bluuebunny/crossref_metadata_2025 huggingface dataset:
Tratamento conservador na síndrome de Boerhaave
Authors: Firme Camila Maria Nascimento , Lima Diego Laurentino , Cordeiro Raquel Nogueira , Wanderley Geraldo José Paraíso , Meira Marconi Roberto Lemos
Published: February 2019

A Síndrome de Boerhaave, ruptura esofagiana espontânea, é uma doença de difícil diagnóstico, por não apresentar manifestações clínicas específicas e seus achados de sinais e sintomas sugerirem outros diagnósticos diferenciais. É uma síndrome que apresenta elevadas taxas de mortalidade e o principal fator para esse desfecho desfavorável é o atraso entre a perfuração do esófago e o tratamento adequado. Exames de imagem são fundamentais para elucidação diagnostica, contribuindo para o tratamento precoce. Diversas modalidades de tratamento estão descritas na literatura, dentre elas, o tratamento cirúrgico, endoscópico ou manejo conservador. A cirurgia ainda é considerada padrão-ouro no tratamento da maioria dos casos. Contudo, apesar de poucos casos descritos na literatura, o manejo conservador, sem necessidade de cirurgia em um primeiro momento, pode ser indicado para determinados grupos de pacientes, com sucesso. Relatamos um caso de paciente com diagnóstico de Síndrome de Boerhaave tratado conservadoramente, com excelente resultado. O tratamento conservador da perfuração esofágica é uma boa alternativa para determinados perfis de paciente e deve ser bem indicado para que se obtenha êxito.
Chronic Atrial and Ventricular Pacing in the Mouse
Authors: Ståhlberg Marcus , Nakagawa Ryo , Bedja Djahida , Zhu Guangshuo , Lin Brian L. , Saberi Amir , Lee Dong I. , Kass David A.
Published: February 2019

Background:

The mouse is the most widely used mammal in experimental biology. Although many clinically relevant in vivo cardiac stressors are used, one that has eluded translation is long-term cardiac pacing. Here, we present the first method to chronically simulate and simultaneously record cardiac electrical activity in conscious mobile mice. We then apply it to study right ventricular pacing induced electromechanical dyssynchrony and its reversal (resynchronization).

Methods and Results:

The method includes a custom implantable bipolar stimulation and recording lead and flexible external conduit and electrical micro-commutator linked to a pulse generator/recorder. This achieved continuous pacing for at least 1 month in 77% of implants. Mice were then subjected to cardiac ischemia/reperfusion injury to depress heart function, followed by 4 weeks pacing at the right ventricle (dyssynchrony), right atrium (synchrony), or for 2 weeks right ventricle and then 2 weeks normal sinus (resynchronization). Right ventricular pacing–induced dyssynchrony substantially reduced heart and myocyte function compared with the other groups, increased gene expression heterogeneity (>10 fold) comparing septum to lateral walls, and enhanced growth and metabolic kinase activity in the late-contracting lateral wall. This was ameliorated by restoring contractile synchronization.

Conclusions:

The new method to chronically pace conscious mice yields stable atrial and ventricular capture and a means to dissect basic mechanisms of electromechanical physiology and therapy. The data on dyssynchrony and resynchronization in ischemia/reperfusion hearts is the most comprehensive to date in ischemic heart disease, and its similarities to nonischemic canine results support the translational utility of the mouse.
Abnormal Fractional Flow Reserve in Nonobstructive Coronary Artery Disease
Authors: Imai Shunsuke , Kondo Takeshi , Stone Gregg W. , Kawase Yoshiaki , Ahmadi Amir A. , Narula Jagat , Matsuo Hitoshi
Published: February 2019

Background:

The basis of discordance between invasive coronary angiographic (ICA) anatomic stenosis and fractional flow reserve (FFR) is not fully understood. We analyzed coronary computed tomography angiography (CTA) characteristics of ICA-verified nonobstructive lesions in the proximal or midleft anterior descending artery with FFR ≤0.8, that is, anatomy-physiology mismatch.

Methods and Results:

CTA and ICA were performed in 108 patients. FFR was measured during intravenous ATP (180 μg/[kg·min]) infusion. CTA-verified plaque characteristics between 53 consecutive ICA-FFR mismatch (ICA–quantitative coronary angiography <50%, FFR≤0.8) and 55 ICA-FFR match (ICA–quantitative coronary angiography<50%, FFR>0.8) vessels were compared. CTA-verified vessel area (20.7±6.7 versus 16.9±4.8 mm
2
;
P
=0.0007), positive area remodeling index (ARI; 1.38±0.23 versus 1.06±0.11;
P
<0.0001), %plaque area (64.7±12.7 versus 57.4±8.5%;
P
<0.0007), jeopardized myocardial mass (46.2±18.5 versus 37.1±14.3 g;
P
= 0.006), and the prevalence of low attenuation plaque (45.3% versus 9.1%;
P
<0.0001) at the minimum lumen area were significantly higher in the ICA-FFR mismatch than the match group. By receiver operation curve analysis, the areas under the curve for positive area remodeling index, %plaque area and jeopardized myocardial mass were 0.921, 0.681, and 0.641, respectively, for the diagnosis of mismatch (cutoff values 1.13, 66% and 58.7 g, respectively). The sensitivity and specificity of area remodeling index >1.13 for predicting ICA-FFR mismatch were 88.7% and 78.2%, respectively.

