bluuebunny/crossref_metadata_2025 huggingface dataset:
A novel residual energy‐based distributed clustering and routing approach for performance study of wireless sensor network
Authors: Ghosh Arnab , Chakraborty Niladri
Published: February 2019

Non‐uniform energy consumption during operation of a cluster‐based routing protocol for large‐scale wireless sensor networks (WSN) is major area of concern. Unbalanced energy consumption in the wireless network results in early node death and reduces the network lifetime. This is because nodes near the sink are overloaded in terms of data traffic compared with the far away nodes resulting in node deaths. In this work, a novel residual energy–based distributed clustering and routing (REDCR) protocol has been proposed, which allows multi‐hop communication based on cuckoo‐search (CS) algorithm and low‐energy adaptive‐clustering–hierarchy (LEACH) protocol. LEACH protocol allows choice of possible cluster heads by rotation at every round of data transmission by a newly developed objective function based on residual energy of the nodes. The information about the location and energy of the nodes is forwarded to the sink node where CS algorithm is implemented to choose optimal number of cluster heads and their positions in the network. This approach helps in uniform distribution of the cluster heads throughout the network and enhances the network stability. Several case studies have been performed by varying the position of the base stations and by changing the number of nodes in the area of application. The proposed REDCR protocol shows significant improvement by an average of 15% for network throughput, 25% for network scalability, 30% for network stability, 33% for residual energy conservation, and 60% for network lifetime proving this approach to be more acceptable one in near future.
Empower faculty to teach marketable skills
Authors: Sutton Halley
Published: February 2019

ATLANTA — With the value of a higher education degree increasingly questioned by politicians, prospective students, and families of prospective students, you want to ensure that your institution is bridging the skills gap that employers perceive to exist. But how can you ensure that your faculty are adequately prepared to teach and train students on so‐called “soft skills” (or 21st‐century skills), such as problem‐solving, communication, and teamwork?
Political comments on social media lead to discipline of medical student
Authors: Rooksby Jacob H.
Published: February 2019

The ability of professional schools to punish students for unprofessional use of online social media while off campus continues to be an issue contested in the courts. A recent decision by the U.S. District Court for the District of New Mexico, Hunt v. Univ. of New Mexico, aligns with other rulings throughout the country in finding that administrators in professional schools may require compliance with defined professionalism standards, even for off‐campus activities, so long as their actions are reasonably related to pedagogical concerns.
Vitamin D deficiency in the aetiology of obesity‐related insulin resistance
Authors: Pramono Adriyan , Jocken Johan W.E. , Blaak Ellen E.
Published: February 2019

The obese insulin‐resistant state is often associated with low circulating concentration of vitamin D 25‐hydroxyvitamin D3 [25(OH)D3]. Fat sequestration of vitamin D in the expanded obese adipose tissue mass has been pointed out as a plausible explanation for this circulating vitamin D deficiency. However, the putative mechanisms behind this hypovitaminosis D remain to be elucidated. The presence of vitamin D receptor and vitamin D–metabolizing enzymes in insulin‐sensitive organs suggests that vitamin D may be involved in glucose and lipid metabolism and may be related to insulin sensitivity. Indeed, mainly in vitro studies support a role of vitamin D in regulating glucose and lipid metabolism in several insulin‐sensitive tissues including adipose tissue, skeletal muscle, liver, as well as pancreatic insulin secretion. A potential role of vitamin D in gut barrier function and metabolism has also been suggested. This review summarizes recent knowledge on vitamin D deficiency in the aetiology of obesity‐related insulin resistance and discusses potential underlying mechanisms. Finally, the role of vitamin D supplementation on insulin sensitivity and glycaemic control is discussed.
Myosin Vb is required for correct trafficking of N‐cadherin and cardiac chamber ballooning
Authors: Grassini Daniela R. , da Silva Jason , Hall Thomas E. , Baillie Gregory J. , Simons Cas , Parton Robert G. , Hogan Benjamin M. , Smith Kelly A.
Published: February 2019

Background

During heart morphogenesis, the cardiac chambers undergo ballooning: a process involving regionalized elongation of cardiomyocytes. Cardiomyocyte shape changes require reorganization of the actin cytoskeleton; however, the genetic regulation of this process is not well understood.

Results

From a forward genetic screen, we identified the zebrafish uq
23ks mutant which manifests chamber ballooning defects. Whole‐genome sequencing‐mapping identified a truncating mutation in the gene, myo5b. myo5b encodes an atypical myosin required for endosome recycling and, consistent with this, increased vesicles were observed in myo5b mutant cardiomyocytes. Expression of RFP‐Rab11a (a recycling endosome marker) confirmed increased recycling endosomes in cardiomyocytes of myo5b mutants. To investigate potential cargo of MyoVb‐associated vesicles, we examined the adherens junction protein, N‐cadherin. N‐cadherin appeared mispatterned at cell junctions, and an increase in the number of intracellular particles was also apparent. Co‐localization with RFP‐Rab11a confirmed increased N‐cadherin‐positive recycling endosomes, demonstrating N‐cadherin trafficking is perturbed in myo5b mutants. Finally, phalloidin staining showed disorganized F‐actin in myo5b cardiomyocytes, suggesting the cytoskeleton fails to remodel, obstructing chamber ballooning.

