0.974 [95% CI, 0.955–0.992] for MMP-8 and 0.962 [95% CI, 0.935–0.988] for sRAGE). Mediation analysis further showed that systemic inflammation can mediate ≤46% of the changes in MMPs and thrombogenicity associated with interquartile range increases in air pollutants.

Conclusions:

Our results suggest that air pollution may prompt cardiovascular events by triggering vulnerable plaque along with heightened thrombogenicity possibly through systemic inflammatory pathways.
Duration of Electrocardiographic Monitoring of Emergency Department Patients With Syncope
Authors: Thiruganasambandamoorthy Venkatesh , Rowe Brian H. , Sivilotti Marco L.A. , McRae Andrew D. , Arcot Kirtana , Nemnom Marie-Joe , Huang Longlong , Mukarram Muhammad , Krahn Andrew D. , Wells George A. , Taljaard Monica
Published: January 2019

Background:

The optimal duration of cardiac rhythm monitoring after emergency department (ED) presentation for syncope is poorly described. We sought to describe the incidence and time to arrhythmia occurrence to inform decisions regarding duration of monitoring based on ED risk stratification.

Methods:

We conducted a prospective cohort study with enrolled adult patients (≥16 years old) presenting within 24 hours of syncope at 6 EDs. We collected baseline characteristics, time of syncope and ED arrival, and the Canadian Syncope Risk Score (CSRS) risk category. We followed subjects for 30 days, and our adjudicated primary outcome was serious arrhythmic conditions (arrhythmias, interventions for arrhythmias, and unexplained death). After excluding patients with an obvious serious condition on ED presentation and those with missing CSRS predictors, we used Kaplan-Meier analysis to describe the time to serious arrhythmic outcomes.

Results:

A total of 5581 patients (mean age, 53.4 years; 54.5% females; 11.6% hospitalized) were available for analysis, including 346 (6.2%) for whom the 30-day follow-up was incomplete and who were censored at the last follow-up time. A total of 417 patients (7.5%) experienced serious outcomes, 207 of which (3.7%; 95% CI, 3.3%–4.2%) were arrhythmic (161 arrhythmias, 30 cardiac device implantations, 16 unexplained deaths). Overall, 4123 (73.9%) were classified as CSRS low risk, 1062 (19.0%) medium risk, and 396 (7.1%) high risk. The CSRS accurately stratified subjects as low risk (0.4% risk for 30-day arrhythmic outcome), medium risk (8.7% risk), and high risk (25.3% risk). One-half of arrhythmic outcomes were identified within 2 hours of ED arrival in low-risk patients and within 6 hours in medium- and high-risk patients, and the residual risk after these cut points were 0.2% for low-risk, 5.0% for medium-risk, and 18.1% for high-risk patients. Overall, 91.7% of arrhythmic outcomes among medium- and high-risk patients, including all ventricular arrhythmias, were identified within 15 days. None of the low-risk patients experienced ventricular arrhythmia or unexplained death, whereas 0.9% of medium-risk patients and 6.3% of high-risk patients experienced them (
P
<0.0001).

Conclusions:

Serious underlying arrhythmia was often identified within the first 2 hours of ED arrival for CSRS low-risk patients and within 6 hours for CSRS medium- and high-risk patients. Outpatient cardiac rhythm monitoring for 15 days for selected medium-risk patients and all high-risk patients discharged from the hospital should also be considered.
Genetic Imbalance Is Associated With Functional Outcome After Ischemic Stroke
Authors: Pfeiffer Dorothea , Chen Bowang , Schlicht Kristina , Ginsbach Philip , Abboud Sherine , Bersano Anna , Bevan Steve , Brandt Tobias , Caso Valeria , Debette Stéphanie , Erhart Philipp , Freitag-Wolf Sandra , Giacalone Giacomo , Grau Armin J. , Hayani Eyad , Jern Christina , Jiménez-Conde Jordi , Kloss Manja , Krawczak Michael , Lee Jin-Moo , Lemmens Robin , Leys Didier , Lichy Christoph , Maguire Jane M. , Martin Juan J. , Metso Antti J. , Metso Tiina M. , Mitchell Braxton D. , Pezzini Alessandro , Rosand Jonathan , Rost Natalia S. , Stenman Martin , Tatlisumak Turgut , Thijs Vincent , Touzé Emmanuel , Traenka Christopher , Werner Inge , Woo Daniel , Del Zotto Elisabetta , Engelter Stefan T. , Kittner Steven J. , Cole John W. , Grond-Ginsbach Caspar , Lyrer Philippe A. , Lindgren Arne ,   on behalf of CADISP; GISCOME; SiGN studies; and ISGC
Published: January 2019

Background and Purpose—

We sought to explore the effect of genetic imbalance on functional outcome after ischemic stroke (IS).

