bluuebunny/crossref_metadata_2025 huggingface dataset:
Recurrence of Pancreatic Ductal Adenocarcinoma after Complete Histopathological Remission Caused by FOLFIRINOX
Authors: Höhn Philipp , Braumann Chris , Nöpel-Dünnebacke Stefanie , Munding Johanna , Uhl Waldemar , Luu Andreas Minh
Published: July 2020

We previously reported 2 cases of pathologic complete response (pCR) of a pancreatic cancer (PC) following neoadjuvant FOLFIRINOX treatment. We now complete our report by a follow-up on both patients. Patient 1 achieved a disease-free survival of 12 months after initial resection until she developed a singular hepatic metastasis. Treatment by FOLFIRINOX and complete removal of the metastasis by atypical liver resection after 6 months allowed for another 12 months of disease control. After intra-abdominal tumor recurrence and development of intracerebral metastases, the patient died 34 months after primary diagnosis. Patient 2 developed hepatic tumor recurrence only 3 months after initial resection. However, treatment by FOLFIRINOX led to a stable disease for 27 months after resection and was followed by atypical liver resection of multiple segments. Six months later, another hepatic recurrence was suspected. Via next-generation sequencing (NGS) of the tumor genome, a deleterious mutation in the ataxia telangiectasia-mutated (ATM) gene, causing a BRCAness, was detected. After initial treatment by FOLFOX, maintenance therapy with the poly-ADP-ribose-polymerase (PARP) inhibitor olaparib was initiated. The patient is now alive for 54 months after initial diagnosis of metastasized pancreatic adenocarcinoma. Tumor recurrence is possible even after pCR of PC and remains challenging. In case of multifocal tumor recurrence, chemotherapy remains the standard treatment. Recently, genetic sequencing allows individualized treatments. In selected cases, highly specialized teams can offer a variety of therapeutic options leading to previously unseen clinical courses.
Psoriasis: Die Rolle der Interleukin-23/Th17-Bahnen bei der kardiometabolischen Komorbidität
Authors: Kirsten Natalia
Published: July 2020

Alterations in the innate and adaptive immunity underpin psoriasis pathophysiology, with the Th17 cells subset now recognized as the fundamental cells in the key controlling pathway involved in its pathogenesis. Since psoriasis is a systemic disease with important comorbidity, further knowledge on the interleukin (IL)-23/Th17 axis led to the hypothesis that there may be shared pathogenic pathways between primary skin disease and comorbidity. Psoriasis has been identified as a risk factor for cardiovascular and metabolic disease, and increasing evidence gives support to this epidemiological observation from the clinical-pathologically field. As an example, increased levels of IL-23 and IL-23R have been found in human atherosclerotic plaque, and levels correlated with symptom duration and mortality. Also, upregulation of IL-23/IL-17 seems to play an important role in both myocardial damage and stroke, with interesting reports on deleterious effect neutralization after administration of related anti-bodies in both associated conditions. In diabetic patients, increased levels of IL-23/IL-17 have also been observed and available data support a synergistic role of IL-23/IL-17 in β-cells damage. In obesity, signs of an expansion of Th17 subset in adipose tissue have been reported, as well as elevated concentrations of IL-23 in obese patients. In non-alcoholic fatty liver disease, closely related to metabolic syndrome, but also in other mentioned cardiometabolic disorders, a predominance of IL-23 and other related pro-inflammatory factors has been identified as participating in their pathogenesis. Thus, the involvement of the IL-23/Th17 axis in these shared psoriasis-cardiometabolic pathogenic mechanisms is reviewed and discussed in the light of the existing preclinical and clinical evidence, including that from comorbid psoriasis patients.
Role of Ulcerative Colitis Endoscopic Index of Severity (UCEIS) versus Mayo Endoscopic Subscore (MES) in Predicting Patients′ Response to Biological Therapy and the Need for Colectomy
Authors: Di Ruscio Mirko , Variola Angela , Vernia Filippo , Lunardi Gianluigi , Castelli Paola , Bocus Paolo , Geccherle Andrea
Published: July 2020

