bluuebunny/crossref_metadata_2025 huggingface dataset:
Enhanced Climate Change Response of Wintertime North Atlantic Circulation, Cyclonic Activity, and Precipitation in a 25-km-Resolution Global Atmospheric Model
Authors: Baker Alexander J. , Schiemann Reinhard , Hodges Kevin I. , Demory Marie-Estelle , Mizielinski Matthew S. , Roberts Malcolm J. , Shaffrey Len C. , Strachan Jane , Vidale Pier Luigi
Published: September 2019

Wintertime midlatitude cyclone activity and precipitation are projected to increase across northern Europe and decrease over southern Europe, particularly over the western Mediterranean. Greater confidence in these regional projections may be established by their replication in state-of-the-art, high-resolution global climate models that resolve synoptic-scale dynamics. We evaluated the representation of the wintertime eddy-driven and subtropical jet streams, extratropical cyclone activity, and precipitation across the North Atlantic and Europe under historical (1985–2011) and RCP8.5 sea surface temperature forcing in an ensemble of atmosphere-only HadGEM3-GA3.0 simulations, where horizontal atmospheric resolution is increased from 135 to 25 km. Under RCP8.5, increased (decreased) frequency of northern (southern) eddy-driven jet occurrences and a basinwide poleward shift in the upper-level westerly flow are simulated. Increasing atmospheric resolution significantly enhances these climate change responses. At 25-km resolution, these enhanced changes in large-scale circulation amplify increases (decreases) in extratropical cyclone track density and mean intensity across the northern (southern) Euro-Atlantic region under RCP8.5. These synoptic changes with resolution impact the overall climate change response of mean and heavy winter precipitation: wetter (drier) conditions in northern (southern) Europe are also amplified at 25-km resolution. For example, the reduction in heavy precipitation simulated over the Iberian Peninsula under RCP8.5 is ~15% at 135 km but ~30% at 25-km resolution. Conversely, a shift to more frequent high extratropical cyclone (ETC)-associated precipitation rates is simulated over Scandinavia under RCP8.5, which is enhanced at 25 km. This study provides evidence that global atmospheric resolution may be a crucial consideration in European winter climate change projections.
Priestly Aesthetics: Disability and Bodily Difference in Leviticus 21
Authors: Belser Julia Watts
Published: September 2019

Leviticus 21:16–23 forbids priests with a wide range of disabilities from offering sacrifice at the altar, a ritual act that Leviticus considers the most sacred responsibility of the priesthood. This essay raises critical questions about the biblical writer’s assumption that God desires the service of those with “perfect” bodies. The essay probes traditional Jewish interpretation of Leviticus 21 and argues that rabbinic texts leach the prohibition of much practical force. Despite offering a path toward more inclusive practice, conventional readings of these texts have left in place power dynamics that presume the inferiority of the disabled body. Yet they also contain the seeds for a conceptual shift that could transform the way contemporary communities engage with disability.

Biblical Priests; Disability; Ethics; Jewish Theology; Leviticus 21; Rabbinic Literature; Talmud
Fully informed? A methodology for assessing covert informant coverage in policing and law enforcement
Authors: Atkinson Colin
Published: September 2019

The use of covert informants has become a mainstay of contemporary policing in the United Kingdom as police, security and enforcement agencies tackle a range of crimes. Within such agencies, the need to understand the extent to which covert informants can provide information on issues of interest has become essential to effective practice. Drawing upon social penetration theory, this article proposes a new methodology to support police and law enforcement agencies in systematically mapping the breadth and depth of informant coverage. The future testing of such a methodology in practice will represent a critical area for further development and debate.
The transformation of foreign investment-induced ‘exo(genous)-urbanisation’ amidst industrial restructuring in the Pearl River Delta, China
Authors: Yang Chun
Published: September 2019

The 2010s have witnessed a growing body of literature on urban transformation and industrial restructuring in the global south, particularly China. However, insufficient attention has been paid to the interplay between the parallel processes in the transition of globalisation. The existing literature on urban transformation and industrial restructuring in China has focused on the analysis of internal dynamics at the national level, whereas the evolution of the lower levels of urban and rural settlements (i.e. towns and villages) in the changing dynamics of globalisation has not been thoroughly discussed. Drawing on the evolutionary notion of ‘strategic coupling’ from Global Production Network (GPN) theory, this study attempts to highlight connections between urban transformation and industrial restructuring in China. Particular attention is paid to the ongoing industrial upgrading, relocation and transformation that started in the mid-2000s, and the subsequent effects on the prevalent foreign direct investment (FDI)-induced exo(genous)-urbanisation in the Pearl River Delta (PRD). Drawing on years of extensive field investigation, particularly in-depth interviews with entrepreneurs, officials, migrants and villagers in representative towns in Dongguan, the current study argues that exo-urbanisation has undergone a paradigm shift and uneven patterns of transformation. Some towns (e.g. Humen and Chang’an) have witnessed stagnation due to the deliberate decoupling of low-skilled migrant labour and labour-intensive firms, whereas others (e.g. Songshanhu) have developed into high-tech zones driven by the strategic recoupling of technology-based domestic firms and a high-skilled workforce. This study sheds light on new avenues for future research on industrial restructuring and urban transformation amidst the changing global–local dynamics.
Postoperative Analgesic Requirement and Pain Perceptions after Nonaerodigestive Head and Neck Surgery
Authors: Stephenson Elizabeth D. , Farzal Zainab , Jowza Maryam , Hackman Trevor , Zanation Adam , Du Eugenie
Published: September 2019

Objectives

Little data exist on associations between patient factors and postoperative analgesic requirement after head and neck (H&N) surgeries. Such information is important for optimizing postoperative care considering concerns regarding opioid misuse. We analyzed factors associated with narcotic use and pain perception following H&N surgery sparing the upper aerodigestive tract.