Conclusions:

In the absence of anatomically significant stenosis, abnormal FFR is more frequently encountered in patients with CTA-derived positive remodeling, larger plaque burden, and low attenuation plaque. These findings contribute to a better understanding of how FFR-based decision-making might translate into demonstrated superior clinical outcomes.
Developing and Testing a Personalized, Evidence-Based, Shared Decision-Making Tool for Stent Selection in Percutaneous Coronary Intervention Using a Pre-Post Study Design
Authors: Chhatriwalla Adnan K. , Decker Carole , Gialde Elizabeth , Catley Delwyn , Goggin Kathy , Jaschke Katie , Jones Philip , deBronkart Dave , Sun Tony , Spertus John A.
Published: February 2019

Background:

Drug-eluting stents reduce the risk of restenosis in patients undergoing percutaneous coronary intervention, but their use necessitates prolonged dual antiplatelet therapy, which increases costs and bleeding risk, and which may delay elective surgeries. While >80% of patients in the United States receive drug-eluting stents, less than a third report that their physicians discussed options with them.

Methods and Results:

An individualized shared decision-making (SDM) tool for stent selection was designed and implemented at 2 US hospitals. In the postimplementation phase, all patients received the SDM tool before their procedure, with or without decision coaching from a trained nurse. All patients were interviewed with respect to their knowledge of stents, their participation in SDM, and their stent preference. Between May 2014 and December 2016, 332 patients not receiving the SDM tool, 113 receiving the SDM tool with coaching, and 136 receiving the tool without coaching were interviewed. Patients receiving the SDM tool + coaching, as compared with usual care, demonstrated higher knowledge scores (mean difference +1.8;
P
<0.001), reported more frequent participation in SDM (odds ratio=2.96;
P
<0.001), and were more likely to state a stent preference (odds ratio=2.00;
P
<0.001). No significant differences were observed between the use of the SDM tool without coaching and usual care. For patients who voiced a stent preference, concordance between stent desired and stent received was 98% for patients who preferred a drug-eluting stent and 50% for patients who preferred a bare metal stent. The SDM tool (with or without coaching) had no impact on stent selection or concordance.

Conclusions:

An SDM tool for stent selection was associated with improvements in patient knowledge and SDM only when accompanied by decision coaching. However, the SDM tool (with or without coaching) had no impact on stent selection or concordance between patients’ stent preference and stent received, suggesting that physician-level barriers to SDM may exist.

Clinical Trial Information

URL:
https://www.clinicaltrials.gov
. Unique Identifier: NCT02046902.
Sex‐Specific Treatment Effects After Primary Percutaneous Intervention: A Study on Coronary Blood Flow and Delay to Hospital Presentation
Authors: Cenko Edina , van der Schaar Mihaela , Yoon Jinsung , Kedev Sasko , Valvukis Marija , Vasiljevic Zorana , Ašanin Milika , Miličić Davor , Manfrini Olivia , Badimon Lina , Bugiardini Raffaele
Published: February 2019

Background

We hypothesized that female sex is a treatment effect modifier of blood flow and related 30‐day mortality after primary percutaneous coronary intervention (
PCI
) for
ST
‐segment–elevation myocardial infarction and that the magnitude of the effect on outcomes differs depending on delay to hospital presentation.

Methods and Results

We identified 2596 patients enrolled in the
ISACS
‐
TC
(International Survey of Acute Coronary Syndromes in Transitional Countries) registry from 2010 to 2016. Primary outcome was the occurrence of 30‐day mortality. Key secondary outcome was the rate of suboptimal post‐
PCI
Thrombolysis in Myocardial Infarction (
TIMI
; flow grade 0–2). Multivariate logistic regression and inverse probability of treatment weighted models were adjusted for baseline clinical covariates. We characterized patient outcomes associated with a delay from symptom onset to hospital presentation of ≤120 minutes. In multivariable regression models, female sex was associated with postprocedural
TIMI
flow grade 0 to 2 (odds ratio [
OR
], 1.68; 95%
CI
, 1.15–2.44) and higher mortality (
OR,
1.72; 95%
CI
, 1.02–2.90). Using inverse probability of treatment weighting, 30‐day mortality was higher in women compared with men (4.8% versus 2.5%;
OR
, 2.00; 95%
CI
, 1.27–3.15). Likewise, we found a significant sex difference in post‐
PCI TIMI
flow grade 0 to 2 (8.8% versus 5.0%;
OR
, 1.83; 95%
CI
, 1.31–2.56). The sex gap in mortality was no longer significant for patients having hospital presentation of ≤120 minutes (
OR
, 1.28; 95%
CI
, 0.35–4.69). Sex difference in post‐
PCI TIMI
flow grade was consistent regardless of time to hospital presentation.

Conclusions

Delay to hospital presentation and suboptimal post‐
PCI TIMI
flow grade are variables independently associated with excess mortality in women, suggesting complementary mechanisms of reduced survival.

