bluuebunny/crossref_metadata_2025 huggingface dataset:
Inertial mass damper for vibration control of cable with sag
Authors: Wang Zhi-Hao , Gao Hui , Fan Bu-qiao , Chen Zheng-Qing
Published: December 2018

It has been theoretically predicted that superior supplemental damping can be generated for a taut cable with an inertial mass damper. This paper extends previous studies to investigate the effect of the cable sag on the efficiency of an inertial mass damper. The general dynamic characteristics of an inclined sag cable with an inertial mass damper installed close to the cable end are theoretically investigated. The parametric analysis of the inertial mass and the damping coefficient of the inertial mass damper are conducted to evaluate the control performance of the cable with different sags. The results show that the inertial mass damper can alleviate the negative effect induced by the cable sag, and the cable sag can even increase modal damping ratios provided by the inertial mass damper. Sags of stay cables used in actual bridges only affect nearly symmetric vibrations of cables, while having little impact on nearly antisymmetric vibrations. The effect of cable sags will reduce the optimal damping coefficient and inertial mass of the inertial mass damper for the first symmetric mode of the cable.
Journalistic memory work and transitional justice in Chile: The case of the declassification of the Colonia Dignidad archives in Berlin
Authors: Gaete Salgado Catalina
Published: December 2018

Transitional justice measures – implemented by states to deal with the aftermaths of past wrongdoings – are covered by the media as news events. As such, they provide a suitable platform for studying interactions between the news media and the past. Nevertheless, journalism’s role as agents of memory in the midst of such processes has often been neglected. This study offers an analysis of how Chilean journalists perceived their roles when covering the declassification of Colonia Dignidad archives, a reparation measure carried out by the German government in 2016. The main results show that the interviewed journalists were aware of their role as agents of memory while also feeling this role being constrained by media routines, which made their coverage constrained and more superficial than they had wanted. This study provides a preliminary analysis of the factors intervening in the practices of news media and past human rights abuses and as such, illuminates the role of journalists into the construction of collective memory within transitional justice scenarios.
International market-oriented strategies for medical tourism destinations
Authors: Borg Erik A. , Ljungbo Kjell
Published: December 2018

Patients seeking medical care are traveling greater distances for treatment. The globalization of health care has given rise to a thriving global medical services industry. The ability to gain access to more advanced treatments and differences in cost and inflexible national health care systems encourage patients to seek treatment abroad. In the new information age, patients seek information about available treatment opportunities with less regard to national boundaries. International hospitals are seeking new marketing strategies for their services. Today, much of the marketing takes place on the Internet, which is accelerating the internationalization of the medical services industry. This article presents a comparative and interpretative study. We have interpreted the market orientation and degree of specialization of hospitals in Singapore and in Sweden, which in turn are compared to leading hospitals in the United States. In this research, we present evidence of different approaches to medical tourism based on different organizational frameworks for the marketing of medical services to international patients. The study indicates that market orientation results in greater emphasis on superior service quality of health care. This in turn leads to the delivery of improved services to patients.
Using Curriculum-Based Measurement to Predict Student Performance on an Eighth-Grade State Reading Assessment
Authors: LeRoux Mindy , Zvoch Keith , Biancarosa Gina
Published: December 2018

The purpose of this study was to investigate the relationship between scores on two common curriculum-based measures (CBMs), oral reading fluency (ORF) and maze, and scores on the previous statewide assessment of reading in Oregon (Oregon Assessment of Knowledge and Skills-Reading/Literature [OAKS-R]). Data obtained from three cohorts of eighth-grade students were used to examine CBM validity, and the relationship between student characteristics and OAKS-R performance. Positive relationships between ORF and maze scores and performance on the OAKS-R were obtained. In addition, the strength of the predictive relationships varied across cohorts, but not as a function of student characteristics. These results suggest that eighth-grade CBM data can be used as an efficient means to identify and intervene with those at risk of performing poorly on the end-of-year, high stakes accountability assessment. Consideration of the tradeoffs associated with using one or more CBMs in middle school is provided.
Preparation and Properties of Cotton-Eastar Nonwovens
Authors: Rong Haoming , Bhat Gajanan S.
Published: December 2018

As biodegradable/compostable cotton-based nonwovens are sustainable materials, there is increasing interest in them, with the expansion of nonwovens into novel applications. Over the past few years, research has been done at the University of Tennessee, Knoxville to produce and evaluate nonwoven products containing cotton/cellulose acetate fibers. Nonwoven fabrics manufactured from cotton and Eastar, a biodegradable thermoplastic fiber have shown great promise. The production of nonwovens by the thermal bonding process from such compositions, and the structure and properties of the resulting products are investigated. The results have shown that, by appropriately selecting the combination of fibers and process conditions, nonwoven fabrics with good performance properties can be produced.
Modeling and controller design for an experimental test bench for aircraft actuators
Authors: Zhou Yong , Zhou Xiaogang
Published: December 2018