Study Design

Prospective cohort.

Setting

Tertiary referral center.

Subjects and Methods

From May to October 2017, data were collected for patients undergoing nonaerodigestive H&N procedures requiring hospitalization. Patients completed a preoperative survey querying chronic pain history, narcotic usage, and postoperative pain expectation. Demographics, surgical data, postoperative narcotic use defined by morphine milligram equivalents (MME), pain scores, and Overall Benefit of Analgesia Score (OBAS) were analyzed.

Results

Seventy‐six patients, 44 (57.9%) females and 32 (42.1%) males with a mean age of 54.0 years, met inclusion criteria. The most common procedures were parotidectomy (27.6%) and total thyroidectomy (19.7%). Average cumulative 24‐hour postoperative MME and calculated MME per hospital day (MME/HD, cumulative MME for hospitalization divided by length of stay) were 40.5 ± 30.6 and 60.8 ± 60.1, respectively. Average pain score throughout the initial 24 hours after surgery was 3.7/10 ± 2.0. Female sex and prior chronic pain diagnosis were associated with higher OBAS after multivariate linear adjustments.

Conclusion

Postoperative narcotic requirement in nonaerodigestive H&N surgery is overall low. Female sex and prior chronic pain diagnosis may be associated with higher postoperative OBAS, a validated assessment of pain and opioid‐related side effects. This study may serve as a comparison for future studies evaluating narcotic‐sparing analgesia and pain perception in nonaerodigestive H&N surgery.
Feminisation of Ascetic Celibacy in Haridwar
Authors: Hamaya Mariko
Published: September 2019

Case studies of male–female ascetic couples in Haridwar in North India complicate the widespread knowledge that male Hindu renouncers are supposed to observe celibacy. Based on extended ethnographic work, this article investigates specifically how female ascetics tackle the dominant androcentric discourses and practise celibacy from a female point of view, focussing on their practice of sevā or spiritual service. The article argues that while female ascetics do not object to the androcentric ideology of celibacy, they follow it only partly, switching their focus from sexual abstinence to devotional sevā. Doing this, female ascetics value controlling emotion more than controlling sexual desire. Through the practice of sevā, they aim for fostering an attitude of devotion as a feminised manifestation of their efforts towards reaching spiritual attainment.
Alcohol Problems, Jealousy, and Cyber Dating Abuse Perpetration Among Men and Women: Toward a Conceptual Model
Authors: Brem Meagan J. , Romero Gloria , Garner Alisa R. , Grigorian Hannah , Stuart Gregory L.
Published: September 2019

Investigations of alcohol use in relation to cyber dating abuse (CDA) remain underdeveloped relative to alcohol-related face-to-face dating abuse research. A critical step toward advancing this area of research would include examining the applicability of alcohol-related partner abuse models to CDA perpetration. Existing models of alcohol-related partner abuse suggested that alcohol and partner abuse are more likely to co-occur in the presence of aggressogenic distal traits. We propose that this model may extend to CDA perpetration. Toward this end, the present study collected cross-sectional data from college students ( N = 258; 56.2% male) to investigate whether trait romantic jealousy moderated the association between alcohol problems and CDA perpetration, controlling for face-to-face dating abuse perpetration. We hypothesized that alcohol problems would positively relate to CDA perpetration among college students with high, but not low, romantic jealousy. We explored whether the interactive effect varied by sex. Results revealed a significant three-way interaction; the moderating role of romantic jealousy in the relation between alcohol problems and CDA perpetration varied by sex. Alcohol problems positively related to CDA perpetration for women with high, but not low, romantic jealousy. Alcohol problems did not relate to CDA perpetration regardless of men’s level of romantic jealousy. These preliminary results suggested that alcohol-related partner abuse models may be useful for conceptualizing CDA perpetration and identifying CDA intervention components.
Hospital's preparedness in road traffic injuries with mass casualties: Exploring a valid and reliable checklist
Authors: Safarpour Hamid , Safi‐Keykaleh Meysam , Eskandari Zahra , Yousefian Shiva , Faghisolouk Farshad , Sohrabizadeh Sanaz
Published: September 2019

Background:

The most important functional factor of hospitals is having a preparedness plan for dealing with disasters and emergencies such as road traffic injuries. There is a gap in the design and the development of a valid and reliable tool to evaluate the levels of hospital preparedness during road traffic injuries with mass casualty.