Background: The main goal in the treatment of ulcerative colitis (UC) is to achieve mucosal healing. Despite being unvalidated, the most widely used scoring system is the Mayo endoscopic subscore (MES). However, the recently established and validated Ulcerative Colitis Endoscopic Index of Severity (UCEIS) represents an interesting alternative method in assessing endoscopic disease activity. Objective: Due to a lack of reliable prognostic factors, the aim of this study was to investigate the diagnostic accuracy of the UCEIS and the MES, in predicting response to biological therapy and the need for colectomy. Methods: We conducted a retrospective, uncontrolled, single-center study on UC patients with endoscopically active disease even with concomitant conventional and/or biological therapy, who had already started or had been changed a biological treatment. Results: Sixty-one UC patients were enrolled. At baseline, 71% were naive to biological therapies and 41% had an extensive colitis. At control time (median time of 11.5 months), MES and UCEIS scores significantly decreased from those at baseline (from 2.6 to 1.8 and 5 to 3.2, respectively, p < 0.001). UCEIS, but not MES, was found to be significantly associated with unresponsiveness to therapy (p = 0.040). Moreover, when UCEIS was ≥7, all patients underwent colectomy after a median time of 5 months (p < 0.001). Conclusion: UCEIS may be superior to MES because of its accuracy and predictive role. Therefore, UCEIS should be considered for use in daily clinical practice.
Kleinzelliges Lungenkarzinom im limitierten Stadium: Multimodale Behandlung unter Einbeziehung radikaler Resektion
Authors: Lesser Thomas
Published: July 2020

Background: The NCCN (National Comprehensive Cancer Network) Clinical Practice Guidelines in Oncology (NCCN guidelines) recommend radical resection for T1–2N0M0 patients with limited-stage small cell lung cancer (LS-SCLC). However, only about 5% of patients with small cell cancer (SCLC) were initially diagnosed as T1–2N0M0. The purpose of our study was to analyze and compare the effects of the comprehensive treatment including radical surgery and concurrent chemoradiotherapy on the prognosis of patients with LS-SCLC. Methods: We comprehensively reviewed the medical data of patients with SCLC diagnosed by pathology in our hospital from January 2011 to April 2018. The Ethics Committee of West China Hospital of Sichuan University approved the study. Finally, 50 patients with good follow-up and complete medical data were selected as the surgical group (S group). According to the clinical characteristics of the patients in the S group, 102 LS-SCLC patients who received concurrent chemoradiotherapy in the same period were included in the CCRT group (concurrent chemoradiotherapy group) as the control group. Then according to the orders of the adjuvant treatments, the patients in the S group were divided into the SA group (radical surgery + adjuvant chemotherapy + adjuvant radiotherapy group, 30 cases in total) and the NS group (neoadjuvant chemotherapy + radical surgery + adjuvant chemotherapy ± adjuvant radiotherapy group, 20 cases in total) for subgroup analysis. The SPSS 23.0 software was used for statistical analysis, and the t test was used for group comparison; Kaplan-Meier was used for survival analysis. P < 0.05 demonstrates a statistically significant difference. Results: The median progress-free survival (PFS) in the S group (73 months) was significantly better than that in the CCRT group (10.5 months, P < 0.0001), and the median overall survival (OS) in the S group (79 months) was also significantly better than that in the CCRT group (23 months, P < 0.0001). Subgroup analysis showed that there was no significant difference between the NS group and the SA group. Conclusions: For LS-SCLC patients, the comprehensive treatment including radical surgery (radical surgery + adjuvant chemotherapy ± adjuvant radiotherapy/neoadjuvant chemotherapy + radical surgery + adjuvant chemotherapy ± adjuvant radiotherapy) may be superior to concurrent chemoradiotherapy.
Morphological Changes and Potential Mechanisms of Intraocular Pressure Reduction after Micropulse Transscleral Cyclophotocoagulation in Rabbits
Authors: Tsujisawa Tatsuhiko , Ishikawa Hitoshi , Uga Shigekazu , Asakawa Ken , Kono Yusuke , Mashimo Kimiyo , Shoji Nobuyuki
Published: July 2020