Methods—

Copy number variation was identified in high-density single-nucleotide polymorphism microarray data of IS patients from the CADISP (Cervical Artery Dissection and Ischemic Stroke Patients) and SiGN (Stroke Genetics Network)/GISCOME (Genetics of Ischaemic Stroke Functional Outcome) networks. Genetic imbalance, defined as total number of protein-coding genes affected by copy number variations in an individual, was compared between patients with favorable (modified Rankin Scale score of 0–2) and unfavorable (modified Rankin Scale score of ≥3) outcome after 3 months. Subgroup analyses were confined to patients with imbalance affecting ohnologs—a class of dose-sensitive genes, or to those with imbalance not affecting ohnologs. The association of imbalance with outcome was analyzed by logistic regression analysis, adjusted for age, sex, stroke subtype, stroke severity, and ancestry.

Results—

The study sample comprised 816 CADISP patients (age 44.2±10.3 years) and 2498 SiGN/GISCOME patients (age 67.7±14.2 years). Outcome was unfavorable in 122 CADISP and 889 SiGN/GISCOME patients. Multivariate logistic regression analysis revealed that increased genetic imbalance was associated with less favorable outcome in both samples (CADISP:
P
=0.0007; odds ratio=0.89; 95% CI, 0.82–0.95 and SiGN/GISCOME:
P
=0.0036; odds ratio=0.94; 95% CI, 0.91–0.98). The association was independent of age, sex, stroke severity on admission, stroke subtype, and ancestry. On subgroup analysis, imbalance affecting ohnologs was associated with outcome (CADISP: odds ratio=0.88; 95% CI, 0.80–0.95 and SiGN/GISCOME: odds ratio=0.93; 95% CI, 0.89–0.98) whereas imbalance without ohnologs lacked such an association.

Conclusions—

Increased genetic imbalance was associated with poorer functional outcome after IS in both study populations. Subgroup analysis revealed that this association was driven by presence of ohnologs in the respective copy number variations, suggesting a causal role of the deleterious effects of genetic imbalance.
Spot Urine Sodium-to-Potassium Ratio Is a Predictor of Stroke
Authors: Averill Michelle M. , Young Rebekah L. , Wood Alexis C. , Kurlak Emily O. , Kramer Holly , Steffen Lyn , McClelland Robyn L. , Delaney Joseph A. , Drewnowski Adam
Published: January 2019

Background and Purpose—

Dietary sodium reduction with concurrent increase in potassium intake is a current public health priority to reduce risk of cardiovascular events. This study explored associations between the spot urine sodium-to-potassium ratio and cardiovascular events in the MESA (Multi-Ethnic Study of Atherosclerosis) longitudinal cohort.

Methods—

The MESA is a prospective cohort study of 6814 adults from 4 ethnic groups (European-, Asian-, African- and Hispanic-American) with a mean age of 62 (±10.2) years and an average of 11.7 (±2.2) years of follow-up. Participants were free of clinical cardiovascular disease at baseline. Spot urine sodium and potassium excretion, as a marker of dietary intake, was collected at baseline. The impact of urinary sodium-to-potassium ratio on adjudicated cardiovascular events was assessed using Cox proportional hazards models.

Results—

Only 39% of MESA participants had a urinary sodium-to-potassium ratio ≤1, and these participants experienced only 74 of the 236 strokes. A sodium-to-potassium ratio >1 was associated with a hazard ratio of 1.47 (95% CI,1.07–2.00) for risk of stroke, adjusting for age, sex, race, cardiovascular risk factors, socio-demographic characteristics, body size, and kidney function.