Objectives:

The aim of this study was to explore a valid and reliable tool for measurement of hospital preparedness in road traffic injuries with mass casualties.

Methods:

This study was conducted in two phases, each comprising different steps: tool design and judgmental evidence. In the first step, the determination of the content domain, sampling from content (item generation), and the formation of the tool and in the second stage, validity and reliability of the tool were performed.

Results:

From the 139 items that were finally set, nine dimensions including command and control, infrastructure and medical equipment, information and communication systems, surge capacity, triage and medical services, safety and security, human resources management, coordination and cooperation, and training and exercise were identified. Content validity index and content validity ratio of the tool were 0.97 and 0.98, respectively. The reliability of the tool was 0.89 with the kappa coefficient, respectively.

Conclusion:

The tool has sufficient reliability and validity for measuring hospital preparedness in road traffic injuries with mass casualties. Thus, this tool can be used for assessing the preparedness of hospitals for better planning, preparedness, and response to road traffic injuries with mass casualties.
Lessons From the Development and Implementation of a Palliative Care Elective for Fourth-Year Medical Students: A Pilot Study
Authors: Stepanyan Katelyn D. , Weiss Timothy E. , Pessegueiro Antonio M. , Pietras Christopher J.
Published: September 2019

Background:

Although palliative care is recognized as an important component of medical school curricula, the content and structure of education in the field is variable and often lacks outpatient exposure. We aimed to develop and implement a palliative care clinical elective for fourth-year medical students incorporating both inpatient and outpatient learning.

Methods:

Fourteen medical students participated in a palliative care elective which included 2 weeks on an inpatient consult service and 1 week of outpatient clinic and home hospice visits. The elective was evaluated using a focus group and previously validated surveys assessing self-rated competency and attitudes toward caring for palliative care patients. Data were analyzed using paired t tests to compare survey response means before and after the elective.

Results:

Of the 14 participating students, 7 completed both the pre- and postelective surveys. Significant improvements in self-rated competency were seen in pain and symptom management ( P < .001), communication ( P < .001), and advance care planning ( P < .01). Survey results also showed improvement in attitudes toward caring for dying patients ( P < .001), with lower scores at the end of the elective suggesting reduced emotional distress. Although the outpatient component was hypothesized to be a major benefit of the curriculum, qualitative data revealed the most highly valued component to be direct observation and feedback during inpatient time.

Conclusion:

Given the highlighted importance of direct observation and feedback as a unique and powerful learning experience, future work should be targeted toward enhancing the quality and timeliness of feedback delivered by the palliative care interdisciplinary team.
Republished: United States Registered Nurse Workforce Report Card and Shortage Forecast
Authors: Juraschek Stephen P. , Zhang Xiaoming , Ranganathan Vinoth , Lin Vernon W.
Published: September 2019

Registered nurses (RNs) play a critical role in health care delivery. With an aging US population, health care demand is growing at an unprecedented pace. Using projected changes in population size and age, the authors developed demand and supply models to forecast the RN job shortage in each of the 50 states. Letter grades were assigned based on projected RN job shortage ratios. The number of states receiving a grade of “D” or “F” for their RN shortage ratio will increase from 5 in 2009 to 30 by 2030, for a total national deficit of 918 232 (725 619 - 1 112 112) RN jobs. There will be significant RN workforce shortages throughout the country in 2030; the western region will have the largest shortage ratio of 389 RN jobs per 100 000. Increased efforts to understand shortage dynamics are warranted.
Republished: Big Things Come in Bundled Packages: Implications of Bundled Payment Systems in Health Care Reimbursement Reform
Authors: Delisle Dennis R.
Published: September 2019

With passage of the Affordable Care Act, the ever-evolving landscape of health care braces for another shift in the reimbursement paradigm. As health care costs continue to rise, providers are pressed to deliver efficient, high-quality care at flat to minimally increasing rates. Inherent systemwide inefficiencies between payers and providers at various clinical settings pose a daunting task for enhancing collaboration and care coordination. A change from Medicare’s fee-for-service reimbursement model to bundled payments offers one avenue for resolution. Pilots using such payment models have realized varying degrees of success, leading to the development and upcoming implementation of a bundled payment initiative led by the Center for Medicare and Medicaid Innovation. Delivery integration is critical to ensure high-quality care at affordable costs across the system. Providers and payers able to adapt to the newly proposed models of payment will benefit from achieving cost reductions and improved patient outcomes and realize a competitive advantage.
Final Amended Report on Safety Assessment on Aminomethyl Propanol and Aminomethyl Propanediol
Authors: Burnett Christina L. , Bergfeld Wilma F. , Belsito Donald V. , Klaassen Curtis D. , Marks James G. , Shank Ronald C. , Slaga Thomas J. , Snyder Paul W. , Andersen F. Alan
Published: September 2019