Introduction: Micropulse transscleral cyclophotocoagulation (MP-TSCPC) is a method for intraocular pressure (IOP) reduction in patients with glaucoma; however, the specific mechanisms underlying its ability to reduce IOP remain unclear. We therefore investigated the morphological changes and mechanisms of IOP reduction after MP-TSCPC. Methods: The right eyes of 4 pigmented rabbits were treated with MP-TSCPC with power setting corresponding to those used in glaucoma patients (1 power: 2,000 mW; time: 160 s; duty cycle: 31.3%). Power settings of 1, 1/8, 1/16, and 1/32 power were applied to the right eyes. The left eyes were used as controls. A light microscope and electron microscope were used to observe morphological findings after 1 week of MP-TSCPC. IOP and IOP reduction rate were compared before and after MP-TSCPC application on days 1, 3, and 5, and at 1 week. Results: In the pre-MP-TSCPC, IOP was 16.7 ± 0.6 mm Hg. The IOP of rabbit treated with the 1 power was 3 mm Hg, with an IOP reduction rate of 80%; however, the eyes developed phthisis bulbi. The IOP was 7.0 ± 0.0 mm Hg 1 week after MP-TSCPC (IOP reduction rate: 59%) in rabbit treated with the 1/8 power. Reduction in IOP was observed, but there was significant tissue invasion to the ciliary body. The IOP was 10.3 ± 0.6 mm Hg (IOP reduction rate: 40%) 1 week after MP-TSCPC in rabbit treated with the 1/16 power, which was more effective to reduce IOP than that with the 1/8 power. Tissue invasion to the ciliary body was negligible, nonpigmented epithelial cells of the pars plicata were damaged, basal infoldings were destroyed, and repair was accompanied by proliferating tissue. No IOP reduction or tissue change was observed in rabbit treated with the 1/32 power. Conclusion: A potential mechanism for IOP reduction in pigmented rabbits is aqueous humor transport dysfunction due to damage to the nonpigmented epithelial cells of the pars plicata and destruction of basal infoldings. The power of MP-TSCPC was consistent with both morphological changes and IOP reduction.
Apresentação
Authors: Maia Carla , Carvalho Danielle Crepaldi , Morettin Eduardo Victorio , Adamatti Margarida Maria , Machado Patrícia Furtado Mendes , Cardenuto Reinaldo
Published: July 2020

Apresentação da edição 54
Noninvasive Prediction of Elevated Wedge Pressure in Pulmonary Hypertension Patients Without Clear Signs of Left‐Sided Heart Disease: External Validation of the OPTICS Risk Score
Authors: Jansen Samara M. A. , Huis in ‘t Veld Anna. E. , Jacobs Wouter , Grotjohan Hans P. , Waskowsky Marc , van der Maten Jan , van der Weerdt Arno , Hoekstra Romke , Overbeek Maria J. , Mollema Sjoerd A. , Tolen Peter Hans C. G. , Hassan El Bouazzaoui Lahssan H. , Vriend Joris W. J. , Roorda J. Milena M. , de Nooijer Ramon , van der Lee Ivo , Voogel Bart (A. J.) , Peels Kathinka , Macken Thomas , Aerts Jacqueline M. , Vonk Noordegraaf Anton , Handoko M. Louis , de Man Frances S. , Bogaard Harm Jan
Published: July 2020

Background

Although most newly presenting patients with pulmonary hypertension (
PH
) have elevated pulmonary artery wedge pressure, identification of so‐called postcapillary
PH
can be challenging. A noninvasive tool predicting elevated pulmonary artery wedge pressure in patients with incident
PH
may help avoid unnecessary invasive diagnostic procedures.

Methods and Results

A combination of clinical data,
ECG,
and echocardiographic parameters was used to refine a previously developed left heart failure risk score in a retrospective cohort of pre‐ and postcapillary
PH
patients. This updated score (renamed the
OPTICS
risk score) was externally validated in a prospective cohort of patients from 12 Dutch nonreferral centers the OPTICS network. Using the updated
OPTICS
risk score, the presence of postcapillary
PH
could be predicted on the basis of body mass index ≥30, diabetes mellitus, atrial fibrillation, dyslipidemia, history of valvular surgery, sum of
SV
1 (deflection in V1 in millimeters) and
RV
6 (deflection in V6 in millimeters) on ECG, and left atrial dilation. The external validation cohort included 81 postcapillary
PH
patients and 66 precapillary
PH
patients. Using a predefined cutoff of >104, the
OPTICS
score had 100% specificity for postcapillary
PH
(sensitivity, 22%). In addition, we investigated whether a high probability of heart failure with preserved ejection fraction, assessed by the H
2
FPEF
score (obesity, atrial fibrillation, age >60 yrs, ≥2 antihypertensives, E/e' >9, and pulmonary artery systolic pressure by echo >35 mmHg), similarly predicted the presence of elevated pulmonary artery wedge pressure. High probability of heart failure with preserved ejection fraction (H
2
FPEF
score ≥6) was less specific for postcapillary
PH
.