The reliable and repeatable experimental ground testing of aircraft actuator is an essential phase before flight testing. It is not an easy task to simulate the alternating aerodynamic forces on actuators reasonably and accurately in a laboratory. In this article, an experimental test bench is designed to simulate the aerodynamic forces by a hydraulic actuator, which replicates the operating conditions that the actuator will encounter in service. In order to improve the force control performance, a feed-forward compensator and a fuzzy proportional–integral–derivative controller are designed. Both simulation and experimental results show that the designed method can improve the control performance.
Product infant failure risk modeling based on quality variation propagation and functional failure dependency
Authors: Chen Zhaoxiang , He Yihai , Liu Fengdi , Zhu Chunling , Zhou Di
Published: December 2018

Product infant failure is the most crucial part of product quality risk that critically affects customer satisfaction. However, most of manufacturers lack sufficient understanding of the formation mechanism of product infant failure and quantitative infant failure risk modeling technology. These issues cause the inefficiency of warranty policy in preventing and controlling infant failure risk. Therefore, first, on the basis of the reverse mapping process of axiomatic design, an infant failure risk formation chain, that is, “process quality variation—physical defect—functional vulnerability—infant failure,” is proposed in this study by considering quality variation propagation and functional failure dependency to determine the inherent formation and dependent enlarging process of the risk. Second, on the basis of the risk formation chain, the infant failure risk is modeled from inherent risk and dependent risk. Specifically, the inherent infant failure risk is computed based on the stream of quality variation in production, whereas the dependent infant failure risk is computed by a Bayesian network by considering the functional failure dependency. Finally, a case study of an illustrative electromechanical system is introduced to verify the applicability of the proposed method. Result shows that the proposed method has a better performance in infant failure risk modeling.
Effects of incision location on specimen quality and complications for temporal artery biopsy
Authors: Czyz Craig N , Allen John B , Cahill Kenneth V , Nabavi Cameron B , Foster Jill A
Published: December 2018

Objectives

Giant cell arteritis is a vision and potentially life-threatening condition requiring prompt and accurate diagnosis. The current gold standard of diagnosis is temporal artery biopsy. The purpose of this study is to review the technique of temporal biopsy in regard to incision placement, and to determine specimen quality and the incidence of complications, specifically seventh nerve injury.

Methods

Retrospective cohort study of 125 consecutive patients (137 biopsies) who underwent temporal artery biopsy. Variables concerning the procedure collected included laterality, incision placement, Doppler ultrasound utilization, length of intraoperative and pathologic specimens, result of the biopsy, motor nerve deficit, brow ptosis, and any intra or postoperative complications.

Results

The patient population was 73% female and 86% Caucasian. The average age at the time of the biopsy was 73.8 (range = 56–89, SD = 8.7). Doppler localization was used on 45% of patients. The mean intraoperative specimen length was 2.6 cm (range = 1.5–4.1, SD = 0.6) and fixed specimen length was 2.0 cm (range = 0.8–4.0, SD = 0.7). Biopsy results were positive in 18% of cases. There were no patients who displayed seventh nerve injury at one-week follow-up. One patient (0.7%) reported persistent anesthesia and one (0.7%) reported persistent paresthesia at the incision site. There were no other intraoperative or postoperative complications reported.

Conclusions

Placement of the incision at or posterior to the temporal hairline reduces the risk of seventh nerve injury. The posterior incision placement did not affect the quality of specimens or decrease the yield of biopsy results as compared to other studies. The overall complication rate (3%) was minimal and did not involve any motor nerve injury.
Analysis of the interaction of thermoacoustic modes with a Green’s function approach
Authors: Bigongiari Alessandra , Heckl Maria
Published: December 2018

In this paper, we will present a fast prediction tool based on a one-dimensional Green's function approach that can be used to bypass numerically expensive computational fluid dynamics simulations. The Green’s function approach has the advantage of providing a clear picture of the physics behind the generation and evolution of combustion instabilities. In addition, the method allows us to perform a modal analysis; single acoustic modes can be treated in isolation or in combination with other modes. In this article, we will investigate the role of higher-order modes in determining the stability of the system. We will initially produce the stability maps for the first and second mode separately. Then the time history of the perturbation will be computed, where both the modes are present. The flame will be modelled by a generic Flame Describing Function, i.e. by an amplitude-dependent Flame Transfer Function. The time-history calculations show the evolution of the two modes resulting from an initial perturbation; both transient and limit-cycle oscillations are revealed. Our study represents a first step towards the modelling of nonlinearity and non-normality in combustion processes.
Endoscopic treatment of chronic pancreatitis in pediatric population: Long‐term efficacy and safety
Authors: Kohoutova D , Tringali A , Papparella G , Perri V , Boškoski I , Hamanaka J , Costamagna G
Published: December 2018

Background

Chronic pancreatitis (CP) in children is an inreasingly recognized disease.

Objective

The purpose of study was to analyse the safety and long‐term efficacy of endoscopic treatment in children with CP.

Methods

Records of 38 patients aged <18 years, referred to the Digestive Endoscopy Unit at Catholic University, Fondazione Policlinico “A. Gemelli” IRCCS between 1991 and 2017, were reviewed. Abdominal pain, analgesia and number of episodes of acute pancreatitis in the pre‐ and post‐ endoscopic retrograde cholangiopancreatography (ERCP) period were evaluated. Need for surgery was assessed. Therapeutic intervention data and complications were interrogated.