Conclusions

MyoVb is required for cardiomyocyte endosomal recycling and appropriate N‐cadherin localization during the onset of chamber ballooning. Cardiomyocytes lacking MyoVb are unable to reorganize their actin cytoskeleton, resulting in failed chamber ballooning. Developmental Dynamics 248:284–295, 2019. © 2019 Wiley Periodicals, Inc.
Hollow NaTi1.9Sn0.1(PO4)3@C Nanoparticles for Anodes of Sodium‐Ion Batteries with Superior Rate and Cycling Properties
Authors: Wang Min , Xie Man , Zhou Zhiming , Huang Yongxin , Wang Ziheng , Mei Yang , Wu Feng , Chen Renjie
Published: February 2019

Herein, two strategies are simultaneously used to synthesize the hollow carbon‐coated nanoparticles of NaTi1.9Sn0.1(PO4)3@C (NTSP@C). The porous morphology of NTST@C is controlled through a trace amount of tin doping while selecting a fire‐new carbon source. The NTSP@C materials present a nanosized structure with a hollow morphology, exhibiting a large specific surface area of ≈71.0 m2 g−1 and a average bore diameter of ≈26.4 nm. Moreover, the carbon layer is ≈5 nm thick with a mass ratio of 6.81%. The NTSP@C sample displays an ultrastrong rate capability (128.8 mA h g−1 at 0.1 C and 101.5 mA h g−1 at 10 C at 1.5–3.0 V) and a superior cycling performance (126.3–115.8 mA h g−1 after 300 cycles at 1 C for a retention ratio of 91.7% and 101.4–87.1 mA h g−1 after 2000 cycles at 10 C for a retention ratio of 85.9%). These excellent electrochemical performances are due to the nanosized structure, unique morphology, and thin carbon layer as a conductive medium. It is clear that the NTSP@C material is a promising anode material that can be incorporated into sodium‐ion batteries to achieve superior electrochemical performance.
Balancing Porosity and Oxygen‐Containing Functionalities of Hierarchically Porous Carbons for Enhanced Capacitive Supercapacitors
Authors: Zhai Duo Duo , Wang Min , Liu Hao , Chen Xiang Ying , Zhang Zhong Jie
Published: February 2019

Herein, a strategy by balancing porosity and oxygen‐containing functionalities is successfully developed to efficiently modulate pore structures as well as relevant capacitive performance toward hierarchically porous carbon materials. It is revealed that the mass ratio of sodium citrate (producing porosity by a self‐template) and F‐127 (producing both porosity and pseudocapacitance) exerts a crucial role for achieving the aforementioned objective. In addition, when the mass ratio of sodium citrate to F‐127 reaches up to 1:1, the carbon sample delivers an excellent cycling stability of 98% within 10 000 cycles and the superior energy densities of 3.6 and 10.6 W h kg−1 when using 6 m KOH and 1 m Na2SO4 (voltage up to 1.8 V) as electrolytes, respectively, in a two‐electrode configuration. Thereby, by balancing the porosity (contribution to transport of electrolytes) and oxygen functionalities (contribution to additional pseudocapacitance), the present carbon materials enable integrated capacitive improvement for supercapacitors. The present scientific strategy of balancing porosity and heteroatom‐doping functionalities can be readily extended for producing other kinds of porous carbon materials especially used in the area of supercapacitors.
Pollen cone teratologies in Sequoia sempervirens (D. Don) Endl. and Widdringtonia nodiflora (L.) Powrie (Cupressaceae) in the light of conifer evolution
Authors: Dörken Veit Martin , Stützel Thomas
Published: February 2019

Different types of pollen cone teratologies in Sequoia sempervirens and Widdringtonia nodiflora were investigated. While wild type pollen cones are uniaxial and hyposporangiate, some teratological polyaxial pollen cones and also perisporangiate microsporangiophores were found. The teratological compound pollen cones in Sequoia seem to represent just random artifacts caused by a spitting of the pollen cone apex, maybe due to a pathogenic event in early developmental stages. In Widdringtonia it remains open, if the compound male reproductive units represent a dense distal cluster of pollen cones or a compound, polyaxial inflorescence comparable to other conifers, e.g. Cephalotaxus (Taxaceae). The perisporangiate microsporangiophores found in some of the teratological pollen cones in Widdringtonia are remarkable, because among extant conifers this type of microsporangiophores is developed only in Taxaceae. Previous studies showed that the perisporangiate type of microsporangiophores represents a radial synangium consisting of several fused hyposporangiate microsporangiophores. However, the perisporangiate microsporangiophores in Taxaceae and Widdringtonia show some distinct structural differences excluding the perisporangiate microsporangiophores in Widdringtonia as representing a radial synangium.
Fighting Novel Diseases amidst Humanitarian Crises
Authors: Gostin Lawrence O. , Sircar Neil R. , Friedman Eric A.
Published: February 2019

The Democratic Republic of the Congo is facing two crises: a potentially explosive Ebola epidemic and a major insurgency. But they are not wholly distinct from each other: the first is intertwined with the second, and public mistrust and political violence add a dangerous dimension to the Ebola epidemic. The World Health Organization and other health emergency responders will increasingly find themselves fighting outbreaks in insecure, misgoverned or ungoverned zones, possibly experiencing active conflict. Yet the WHO has neither the mission nor the capabilities to navigate these security threats. We cannot expect that the usual public health strategy will succeed when health workers’ lives are directly imperiled and community resistance runs deep. Tackling health emergencies amidst complex humanitarian crises requires fresh thinking. Here, we offer a blueprint for fighting diseases in complex humanitarian emergencies. The building blocks of security and trust include high‐level political support, street‐level diplomacy, community engagement, enhanced funding, and protection of health professionals working in conflict or disaster zones.
Pregnant Women Can Finally Expect Better
Authors: Ballantyne Angela
Published: February 2019