Aminomethyl propanol and aminomethyl propanediol are substituted aliphatic alcohols that function as pH adjusters in cosmetic products at concentrations less than 10%; additionally, aminomethyl propanediol is a fragrance. Extensive oral toxicity data are reviewed, with fewer inhalation toxicity data. Dermal toxicity data are presented that demonstrate, for example, that a mascara with 1.92% aminomethyl propanediol does not cause dermal irritation or allergic contact sensitization, suggesting that the maximum reported use concentration of 2% in mascara would be safe. Although these ingredients are primary amines that are not substrates for N-nitrosation, they may contain secondary amines as impurities in finished products that may undergo N-nitrosation. These ingredients should not be included in cosmetic formulations containing N-nitrosating agents. The Cosmetic Ingredient Review Expert Panel concludes that aminomethyl propanol and aminomethyl propanediol are safe as cosmetic ingredients in the practices of use and concentrations as described in this safety assessment.
Modeling 1,3-D Concentrations in Ambient Air in High Use Airsheds of the United States
Authors: van Wesenbeeck Ian , Cryer S , deCirugeda Helle O , Yan Z , Driver J
Published: September 2019

Soil fumigants, such as 1,3-dichloropropene (1,3-D), are used on a variety of different crops in high use areas in the United States, including the Pacific Northwest, the mid-Atlantic coast, and the Southeast coastal plains. Contaminant concentrations in air are often required for environmental exposure and human risk assessment. The SOil Fumigant Exposure Assessment (SOFEA) model, originally developed to explore volatile pesticide exposure and bystander risk, has recently been upgraded using AERMOD, the US Environmental Protection Agency’s (EPA) recommended regulatory air dispersion model to predict short-, medium-, and long-term pesticide concentrations in air resulting from representative agronomic practices in large airsheds. Modeling air concentrations has several advantages over monitoring such as the ability to predict concentrations at multiple locations and airsheds at a much greater temporal frequency than could be practically accomplished through monitoring alone. The agricultural modeling tool presented herein was parameterized using 1,3-D application data (mass, date, and depth applied, location, etc) obtained from growers in each study area, and local weather data and hourly concentrations of 1,3-D in ambient air were simulated for large airsheds. The human equivalent concentrations (HECs) for acute, short-term, sub-chronic, and chronic exposure of 1,3-D were not exceeded in any of the study areas investigated. These simulated 1,3-D concentrations are used to assess human exposure and risk, which considers human-life-stage-specific exposure factors, including residential mobility, time-activity patterns, and age-specific inhalation rates and body weights.
Assessment of Pleural Effusion and Small Pleural Drain Insertion by Resident Doctors in an Intensive Care Unit: An Observational Study
Authors: Vetrugno Luigi , Guadagnin Giovanni M , Barbariol Federico , D’Incà Stefano , Delrio Silvia , Orso Daniele , Girometti Rossano , Volpicelli Giovanni , Bove Tiziana
Published: September 2019

Small-bore pleural drainage device insertion has become a first-line therapy for the treatment of pleural effusions (PLEFF) in the intensive care unit; however, no data are available regarding the performance of resident doctors in the execution of this procedure. Our aim was to assess the prevalence of complications related to ultrasound-guided percutaneous small-bore pleural drain insertion by resident doctors. In this single-center observational study, the primary outcome was the occurrence of complications. Secondary outcomes studied were as follows: estimation of PLEFF size by ultrasound and postprocedure changes in PaO2/FiO2 ratio. In all, 87 pleural drains were inserted in 88 attempts. Of these, 16 were positioned by the senior intensivist following a failed attempt by the resident, giving a total of 71 successful placements performed by residents. In 13 cases (14.8%), difficulties were encountered in advancing the catheter over the guidewire. In 16 cases (18.4%), the drain was positioned by a senior intensivist after a failed attempt by a resident. In 8 cases (9.2%), the final chest X-ray revealed a kink in the catheter. A pneumothorax was identified in 21.8% of cases with a mean size (±SD) of just 10 mm (±6; maximum size: 20 mm). The mean size of PLEFF was 57.4 mm (±19.9), corresponding to 1148 mL (±430) according to Balik’s formula. Ultrasound-guided placement of a small-bore pleural drain by resident doctors is a safe procedure, although it is associated with a rather high incidence of irrelevant pneumothoraces.
The Source of Polycystic Ovarian Syndrome
Authors: Raperport Claudia , Homburg Roy
Published: September 2019

The source of polycystic ovarian syndrome (PCOS) is much debated and is likely to be multifactorial. There is an apparent familial inheritance with first-degree relatives of sufferers more likely to be affected. Twin studies have suggested a genetic cause but candidate genes are yet to be verified. Genes affecting insulin resistance, steroid hormone production, and inflammatory cytokine responses have all been implicated. Current thinking supports the theory that exposure to environmental factors in utero predisposes a female foetus to hyperandrogenism, insulin resistance, and polycystic ovaries in adult life. Which environmental factors have an impact on the foetus and the mechanisms of exposure are still to be confirmed. Animal studies have shown a clear correlation between hyperexposure of the foetus to androgens in utero and future development of a PCOS pattern of symptoms. Placental aromatases should neutralise androgens from the maternal circulation and prevent them reaching the foetal circulation. Our hypothesis is that the high maternal anti-Mullerian hormone (AMH) levels in PCOS block the placental aromatase and allow passage of testosterone through the placenta. This maternal testosterone acts on the foetal ovaries and ‘programmes’ them to recruit more preantral follicles and so produce higher AMH levels when they become functional at around 36 weeks of gestation. The high AMH concentrations in PCOS also seem to increase luteinizing hormone release and inhibit follicle stimulating hormone action on aromatase, so adding to the hyperandrogenic environment of adult PCOS.
The development of US physical education teachers’ motivating styles: A socialization perspective
Authors: Washburn Nicholas S , R Richards K Andrew , Sinelnikov Oleg A
Published: September 2019