Conclusions—

The spot urine sodium-to-potassium ratio (measurable in routine care) is associated with stroke. A urine sodium-to-potassium ratio of ≤1, may be related to a clinically relevant reduction in stroke risk and is a feasible target for health interventions.
An annotated checklist of the macrodasyidan Gastrotricha from India
Authors: CHATTERJEE TAPAS , PRIYALAKSHMI GEETHA , TODARO M. ANTONIO
Published: January 2019

We present a checklist of the macrodasyidan Gastrotricha fauna of India derived from original articles and comprehensive monographies regarding the Indian Fauna. Taxa and specimens described from India are discussed with special attention to their status, especially those species previously known from distant geographic areas. A total of 43 species have been recorded from 4 States and 2 Union territories. A careful taxonomic assessment indicated that many species are in need of re-description as the reported anatomical traits are not sufficient to grant a modern, robust identification. The situation is particularly poor for two species (Macrodasys indicus Govindankutty & Nair, 1969 and Paradasys lineatus Rao, 1980), which consequently, are considered here to be species inquirendae; moreover, the Indian records of Tetranchyroderma hystrix and T. massiliense reported from Kerala are doubtful and consequently the two species should not be included among the fauna of the Indian region until proper evidence is found. It is necessary to unravel the true identities of many Indian species through a comparison to topotypical material. We recommend that future comparisons between related species and conspecifics from different populations to include molecular sequence data
Finaritra! A splendid new leaf-tailed gecko (Uroplatus) species from Marojejy National Park in north-eastern Madagascar
Authors: RATSOAVINA FANOMEZANA MIHAJA , RASELIMANANA ACHILLE P. , SCHERZ MARK D. , RAKOTOARISON ANDOLALAO , RAZAFINDRAIBE JARY H. , GLAW FRANK , VENCES MIGUEL
Published: January 2019

The Marojejy Massif in northern Madagascar is a constant source of herpetological surprises. Herein we describe a new species of leaf-mimicking leaf-tailed gecko, Uroplatus finaritra sp. nov., based on morphological and molecular phylogenetic evidence. This new species inhabits the rainforests of Marojejy National Park at low elevations and is morphologically similar to Uroplatus phantasticus, but differs by having a larger body size, relatively shorter tail, and dark-red pigmentation of the oral mucosa. Molecular data reveals a distance of 14.0–14.7% in the 16S rRNA gene to U. phantasticus, and haplotype sharing in the c-mos nuclear gene only with species of much shorter tails (i.e., with U. kelirambo and two undescribed candidate species). Similar to other members of the leaf-mimicking Uroplatus species in northern Madagascar, Uroplatus finaritra sp. nov. likely has a small geographic distribution, and is currently known only from the lowland rainforests of Marojejy. We discuss the value of the buccal mucosa colouration and tail dimensions of Uroplatus as taxonomic characters, and the potential drivers of their evolution. In order to reduce the risk of international trade under incorrect species names we suggest that exported CITES species should be obligatorily accompanied by information about their precide geographic origin within Madagascar.
Description of larva of Euphaea superba Kimmins, 1936 (Odonata: Zygoptera: Euphaeidae) from China
Authors: WU XIANGJUAN , LIU ZHEN , CHEN YU , WANG BEIXIN
Published: January 2019

The final stadium larva of Euphaea superba Kimmins, 1936 is described and illustrated based on a male and a female specimens collected in Zhejiang province, China. The larvae were associated with the adults by mtCOI gene sequence. The larva of E. superba is diagnosed from other described members of the genus by the gena having 2–4 spines on outer side, the movable hook about 1.6 time as long as median cleft and female with primary genitalia extending to the posterior margin of abdominal segment 10.
Seeing Weather Through Chaos: A Case Study of Disembedding Skills in Undergraduate Meteorology Students
Authors: McNeal Peggy , Petcovic Heather , Bals-Elsholz Teresa , Ellis Todd
Published: January 2019

Disembedding, or recognizing patterns in a distracting background, is a spatial thinking skill that is particularly relevant to the interpretation of meteorological surface and upper-air maps. Difficulty “seeing” patterns such as cyclonic flow, thermal ridges, or pressure gradients can make weather analysis challenging for students. In this qualitative case study, we characterize how three undergraduate meteorology students with varying disembedding skill complete a series of meteorological tasks. Videos and transcribed verbal data collected during the task, as well as participant products, were analyzed for instances of disembedding and rule-based reasoning. Results demonstrate that the student with greater disembedding skill relied on observing patterns embedded in meteorological maps in conjunction with rule-based reasoning, whereas the two students with lower disembedding skill preferred generalized application of rules. These results can aid meteorology instructors in recognizing students who struggle with disembedding data and patterns and inform the development of instructional interventions in undergraduate meteorology classrooms.
Problems with Students on Medication
Authors: Gadow Kenneth D.
Published: January 2019