A decade of advocacy for the inclusion of pregnant women in the clinical research agenda is starting to pay off. In September, the United States Task Force on Research Specific to Pregnant Women and Lactating Women issued its advice to the secretary of Health and Human Services on addressing gaps in knowledge and research on safe and effective therapies for pregnant women and lactating women. The task force is pushing for major reforms. If its recommendations are taken up, we can anticipate a significant shift in pregnancy research in the United States. This will affect pregnant women, clinicians caring for them, researchers, and institutional review boards.
Artificial Intelligence and Black‐Box Medical Decisions: Accuracy versus Explainability
Authors: London Alex John
Published: February 2019

Although decision‐making algorithms are not new to medicine, the availability of vast stores of medical data, gains in computing power, and breakthroughs in machine learning are accelerating the pace of their development, expanding the range of questions they can address, and increasing their predictive power. In many cases, however, the most powerful machine learning techniques purchase diagnostic or predictive accuracy at the expense of our ability to access “the knowledge within the machine.” Without an explanation in terms of reasons or a rationale for particular decisions in individual cases, some commentators regard ceding medical decision‐making to black box systems as contravening the profound moral responsibilities of clinicians. I argue, however, that opaque decisions are more common in medicine than critics realize. Moreover, as Aristotle noted over two millennia ago, when our knowledge of causal systems is incomplete and precarious—as it often is in medicine—the ability to explain how results are produced can be less important than the ability to produce such results and empirically verify their accuracy.
Capacity for Preferences and Pediatric Assent: Implications for Pediatric Practice
Authors: Navin Mark Christopher , Wasserman Jason Adam
Published: February 2019

In the past thirty to forty years, clinicians and bioethicists have expanded the scope for children’s participation in decision‐making about their medical care, often under the banner of “pediatric assent.” The success of this movement was signaled perhaps most strongly by the creation of American Academy of Pediatrics guidance on pediatric assent in 1995. We agree with the AAP that both the best interests of the child patient and the need to respect the child patient are reasons to take seriously children’s treatment preferences. However, we argue that the AAP could provide a stronger and more stable ethical foundation for pediatric assent. Current policy documents invoke a conception of respect that is grounded in autonomy and cannot apply in most cases of pediatric assent. We argue that the mere fact that children have treatment preferences is a reason to support pediatric assent. We defend this claim by focusing on the importance of what we have called “capacity for preferences.” The notion of capacity for preferences underscores that the moral value of a patient’s preferences is not reducible to considerations of either autonomy or best interests.
High expression of MLANA in the plasma of patients with head and neck squamous cell carcinoma as a predictor of tumor progression
Authors: Rodrigues‐Junior Dorival Mendes , Tan Soon Sim , Lim Sai Kiang , de Souza Viana Luciano , Carvalho Andre Lopes , Vettore Andre Luiz , Iyer N. Gopalakrishna
Published: February 2019

Background

There is a paucity of plasma‐based biomarkers that predict outcome in patients with head and neck squamous cell carcinoma (HNSCC) treated with chemoradiation therapy (CRT). Here, we evaluate the prognostic potential of plasma Melanoma‐Antigen Recognized by T‐cells 1 (MLANA) in this setting.

Methods

MLANA expression in HNSCC lines were evaluated by reverse transcription polymerase chain reaction, whereas plasma levels were quantified using ELISA in 48 patients with locally advanced HNSCC undergoing a phase 2 trial with CRT.

Results

MLANA is expressed at variable levels in a panel of HNSCC lines. In plasma, levels were elevated in patients with tumor relapse compared to those without (P < .004); 73.9% of the patients expressing high plasma MLANA levels progressed with recurrent disease (P = .020). Multivariate analysis showed that plasma MLANA levels and tumor resectability were independent prognostic factors for progression free survival.

Conclusion

Plasma MLANA expression appears to be an effective noninvasive biomarker for outcomes in patients treated with CRT, and could potentially guide therapeutic decisions in this context.
Two‐year follow‐up of a randomised controlled trial to assess the sustainability of a school intervention to improve the implementation of a school‐based nutrition policy
Authors: Wolfenden Luke , Nathan Nicole , Reilly Kathryn , Delaney Tessa , Janssen Lisa M. , Reynolds Renee , Sutherland Rachel , Hollis Jenna , Lecathelinais Christophe , Williams Christopher M. , Wyse Rebecca , Wiggers John , Yoong Serene
Published: February 2019

Issue addressed

School‐based nutrition policies can have a positive effect on the school food environment. The primary aim of this study was to assess the primary school adherence to a mandatory state‐wide healthy canteen policy 12 months after an effective multi‐strategic implementation intervention concluded.

Methods

Primary schools were randomised to (a) a 12‐14 months multi‐strategic intervention or (b) no‐intervention (control). The intervention aimed to improve implementation of a state‐wide canteen policy by encouraging schools to remove unhealthy food and beverages (classified as ‘‘red’’ or ‘‘banned’’) from canteen menus and replace with healthy items (classified as ‘‘green’’). No implementation support was provided to either group by the research team between the 12 and 24 months data collection period.