Results

In total 158 ERCPs were performed. Median post‐ERCP follow‐up was 7 years. The majority of patients had CP type IV (47%) and type Ib (37%) (Cremer's classification). Major papilla pancreatic sphincterotomy was performed in 47%, major and minor in 24% and minor in 29% of patients. Stones/plugs were removed in at least one ERCPs in 66% individuals. Eleven out of 38 patients had stricture of the pancreatic duct; these were dilated and stented in 5/11 and stented in 6/11. Five complications were recorded (3%). Severity and frequency of abdominal pain improved significantly; p < 0.001. Use of analgesia and number of episodes of acute pancreatitis decreased significantly; p < 0.001. One child required subsequent surgery.

Conclusion

Endoscopic management of symptomatic CP in children is safe and effective.
Charcoal granuloma mimicking breast cancer: an emerging diagnosis
Authors: Salvador Gabriel Lucca de Oliveira , Barbieri Poliana Palma , Maschke Laura , Nunes Anna Luisa Aranha , Louveira Maria Helena , Budel Vinicius Milani
Published: December 2018

Background

Image-guided charcoal injection in suspicious breast lesions for preoperative localization is a procedure that has been increasing over the years because it is safer, faster, and more affordable when compared to needle-wire preoperative localization. To date, no complications have been associated with the method. However, in recent years there have been some reports about charcoal granulomas mimicking malignant lesions in some postoperative patients or in a conservative follow-up.

Purpose

To report a series of 11 cases which had suspicious imaging findings for malignancy and resulted in charcoal granulomas on histopathological analysis.

Material and Methods

A database of 1650 patients that attended our center from January 2007 to June 2018 was reviewed and detected 495 patients who had been previously submitted to ultrasound-guided charcoal marking in a breast lesion. Then, patients whose imaging studies were compatible with new suspicious lesions on mammography, breast ultrasound, and/or magnetic resonance imaging and biopsy of this new lesion indicating charcoal granuloma were selected.

Results

From 495 patients who had undergone charcoal localization injections in previous biopsies, we selected 11 who had new lesions with malignant characteristics on imaging studies but histopathological analysis resulted in charcoal granuloma.

Conclusion

Charcoal granuloma should be considered in patients with previous preoperative injection localization, since the residual charcoal in the breast tissue may form granulomas and mimic malignant lesions on follow-up imaging studies.
Acquired Hemophilia A Presenting as Intramuscular Hematoma
Authors: Al-Shbool Ghassan , Vakiti Anusha
Published: December 2018

Acquired hemophilia A poses a clinical and diagnostic challenge. Although rare, it is still the most common acquired factor deficiency. We present a case of acquired hemophilia A diagnosed in a 71-year-old female who presented with a right thigh hematoma of acute onset. The diagnosis was established based on the coagulation profile along with factor VIII levels, mixing studies, and inhibitor levels. The patient received multiple lines of therapy including steroids, factor VIIa, Obizur (porcine-derived recombinant factor VIII), followed by multiple cycles of chemotherapy including cyclophosphamide and rituximab.
“Black Genius, Asian Fail”: The Detriment of Stereotype Lift and Stereotype Threat in High-Achieving Asian and Black STEM Students
Authors: McGee Ebony
Published: December 2018

Asians are typically situated at the top of the STEM educational and career hierarchy and enjoy a host of material benefits as a result. Thus, their STEM lives are often considered problem-free. This article describes the role of race-based stereotypes in shaping the experiences of high-achieving Black and Asian STEM college students. Their experiences exposed the insidious presence of anti-Black and pro-Asian sentiment, operationalized through the frameworks of stereotype threat and stereotype lift. Stereotype threat and stereotype lift situate the racialized experiences of Black and Asian students as opposites, thereby ignoring their shared marginalization and responses to being stereotyped. I argue that both racial groups endure emotional distress because each group responds to its marginalization with an unrelenting motivation to succeed that imposes significant costs. I aim to demonstrate that Black and Asian college students are burdened with being stereotyped and judged unfairly, enduring sometimes debilitating consequences even while they are praised for fulfilling or defying stereotypes. Discussion includes coalition building among racial groups of color in STEM, serving in part to co-construct racialized psycho-social coping skills, and a strategy for more equitable material outcomes for Black STEMers.
Elastic reflection waveform inversion based on the decomposition of sensitivity kernels
Authors: Ren Zhiming , Li Zhenchun , Gu Bingluo
Published: December 2018

Full-waveform inversion (FWI) has the potential to obtain an accurate velocity model. Nevertheless, it depends strongly on the low-frequency data and the initial model. When the starting model is far from the real model, FWI tends to converge to a local minimum. Based on a scale separation of the model (into the background model and reflectivity model), reflection waveform inversion (RWI) can separate out the tomography term in the conventional FWI kernel and invert for the long-wavelength components of the velocity model by smearing the reflected wave residuals along the transmission (or “rabbit-ear”) paths. We have developed a new elastic RWI method to build the P- and S-wave velocity macromodels. Our method exploits a traveltime-based misfit function to highlight the contribution of tomography terms in the sensitivity kernels and a sensitivity kernel decomposition scheme based on the P- and S-wave separation to suppress the high-wavenumber artifacts caused by the crosstalk of different wave modes. Numerical examples reveal that the gradients of the background models become sufficiently smooth owing to the decomposition of sensitivity kernels and the traveltime-based misfit function. We implement our elastic RWI in an alternating way. At each loop, the reflectivity model is generated by elastic least-squares reverse time migration, and then the background model is updated using the separated traveltime kernels. Our RWI method has been successfully applied in synthetic and real reflection seismic data. Inversion results demonstrate that the proposed method can retrieve preferable low-wavenumber components of the P- and S-wave velocity models, which are reliable to serve as a starting model for conventional elastic FWI. Also, our method with a two-stage inversion workflow, first updating the P-wave velocity using the PP kernels and then updating the S-wave velocity using the PS kernels, is feasible and robust even when P- and S-wave velocities have different structures.
A Behavior-Modification, Clinical-Grade Mobile Application to Improve Breast Cancer Survivors' Accountability and Health Outcomes
Authors: Stubbins Renee , He Tiancheng , Yu Xiaohui , Puppala Mamta , Ezeana Chika F. , Chen Shenyi , Valdivia y Alvarado Miguel , Ensor Joe , Rodriguez Angel , Niravath Polly , Chang Jenny , Wong Stephen T.C. , Patel Tejal
Published: December 2018