Problems teachers encounter with students receiving medication were determined from 1,110 teacher questionnaires obtained from two slate-wide surveys. The results indicated that teachers (a) need more information about medication and (b) are often excluded from meaningful involvement in the treatment process. Teachers thought that medication impaired school performance in some cases. The data also showed the problems associated with the treatment of behavior disorders to be similar to the problems reported for students receiving medication for seizures. However, teachers were more apt to disagree with treatment-related decisions in the case of the former. Suggestions for remedying some problems are discussed.
Mediation: A Process that Works
Authors: Ekstrand Richard E. , Edmister Patricia
Published: January 2019

A comment to P.L. 94-142, The Education for all Handicapped Children Act, encourages mediation as an intervening step prior to a formal due process hearing. It also emphasizes that the mediation process may not be used to deny or delay a parent's right to formal due process. This article offers practical thoughts on mediation to school systems which are involved in disagreements related to the implementation of the Act and notes some of the potential advantages of this intervening step. The authors recommend training programs for school personnel who may be designated as mediators as well as for other staff members who may participate in mediation sessions, IEP meetings, placement meetings, and due process hearings.
Portraits of Mentor-Junior Faculty Relationships: From Power Dynamics to Collaboration
Authors: Cowin Kathleen M. , Cohen Leonora M. , Ciechanowski Kathryn M. , Orozco Richard A.
Published: January 2019

This qualitative self-study of the mentoring experiences of three junior faculty members and their mentor addressed the question: How did we negotiate the dynamics of powerlessness and power in our mentor-junior faculty relationships? Using portraiture as the methodology, we created dialogic word “portraits” to illustrate our mentoring processes, based on retrospective reviews of our emails, discussion transcriptions, and free-writes. The portraits were examined for patterns relating to power, powerlessness, and the process of negotiation that involved race, gender, mentor credibility, novice authority, frustration, disagreements, and ultimately, collaboration. While the larger study also addressed the relationships within the institution, this article focuses on the mentoring relationships that supported the junior faculty members’ efforts to write for publication, including this article.

The study that is reported in this article is part of a larger investigation that focused on power and powerlessness, as experienced by junior faculty, both in the institution and with the mentor, and the ways these concerns were negotiated, as we found these concepts evidenced repeatedly in the portraits that captured our interactions. The data were used to answer the following question: How did we negotiate the dynamics of powerlessness and power in our mentor-junior faculty relationships?
Alternative Risk Models for Ranking Locations for Safety Improvement
Authors: Miranda-Moreno Luis F. , Fu Liping , Saccomanno Frank F. , Labbe Aurelie
Published: January 2019

Many types of statistical models have been proposed for estimating accident risk in transport networks, ranging from basic Poisson and negative binomial models to more complicated models, such as zero-inflated and hierarchical Bayesian models. However, little systematic effort has been devoted to comparing the performance and practical implications of these models and ranking criteria when they are used for identifying hazardous locations. This research investigates the relative performance of three alternative models: the traditional negative binomial model, the heterogeneous negative binomial model, and the Poisson lognormal model. In particular, this work focuses on the impact of the choice of two alternative prior distributions (i.e., gamma versus lognormal) and the effect of allowing variability in the dispersion parameter on the outcome of the analysis. From each model, two alternative accident estimators are computed by using the conditional mean under both marginal and posterior distributions. A sample of Canadian highway—railway intersections with an accident history of 5 years is used to calibrate and evaluate the three alternative models and the two ranking criteria. It is concluded that the choice of model assumptions and ranking criteria can lead to considerably different lists of hazardous locations.
Analysis of Types of Crashes at Signalized Intersections by Using Complete Crash Data and Tree-Based Regression
Authors: Abdel-Aty Mohamed , Keller Joanne , Brady Patrick A.
Published: January 2019