Results

Seventy schools participated, of which 56 schools were assessed at 24‐month follow‐up. Intervention schools were less likely to have a menu which contained ‘‘red/banned’’ items at 24‐month follow‐up (RR = 2.28; 95% CI: 1.18‐4.40; P = 0.01). Intervention schools, however, were not more likely than controls to have a menu which contained >50% ‘‘green’’ items at 24‐month follow‐up (RR = 1.29; 95% CI: 0.98‐1.70; P = 0.10). Intervention schools were more likely to adhere to both policy components (no red/banned items and >50% green items on the menu) than control schools (RR = 2.61; 95% CI: 1.29‐5.29; P = 0.006). Among intervention schools that were fully adherent to the policy following implementation support (12‐month post baseline), all were also adherent at the 24‐month follow‐up.

Conclusion

The intervention was effective in achieving long‐term school adherence to a state‐wide canteen policy at 24‐month follow‐up.

So what?

The findings suggest that sustained improvements in implementation of school nutrition policies is possible following a period (12 months) of comprehensive implementation support.
Rainfall partitioning through a mixed cedar swamp and associated C and N fluxes in Southern Ontario, Canada
Authors: Duval Tim P.
Published: February 2019

Partitioning of rainfall through a forest canopy into throughfall, stemflow, and canopy interception is a critical process in the water cycle, and the contact of precipitation with vegetated surfaces leads to increased delivery of solutes to the forest floor. This study investigates the rainfall partitioning over a growing season through a temperate, riparian, mixed coniferous‐deciduous cedar swamp, an ecosystem not well studied with respect to this process. Seasonal throughfall, stemflow, and interception were 69.2%, 1.5%, and 29.3% of recorded above‐canopy precipitation, respectively. Event throughfall ranged from a low of 31.5 ± 6.8% for a small 0.8‐mm event to a high of 82.9 ± 2.4% for a large 42.7‐mm event. Rain fluxes of at least 8 mm were needed to generate stemflow from all instrumented trees. Most trees had funnelling ratios <1.0, with an exponential decrease in funnelling ratio with increasing tree size. Despite this, stand‐scale funnelling ratios averaged 2.81 ± 1.73, indicating equivalent depth of water delivered across the swamp floor by stemflow was greater than incident precipitation. Throughfall dissolved organic carbon (DOC) and total dissolved nitrogen (TDN) averaged 26.60 ± 2.96 and 2.02 ± 0.16 mg L−1, respectively, which were ~11 and three times above‐canopy rain levels. Stemflow DOC averaged 73.33 ± 7.43 mg L−1, 35 times higher than precipitation, and TDN was 4.45 ± 0.56 mg L−1, 7.5 times higher than rain. Stemflow DOC concentration was highest from Populus balsamifera and TDN greatest from Thuja occidentalis trees. Although total below‐canopy flux of TDN increased with increasing event size, DOC flux was greatest for events 20–30 mm, suggesting a canopy storage threshold of DOC was readily diluted. In addition to documenting rainfall partitioning in a novel ecosystem, this study demonstrates the excess carbon and nitrogen delivered to riparian swamps, suggesting the assimilative capacity of these zones may be underestimated.
Treatment of melanoma of unknown primary in the era of immunotherapy and targeted therapy: A Dutch population‐based study
Authors: Verver D , van der Veldt AAM , van Akkooi ACJ , Verhoef C , Grünhagen DJ , Louwman WJ
Published: February 2019

Melanoma of unknown primary (MUP) may have a different biology to melanoma of known primary, but clinical trials of novel therapies (e.g., immune checkpoint or BRAF/MEK inhibitors) have not reported the outcomes in this population. We therefore evaluated the overall survival (OS) among patients with MUP in the era of novel therapy. Data for stage III or IV MUP were extracted from a nationwide database for the period 2003–2016, with classification based on the eighth edition of the American Joint Committee on Cancer criteria. The population was divided into pre‐ (2003–2010) and post‐ (2011–2016) novel therapy eras. Also, OS in the post‐novel era was compared between patients with stage IV MUP by whether they received novel therapy. In total, 2028 of 65,110 patients (3.1%) were diagnosed with MUP. Metastatic sites were known in 1919 of 2028 patients, and most had stage IV disease (53.8%). For patients with stage III MUP, the 5‐year OS rates were 48.5% and 50.2% in the pre‐ and post‐novel eras, respectively (p = 0.948). For those with stage IV MUP, the median OS durations were unchanged in the pre‐novel era and post‐novel era when novel therapy was not used (both 4 months); however, OS improved to 11 months when novel therapy was used in the post‐novel era (p < 0.001). In conclusion, more than half of the patients with MUP are diagnosed with stage IV and the introduction of novel therapy appears to have significantly improved the OS of these patients.
The preventable burden of breast cancers for premenopausal and postmenopausal women in Australia: A pooled cohort study
Authors: Arriaga Maria E. , Vajdic Claire M. , Canfell Karen , MacInnis Robert J. , Banks Emily , Byles Julie E. , Magliano Dianna J. , Taylor Anne W. , Mitchell Paul , Giles Graham G. , Shaw Jonathan E. , Gill Tiffany K. , Klaes Elizabeth , Velentzis Louiza S. , Cumming Robert G. , Hirani Vasant , Laaksonen Maarit A.
Published: February 2019