Purpose

Only 34% of breast cancer survivors engage in the recommended level of physical activity because of a lack of accountability and motivation. Methodist Hospital Cancer Health Application (MOCHA) is a smartphone tool created specifically for self-reinforcement for patients with cancer through the daily accounting of activity and nutrition and direct interaction with clinical dietitians. We hypothesize that use of MOCHA will improve the accountability of breast cancer survivors and help them reach their personalized goals.

Patients and Methods

Women with stages I to III breast cancer who were at least 6 months post–active treatment with a body mass index (BMI) greater than 25 kg/m2 were enrolled in a 4-week feasibility trial. The primary objective was to demonstrate adherence during weeks 2 and 3 of the 4-week study period (14 days total). The secondary objective was to determine the usability of MOCHA according to the system usability scale. The exploratory objective was to determine weight loss and dietitian-participant interaction.

Results

We enrolled 33 breast cancer survivors who had an average BMI of 31.6 kg/m2. Twenty-five survivors completed the study, and the average number of daily uses was approximately 3.5 (range, 0 to 12) times/day; participants lost an average of 2 lbs (+4 lbs to −10.6 lbs). The average score of usability (the second objective) was 77.4, which was greater than the acceptable level. More than 90% of patients found MOCHA easy to navigate, and 84% were motivated to use MOCHA daily.

Conclusion

This study emphasizes the importance of technology use to improve goal adherence for patients by providing real-time feedback and accountability with the health care team. MOCHA focuses on the engagement of the health care team and is integrated into clinical workflow. Future directions will use MOCHA in a long-term behavior modification study.
Phase I/II Study of Stem-Cell Transplantation Using a Single Cord Blood Unit Expanded Ex Vivo With Nicotinamide
Authors: Horwitz Mitchell E. , Wease Stephen , Blackwell Beth , Valcarcel David , Frassoni Francesco , Boelens Jaap Jan , Nierkens Stefan , Jagasia Madan , Wagner John E. , Kuball Jurgen , Koh Liang Piu , Majhail Navneet S. , Stiff Patrick J. , Hanna Rabi , Hwang William Y.K. , Kurtzberg Joanne , Cilloni Daniela , Freedman Laurence S. , Montesinos Pau , Sanz Guillermo
Published: December 2018

Purpose

Increasing the number of hematopoietic stem and progenitor cells within an umbilical cord blood (UCB) graft shortens the time to hematopoietic recovery after UCB transplantation. In this study, we assessed the safety and efficacy of a UCB graft that was expanded ex vivo in the presence of nicotinamide and transplanted after myeloablative conditioning as a stand-alone hematopoietic stem-cell graft.

Methods

Thirty-six patients with hematologic malignancies underwent transplantation at 11 sites.

Results

The cumulative incidence of neutrophil engraftment at day 42 was 94%. Two patients experienced secondary graft failure attributable to viral infections. Hematopoietic recovery was compared with that observed in recipients of standard UCB transplantation as reported to the Center for International Blood and Marrow Transplant Research (n = 146). The median time to neutrophil recovery was 11.5 days (95% CI, 9 to 14 days) for recipients of nicotinamide-expanded UCB and 21 days (95% CI, 20 to 23 days) for the comparator ( P < .001). The median time to platelet recovery was 34 days (95% CI, 32 to 42 days) and 46 days (95% CI, 42 to 50 days) for the expanded and the comparator cohorts, respectively ( P < .001). The cumulative incidence of grade 2 to 4 acute graft-versus-host disease (GVHD) at day 100 was 44%, and grade 3 and 4 acute GVHD at day 100 was 11%. The cumulative incidence at 2 years of all chronic GVHD was 40%, and moderate/severe chronic GVHD was 10%. The 2-year cumulative incidences of nonrelapse mortality and relapse were 24% and 33%, respectively. The 2-year probabilities of overall and disease-free survival were 51% and 43%, respectively.