Clinical Trial Registration

URL
:
http://www.clinicaltrials.gov
. Unique identifier:
NCT
01218776.
The Response of the Midlatitude Jet to Regional Polar Heating in a Simple Storm-Track Model
Authors: Ruggieri Paolo , Kucharski Fred , Novak Lenka
Published: February 2019

Given the recent changes in the Arctic sea ice, understanding the effects of the resultant polar warming on the global climate is of great importance. However, the interaction between the Arctic and midlatitude circulation involves a complex chain of mechanisms, which leaves state-of-the-art general circulation models unable to represent this interaction unambiguously. This study uses an idealized general circulation model to provide a process-based understanding of the sensitivity of the midlatitude circulation to the location of high-latitude warming. A simplified atmosphere is simulated with a single zonally localized midlatitude storm track, which is analogous to the storm tracks in the Northern Hemisphere. It is found that even small changes in the position of the forcing relative to that storm track can lead to very different responses in the midlatitude circulation. More specifically, it is found that heating concentrated in one region may cause a substantially stronger global response compared to when the same amount of heating is distributed across all longitudes at the same latitude. Linear interference between climatological and anomalous flow is an important component of the response, but it does not explain differences between different longitudes of the forcing. Feedbacks from atmospheric transient eddies are found to be associated with this strong response. A dependence between the climatological jet latitude and the jet response to polar surface heating is found. These results can be used to design and interpret experiments with complex state-of-the-art models targeted at Arctic–midlatitude interactions.
On the Use of Geophysical Parameters for the Top-of-Atmosphere Shortwave Clear-Sky Radiance-to-Flux Conversion in EarthCARE
Authors: Tornow F. , Domenech C. , Fischer J.
Published: February 2019

We have investigated whether differences across Clouds and the Earth’s Radiant Energy System (CERES) top-of-atmosphere (TOA) clear-sky angular distribution models, estimated separately over regional (1° × 1° longitude–latitude) and temporal (monthly) bins above land, can be explained by geophysical parameters from Max Planck Institute Aerosol Climatology, version 1 (MAC-v1), ECMWF twentieth-century reanalysis (ERA-20C), and a MODIS bidirectional reflectance distribution function (BRDF)/albedo/nadir BRDF-adjusted reflectance (NBAR) Climate Modeling Grid (CMG) gap-filled products (MCD43GF) climatology. Our research aimed to dissolve binning and to isolate inherent properties or indicators of such properties, which govern the TOA radiance-to-flux conversion in the absence of clouds. We collocated over seven million clear-sky footprints from CERES Single Scanner Footprint (SSF), edition 4, data with above geophysical auxiliary data. Looking at data per surface type and per scattering direction—as perceived by the broadband radiometer (BBR) on board Earth Clouds, Aerosol and Radiation Explorer (EarthCARE)—we identified optimal subsets of geophysical parameters using two different methods: random forest regression followed by a permutation test and multiple linear regression combined with the genetic algorithm. Using optimal subsets, we then trained artificial neural networks (ANNs). Flux error standard deviations on unseen test data were on average 2.7–4.0 W m−2, well below the 10 W m−2 flux accuracy threshold defined for the mission, with the exception of footprints containing fresh snow. Dynamic surface types (i.e., fresh snow and sea ice) required simpler ANN input sets to guarantee mission-worthy flux estimates, especially over footprints consisting of several surface types.
Stochastic Parameterization of Subgrid-Scale Velocity Enhancement of Sea Surface Fluxes
Authors: Bessac Julie , Monahan Adam H. , Christensen Hannah M. , Weitzel Nils
Published: February 2019

Subgrid-scale (SGS) velocity variations result in gridscale sea surface flux enhancements that must be parameterized in weather and climate models. Traditional parameterizations are deterministic in that they assign a unique value of the SGS velocity flux enhancement to any given configuration of the resolved state. In this study, we assess the statistics of SGS velocity flux enhancement over a range of averaging scales (as a proxy for varying model resolution) through systematic coarse-graining of a convection-permitting atmospheric model simulation over the Indian Ocean and west Pacific warm pool. Conditioning the statistics of the SGS velocity flux enhancement on 1) the fluxes associated with the resolved winds and 2) the precipitation rate, we find that the lack of a separation between “resolved” and “unresolved” scales results in a distribution of flux enhancements for each configuration of the resolved state. That is, the SGS velocity flux enhancement should be represented stochastically rather than deterministically. The spatial and temporal statistics of the SGS velocity flux enhancement are investigated by using basic descriptive statistics and through a fit to an anisotropic space–time covariance structure. Potential spatial inhomogeneities of the statistics of the SGS velocity flux enhancement are investigated through regional analysis, although because of the relatively short duration of the simulation (9 days) distinguishing true inhomogeneity from sampling variability is difficult. Perspectives for the implementation of such a stochastic parameterization in weather and climate models are discussed.
Outcomes Using a Postoperative Protocol in Pediatric Single-Stage Laryngotracheal Reconstruction
Authors: Thottam Prasad John , Gilliland Taylor , Ettinger Nicholas , Baijal Rahul , Mehta Deepak
Published: February 2019

Objectives:

The aim of this study was to evaluate single-stage laryngotracheal reconstruction (ssLTR) outcomes before and after the implementation of a postoperative care protocol in pediatric patients.

Methods:

A case-control study with chart review was conducted at 2 tertiary academic centers from 2010 to 2016. Pediatric patients who underwent ssLTR with a postoperative care protocol were compared with those who did not receive care under this protocol. Data regarding perioperative management were collected and compared using χ2 and Wilcoxon rank tests. Planned extubation, length of intubation in the intensive care unit, and complications were examined.