Estimates of the future breast cancer burden preventable through modifications to current behaviours are lacking. We assessed the effect of individual and joint behaviour modifications on breast cancer burden for premenopausal and postmenopausal Australian women, and whether effects differed between population subgroups. We linked pooled data from six Australian cohort studies (n = 214,536) to national cancer and death registries, and estimated the strength of the associations between behaviours causally related to cancer incidence and death using adjusted proportional hazards models. We estimated exposure prevalence from representative health surveys. We combined these estimates to calculate Population Attributable Fractions (PAFs) with 95% confidence intervals (CIs), and compared PAFs for population subgroups. During the first 10 years follow‐up, there were 640 incident breast cancers for premenopausal women, 2,632 for postmenopausal women, and 8,761 deaths from any cause. Of future breast cancers for premenopausal women, any regular alcohol consumption explains 12.6% (CI = 4.3–20.2%), current use of oral contraceptives for ≥5 years 7.1% (CI = 0.3–13.5%), and these factors combined 18.8% (CI = 9.1–27.4%). Of future breast cancers for postmenopausal women, overweight or obesity (BMI ≥25 kg/m2) explains 12.8% (CI = 7.8–17.5%), current use of menopausal hormone therapy (MHT) 6.9% (CI = 4.8–8.9%), any regular alcohol consumption 6.6% (CI = 1.5–11.4%), and these factors combined 24.2% (CI = 17.6–30.3%). The MHT‐related postmenopausal breast cancer burden varied by body fatness, alcohol consumption and socio‐economic status, the body fatness‐related postmenopausal breast cancer burden by alcohol consumption and educational attainment, and the alcohol‐related postmenopausal breast cancer burden by breast feeding history. Our results provide evidence to support targeted and population‐level cancer control activities.
Improved treatment outcome of pembrolizumab in patients with nonsmall cell lung cancer and chronic obstructive pulmonary disease
Authors: Shin Sun Hye , Park Hye Yun , Im Yunjoo , Jung Hyun Ae , Sun Jong‐Mu , Ahn Jin Seok , Ahn Myung‐Ju , Park Keunchil , Lee Ho Yun , Lee Se‐Hoon
Published: February 2019

Emerging immune profiling data suggest a higher sensitivity to immune checkpoint inhibitors (ICIs) in nonsmall cell lung cancer (NSCLC) patients with chronic obstructive pulmonary disease (COPD), compared to those without COPD. This study aimed to investigate the clinical impact of COPD on the treatment response to ICIs in a large number of patients with NSCLC. In total, 133 patients with spirometry test results were retrospectively identified among those who received palliative pembrolizumab for NSCLC. COPD was defined as pre‐bronchodilator forced expiratory volume in 1 s/forced vital capacity <0.7. Overall survival (OS), progression‐free survival (PFS), and objective response rate were analyzed according to the presence of COPD. Spirometry‐based COPD was present in 59 (44%) patients. Patients with COPD had better OS (hazard ratio [HR] for death, 0.45; 95% confidence interval [CI], 0.26–0.78) and PFS (HR for disease progression or death, 0.50; 95% CI, 0.31–0.79) than those without COPD. These associations persisted after adjusting for potential confounders including smoking history. The response rate was also higher in patients with COPD than in those without COPD (38.2% vs. 20.5%, p = 0.028). Spirometry‐defined COPD was associated with a significantly longer OS and PFS in patients with NSCLC treated with palliative pembrolizumab. Identifying coexisting COPD could predict favorable treatment outcomes in patients with NSCLC treated with pembrolizumab.
Relationships of serum placental growth factor and soluble fms‐like tyrosine kinase‐1 with fetal and uterine artery Doppler indices in pre‐eclampsia
Authors: Li Jingyu , Cai Ailu , Yuan Qian , Ding Hao , Zhao Dan
Published: February 2019

Objective

To compare serum placental growth factor (PlGF) and soluble fms‐like tyrosine kinase‐1 (sFlt‐1) concentrations among women with pre‐eclampsia and healthy control women and to evaluate the associations of serum PlGF and sFlt‐1 with fetal and uterine artery Doppler indices in pre‐eclampsia.

Methods

A prospective cross‐sectional study of 33 women with pre‐eclampsia and 33 normotensive pregnant women attending a university hospital in China between January and November 2014. Serum PlGF and sFlt‐1 were assayed by enzyme linked immunosorbent assays. Doppler indices of the uterine artery, umbilical artery, fetal middle cerebral artery, and ductus venosus were measured.

Results

The pulsatility index of the uterine artery was negatively correlated with PlGF (r, −0.487; P=0.004) and positively correlated with sFlt‐1 (r, 0.420; P=0.015). Gestational age at birth was positively correlated with PlGF (r, 0.601, P<0.001) and negatively correlated with sFlt‐1 (r, −0.568; P=0.001). Birth weight was positively correlated with PlGF (r, 0.555; P=0.001) and negatively correlated with sFlt‐1 (r, −0.552; P=0.001). Apgar score was negatively correlated with sFlt‐1 (r, −0.427; P=0.017).

Conclusion

Lower PlGF and higher sFlt‐1 levels in maternal serum were significantly associated with increased uterine arterial impedance in pre‐eclampsia.
The effects of hysterectomy with bilateral salpingectomy on ovarian reserve
Authors: Yuan Zhen , Cao Dongyan , Bi Xiaoning , Yu Mei , Yang Jiaxin , Shen Keng
Published: February 2019

Objective

To determine whether ovarian reserve is compromised after hysterectomy with bilateral salpingectomy.