Physical education (PE) teachers’ interpersonal sentiments and behaviours towards students during class define their motivating styles. These motivating styles range from those that support student autonomy to those that pressure students to think and behave in certain ways. Motivating styles are believed to develop through teachers’ prior socialization experiences and the way they are socialized in their current school environments. Drawing from the theories of self-determination and occupational socialization, this study examined the impact of psychological need satisfaction and frustration throughout the socialization process on PE teachers’ motivating styles. Twenty-nine US physical educators with identified autonomy-supportive ( n = 9), controlling ( n = 8), and neutral ( n = 12) motivating styles, based on responses to the Problems in Schools Questionnaire, were formally interviewed. Inductive analysis generated six analyst-constructed typologies describing the teachers’ motivating styles linked to their socialization experiences: (a) Humanitarians; (b) Concrete Roses; (c) Stage Managers; (d) Referees; (e) Coasters; and (f) Jaded Shepherds. Factors affecting motivating styles included the inductive or deductive nature of the contexts in which participants were involved during their acculturation and professional socialization, their professional identity, and the extent to which they experienced psychological need satisfaction and frustration through socializing experiences at work. In general, the results of this study suggest that more autonomy-supportive teachers (a) tend to have experienced inductive contexts growing up, (b) identify chiefly as PE teachers rather than coaches of extracurricular school sports, and (c) enjoy psychological need satisfaction at work.
Spray characterization for engine combustion network Spray G injector using high-fidelity simulation with detailed injector geometry
Authors: Yue Zongyu , Battistoni Michele , Som Sibendu
Published: September 2019

This article presents a computational fluid dynamics study of the engine combustion network Spray G, focusing on the transient characteristics of the spray during the start of injection and the impacts of nozzle geometry details derived from the manufacturing process. The large-eddy-simulation method, coupled with the volume-of-fluid method, was used to model the high-speed turbulent two-phase flow. A moving-needle boundary condition was applied to capture the internal flow boundary condition accurately. The injector geometry was measured with micron-level resolution using X-ray tomographic imaging at the Advanced Photon Source at Argonne National Laboratory, providing detailed machining tolerance and defects from manufacturing and a realistic rough surface. For comparison, a nominal geometry and a modified geometry incorporating measured large-scale geometric features but no surface details were also used in the simulations. Spray characteristics such as mass flow rate, injection velocity, and Sauter mean diameter were analyzed. Significantly distinct spray characteristics in terms of injection velocity, spray morphology, and primary breakup mechanism were predicted using different nozzle geometries, which is mainly attributable to the realistic surface finish and manufacturing defects. The measured high-resolution geometry predicts a lower injection velocity, a wider-spreading spray, and an overall slower breakup rate with evident injector tip wetting compared to the ideally smooth nozzle boundary. This result implies that the manufacturing details of the injector, which are usually ignored in fuel injection studies, have a significant impact on the spray development process and should be taken into account for design optimization.
Association of Nutritional Assessment by Phase Angle With Mortality in Kidney Transplant Patients in an 8-Year Follow-Up
Authors: kaya Eda , Bakir Alev , Koseoglu Yusuf Kenan , Velidedeoglu Mehmet , Trabulus Sinan , Seyahi Nurhan
Published: September 2019

Background:

Phase angle is a bioimpedance analysis parameter that indirectly shows body cell mass. Its association with mortality has been shown in patients receiving dialysis treatment. However, assessment with mortality in kidney transplant recipients has not been studied previously.

Methods:

We examined 158 kidney transplant recipients who underwent bioimpedance analysis 8 years ago in a cross-sectional study. We contacted them again and investigated the presence of cardiovascular events, cancer, angina pectoris, and claudication. Data regarding mortality, graft failure, and creatinine values were collected from recipients’ files.

Findings:

During the follow-up period, 15 recipients died, 26 lost graft function, 36 experienced cardiovascular events, and 4 developed cancer. Phase angle was significantly associated with mortality during the 8-year follow-up period of kidney transplant recipients ( P < .001). The cutoff value for phase angle as a predictor of mortality was ≤5.85. Moreover, a phase angle value lower than 5.85 indicated 5.33 times higher risk of mortality.