Results:

Nineteen patients completed ssLTR after the protocol was initiated, and 26 prior patients were used as control subjects. Planned extubation failed in 9 patients (35%) in the control group compared with 1 patient (5%) in the protocol group ( P < .05). Using a structured protocol demonstrated a decrease in delayed extubation and intensive care unit stay ( P < .05). Despite more postprotocol patients’ requiring posterior graft placement, preprotocol patients were less likely to be extubated within 7 days ( P < .05).

Conclusions:

The authors propose an intensive care unit protocol that uses a combination of pharmacologic agents to optimally reduce the risk for adverse events that delay time to extubation and thus decannulation. Timely extubation was more likely with the use of this postoperative care protocol using a multidisciplinary approach involving otolaryngologists, pharmacists, intensivists, and anesthesiologists.
On visible homelessness and the micro-aesthetics of public space
Authors: Young Alison , Petty James
Published: February 2019

In this article, we investigate the circumstances that have produced the current municipal regulatory approach to homelessness in the City of Melbourne, Victoria, and the ways in which visibly homeless people are policed through a micro-aesthetics of their presence in public space, which involves the monitoring of their bodily demeanour and their physical possessions. Our study contributes to and draws from a range of debates, including studies of the governmental conjunction of poverty and crime, analysis of the co-implication of law and spatiality, research on the criminalisation of homelessness and homeless people, and the burgeoning criminological interest in the significance of the visual field for our understandings of crime and criminality. This article recounts how homelessness, public space and questions of aesthetics have recently coalesced in debates about the regulation of homelessness in the public space of Melbourne’s city centre. It approaches the issues through comparative consideration of genres of municipal management frameworks in other jurisdictions, detailed textual consideration of the Protocol on Homelessness in the City of Melbourne and an empirical study of visible homelessness in the public places of central Melbourne.
Status seeking in the friendly Nordic neighborhood
Authors: Røren Pål
Published: February 2019

The article argues that the way status is pursued in social groups in world politics is contingent on the type of social relations that constitute interaction between the members. The Nordic region is a group of countries marked by friendship and trust. Here, the numerous societal linkages between the Nordic countries have made their region into a ‘friendly neighborhood’. This has changed the way that these countries pursue status. To explore this status dynamic, the article draws on a series of interviews with Nordic diplomats and argues that a strong friendship both enables collective status seeking, and constrains individual status seeking. Specifically, turning their social group into a friendly neighborhood allows the Nordic countries to posture as a collective polity and seek status on behalf of it. This grants them more status recognition in world politics. Moreover, friendship does not eliminate status rivalry, but it does turn it into a friendly kind of status competition. Indeed, while the intra-regional intensity of the competition endures, the article finds that the Nordic countries are unlikely to compete in ways that might harm their friendship or their neighborhood.
Dying to Live Forever: Identity and Virtue in the Resurrection of the Martyrs
Authors: Moss Candida R.
Published: February 2019

In recent scholarship the emergence of belief in the resurrection of the body in the writings of the early Church has been linked to the experience of martyrdom and persecution. By contrast, this article seeks to treat the resurrection of martyrs in the writings of the apologists as part of a broader philosophically informed conversation about identity and change. Rather than seeing the writings of the apologists as contingent theology, it argues that writers like Tertullian and Athenagoras use the resurrection of the martyrs both to address anxieties about the persistence of identity, and to highlight the ethical importance of the functionality of the body.
ViEWS: A political violence early-warning system
Authors: Hegre Håvard , Allansson Marie , Basedau Matthias , Colaresi Michael , Croicu Mihai , Fjelde Hanne , Hoyles Frederick , Hultman Lisa , Högbladh Stina , Jansen Remco , Mouhleb Naima , Muhammad Sayyed Auwn , Nilsson Desirée , Nygård Håvard Mokleiv , Olafsdottir Gudlaug , Petrova Kristina , Randahl David , Rød Espen Geelmuyden , Schneider Gerald , von Uexkull Nina , Vestby Jonas
Published: February 2019

This article presents ViEWS – a political violence early-warning system that seeks to be maximally transparent, publicly available, and have uniform coverage, and sketches the methodological innovations required to achieve these objectives. ViEWS produces monthly forecasts at the country and subnational level for 36 months into the future and all three UCDP types of organized violence: state-based conflict, non-state conflict, and one-sided violence in Africa. The article presents the methodology and data behind these forecasts, evaluates their predictive performance, provides selected forecasts for October 2018 through October 2021, and indicates future extensions. ViEWS is built as an ensemble of constituent models designed to optimize its predictions. Each of these represents a theme that the conflict research literature suggests is relevant, or implements a specific statistical/machine-learning approach. Current forecasts indicate a persistence of conflict in regions in Africa with a recent history of political violence but also alert to new conflicts such as in Southern Cameroon and Northern Mozambique. The subsequent evaluation additionally shows that ViEWS is able to accurately capture the long-term behavior of established political violence, as well as diffusion processes such as the spread of violence in Cameroon. The performance demonstrated here indicates that ViEWS can be a useful complement to non-public conflict-warning systems, and also serves as a reference against which future improvements can be evaluated.
No Social Revolution Without Sexual Revolution
Authors: Duong Kevin
Published: February 2019