Conclusions

In a community setting, the
OPTICS
risk score can predict elevated pulmonary artery wedge pressure in
PH
patients without clear signs of left‐sided heart disease. The
OPTICS
risk score may be used to tailor the decision to perform invasive diagnostic testing.
Oxidized Low‐Density Lipoprotein Induces Macrophage Production of Prothrombotic Microparticles
Authors: Marchini Julio F. , Manica Andre , Crestani Paulo , Dutzmann Jochen , Folco Eduardo J. , Weber Heinz , Libby Peter , Croce Kevin
Published: July 2020

Background

Activated vascular cells produce submicron prothrombotic and proinflammatory microparticle vesicles. Atherosclerotic plaques contain high levels of microparticles. Plasma microparticle levels increase during acute coronary syndromes and the thrombotic consequences of plaque rupture likely involve macrophage‐derived microparticles (MΦMPs). The activation pathways that promote MΦMP production remain poorly defined. This study tested the hypothesis that signals implicated in atherogenesis also stimulate MΦMP production.

Methods and Results

We stimulated human primary MΦs with proinflammatory cytokines and atherogenic lipids, and measured MΦMP production by flow cytometry. Oxidized low‐density lipoprotein (oxLDL; 25 µg/mL) induced MΦMP production in a concentration‐dependent manner (293% increase;
P
<0.001), and these oxLDL MΦMP stimulatory effects were mediated by CD36. OxLDL stimulation increased MΦMP tissue factor content by 78% (
P
<0.05), and oxLDL‐induced MΦMP production correlated with activation of caspase 3/7 signaling pathways. Salvionolic acid B, a CD36 inhibitor and a CD36 inhibitor antibody reduced oxLDL‐induced MΦMP by 67% and 60%, respectively. Caspase 3/7 inhibition reduced MΦMP release by 52% (
P
<0.01) and caspase 3/7 activation increased MΦMP production by 208% (
P
<0.01). Mevastatin pretreatment (10 µM) decreased oxLDL‐induced caspase 3/7 activation and attenuated oxLDL‐stimulated MΦMP production and tissue factor content by 60% (
P
<0.01) and 43% (
P
<0.05), respectively.

Conclusions

OxLDL induces the production of prothrombotic microparticles in macrophages. This process depends on caspases 3 and 7 and CD36 and is inhibited by mevastatin pretreatment. These findings link atherogenic signaling pathways, inflammation, and plaque thrombogenicity and identify a novel potential mechanism for antithrombotic effects of statins independent of LDL lowering.
Optimal Revascularization Strategy in Non–ST‐Segment–Elevation Myocardial Infarction With Multivessel Coronary Artery Disease: Culprit‐Only Versus One‐Stage Versus Multistage Revascularization
Authors: Kim Min Chul , Hyun Ju Yong , Ahn Youngkeun , Bae SungA , Hyun Dae Young , Cho Kyung Hoon , Sim Doo Sun , Hong Young Joon , Kim Ju Han , Jeong Myung Ho , Kim Hyo‐Soo , Gwon Hyeon Cheol , Seong In Whan , Hwang Kyoung‐Kook , Chae Shung Chull , Hur Seung Ho , Cha Kwang Soo , Oh Seok Kyu
Published: July 2020

Background

Few studies have investigated optimal revascularization strategies in non–ST‐segment–elevation myocardial infarction with multivessel disease. We investigated 3‐year clinical outcomes according to revascularization strategy in patients with non–ST‐segment–elevation myocardial infarction and multivessel disease.

Methods and Results

This retrospective, observational, multicenter study included patients with non–ST‐segment–elevation myocardial infarction and multivessel disease without cardiogenic shock. Data were analyzed at 3 years according to the percutaneous coronary intervention strategy: culprit‐only revascularization (COR), 1‐stage multivessel revascularization (MVR), and multistage MVR. The primary outcome was major adverse cardiac events (MACE: a composite of all‐cause death, nonfatal spontaneous myocardial infarction, or any repeat revascularization). The COR group had a higher risk of MACE than those involving other strategies (COR versus 1‐stage MVR; hazard ratio, 0.65; 95% CI, 0.54–0.77;
P
<0.001; and COR versus multistage MVR; hazard ratio, 0.74; 95% CI, 0.57–0.97;
P
=0.027). There was no significant difference in the incidence of MACE between 1‐stage and multistage MVR (hazard ratio, 1.14; 95% CI, 0.86–1.51;
P
=0.355). The results were consistent after multivariate regression, propensity score matching, inverse probability weighting, and Bayesian proportional hazards modeling. In subgroup analyses stratified by the Global Registry of Acute Coronary Events score, 1‐stage MVR lowered the risk of MACE compared with multistage MVR in low‐to‐intermediate risk patients but not in patients at high risk.