Discussion:

Phase angle was a predictor of mortality in kidney transplant recipients. Since phase angle is an inexpensive, easy-to-perform, and noninvasive method, it might be considered as an additional tool to assess survival in kidney transplant recipients.
The Development and Applications of a Dual Optical Imaging System for Studying Glioma Stem Cells
Authors: Tai Po-An , Liu Yen-Lin , Wen Ya-Ting , Lin Chien-Min , Huynh Thanh-Tuan , Hsiao Michael , Wu Alexander T. H. , Wei Li
Published: September 2019

Glioblastoma multiforme represents one of the deadliest brain tumor types, manifested by a high rate of recurrence and poor prognosis. The presence of glioma stem cells (GSCs) can repopulate the tumor posttreatment and resist therapeutics. A better understanding of GSC biology is essential for developing more effective interventions. We established a CD133 promoter-driven dual reporter, expressing green fluorescent protein (GFP) and firefly luciferase (CD133-LG), capable for in vitro and in vivo imaging of CD133+ GSCs. We first demonstrated the reporter enabled in vitro analyses of GSCs. DBTRG-05MG (Denver Brain Tumor Research Group 05) carrying CD133-LG (DBTRG-05MG-CD133-LG) system reported increased GFP/luciferase activities in neurospheres. Additionally, we identified and isolated CD133+/GFP+ cells with increased tumorigenic properties, stemness markers, Notch1, β-catenin, and Bruton’s tyrosine kinase (Btk). Furthermore, prolonged temozolomide (TMZ) treatment enriched GSCs (reflected by increased percentage of CD133+ cells). Subsequently, Btk inhibitor, ibrutinib, suppressed GSC generation and stemness markers. Finally, we demonstrated real-time evaluation of anti-GSC function of ibrutinib in vivo with TMZ-enriched GSCs. Tumorigenesis was noninvasively monitored by bioluminescence imaging and mice that received ibrutinib showed a significantly lower tumor burden, indicating ibrutinib as a potential GSC inhibitor. In conclusion, we established a dual optical imaging system which enables the identification of CD133+ GSCs and screening for anti-GSC drugs.
Synthesis of 6,13-dihydro-6,13-ethanopentacene-15,16-diimine palladium(II) complex and steric effect of the backbone polycyclic aromatic system on palladium-catalyzed olefin polymerization
Authors: Huo Ping , Yuan Lin , Liu Wanyun , Liu Lin , Mei Guangquan
Published: September 2019

The synthesis and characterization of a novel 6,13-dihydro-6,13-ethanopentacene-15,16-diimine palladium(II) complex are described. The effect of the backbone framework of the α-diimine metal catalyst on the polymerization reaction of norbornene and 1-octene is investigated. Compared to the 9,10-dihydro-9,10-ethanoanthracene-11,12-diimine palladium(II) complex (C1), the 6,13-dihydro-6,13-ethanopentacene-15,16-diimine palladium(II) complex (C2) with a polycyclic aromatic system on the backbone exhibits relatively high activities and leads to high molecular weights as well as narrow molecular weight distributions depending on the variation in feed ratios for copolymerization of norbornene and 1-octene. Moreover, the copolymers obtained using the 6,13-dihydro-6,13-ethanopentacene-15,16-diimine palladium(II) complex (C2) with large steric hindrance show high thermal stability and high glass transition temperatures.
Single application of airway stents in thoracogastric-airway fistula: results and prognostic factors for its healing
Authors: Wang Hongwu , Tao Meimei , Zhang Nan , Zou Hang , Li Dongmei , Ma Hongming , Zhou Yunzhi
Published: September 2019

Background:

Thoracogastric-airway fistula (TGAF) post-thoracic surgery is a rare and challenging complication for esophagectomy. The aim of this study was to explore the effectiveness of airway stenting for TGAF patients and find related factors coupled with healing of fistula.

Methods:

This is a retrospective study involving patients with TGAF who were treated with airway stentings. Based on different TGAF locations and sizes on chest computed tomography, covered metallic or silicon airway stents were implanted to cover orifices under interventional bronchoscopy. TGAF healing was defined as the primary outcome, and complete sealing of TGAF as the second outcome. The predictors for TGAF healing were analyzed in univariate and multivariate analysis.

Results:

A total of 58 TGAF patients were included, of whom 7 received straight covered metallic stents, 5 straight silicon stents, 3 L-shaped covered metallic stents, 21 large Y-shaped covered metallic stents, 17 large Y-shaped silicon stents, and 5 with Y-shaped covered metallic stents. Healing was achieved in 20 (34.5%) patients, and complete sealing in 45 (77.6%) patients. There were no significant differences in healing rate and complete sealing rate between patients receiving metallic stents and those with silicon stents. In univariate analysis, lacking a previous history of radiotherapy or chemotherapy, nonmalignant fistulas, small fistulas, and shorter postesophagectomy duration were found associated with a higher rate of TGAF healing. Only shorter postesophagectomy duration was associated with TGAF healing in multivariate analysis.

Conclusions:

Both silicon and covered metallic airway stenting are effective methods to close TGAF. A shorter postesophagectomy period may predict better TGAF healing. The reviews of this paper are available via the supplemental material section.
A novel protocol for three-dimensional rotational venography with low-dose contrast media in preoperative angiography of brain tumours
Authors: Kashimoto Kimiaki , Asai Katsunori , Kinoshita Manabu , Okita Yoshiko , Tanabe Shogo , Yamane Yasuhiko , Kawamata Minoru , Yoneda Akitoshi , Nakanishi Katsuyuki
Published: September 2019

Aim

The most appropriate imaging protocol for three-dimensional rotational venography (3D RV) has not been established. The aim of this study was to optimise the protocol for 3D RV with low-dose contrast media using time–density curve analysis.