Recent studies have revealed how workers’ movements adapted republicanism into a language of anticapitalism in the nineteenth century. Much less attention has been paid, however, to the role feminists played in this process. This essay addresses this oversight by introducing the voices of the utopian socialists under July Monarchy France. These socialists insisted that there could be no social revolution without sexual revolution. Although they are often positioned outside of the republican tradition, this essay argues that the utopian socialists are better understood as rendering the legacy of classical and French republicanism compatible with nascent workers’ movements in the 1830s. By foregrounding the feminist Flora Tristan, this essay shows how utopian socialists weaponized republican tropes to address the social question, thereby expanding what a republican critique of capitalism could look like.
Stressed Out and Strapped: Examining the Link Between Psychological Difficulties and Student Weapon Carrying and Use
Authors: Johnson Cheryl L. , Wilcox Pamela , Peterson Samuel
Published: February 2019

Using data on middle-school adolescents from the Rural Substance Abuse and Violence Project (RSVP), the authors examined the extent to which psychological difficulties are related to student weapon carrying and use, net of other criminological variables. Furthermore, the authors examined whether psychological difficulties had variable effects across school contexts. Initial logistic regression models showed that variables tapping psychological difficulties (fear of crime, family history of mental illness, and low self-control) were significantly related to student weapon carrying and use. Once other criminological and demographic controls were added, only low self-control remained significant. Multilevel models incorporating random slope coefficients and cross-level interactions showed that the relationship between low self-control and student weapon carrying/use was attenuated in schools with higher levels of school efficacy and school security. Similarly, the relationship between fear of crime and weapon carrying depended on the level of school security, with the effect weakened as school security increased.
Workup of Suspected Chest Metastases on 18F-FDG-PET/CT in Head and Neck Cancer: Worth the Wait?
Authors: Leto Christopher J. , Sharbel Daniel , Wang Chien Wei , Bone Tyler M. , Liebman Robert M. , Byrd J. Kenneth , Groves Michael W.
Published: February 2019

The objective of our study is to assess the impact of equivocal or positive positron emission tomography combined with low-dose noncontrast computed tomography (PET/CT) findings in the chest on treatment for head and neck cancer (HNC). We reviewed charts of patients presented at Augusta University’s Head and Neck Tumor Board (AUTB) between 2013 and 2016 with the following exclusion criteria: <18 years, Veterans Affairs patients, those with incomplete data, and those without a history of head and neck squamous cell carcinoma. The lung/thorax sections of the radiologists’ PET/CT reports were graded as “Positive, Equivocal, or Negative” for chest metastases. Patients who underwent workup for suspected chest metastases were assessed for treatment delays, changes in treatment plans, and complications. In addition, we evaluated the time between AUTB presentation and peri-treatment PET/CT to primary treatment initiation were calculated between groups. There was a total of 363 patients with PET/CT prior to treatment, the read was “Negative” in 71.3% (n = 259), “Equivocal” in 20.9% (n = 76), and “Positive” in 5.8% (n = 21). Of 272 patients with complete treatment data, 22 underwent workup for suspected chest metastases. Mean time from PET/CT to treatment initiation was 27.5 days without workup and 64.9 days with workup ( P < .0001), and from AUTB presentation was 29.1 days without workup and 62.5 days with workup ( P < .0001). Five (19.2%) patients experienced a complication from workup. Twenty (76.9%) patients had no changes in their treatment plan after workup. In conclusion, our results for potential chest metastases on PET/CT in patients with HNC are often not clear-cut. Workup of suspected chest metastasis based on PET/CT findings significantly delays primary treatment initiation and may cause serious complications.
Polyaniline/attapulgite-supported nanoscale zero-valent iron for the rival removal of azo dyes in aqueous solution
Authors: Xu Hui , Zhang Yajuan , Cheng Yong , Tian Weiguo , Zhao Zeting , Tang Jin
Published: February 2019

In this paper, polyaniline/attapulgite (PANI/APT)-supported nanoscale zero-valent iron (nZVI) composites were synthesized by liquid-phase chemical reduction method and used for the removal of two kinds of dyes. The structure of as-prepared nZVI/PANI/APT was characterized by various test methods. The removal property and degradation mechanism for azo (alizarin yellow R, methyl red, chrome black T, methyl orange) and non-azo (methylene blue, rhodamine B) dyes in aqueous solution were investigated. The presence of PANI/APT can decrease the aggregation of nZVI particles with maintenance of reactivity and improving adsorption capacity for degradation azo dye. The experiment results showed that the removal property of the composite materials on azo dyes is obviously better than that on non-azo dyes. The varying removal efficiencies of dyes depend on the different degradation mechanisms. Azo dyes removal by nZVI/PANI/APT was mainly due to the reductive cleavage of the N = N of nZVI, while non-azo dyes removal mainly contributes to the adsorption of PANI/APT. The study demonstrated that nZVI/PANI/APT has potential applications for the removal of azo dyes from wastewaters.
A study investigating the validity of an accelerometer in quantification of step count in adult hospital inpatients recovering from critical illness
Authors: Anderson Jayne Lesley , Yoward L Samantha , Green Angela J
Published: February 2019

Objective:

To determine the validity of the ActiGraph GT3X accelerometer in step count quantification when compared to observed step count in hospitalised adults recovering from critical illness.

Setting:

Large National Health Service (NHS) Hospitals Trust.

Subjects:

In total, 20 hospital ward-based adults (age: mean 62.3, SD 11.5) who had required greater than 48 hours of mechanical ventilation in the intensive care unit.

Main measures:

Participants walked self-selected distances and speeds as part of a semi-structured movement protocol not exceeding 3 hours. Two ActiGraph GT3X accelerometers were worn, one on the thigh and one on the ankle of the non-dominant leg. Accelerometer-recorded step counts were compared against observed step counts.