Methods

A prospective longitudinal study was conducted among 84 women who underwent hysterectomy with bilateral salpingectomy at a tertiary medical center in Beijing, China, between August 2, 2015, and January 15, 2017. Serum levels of anti‐Müllerian hormone (AMH) and follicle‐stimulating hormone (FSH) were measured to assess ovarian function before undergoing the procedure (baseline) and at weeks 1 and 6 after surgery (postoperative period).

Results

The median age was 41.61 ± 0.62 years. Age negatively correlated with the serum AMH level at baseline (P<0.001), as well as with preoperative‐to‐postoperative changes in the concentration of this hormone (P<0.001). Serum AMH levels were lower in the postoperative period versus the preoperative period (P<0.001). By contrast, serum FSH levels were higher in the postoperative period than in the preoperative period (P<0.001). Moreover, no correlation was found with body mass index.

Conclusions

Hysterectomy with bilateral salpingectomy compromised ovarian reserve, with the damage being most severe among younger patients.
Women, Community Colleges, and STEM Careers
Authors: Wang Xueli , Wickersham Kelly
Published: February 2019

Two‐year colleges are an increasingly used but understudied pathway to STEM degrees for women from historically underserved backgrounds. This chapter discusses the community college promise in solving the gender gap in STEM attainment, as well as related research findings and directions.
Warming the Chill: Insights for Institutions and Researchers to Keep Women in STEM
Authors: Šaras Emily Daina , Perez‐Felkner Lara , Nix Samantha
Published: February 2019

This chapter leverages STEM‐focused Integrated Postsecondary Data System (IPEDS) data to investigate the consequences of chilly institutional climates across institutional types, with particular attention to implications for institutions and researchers. Further, we synthesize the literature, findings, and recommendations across the volume and offer actionable suggestions for institutional researchers, policy makers, administrators, and faculty.
Centering Disciplinary Literacies on Student Consciousness: A Tanzanian Case Study
Authors: Wilder Phillip , Msseemmaa Daudi
Published: February 2019

In 2008, Moje pondered responsive literacy teaching to what end, before arguing that disciplinary literacy should provide the answer in secondary school classrooms. Since then, research into literacy within school disciplines has foregrounded the reading, writing, and reasoning of experts within disciplines while backgrounding (or ignoring) worthy problems and student dignity. Using the case study of Neema, a 16‐year‐old Tanzanian student, the authors seek to humanize and pragmatize the answer to Moje’s question, suggesting that disciplinary literacies and responsive pedagogy should be the means to a vital end: the elevated consciousness of students. Only when teaching supports how students develop greater consciousness of their presence in the world and of their inherent worth can teaching be considered responsive.
Peer Tutoring: “To Teach Is to Learn Twice”
Authors: Fisher Douglas , Frey Nancy
Published: February 2019

This forum highlights research that literacy teachers, students, and others can explore, use, or adapt as they provide literacy instruction and develop related programs and research agendas.
Critical Literacy and the Importance of Reading With and Against a Text
Authors: Janks Hilary
Published: February 2019

This department explores critical perspectives on issues at the intersection of policy and practice in order to generate fresh questions about enduring dilemmas, new challenges, and debates.
Implementation and outcomes of an advanced antimicrobial stewardship program at a quaternary care hospital in the United Arab Emirates
Authors: El‐Lababidi Rania Mohammad , Mooty Mohammad , Bonilla Maria Fernanda , Nusair Ahmad , Alatoom Adnan , Mohamed Shafii
Published: February 2019

Purpose

The implementation of an advanced antimicrobial stewardship program (ASP) at a quaternary care hospital in the United Arab Emirates is described, including a report on the implementation and outcomes of the program.

Methods

This was a single‐center quasi‐experimental study to assess the impact of the ASP on antimicrobial use measures, ASP interventions performed, and clinical outcomes by comparing the data collected at baseline, from the third quarter (Q3) 1 July 2015 to the fourth quarter (Q4) of 31 December 2017, approximately 2 years following program implementation.

Results

From 1 July 2015 until 31 December 2017, the program reported a total direct cost savings estimated at $1 339 499, despite a significant increase in patient discharges and total patient‐days. The antimicrobial cost per inpatient‐day decreased by 32% from $47.2 to $32.3. Usage of monitored antimicrobials decreased despite an increase in patient census since hospital opening. Hospital‐onset Clostridioides difficile infection (CDI) rates decreased from 0.46 cases per 1000 patient days in 2015 to 0.12 cases per 1000 patient days in 2017 (P = 0.035, 95% CI 0.08 to 0.91). Hospital‐onset infections due to multidrug‐resistant organisms (MDROs) decreased from 2.39 cases per 1000 patient days in 2015 to 0.38 cases per 1000 patient days in 2017 (P = 0.05, 95% CI 0.09 to 0.28). Overall, the number of ASP interventions amounted to a total of 4123 interventions, with an acceptance rate of 91%.