Conclusions

MVR reduced 3‐year MACE in patients with non–ST‐segment–elevation myocardial infarction and multivessel disease compared with COR. However, 1‐stage MVR was not superior to multistage MVR for reducing MACE except in low‐to‐intermediate risk patients.
Clinical Course and Mortality of Stroke Patients With Coronavirus Disease 2019 in Wuhan, China
Authors: Zhang Lijuan , Sun Wenwu , Wang Yujun , Wang Xiaopin , Liu Yanli , Zhao Su , Long Ding , Chen Liangkai , Yu Li
Published: July 2020

Background and Purpose:

No studies have reported the effect of the coronavirus disease 2019 (COVID-19) epidemic on patients with preexisting stroke. We aim to study the clinical course of COVID-19 patients with preexisting stroke and to investigate death-related risk factors.

Methods:

We consecutively included 651 adult inpatients with COVID-19 from the Central Hospital of Wuhan between January 2 and February 15, 2020. Data on the demography, comorbidities, clinical manifestations, laboratory findings, treatments, complications, and outcomes (ie, discharged or death) of the participants were extracted from electronic medical records and compared between patients with and without preexisting stroke. The association between risk factors and mortality was estimated using a Cox proportional hazards regression model for stroke patients infected with severe acute respiratory syndrome coronavirus 2.

Results:

Of the 651 patients with COVID-19, 49 with preexisting stroke tended to be elderly, male, had more underlying comorbidities and greater severity of illness, prolonged length of hospital stay, and greater hospitalization expenses than those without preexisting stroke. Cox regression analysis indicated that the patients with stroke had a higher risk of developing critical pneumonia (adjusted hazard ratio, 2.01 [95% CI, 1.27–3.16]) and subsequent mortality (adjusted hazard ratio, 1.73 [95% CI, 1.00–2.98]) than the patients without stroke. Among the 49 stroke patients, older age and higher score of Glasgow Coma Scale or Sequential Organ Failure Assessment were independent risk factors associated with in-hospital mortality.

Conclusions:

Preexisting stroke patients infected with severe acute respiratory syndrome coronavirus 2 were readily predisposed to death, providing an important message to individuals and health care workers that preventive measures must be implemented to protect and reduce transmission in stroke patients in this COVID-19 crisis.
Ideophonic reduplication of content words in Mandarin Chinese: A category shift and its typological background
Authors: Danqing LIU , Danqing LIU
Published: July 2020

Ideophonic reduplication is a special type of reduplication in Mandarin Chinese. By repeating the mere sounds of a word or expression taken from the linguistic context, it turns content words into temporary ideophones. I argue that this operation highlights the signifiant (the acoustic form) and downplays the signifié (the concept referring to the subject in reality) of the reduplicated segments. This type of reduplication differs from pragmatic repetition, and it has a number of distinctive characteristics. I argue that the development of ideophonic reduplication in Chinese is closely connected with the typological characteristics of Chinese.
Owen revisited: a reappraisal of morphology in evolutionary biology
Authors: Minelli Alessandro , Schram Frederick R.
Published: July 2020

A new analysis within the framework of developmentalgenetics provides both raw data and theoretical support to the “old” morphology and suggests a new, more predictive, approach to the concept of homology. We distinguish between “positional homologues” and “structural homologues” as independent components of the more general concept of homology. We discuss some general patterns seen in the anatomy of animals and in their morphogenesis. Slack et al. (1993) advanced the concepts of the “zootype”, a particular spatial pattern of gene expression, and the “phylotype”, a particular stage of embryonic development that expresses the zootype. We build upon these concepts and expand them. This allows us to propose some additional phylotypes (arthrotype, cyclotype, platytype, malacotype, trimerotype) that may guide future investigations towards understanding the genesis of metazoan form.
New records of Ascomycetes from the Tropical Montane Cloud Forests of eastern Mexico