Results:

In total, 31 separate walking episodes were analysed. A mean (SD) of 45.87 (±19.72) steps was calculated for observed step count (range 15–90). Mean differences (95% limits of agreement) of −0.84 steps (−3.88 to 2.2) for the ankle placement and −17.7 steps (−40.63 to 5.25) for the thigh were calculated. Intraclass correlation coefficients (95% confidence intervals) of 0.99 (0.99 to 1.0) and 0.46 (−0.1 to 0.78) were determined for the ankle and thigh, respectively. Placement sites were well tolerated by 95% of participants.

Conclusion:

An ankle-mounted ActiGraph GT3X accelerometer demonstrates validity in quantification of step count in hospitalised adults recovering from critical illness. A thigh placement was not considered valid.
Cerebral vasomotor reactivity during hypo- and hypercapnia across the adult lifespan
Authors: Tomoto Tsubasa , Riley Jonathan , Turner Marcel , Zhang Rong , Tarumi Takashi
Published: February 2019

Age is the strongest risk factor for cerebrovascular disease; however, age-related changes in cerebrovascular function are still not well understood. The objective of this study was to measure cerebral vasomotor reactivity (CVMR) during hypo- and hypercapnia across the adult lifespan. One hundred fifty-three healthy participants (21–80 years) underwent measurements of cerebral blood flow velocity (CBFV) via transcranial Doppler, mean arterial pressure (MAP) via plethysmograph, and end-tidal CO2 (EtCO2) via capnography during hyperventilation (hypocapnia) and a modified rebreathing protocol (hypercapnia). Cerebrovascular conductance (CVCi) and resistance (CVRi) indices were calculated from the ratios of CBFV and MAP. CVMRs were assessed by the slopes of CBFV and CVCi in response to changes in EtCO2. The baseline CBFV and CVCi decreased and CVRi increased with age. Advanced age was associated with progressive declines in CVMR during hypocapnia indicating reduced cerebral vasoconstriction, but increases in CVMR during hypercapnia indicating increased vasodilation. A negative correlation between hypo- and hypercapnic CVMRs was observed across all subjects (CBFV%/ EtCO2: r = −0.419, CVCi%/ EtCO2: r = −0.442, P < 0.0001). Collectively, these findings suggest that aging is associated with decreases in CBFV, increases in cerebrovascular resistance, reduced vasoconstriction during hypocapnia, but increased vasodilatory responsiveness during hypercapnia.
The cardiovascular effects of crystalloid administration in endoscopy patients
Authors: Cowie Brian S , Buckley Aisling B , Kluger Roman , Phan Tuong D
Published: February 2019

Intravenous fluids are commonly administered for patients having colonoscopy despite relatively little data to support this practice. It is unclear what, if any, effect crystalloid administration has on stroke volume and cardiac output in patients who are fasting and have had bowel preparation agents. We aimed to assess the physiological effect of 10 ml/kg of crystalloid administration in colonoscopy patients on haemodynamic parameters including stroke volume, stroke volume variation and cardiac output, as measured with transthoracic echocardiography. Our secondary aims were to determine whether stroke volume variation predicted fluid responsiveness in gastrointestinal endoscopy patients and whether these haemodynamic measures are different in fasting patients with bowel preparation (colonoscopy patients) compared to fasting patients alone (gastroscopy patients). We recruited 54 patients having elective gastrointestinal endoscopy (25 colonoscopy, 29 gastroscopy). All patients had stroke volume, cardiac output and stroke volume variation measured with transthoracic echocardiography at baseline. In colonoscopy patients, stroke volume, cardiac output and stroke volume variation were remeasured after 10 ml/kg of intravenous crystalloid. Administration of 10 ml/kg of crystalloid increases stroke volume by 19.6 ml ( p < 0.00005) and cardiac output by 0.81 l/min ( p < 0.001). Stroke volume variation reduced from 23% to 14% after fluid administration ( p < 0.0011). The optimum threshold of stroke volume variation to predict fluid responsiveness was 21% with a sensitivity of 77.8% and specificity of 62.5%. Administration of 10 ml/kg of crystalloid increases stroke volume and cardiac output, and reduces stroke volume variation in fasting elective colonoscopy patients.
Safe Streets for All? Analyzing Infrastructural Response to Pedestrian and Cyclist Crashes in New York City, 2009–2018
Authors: Rebentisch Hannah , Wasfi Rania , Piatkowski Daniel P. , Manaugh Kevin
Published: February 2019

Although cycling and walking carry a host of benefits, neither the benefits nor the risks—those of injury and fatality—are equitably distributed. Although research has shown higher income and gentrified areas have better access to protected bicycle infrastructure, low-income and communities of color are overrepresented in severe injury and fatality rates among cyclists and pedestrians. This research employs temporal, spatial, and socio-economic data to study the distribution of cycling infrastructure and safety improvements in New York City between income groups and boroughs. The integration of temporal data representing pedestrian and cyclist injury and fatality, and infrastructure installation date, point toward the establishment of time trends in the relationship between traffic violence and safety investment. Socio-economic factors are analyzed to see how this relationship and access more generally are related to income. We observed that lower-income groups continue to be overrepresented in crashes across New York’s boroughs, with the exception of Manhattan, and although crash rates have fallen in the years since 2009, these gains do not improve the position of lower-income groups, which continue to experience a disproportionate share of fatalities and injuries. However, longitudinal multi-level logistic models controlling for reported pedestrian and cyclist injuries in previous years uncovered additional relationships between socio-economic status, injuries, location, and safety investment. For example, the implementation of safety improvements and speed humps are significantly related to reported injuries in previous years; this finding supports the city’s stated goals of targeting improvements to areas most in need of improved safety for vulnerable road users.
Employees’ Managed Resentment: Public Procurement and the Part of Emotions in Social Change
Authors: Benjamin Orly
Published: February 2019