Conclusion

The implementation of an advanced ASP at a quaternary care hospital in the United Arab Emirates was associated with a decrease in antimicrobial utilization, antimicrobial expenditure, and a reduction in hospital‐onset CDI and MDRO rates. To our knowledge, this is the first report describing the outcomes of an advanced ASP program at a quaternary care hospital utilizing real‐time surveillance software and CDSS in the Middle East.
Excited state tracking during the relaxation of coordination compounds
Authors: Sanz García Juan , Boggio‐Pasqua Martial , Ciofini Ilaria , Campetella Marco
Published: February 2019

The ability to locate minima on electronic excited states (ESs) potential energy surfaces both in the case of bright and dark states is crucial for a full understanding of photochemical reactions. This task has become a standard practice for small‐ to medium‐sized organic chromophores thanks to the constant developments in the field of computational photochemistry. However, this remains a very challenging effort when it comes to the optimization of ESs of transition metal complexes (TMCs), not only due to the presence of several electronic ESs close in energy, but also due to the complex nature of the ESs involved. In this article, we present a simple yet powerful method to follow an ES of interest during a structural optimization in the case of TMCs, based on the use of a compact hole‐particle representation of the electronic transition, namely the natural transition orbitals (NTOs). State tracking using NTOs is unambiguously accomplished by computing the mono‐electronic wave function overlap between consecutive steps of the optimization. Here, we demonstrate that this simple but robust procedure works not only in the case of the cytosine but also in the case of the ES optimization of a ruthenium nitrosyl complex which is very problematic with standard approaches. © 2019 The Authors. Journal of Computational Chemistry published by Wiley Periodicals, Inc.
A perturbation‐based super‐CI approach for the orbital optimization of a CASSCF wave function
Authors: Kollmar Christian , Sivalingam Kantharuban , Helmich‐Paris Benjamin , Angeli Celestino , Neese Frank
Published: February 2019

A perturbation theory‐based algorithm for the iterative orbital update in complete active space self‐consistent‐field (CASSCF) calculations is presented. Following Angeli et al. (J. Chem. Phys. 2002, 117, 10525), the first‐order contribution of singly excited configurations to the CASSCF wave function is evaluated using the Dyall Hamiltonian for the determination of a zeroth‐order Hamiltonian. These authors employ an iterative diagonalization of the first‐order density matrix including the first‐order correction arising from single excitations, whereas the present approach uses the single‐excitation amplitudes directly for the construction of the exponential of an anti‐Hermitian matrix resulting in a unitary matrix which can be used for the orbital update. At convergence, the single‐excitation amplitudes vanish as a consequence of the generalized Brillouin's theorem. It is shown that this approach in combination with direct inversion of the iterative subspace (DIIS) leads to very rapid convergence of the CASSCF iteration procedure. © 2019 Wiley Periodicals, Inc.
Extracting the mechanisms and kinetic models of complex reactions from atomistic simulation data
Authors: Wu Yanze , Sun Huai , Wu Liang , Deetz Joshua D.
Published: February 2019

Determining reaction mechanisms and kinetic models, which can be used for chemical reaction engineering and design, from atomistic simulation is highly challenging. In this study, we develop a novel methodology to solve this problem. Our approach has three components: (1) a procedure for precisely identifying chemical species and elementary reactions and statistically calculating the reaction rate constants; (2) a reduction method to simplify the complex reaction network into a skeletal network which can be used directly for kinetic modeling; and (3) a deterministic method for validating the derived full and skeletal kinetic models. The methodology is demonstrated by analyzing simulation data of hydrogen combustion. The full reaction network comprises 69 species and 256 reactions, which is reduced into a skeletal network of 9 species and 30 reactions. The kinetic models of both the full and skeletal networks represent the simulation data well. In addition, the essential elementary reactions and their rate constants agree favorably with those obtained experimentally. © 2019 Wiley Periodicals, Inc.
Semiquantitative, fully automated urine test strip analysis
Authors: Oyaert Matthijs , Delanghe Joris R.
Published: February 2019

Objectives

Urinalysis is one of the most frequently ordered diagnostic laboratory tests. In order to reduce workload and costs, rapid screening tests such as urine test strip analyses are applied. The aim of this study was to evaluate the analytical performance of the UC‐3500 as well as the diagnostic performance in comparison with reference methods.

Design and methods

We measured within‐run and between‐run imprecision based on quantitative reflectance values. 347 prospectively included urine specimens were investigated for the presence of glucose, protein, albumin, leukocyte esterase, and hemoglobin peroxidase activity, and ordinal scale results were compared to an automated urine particle analyzer (UF‐5000, Sysmex, Kobe, Japan) and wet chemistry (Roche Cobas 8000, Mannheim, Germany).

Results

Within‐run and between‐run imprecision results based on reflectance data for both the 9 and 11 parameter test strips ranged from 0.07% to 1.36% for the low‐level control and from 0.37% to 6.13% for the high‐level control, depending on the parameter. Regarding diagnostic performance, the sensitivity/specificity for glucose, protein, albumin, leukocyte esterase, and hemoglobin peroxidase was 100/60%, 94.2/88.2%, 81.8/89.2%, 81.7/92.8%, and 85.1/88.6%, respectively; the negative predictive value was 100%, 83.3%, 89.1%, 94.6%, and 96.1%. The Spearman correlation coefficients of the UC‐3500 vs reference methods ranged from 0.915 to 0.967, depending on the parameter.