Methods

Twenty-five consecutive patients with brain tumours who received preoperative assessment with 3D RV were retrospectively collected and included in this study. To optimise the imaging delay time of 3D RV with low-dose contrast media, time–density curve analysis was performed on two-dimensional conventional angiography. The image quality for depicting cortical veins and venous sinuses was compared to that of magnetic resonance (MR) venography in five cases.

Results

A total of 27 3D RVs were performed in 25 patients. The time–density curves of cortical veins were different from those of cerebral arteries or sinuses. The mean time to peak of cortical veins was significantly longer than the time to peak of cerebral arteries (2.47 ± 0.35 seconds vs. 6.44 ± 1.14 seconds; p < 0.0001) and shorter than the time to peak of venous sinuses (6.44 ± 1.14 seconds vs. 8.18 ± 1.12 seconds; p < 0.0001). The optimal imaging delay time could be determined as the phases in which cortical arterial opacities disappeared and cortical veins started to appear. The mean dose of injected contrast media was 5.3 mL. The image quality of cortical veins in 3D RV was superior to that in MR venography in all cases.

Conclusions

Three-dimensional RV with low-dose contrast media was useful for the preoperative assessment of cortical veins in patients with brain tumours.
The Italian Constitutional Court and the constitutionality of the criminalisation of assisted suicide of patients suffering from serious and incurable diseases
Authors: Veas Javier Escobar
Published: September 2019

On 16 November 2018, the Italian Constitutional Court addressed for the first time the controversial issue of the constitutionality of the criminalisation of assisted suicide of patients suffering from serious and incurable diseases. In its judgment, the Court held that the criminalisation of assisted suicide is not contrary to the Constitution, rejecting the existence of a right to die, in line with the European Court of Human Rights case law. Nevertheless, the Constitutional Court recognised that in cases of patients suffering from serious and incurable diseases, an absolute prohibition on assisted suicide could run contrary to the freedom of self-determination and the constitutional principles of human dignity and equality. The present note describes and analyses the facts of the case and the reasoning of the Constitutional Court, especially the structure of the argument and the new ‘decision technique’ adopted.
Exploring an Association of Demographic, Oral, and Systemic Health Factors Among Patients Attending a Teaching Dental Center
Authors: Mian Farrukh Imran , Hamza Syed Ameer , Bokhari Syed Akhtar Hussain
Published: September 2019

Background:

Updated information on oral health status could be used to monitor oral disease patterns, as widespread variations in oral health outcomes within and between different countries are reported.

Aim:

The objective was to examine the status of oral and systemic health and their association with demographic characteristics of the population attending a public dental center.

Methods:

A cross-sectional secondary analysis of the patients’ record was conducted during June 2017 attending the dental center of Madina Teaching hospital Faisalabad, Pakistan. Study variables were analyzed using the t test and the c2 test with a significance level of P ≤ .050.

Results:

The mean age of the study sample was 31.9 ± 14.5 years; 56% were females; 48% had primary or higher education; 9% were hypertensive; 5% had hepatitis; and 5% diabetes mellitus; 52% were with poor oral hygiene, 68% had dental caries, 84% had no fillings, 27% had tooth loss, and 99% functional dentition; 74% patients had calculus, 67% had gingivitis, and 5% had periodontitis. Age was the strongest risk indicator. Dental caries, tooth loss, poor oral hygiene, gingivitis, periodontitis, and tooth mobility were significantly associated with diabetes mellitus; tooth loss and tooth mobility were associated with cardiac disease; tooth loss, periodontitis, and tooth mobility were associated with hypertension, whereas tooth loss and calculus were associated with hepatitis. Higher age and lower income were positively associated with poor oral hygiene.

Conclusion:

Age and gender remain to be the strongest predictors for both oral and systemic conditions. Poor oral health and tooth loss showed a strong relationship with chronic systemic conditions.
Racial Segregation in the Southern Schools, School Districts, and Counties Where Districts Have Seceded
Authors: Taylor Kendra , Frankenberg Erica , Siegel-Hawley Genevieve
Published: September 2019

The establishment of new school districts in predominantly White municipalities in the South is restructuring school and housing segregation in impacted countywide school systems. This article compares the contribution of school district boundaries to school and residential segregation in the Southern counties that experienced secession since 2000. Merging together several data sets, including Common Core of Data, census data, and shapefiles at multiple geographic scales, we measure segregation of public school students and the entire population over time. We show that school district secession is restructuring school segregation in the counties where secession is occurring, with segregation increasingly occurring because students attend different school districts. Additionally, in the most recent year of analysis, residents were increasingly stratified by race in different school districts. Segregation patterns differ substantially, however, depending on the history of secession in the county.
Case-Based Group Learning Using Concept Maps to Achieve Multiple Educational Objectives and Behavioral Outcomes
Authors: Slieman Tony A , Camarata Troy
Published: September 2019