Conclusion

UCB expanded ex vivo with nicotinamide shortens median neutrophil recovery by 9.5 days (95% CI, 7 to 12 days) and median platelet recovery by 12 days (95% CI, 3 to 16.5 days). This trial establishes feasibility, safety, and efficacy of an ex vivo expanded UCB unit as a stand-alone graft.
Phase I/II Trial to Evaluate the Efficacy and Safety of Nanoparticle Albumin-Bound Paclitaxel in Combination With Gemcitabine in Patients With Pancreatic Cancer and an ECOG Performance Status of 2
Authors: Macarulla Teresa , Pazo-Cid Roberto , Guillén-Ponce Carmen , López Rafael , Vera Ruth , Reboredo Margarita , Muñoz Martin Andrés , Rivera Fernando , Díaz Beveridge Roberto , La Casta Adelaida , Martín Valadés José , Martínez-Galán Joaquina , Ales Immaculada , Sastre Javier , Perea Sofia , Hidalgo Manuel
Published: December 2018

Purpose

Gemcitabine plus nanoparticle albumin-bound (NAB) paclitaxel (GA) significantly improved survival compared with gemcitabine alone in patients with metastatic pancreatic ductal adenocarcinoma (PDAC) and a Karnofsky performance status (PS) of 70% or greater. Because of the low number of patients with reduced PS, the efficacy of this regimen in fragile patients remains unclear. This study aimed to evaluate the efficacy and tolerability of different GA dosing regimens in patients with a poor PS.

Patients and Methods

In the phase I part of this study, patients were randomly assigned to one of the following four parallel GA treatment arms (six patients per arm): a biweekly schedule of NAB-paclitaxel (150 mg/m2 [arm A] or 125 mg/m2 [arm C]) plus gemcitabine 1,000 mg/m2 or a standard schedule of 3 weeks on and 1 week off of NAB-paclitaxel (100 mg/m2 [arm B] or 125 mg/m2 [arm D]) plus gemcitabine 1,000 mg/m2. The two regimens with the better tolerability profile on the basis of predefined criteria were evaluated in the phase II part of the study, the primary end point of which was 6-month actuarial survival.

Results

Arms B and D were selected for the phase II part of the study. A total of 221 patients (111 patients in arm B and 110 patients in arm D) were enrolled. Baseline characteristics including median age (71 and 68 years in arms B and D, respectively), sex (51% and 55% men in arms B and D, respectively), and metastatic disease (88% and 84% in arms B and D, respectively) were comparable between arms. The most frequent grade 3 or 4 toxicities in arms B and D were anemia (12% and 7%, respectively), neutropenia (32% and 30%, respectively), thrombocytopenia (7% and 11%, respectively), asthenia (14% and 16%, respectively), and neurotoxicity (11% and 16%, respectively). In arms B and D, there were no significant differences in response rate (24% and 28%, respectively), median progression-free survival (5.7 and 6.7 months, respectively), and 6-month overall survival (63% and 69%, respectively).

Conclusion

NAB-paclitaxel administered at either 100 and 125 mg/m2 in combination with gemcitabine on days 1, 8, and 15 every 28 days is well tolerated and results in acceptable safety and efficacy in patients with metastatic pancreatic ductal adenocarcinoma and a poor PS.
Global Development of Anticancer Therapies for Rare Cancers, Pediatric Cancers, and Molecular Subtypes of Common Cancers
Authors: Lyerly H. Kim , Ren Jun , Canetta Renzo , Kim Gi Hyun , Nagai Sumimasa , Yamaguchi Tomohiro , Hatogai Ken , Katayama Hiroshi , Da Rocha Dias Silvy , McManus Daniel , Soltys Kathy , Yang Zhimin , Olopade Olufumilayo , Goodman Nancy , Reaman Greg , Gross Thomas
Published: December 2018

Advances in genetic sequencing and other diagnostic technologies have enabled the use of precision medicine in clinical cancer care, as well as the development of novel therapies that are targeted to specific molecular drivers of cancer. Developing these new agents and making them accessible to patients requires global clinical studies and regulatory review and approval by different national regulatory agencies. Whereas these global trials present challenges for drug developers who conduct them and regulatory agencies who oversee them, they also raise practical issues about patients with low-frequency cancers who need these therapies. A lack of uniform standards in both regulatory approval for marketing and reimbursement for approved agents across countries may make the newly developed agent either unavailable or inaccessible to patients in certain countries or regions, even if patients from those countries or regions participated in the clinical research that established the safety and efficacy of the agent. In an effort to further understand and address this need, we convened an international workshop in 2017 in North Bethesda, MD. After presentations of the individual regulatory pathways for marketing approval and reimbursement for individual nations, participants discussed expedited pathways and specific challenges for uncommon cancers. As a matter of justice, agents being developed for rare cancers, pediatric cancers, or uncommon molecular subsets of common cancers need a pragmatic, science-based regulatory policy framework to clearly specify the type and quantity of evidence needed to demonstrate efficacy from these trials and evidence to support accessibility.
Unplanned Hospitalization Among Individuals With Cancer in the Year After Diagnosis
Authors: Whitney Robin L. , Bell Janice F. , Tancredi Daniel J. , Romano Patrick S. , Bold Richard J. , Wun Ted , Joseph Jill G.
Published: December 2018

PURPOSE:

Reducing acute care use is an important strategy for improving value in cancer care. However, little information is available to describe and compare population-level hospital use across cancer types. Our aim was to estimate unplanned hospitalization rates and to describe the reasons for hospitalization in a population-based cohort recently diagnosed with cancer.