Authors: RAYMUNDO TANIA , VALENZUELA RICARDO , RAMÍREZ-MARTÍNEZ JULIO CESAR , MARTÍNEZ-PINEDA MICHELLE , VILLAGRÁN AURORA COBOS , TREJO-ARANA ANDREA , SÁNCHEZ-FLORES MARCOS , GAY-GONZÁLEZ ALFONSO D. , LUNA-VEGA ISOLDA
Published: July 2020

The tropical montane cloud forest is an important reservoir of the diversity of Mexican ascomycetes. We cite and describe 17 species that had not been recorded in this vegetation type. Fifteen of them are new records for Mexico. Some of these species are associated with angiosperms and some with other fungi. Ongoing efforts are required to carry out floristic, taxonomic, phylogenetic and ecological studies of this group of fungi in such a diverse ecosystem that is cataloged as threatened.
Additions to Karst Fungi 4: Botryosphaeria spp. associated with woody hosts in Guizhou province, China including B. guttulata sp. nov.

Authors: CHEN YA-YA , DISSANAYAKE ASHA J. , LIU ZUO-YI , LIU JIAN-KUI (JACK)
Published: July 2020

Members of Botryosphaeria encompass important plant pathogens, saprobes and endophytes on a wide range of woody hosts worldwide. Botryosphaeria species are difficult to differentiate due to the overlapping morphological characteristics and the molecular data analyses are necessary recently when species identification is carried out. In this study, 28 Botryosphaeria isolates were obtained from decaying woody hosts in six nature reserves in Guizhou province, China. Based on both morphological characteristics and molecular analysis of combined ITS and tef1-α sequence data, four known species (Botryosphaeria dothidea, B. minutispermatia, B. sinensia and B. wangensis) are identified and one new species B. guttulata is introduced. Botryosphaeria sinensia (32% of the isolates obtained from various hosts) is the abundant species, followed by B. dothidea (28.5% of the isolates), B. guttulata (28.5% of the isolates), B. minutispermatia (7% of the isolates) and B. wangensis (4% of the isolates). These results represent the first study of Botryosphaeria species associated with woody hosts from nature reserves in Guizhou province, China. Our findings indicate that there is a potential of Botryosphaeria species remain to be discovered in this unique landform (Karst formations) in Guizhou province, China.
Headline Indicators for Global Climate Monitoring
Authors: Trewin Blair , Cazenave Anny , Howell Stephen , Huss Matthias , Isensee Kirsten , Palmer Matthew D. , Tarasova Oksana , Vermeulen Alex
Published: July 2020

The World Meteorological Organization has developed a set of headline indicators for global climate monitoring. These seven indicators are a subset of the existing set of essential climate variables (ECVs) established by the Global Climate Observing System and are intended to provide the most essential parameters representing the state of the climate system. These indicators include global mean surface temperature, global ocean heat content, state of ocean acidification, glacier mass balance, Arctic and Antarctic sea ice extent, global CO2 mole fraction, and global mean sea level. This paper describes how well each of these indicators are currently monitored, including the number and quality of the underlying datasets; the health of those datasets; observation systems used to estimate each indicator; the timeliness of information; and how well recent values can be linked to preindustrial conditions. These aspects vary widely between indicators. While global mean surface temperature is available in close to real time and changes from preindustrial levels can be determined with relatively low uncertainty, this is not the case for many other indicators. Some indicators (e.g., sea ice extent) are largely dependent on satellite data only available in the last 40 years, while some (e.g., ocean acidification) have limited underlying observational bases, and others (e.g., glacial mass balance) with data only available a year or more in arrears.
The Post-Wildfire Impact of Burn Severity and Age on Black Carbon Snow Deposition and Implications for Snow Water Resources, Cascade Range, Washington
Authors: Uecker Ted M. , Kaspari Susan D. , Musselman Keith N. , McKenzie Skiles S.
Published: July 2020