Conclusion

This fully automated urine test strip analyzer overall shows a satisfying performance and can reliably screen out negative urine samples in order to focus on further characterization of positive samples in the following steps of the workflow.
Ruptured inferior vena cava aneurysm in the setting of mural vascular malformation: A case report
Authors: Momeni Mohammad , Momeni Fatemeh
Published: February 2019

Aneurysm of the inferior vena cava is a rare anomaly with a very few reported cases worldwide. We report the case of a 26‐years‐old man with acute severe abdominal pain and hypovolemic shock following an episode of syncope. Ultrasonography showed a fusiform aneurysmal dilation of the infra‐hepatic inferior vena cava (IVC), with a large saccular portion at its posterolateral wall and mural thrombosis. Abdominal computed tomography scan revealed extension to the right renal vein and adhesion to the right kidney. The saccular aneurysm and the right kidney were resected, and anatomopathological examination revealed a cavernous hemangioma. All symptoms disappeared after surgery. This is the first reported case of symptomatic congenital saccular aneurysm of the IVC due to mural vascular malformation and with involvement of the right kidney leading to nephrectomy.
The effect of reinforcement probability on time discrimination in the midsession reversal task
Authors: Santos Cristina , Soares Catarina , Vasconcelos Marco , Machado Armando
Published: February 2019

We examined how biasing time perception affects choice in a midsession reversal task. Given a simultaneous discrimination between stimuli S1 and S2, with choices of S1 reinforced during the first, but not the second half of the trials, and choices of S2 reinforced during the second, but not the first half of the trials, pigeons show anticipation errors (premature choices of S2) and perseveration errors (belated choices of S1). This suggests that choice depends on timing processes, on predicting when the contingency reverses based on session duration. We exposed 7 pigeons to a midsession reversal task and manipulated the reinforcement rate on each half of the session. Compared to equal reinforcement rates on both halves of the session, when the reinforcement rate on the first half was lower than on the second half, performance showed more anticipation and less perseveration errors, and when the reinforcement rate on the first half was higher than on the second half, performance showed a remarkable reduction of both types of errors. These results suggest that choice depends on both time into the session and the outcome of previous trials. They also challenge current models of timing to integrate local effects.
Enhancing engineering students' ethical reasoning: Situating reflexive principlism within the SIRA framework
Authors: Hess Justin L. , Beever Jonathan , Zoltowski Carla B. , Kisselburgh Lorraine , Brightman Andrew O.
Published: February 2019

Background

Educating engineers to reason through the ethical decisions they encounter when developing or implementing new technologies is a critical challenge. However, engineering educators have not widely adopted a framework for preparing engineering students to analyze ethical issues.

Purpose/Hypothesis

We developed and tested an approach for enhancing the ethical reasoning of engineering students. This approach integrates reflexive principlism, an ethical reasoning approach, within a structured learning framework, scaffolded, interactive, and reflective analysis, or SIRA. We hypothesized that students' ethical reasoning abilities and empathic perspective‐taking tendencies would increase.

Design/Method

We implemented and tested the integrated approach over five semesters with graduate‐level engineering students through a quasi‐experimental, controlled research design. We measured changes in ethical reasoning using the Engineering Ethical Reasoning Instrument (EERI) and the Defining Issues Test 2 (DIT2) and empathic tendencies using the Interpersonal Reactivity Index (IRI). We examined relationships among measures through correlation analysis.

Results

The EERI instrumentation indicated that the approach significantly increased the ethical reasoning abilities of graduate‐level engineering students. However, the DIT2 findings did not indicate change. The IRI indicated perspective‐taking tendencies were enhanced and personal distress tendencies were reduced. Postcourse correlational data indicated moderate relationships between perspective‐taking and ethical reasoning as measured by the IRI and the EERI indexes.

Conclusions

This study provides a theoretical approach for developing ethical reasoning and empathic perspective‐taking among graduate‐level engineering students. It also provides a theoretical framework, a pedagogical approach, and evaluation methods that others may utilize.
Alternative Dispute Resolution: A Tool for Managing Leadership Conflict in a Church
Authors: Afolabi Oluwaseun O.
Published: February 2019

Dispute within a church is unavoidable since members come from diverse backgrounds which make their opinions and ways of viewing issues different and sometimes conflicting. Management of leadership conflict in a church has not been given much attention despite the fact that leadership conflict is often rampant in a church. Such conflict likely undermines the essence of the church and its leadership, which supposed to be an epitome for other forms of leadership in society. Though scholars have postulated several ways of managing church based conflicts, little or no attention has been given to the use of alternative dispute resolution to address leadership conflict in a church. Hence, the current paper examines how alternative dispute resolution may be use to resolve church based leadership conflict.
Taking the Leadership Role: Understanding Leadership Across Team and Organizational Boundaries in View of the Changing Employment Relationship
Authors: Coun Martine , Peters Pascale , Blomme Rob
Published: February 2019

Contemporary knowledge workers cooperate more and more in multiple, temporary, and often virtual teams with peers within and across organizational boundaries. The growing involvement of multiple actors inside and outside organizations has severe implications for how the employment relationship is managed. In the current article it is argued that leadership is becoming not only increasingly distributed but also diffuse. Leadership is no longer “what those in leadership positions do,” but refers to a process by which one or more actors stimulate themselves and each other in order to pursue values, goals, and objectives. Whoever takes on a leadership role, needs to understand the way actors can be motivated and energized to address future needs and requirements in organizations. Building on insights from human resource management, leadership, and organizational behavior literature, how multiple actors are stimulated to take on their leadership roles in order to foster salient outcomes for multiple parties is explored in the current article.