MATERIALS AND METHODS:

California Cancer Registry data linked with administrative inpatient data were used to examine unplanned hospitalization among individuals diagnosed with cancer between 2009 and 2012 (n = 412,850). Hospitalizations for maintenance chemotherapy, radiotherapy, or planned surgery were excluded. Multistate models were used to estimate age-adjusted unplanned hospitalization rates, accounting for survival.

RESULTS:

Approximately 67% of hospitalizations in the year after diagnosis were unplanned, 35% of newly diagnosed individuals experienced an unplanned hospitalization, and 67% of unplanned hospitalizations originated in the emergency department (ED). Nonmalignancy principal diagnoses most frequently associated with unplanned hospitalization included infection (15.8%) and complications of a medical device or care (6.5%). Unplanned hospitalization rates were highest for individuals with hepatobiliary or pancreatic cancer (2.08 unplanned hospitalizations per person-year at risk), lung cancer (1.58 unplanned hospitalizations), and brain or CNS cancer (1.47 unplanned hospitalizations), and were lowest among individuals with prostate cancer (0.18 unplanned hospitalizations) and melanoma (0.25 unplanned hospitalizations).

CONCLUSION:

The population burden of unplanned hospitalization among individuals newly diagnosed with cancer is substantial. Many unplanned hospitalizations originate in the ED and are associated with potentially preventable admission diagnoses. Efforts to reduce unplanned hospitalization might target subgroups at higher risk and focus on the ED as a source of admission.
Proton Sensitivity of Corticotropin-Releasing Hormone Receptor 1 Signaling to Proopiomelanocortin in Male Mice
Authors: Kameda Hiraku , Yamamoto Masaaki , Tone Yukiko , Tone Masahide , Melmed Shlomo
Published: December 2018

Because an acidic cellular microenvironment is engendered by inflammation and may determine cell differentiation, we elucidated the impact of acidic conditions on induction of proopiomelanocortin (POMC) expression. Here, we demonstrate mechanisms for proton sensitivity of CRH receptor 1 (CRHR1) signaling to POMC and ACTH production. Low pH (6.8) resulted in doubling of POMC expression and ACTH production in pituitary cell line AtT-20 and in primary mouse pituitary cells. Using CRISPR knockout, we show that CRHR1 is necessary for acid-induced POMC expression, and this induction is mediated by CRHR1 histidine residues and calmodulin-dependent protein kinase II in both pituitary corticotroph cells and in nonpituitary cell lines expressing ectopic ACTH. In contrast, CRH ligand binding affinity to CRHR1 was decreased with acidic pH, implying that proton-induced POMC expression prevails in acidic conditions independently of CRH ligand binding. The results indicate that proton-induced CRHR1 signaling regulates ACTH production in response to an acidic microenvironment.
The overlap between miscarriage and extreme preterm birth in a limited-resource setting on the Thailand-Myanmar border: a population cohort study
Authors: McGready Rose , Paw Moo Kho , Wiladphaingern Jacher , Min Aung Myat , Carrara Verena I. , Moore Kerryn A. , Pukrittayakamee Sasithon , Nosten François H.
Published: December 2018

Background : No universal  demarcation of gestational age  distinguishes miscarriage and stillbirth or extreme preterm birth (exPTB). This study provides a synopsis of outcome between 22 to <28 weeks gestation from a low resource setting.

Methods : A retrospective record review of a population on the Thailand-Myanmar border was conducted. Outcomes were classified as miscarriage, late expulsion of products between 22 to < 28 weeks gestation with evidence of non-viability (mostly ultrasound absent fetal heart beat) prior to 22 weeks; or  exPTB (stillbirth/live born) between 22 to < 28 weeks gestation when the fetus was viable at ≥22 weeks. Termination of pregnancy and gestational trophoblastic disease were excluded.

Results : From 1995-2015, 80.9% (50,046/ 61,829) of registered women had a known pregnancy outcome, of whom 99.8% (49,931) had a known gestational age. Delivery  between 22 to <28 weeks gestation included 0.9% (472/49,931) of pregnancies after removing 18 cases (3.8%) who met an exclusion criteria. Most  pregnancies had an ultrasound: 72.5% (n=329/454);  43.6% (n=197) were classified as  miscarriage and 56.4% (n=257) exPTB.  Individual record review of miscarriages estimated that fetal death had occurred at a median of 16 weeks, despite late expulsion between 22 to <28 weeks. With available data (n=252, 5 missing) the proportion of stillbirth was 47.6% (n=120), congenital abnormality 10.5% (24/228, 29 missing) and neonatal death was 98.5% (128/131, 1 missing). Introduction of ultrasound was associated with a 2-times higher odds of classification of outcome as exPTB rather than miscarriage.

Conclusion : In this low resource setting few (<1%) pregnancy outcomes occurred in the 22 to <28 weeks gestational window; four in ten  were miscarriage (late expulsion) and neonatal mortality approached 100%.  In the scale-up to preventable newborns deaths (at least initially) greater benefits will be obtained by focusing on the viable newborns of ≥ 28 weeks gestation.
Genomic and transcriptomic comparisons of closely related malaria parasites differing in virulence and sequestration pattern
Authors: Lin Jing-wen , Reid Adam J. , Cunningham Deirdre , Böhme Ulrike , Tumwine Irene , Keller-Mclaughlin Sara , Sanders Mandy , Berriman Matthew , Langhorne Jean
Published: December 2018

Background: Malaria parasite species differ greatly in the harm they do to humans. While P. falciparum kills hundreds of thousands per year, P. vivax kills much less often and P. malariae is relatively benign. Strains of the rodent malaria parasite Plasmodium chabaudi show phenotypic variation in virulence during infections of laboratory mice. This make it an excellent species to study genes which may be responsible for this trait. By understanding the mechanisms which underlie differences in virulence we can learn how parasites adapt to their hosts and how we might prevent disease.