Resentment, that is triggered by deprived entitlement, was suggested as particularly salient for energizing action and change in labor relations. However, its relationship with estrangement has not yet been examined as relevant to social change in times of contracting out services. I investigate this question in my research of public procurement as a mode of contract-based service delivery, examining two types of related jobs. The analysis of interviews with 30 employees and 12 administrators, all women, revealed the emergence of managed resentment and the conditions of its coexistence with estrangement. I demonstrate a learning process in which resentment energizes action but encounters lack of recognition. Managed resentment follows but remains protected from estrangement only by positive emotions created in care relations. I discuss possible meanings of these subjective developments for social change in the contexts of women’s encounter with lack of recognition of their skilled or professional contributions.
Trends in the Utilization of Life-Sustaining Procedures and Palliative Care Consultation Among Dying Patients With Advanced Chronic Pancreas Illnesses in US Hospitals: 2005 to 2014
Authors: Liu Xibei , Shen Jay J. , Kim Pearl , Kim Sun Jung , Ukken Johnson , Choi Younseon , Hwang In Choel , Lee Jae-Hoon , Chun Sung-Youn , Hwang Jinwook , Choi Haneul , Yeom Hyeyoung , Lee Yong-Jae , Yoo Ji Won
Published: February 2019

Aim:

Pancreas cancer continues to carry a poor prognosis. Hospitalized patients with advanced chronic pancreatic illnesses increasingly receive palliative care due to its perceived clinical benefits. Meanwhile, a growing proportion of elderly patients are reportedly receiving life-sustaining procedures. Temporal trends in the utilization of life-sustaining procedures and palliative care consultation among dying patients with advanced chronic pancreatic illnesses in US hospitals were examined.

Methods and Materials:

A serial, cross-sectional analysis was carried out using the National Inpatient Sample Database. Decedents 18 years and older with a principal diagnosis of pancreas cancer or other advanced chronic pancreatic illnesses from 2005 through 2014. The compound annual growth rates (CAGRs) and Cochrane-Armitage correction of χ2 statistic were used. The receipt of life-sustaining systemic procedures, intra-abdominal local procedures and surgeries, and palliative care consultation were examined. Multilevel multivariate logistic regressions were performed to examine the association of various procedures with the utilization of palliative care consultation.

Results:

Among 77 394 183 hospitalizations, 29 515 patients were examined. The CAGRs of systemic procedures, intra-abdominal procedures, surgeries, and palliative care were −4.19% ( P = .008), 2.17%, −1.40%, and 14.03% ( P < .001), respectively. The receipt of systemic procedures (odds ratio [OR] = 2.40, 95% confidence interval [CI], 2.08-2.74), local intra-abdominal procedures (OR = 1.46, 95% CI, 1.27-1.70), and surgeries (OR = 2.51, 95% CI, 2.07-3.05) was associated with palliative care consultation ( Ps < .001).

Conclusions:

Among adults with pancreatic cancer or other advanced chronic pancreatic illnesses in the US hospitals from 2005 to 2014, the utilization of life-sustaining systemic procedures decreased while the prevalence of palliative care consultation increased.
Playing God or Participating in God? What Considerations Might the New Testament Bring to the Ethics of the Biotechnological Future?
Authors: Macaskill Grant
Published: February 2019

The Bible is normative for all Christian theology and ethics, including responsible theological reflection on the biotechnological future. This article considers the representation of creaturehood and what might be labelled ‘deification’ within the biblical material, framing these concepts in terms of participation in providence and redemption. This participatory emphasis allows us to move past the simplistic dismissal of biotechnological progress as ‘playing God’, by highlighting ways in which the development of technology and caregiving are proper creaturely activities, but ones that must be morally aligned to the goodness of God. Framing our approximation of divine character in terms of ‘deification’ highlights its relational and soteriologically defined shape, preventing us from conceiving its attainment in any way that is loosed from the death and resurrection of Jesus Christ. The discussion allows us to affirm the pursuit of biotechnological research, but to recognize that it is unable by itself to accomplish certain ends, and that it must be pursued in alignment with the standards of goodness by which God loves his world.
Multi-objective optimization strategy of adaptive cruise control considering regenerative energy
Authors: Wu Di , Zhu Bo , Tan Dongkui , Zhang Nong , Gu Jiaxin
Published: February 2019