Knowledge integration is an important aspect of education. In clinical education, there is an emphasis on the integration of basic medical science with clinical practice to provide a higher order of comprehension for future physicians. Also of importance in medical education is the promotion and development of professional behaviors (i.e., teamwork and interpersonal professional behavior). We set out to design and implement a weekly, 2 hour educational active learning activity for first-year preclinical medical students to foster knowledge integration and to promote professional development. As part of our case-based curriculum, we used a small-group active-learning approach involving 3 stages: concept mapping, student peer-review, and student group evaluation. Specific learning objectives and behavioral outcomes were designed to focus the learning activities. Rubrics were designed to (1) assess learners’ group generated concept maps, (2) determine effective student peer review, and (3) appropriate evaluation of group dynamics. In addition to assessment data from the rubrics, course evaluations from participating students were collected. Analysis of rubric assessments and student evaluation data confirmed that there was significant statistical achievement in critical thinking and teamwork among students. Furthermore, when analyzing concept mapping scores between the first and last case, the data displayed significant statistical improvement supporting that student groups were further integrating basic science and clinical concepts. Our concept map-based active-learning approach achieved our designated objectives and outcomes.
Viscoacoustic anisotropic wave equations
Authors: Hao Qi , Alkhalifah Tariq
Published: September 2019

The wave equation plays a central role in seismic modeling, processing, imaging and inversion. Incorporating attenuation anisotropy into the acoustic anisotropic wave equations provides a choice for acoustic forward and inverse modeling in attenuating anisotropic media. However, the existing viscoacoustic anisotropic wave equations are obtained for a specified viscoacoustic model. We have developed a relatively general representation of the scalar and vector viscoacoustic wave equations for orthorhombic anisotropy. We also obtain the viscoacoustic wave equations for transverse isotropy as a special case. The viscoacoustic orthorhombic wave equations are flexible for multiple viscoacoustic models. We take into account the classic visocoacoustic models such as the Kelvin-Voigt, Maxwell, standard-linear-solid and Kjartansson models, and we derive the corresponding viscoacoustic wave equations in differential form. To analyze the wave propagation in viscoacoustic models, we derive the asymptotic point-source solution of the scalar wave equation. Numerical examples indicate a comparison of the acoustic waveforms excited by a point source in the viscoacoustic orthorhombic models and the corresponding nonattenuating model, and the effect of the attenuation anisotropy on the acoustic waveforms.
The roles of joint tissues and jaw muscles in palatal biomechanics of the Savannah monitor (Varanus exanthematicus) and their significance for cranial kinesis
Authors: Wilken Alec T. , Middleton Kevin M. , Sellers Kaleb C. , Cost Ian N. , Holliday Casey M.
Published: September 2019

Many vertebrates exhibit cranial kinesis, or movement between bones of the skull and mandible other than at the jaw joint. Many kinetic species possess a particular suite of features to accomplish this movement, including flexible cranial joints and protractor musculature. Whereas the musculoskeletal anatomy of these kinetic systems is well understood, how these joints are biomechanically loaded, how different soft tissues affect joint loading and kinetic capacity, and how the protractor musculature loads the skull remain poorly understood. Here we present a Finite Element Model of the savannah monitor, Varanus exanthematicus, a modestly kinetic lizard, to better elucidate the roles of soft tissue in mobile joints and protractor musculature on cranial loading. We describe the 3D resultants of jaw muscles and the histology of palatobasal, otic and jaw joints. We tested the effects of joint tissue types, bite point, and muscle loads to evaluate the biomechanical role of muscles on the palate and braincase. We found the jaw muscles have significant mediolateral components that can impart stability across palatocranial joints. We found articular tissues affect the magnitude of strains experienced around the palatobasal and otic joints. We found that without protractor muscle loading, the palate, quadrate and braincase experience higher strains suggesting this muscle helps insulate the braincase and palatoquadrate from high loads. Finally, we found the cross-sectional properties of the bones of Varanus exanthematicus are well suited for performing under torsional loads. These findings suggest that torsional loading regimes may have played a more important role in the evolution of cranial kinesis in lepidosaurs than previously appreciated.
Drawing (Upon) Human Rights: Reading the Illustrated Version of the UDHR
Authors: K Nayar Pramod
Published: September 2019

This essay examines the illustrated version of the Universal Declaration of Human Rights. The use of stick-figures, it argues, is a verbal-visual discourse that performs the human subject as an anonymous yet identifiably human person. Emphasising the constructed nature of the human, the combination of text and image functions as an instance of ‗expository discourse‘. In the second section of the essay I propose that the UDHR‘s illustrated version uses the aesthetics of ‗figurative realism‘ wherein the representation of the human person as a stick means that we see a figure who stands in for the person. It concludes by arguing that these minimalist representations signal the UDHR‘s foundational nature rather than its simplicity. The UDHR‘s reliance on the drawn line forces attention to the process, the mechanics by which we make human persons, or unmake them.