Methods: Here we present a complete reference genome sequence for a more virulent P. chabaudi strain, PcCB, and perform a detailed comparison with the genome of the less virulent PcAS strain.

Results: We found the greatest variation in the subtelomeric regions, in particular amongst the sequences of the pir gene family, which has been associated with virulence and establishment of chronic infection. Despite substantial variation at the sequence level, the repertoire of these genes has been largely maintained, highlighting the requirement for functional conservation as well as diversification in host-parasite interactions. However, a subset of pir genes, previously associated with increased virulence, were more highly expressed in PcCB, suggesting a role for this gene family in virulence differences between strains. We found that core genes involved in red blood cell invasion have been under positive selection and that the more virulent strain has a greater preference for reticulocytes, which has elsewhere been associated with increased virulence.

Conclusions: These results provide the basis for a mechanistic understanding of the phenotypic differences between Plasmodium chabaudi strains, which might ultimately be translated into a better understanding of malaria parasites affecting humans.
Measuring and Exploiting the Impact of Exhibition Scheduling on Museum Attendance
Authors: Martínez-de-Albéniz Victor , Valdivia Ana
Published: December 2018

Problem definition: Attendance at a museum fluctuates over time and is largely dependent on the exhibitions on display. Schedules can be adjusted to maximize the museum's objectives. Academic/practical relevance: In this paper, we build a model to study and manage the impact of exhibitions on the number of museum visitors. Methodology: We first estimate the model using data collected from two large museums in Barcelona. We then build an optimization framework in which the museum operator can choose the best duration and synchronization of exhibitions. Results: We find that, in addition to seasonality, exhibition type, display location, and life cycle affect attendance significantly. We characterize the optimal schedule: optimal durations increase with exhibition attractiveness and seasonality factors, and multiple exhibitions should be synchronized when there are no penalties from congestion. Managerial implications: Operations research techniques and in particular exhibition scheduling can be a valuable lever for museums to increase their impact on visitors.
Pressure ulcer definitions and core curricula—how does this affect wound care and the older patient?
Authors: Blackburn Joanna , Ousey Karen
Published: December 2018

Chronic wounds are associated with a significant patient, healthcare and financial burden and can have extensive implications for healthcare. Age is a significant risk factor for developing chronic wounds, due to physical changes in skin integrity and several age-related complex comorbidities, including poor nutrition and mobility. Pressure ulcers (PU) are a common type of chronic wound that can have a substantial impact on health-related quality of life and patient outcomes. Understanding the extent of PU harm is problematic, due to discrepancies in the definition, recording and reporting of PUs on both a local and national level. Education and training are central to ensuring the risk factors associated with PU development are recognised, and a consistent and coherent structure to the definition, measurement and reporting of PUs across the NHS is developed.
Análisis y reflexión sobre el alcance del desarrollo de conciencia corpórea en la formación docente universitaria
Authors: Guillén Elcira Claudia
Published: December 2018

Este artículo propone una reflexión sobre lo que implica el desarrollo de conciencia de corporeidad en la constitución de subjetividades autónomas vinculadas al ejercicio pleno de la ciudadanía. Se postula la Expresión Corporal como disciplina artística que, concibiendo a la persona que la vivencia como sujeto que es en su cuerpo, propicia el desarrollo de conciencia holística, aquella que lo dimensiona en su humanidad: sujeto creativo, meta cognitivo, que se constituye en una sociedad y en una cultura, siendo quien la significa y re-significa. Para ello, se describe la Expresión Corporal en relación a la conciencia de corporeidad; se puntualiza la concepción de cuerpo que impera en el sistema universitario; y se pone en las voces de las estudiantes el impacto del ejercicio de la Expresión Corporal en su formación docente universitaria. Este análisis arroja resultados que permiten el arribo a conclusiones vinculantes entre formación universitaria y conciencia de corporeidad.
Reconstitución epistémica/estética: la aesthesis decolonial una década después
Authors: Mignolo Walter
Published: December 2018