A multi-objective optimization strategy considering regenerative braking was proposed. Taking into account the impact of relative velocity, driver style, and road adhesion conditions, a variable time headway strategy was first proposed. Then, a multi-objective optimization strategy in adaptive cruise system was designed under the model predictive control framework. The incremental adaptive model predictive control with time-varying weights was constructed to be used as the upper controller, and slack variable was used to process the constraints. The constraints of regenerative braking were analyzed, and a new brake force distribution strategy based on multi-source information fusion was proposed to further optimize the economy. On the AMESim & Simulink co-simulation platform, a battery electric vehicle model was built and the proposed strategy was simulated. The results showed that, comparing to the constant-weight strategy, the proposed strategy had better robustness, which could rapidly and timely adjust the control target and guarantee the safety, comfort, economy, and following. The multi-source information braking force distribution strategy can guarantee several goals of the system while improving the economy. It can regenerate more braking energy, and the braking regenerative energy contribution increased by 5.68%.
Humans take control of fire-driven diversity changes in Mediterranean Iberia’s vegetation during the mid–late Holocene
Authors: Connor Simon E , Vannière Boris , Colombaroli Daniele , Anderson R Scott , Carrión José S , Ejarque Ana , Gil Romera Graciela , González-Sampériz Penélope , Hoefer Dana , Morales-Molino César , Revelles Jordi , Schneider Heike , van der Knaap Willem O , van Leeuwen Jacqueline FN , Woodbridge Jessie
Published: February 2019

Fire regime changes are considered a major threat to future biodiversity in the Mediterranean Basin. Such predictions remain uncertain, given that fire regime changes and their ecological impacts occur over timescales that are too long for direct observation. Here we analyse centennial- and millennial-scale shifts in fire regimes and compositional turnover to track the consequences of fire regime shifts on Mediterranean vegetation diversity. We estimated rate-of-change, richness and compositional turnover (beta diversity) in 13 selected high-resolution palaeoecological records from Mediterranean Iberia and compared these with charcoal-inferred fire regime changes. Event sequence analysis showed fire regime shifts to be significantly temporally associated with compositional turnover, particularly during the last three millennia. We find that the timing and direction of fire and diversity change in Mediterranean Iberia are best explained by long-term human–environment interactions dating back perhaps 7500 years. Evidence suggests that Neolithic burning propagated a first wave of increasing vegetation openness and promoted woodland diversity around early farming settlements. Landscape transformation intensified around 5500 to 5000 cal. yr BP and accelerated during the last two millennia, as fire led to permanent transitions in ecosystem state. These fire episodes increased open vegetation diversity, decreased woodland diversity and significantly altered richness on a regional scale. Our study suggests that anthropogenic fires played a primary role in diversity changes in Mediterranean Iberia. Their millennia-long legacy in today’s vegetation should be considered for biodiversity conservation and landscape management.
The origin and spread of olive cultivation in the Mediterranean Basin: The fossil pollen evidence
Authors: Langgut Dafna , Cheddadi Rachid , Carrión Josѐ Sebastián , Cavanagh Mark , Colombaroli Daniele , Eastwood Warren John , Greenberg Raphael , Litt Thomas , Mercuri Anna Maria , Miebach Andrea , Roberts C Neil , Woldring Henk , Woodbridge Jessie
Published: February 2019

Olive ( Olea europaea L.) was one of the most important fruit trees in the ancient Mediterranean region and a founder species of horticulture in the Mediterranean Basin. Different views have been expressed regarding the geographical origins and timing of olive cultivation. Since genetic studies and macro-botanical remains point in different directions, we turn to another proxy – the palynological evidence. This study uses pollen records to shed new light on the history of olive cultivation and large-scale olive management. We employ a fossil pollen dataset composed of high-resolution pollen records obtained across the Mediterranean Basin covering most of the Holocene. Human activity is indicated when Olea pollen percentages rise fairly suddenly, are not accompanied by an increase of other Mediterranean sclerophyllous trees, and when the rise occurs in combination with consistent archaeological and archaeobotanical evidence. Based on these criteria, our results show that the southern Levant served as the locus of primary olive cultivation as early as ~6500 years BP (yBP), and that a later, early/mid 6th millennium BP cultivation process occurred in the Aegean (Crete) – whether as an independent large-scale management event or as a result of knowledge and/or seedling transfer from the southern Levant. Thus, the early management of olive trees corresponds to the establishment of the Mediterranean village economy and the completion of the ‘secondary products revolution’, rather than urbanization or state formation. From these two areas of origin, the southern Levant and the Aegean olive cultivation spread across the Mediterranean, with the beginning of olive horticulture in the northern Levant dated to ~4800 yBP. In Anatolia, large-scale olive horticulture was palynologically recorded by ~3200 yBP, in mainland Italy at ~3400 yBP, and in the Iberian Peninsula at mid/late 3rd millennium BP.
Men’s Refashioning of Masculine Identities in Uganda and Their Self-Management of HIV Treatment
Authors: Russell Steve
Published: February 2019

Studies in sub-Saharan Africa show that masculine identities contribute to men’s relatively lower uptake of HIV services. Although useful, these studies pay less attention to men’s agency to negotiate and refashion masculine identities which better suit their lives as men living with HIV. In this article, I analyze the refashioning of masculine identities among men living with HIV in Uganda, adjustment processes which helped their self-management, and adherence to treatment. In-depth interviews with 18 men are thematically analyzed. Physical recovery was the embodiment of recovered masculinity and underpinned the men’s ability to refashion alternative, hybrid masculinities. Men negotiated and refashioned two forms of dominant masculinity already identified in this context, respectability and reputation, notably being a responsible father again and supporting other men with HIV, and being strong, resilient and an HIV survivor. Understanding men’s refashioning of masculinities can inform service providers’ approaches to reach more men with HIV treatment.