Many studies have shown that intersections are among the most dangerous locations of a roadway network. Therefore, there is a need to understand the factors that contribute to traffic crashes at such locations. One approach is to classify intersections and quantify the effects that configuration, geometric characteristics, and traffic volume have on the number of crashes at signalized intersections. This paper addresses the different factors that affect crashes, by type of collision, at signalized intersections. It also looks into the quality and completeness of the crash data and the effect that incomplete data have on the final results. Data from multiple sources were cross-checked to ensure the completeness of all crashes, including minor crashes that were usually unreported or were not coded into crash databases. The tree-based regression methodology was adopted in this study to cope with multicollinearity between variables, missing observations, and the fact that the true model form was unknown. The results showed a significant discrepancy in the factors that were found to affect the different collision types and their influence in each model. The two most significant differences in comparison with the total crash model as a base case were found to be in the models of head-on and left-turn crashes. The results also showed that the important factors were relatively consistent for rear-end, right-turn, and sideswipe crashes when minor crashes were considered. However, angle and head-on crashes showed significant changes in the model structure when minor crashes were added to the data set because these types of crashes were less stable. Finally, different roadway characteristics were correlated with different types of crashes.
Introductory Guide to Systematic Reviews and Meta-Analysis
Authors: Elvik Rune
Published: January 2019

This paper is an introductory guide to systematic reviews and metaanalysis. Meta-analysis is defined, and important textbooks are introduced. The types of research problems that lend themselves to meta-analysis, how to prepare for a meta-analysis, the main stages of the analysis itself, and how to present a meta-analysis are all discussed. Some brief examples of meta-analysis in transport research are given.
Study of Short-Run Grain Movements on the Inland Waterway System
Authors: Thoma Mark A. , Wilson Wesley W.
Published: January 2019

Time series techniques—particularly impulse–response functions and variance decompositions—are used to characterize the short-run relationships between 17 variables in a vector autoregressive model designed to trace the short-run interconnections among variables affecting lockages on the Mississippi and Illinois Rivers. The model contains five categories of variables: lockages, barge rates, grain bids, rail rates, and rail deliveries. Variance decompositions are constructed that identify barge rates as the most important variable affecting lockages at both short and long horizons. Barge rates are, in turn, explained largely by lockages and rail rates, indicating two-way feedback or bidirectional causality between lockages and barge rates. Impulse–response functions are also examined. The variance decompositions indicate that barge rates are important in explaining lockages, and the impulse–response functions show how lockages and other variables respond to such shocks. In general, there is a substitution away from barge transportation and toward rail transportation when barge rates increase. The results are useful for illuminating the causal relationships among variables in the model and for understanding behavioral relationships present in the data and can be used to guide short- and long-run planning models. For example, many planning models assume that barge traffic does not respond significantly to changes in barge rates; however, results obtained here imply that barge traffic and rail deliveries do respond to such changes. This potentially important implication illustrates the usefulness of the time series techniques used.
Multiscenario, Spatially Detailed Forecasting of Utility Steam Coal for the Ohio River Navigation System
Authors: Watkins Jeff , Kelz Dale W.
Published: January 2019

The U.S. Army Corps of Engineers has pursued continual refinement in the waterway traffic forecasts used in project economic analyses. The multiscenario forecasting of utility steam coal described in this paper, based on the work of Hill & Associates, Inc. (H&A), is a substantial refinement of previous forecasting efforts. H&A prepares 20-year steam coal forecasts on the basis of the interaction of two major linear programming models: the National Power Model (NPM) and the Utility Fuel Economics Model (UFEM). The NPM is a utility industry model that dispatches all electric generating plants in the United States (coal and noncoal), producing forecasts of generation by fuel type within a context of transmission and environmental constraints. The UFEM makes use of highly detailed coal supply data (for approximately 98 coal types) to allocate fuels among plants and units. These two models develop forecasts of coal demand for electricity generation, by type of coal, which were then “mapped” to the waterway. H&A prepared separate forecast scenarios based on three alternative environmental regulatory futures. The first is a continuation of existing law (in this case, the national ambient air quality standards). The second H&A scenario reflects implementation of the administration's Clear Skies Initiative. The final H&A scenario is an implementation of the Clear Skies Initiative without the proposal's severe mercury restrictions.