Mi argumento conjuga dos instancias decoloniales. La primera es la re-orientación decolonial introducida por Aníbal Quijano (en 1990) en el mero cierre de la Guerra Fría. En los 80s era ya evidente que los objetivos de la descolonización no podrían lograrse por medio de la fundación de Estados nacionales. Quijano intuyó que la colonialidad del poder era un estructura invisible y subyacente de la civilización occidental, oculta bajo las promesas vertidas en nombre de la modernidad. Para Quijano la tarea decolonial era, en primer lugar, desprendernos de la colonialidad del poder y, en segundo lugar, engancharnos en la reconstitución epistemológica. La segunda instancia, 20 años después, fue la introducción de reflexiones decoloniales en el marco de la colonialidad del poder de la restitución estética. En los procesos de avanzar en la reconstitución epistemológica y estética, rescatamos el concepto de aestésis (aiesthésis) del olvido al que la relegó la hegemonía de la estética. Aunque el vocablo proviene de Grecia, nos apropiamos de ella en el marco del pensamiento decolonial. En este ensayo reintroduzco el concepto de gnosis, ya incorporado en Local Histories/Global Designs (2000), para re-organizar los sentidos y la política de la reconstitución epistémica/estética (dos conceptos moderno/coloniales) mediante la introducción de gnosis y aestésica, dos conceptos decoloniales apropiados y expropiados del Griego antiguo y sepultados en el vocabulario moderno/colonial.
Modelo para la evaluación de habilidades profesionales en un sistema de laboratorios a distancia
Authors: Mar Cornelio Omar , Gulín González Jorge
Published: December 2018

La evaluación del comportamiento de los estudiantes en el desarrollo de sus actividades profesionales representa un elemento importante para medir su rendimiento académico. En la Universidad Central Martha Abreu de las Villas se implementan prácticas profesionales a distancias mediante un sistema de laboratorios a distancia. Sin embargo, no se cuenta con procedimientos que permita mediar las habilidades profesionales. La presente investigación describe una solución a la problemática planteada a partir del desarrollo de un modelo para la evaluación de habilidades profesionales para el sistema de laboratorios a distancia. El modelo propuesto utiliza un enfoque multicriterio multiexperto con el empleo de mapa cognitivo difuso para representar el conocimiento causal. Se aplican dos experimentos para comprobar el impacto de la propuesta utilizándose la prueba no paramétrica de rango con signo de Wilconxon. Se obtuvo como resultado del primer experimento que existe una diferencia estadística significativa del control de acceso inferido por el modelo respecto al total de personas que desarrollaron las prácticas de laboratorios; en el segundo experimento se comprobó que no existe una diferencia estadística significativa del control de acceso inferido por el modelo respecto al desarrollo exitoso de las prácticas de laboratorio. Los resultados corroboran que su aplicación garantiza el diagnóstico de habilidades profesionales para el control de acceso de las prácticas de laboratorios en el sistema de laboratorios a distancia.
BEKERJANYA HUKUM TENTANG DESA DI RANAH PEMBERDAYAAN POLITIK, SOSIAL, DAN EKONOMI PEREMPUAN DESA
Authors: Kushandajani Kushandajani
Published: December 2018

Kehadiran UU No. 6/2014 tentang Desa diharapkan berperan sebagai daya ungkit pembangunan desa, dimana secara eksplisit mengakui peran perempuan di dalamnya. Namun apakah perempuan yang tinggal di desa mampu menjawab persoalan ini melalui penelusuran tiga dimensi pemberdayaan perempuan yaitu politik, sosial, dan ekonomi ? Penelitian kualitatif non-doktriner dipilih dengan penggunaan teknik pengumpulan data wawancara mendalam dan FGD. Hasil penelitian menunjukkan di ranah politik keikutsertaan perempuan di struktur pemerintahan desa maupun di Badan Permusyawaratan Desa sangat sedikit dan  tidak ambil peran penting dalam proses pengambilan keputusan. Dalam dimensi sosial, perempuan terlibat  kuat di bidang pendidikan, kesehatan, pendampingan hukum, dan penanggulangan kemiskinan.. Dalam dimensi ekonomi perempuan juga kuat perannya dalam pengembangan ekonomi lokal, seperti pertanian dan industri rumah tangga. Simpulan riset menunjukkan bahwa pemberdayaan perempuan terlihat kuat di non-politik area.
PERLINDUNGAN HUKUM TERHADAP INVESTOR EMAS
Authors: Prananingtyas Paramita
Published: December 2018

Emas, suatu benda yang sangat bernilai. Selama berabad-abad telah diakui sebagai logam mulia, yang mendapatkan tempat tertinggi sebagai pilihan investasi masyarakat.  Investor-investor yang tergiur dengan keuntungan maksimal yang ditawarkan dari berinvestasi pada emas inilah yang menjadi sasaran empuk para pengelola investasi emas illegal. Keadaan tersebut memunculkan beberapa masalah dalam naskah ini, antara lain mengenai bentuk investasi emas dan  bentuk perlindungan hukum bagi para investor yang terlibat dalam penipuan investasi emas. Metode penelitian dalam penelitian ini adalah yuridis empiris, dengan teknik purposive sampling. Hasil penelitian yang diperoleh adalah investasi emas dapat dilakukan dengan berbagai cara antara lain melalui pembelian emas perhiasan dengan kadar 22 karat. 18 karat dan 12 karat, emas batangan dengan kadar 24 karat, emas koin dengan kadar 22 karat dan berinvestasi emas secara tidak langsung atau berjangka dengan sistem online. Penipuan investasi emas dilakukan oleh para pengelola jasa investasi emas yang tidak menyerahkan emas dalam bentuk fisik kepada para investor dan memakai sistem money game atau skema ponzy untuk menarik minat para calon investor. Perlindungan hukum bagi para investor emas telah diatur oleh Otoritas Jasa Keuangan (OJK) melalui Satgas Waspada Investasi, SiPeka dan FCC. Namun pelaksanaan tugas dan kewenangan OJK ini masih belum maksimal.