Wildfires in the snow zone affect ablation by removing forest canopy, which enhances surface solar irradiance, and depositing light absorbing particles [LAPs, such as black carbon (BC)] on the snowpack, reducing snow albedo. How variations in BC deposition affects post-wildfire snowmelt timing is poorly known and highly relevant to water resources. We present a field-based analysis of BC variability across five sites of varying burn age and burn severity in the Cascade Range, Washington State, United States. Single particle soot photometer (SP2) analyses of BC snow concentrations were used to assess the impact of BC on snow albedo, and radiative transfer modeling was used to estimate the radiative effect of BC on snowmelt. Results were compared to Snowpack Telemetry (SNOTEL) data from one site that burned in 2012 and another in a proximal unburned forest. We show that post-wildfire forests provide a significant source of BC to the snowpack, and this effect increases by an order of magnitude in regions of high versus low burn severity, and decreased by two orders of magnitude over a decade. There is a shift in the timing of snowmelt, with snow disappearance occurring on average 19 ± 9 days earlier post-wildfire (2013–19) relative to pre-wildfire (1983–2012). This study improves understanding of the connection between wildfire activity and snowmelt, which is of high relevance as climate change models project further decreases in snowpack and increases in wildfire activity in the Washington Cascades.
Using Artificial Neural Networks for Generating Probabilistic Subseasonal Precipitation Forecasts over California
Authors: Scheuerer Michael , Switanek Matthew B. , Worsnop Rochelle P. , Hamill Thomas M.
Published: July 2020

Forecast skill of numerical weather prediction (NWP) models for precipitation accumulations over California is rather limited at subseasonal time scales, and the low signal-to-noise ratio makes it challenging to extract information that provides reliable probabilistic forecasts. A statistical postprocessing framework is proposed that uses an artificial neural network (ANN) to establish relationships between NWP ensemble forecast and gridded observed 7-day precipitation accumulations, and to model the increase or decrease of the probabilities for different precipitation categories relative to their climatological frequencies. Adding predictors with geographic information and location-specific normalization of forecast information permits the use of a single ANN for the entire forecast domain and thus reduces the risk of overfitting. In addition, a convolutional neural network (CNN) framework is proposed that extends the basic ANN and takes images of large-scale predictors as inputs that inform local increase or decrease of precipitation probabilities relative to climatology. Both methods are demonstrated with ECMWF ensemble reforecasts over California for lead times up to 4 weeks. They compare favorably with a state-of-the-art postprocessing technique developed for medium-range ensemble precipitation forecasts, and their forecast skill relative to climatology is positive everywhere within the domain. The magnitude of skill, however, is low for week-3 and week-4, and suggests that additional sources of predictability need to be explored.
Ensemble Variability in Rainfall Forecasts of Hurricane Irene (2011)
Authors: Smith Molly B. , Torn Ryan D. , Corbosiero Kristen L. , Pegion Philip
Published: July 2020

Tropical cyclones (TCs) moving into the midlatitudes can produce extreme precipitation, as was the case with Hurricane Irene (2011). Despite the high-impact nature of these events, relatively few studies have explored the sensitivity of TC precipitation forecasts to model initial conditions. Here, the physical processes that modulate precipitation forecasts over the Northeast United States during Irene are investigated using an 80-member 0.5° Global Forecasting System (GFS) ensemble. The members that forecast the highest total precipitation over the Catskill Mountains in New York (i.e., wet members) are compared with the members that predicted the least precipitation (i.e., dry members). Results indicate that the amount of rainfall is tied to storm track, with the wetter members forecast to move farther west than the dry members. This variability in storm track appears to be associated with variability in analyzed upper-tropospheric potential vorticity (PV), such that the wetter members feature greater cyclonic PV southwest of Irene when Irene is off the Carolina coast. By contrast, the wetter members of a 3-km Weather Research and Forecasting (WRF) Model ensemble, initialized from the same GFS ensemble forecasts, show little sensitivity to track. Instead, the wetter members are characterized by stronger lower-tropospheric winds perpendicular to the eastern face of the Catskills, allowing maximum upslope forcing and horizontal moisture flux convergence during the period of heaviest rainfall. The drier members, on the other hand, have the greatest quasigeostrophic forcing for ascent, implying that the members’ differences in mesoscale topographic forcing are the dominant influence on rainfall rate.
The role of social work in the field of education during COVID-19
Authors: Cifuentes-Faura Javier
Published: July 2020

The COVID-19 crisis has meant the suppression of face-to-face educational activity in most countries. Faced with this situation, social workers must guarantee the educational community their support, through telematic media, to ensure the social protection of all students, especially the most vulnerable.
The conundrum of old age and COVID-19 responses in Eswatini and Zimbabwe
Authors: Nhapi Tatenda Goodman , Dhemba Jotham
Published: July 2020

This article explores domains of challenges in guaranteeing enhanced social functioning for Southern African countries of Zimbabwe and Eswatini in the context of COVID-19. Government of Zimbabwe (GoZ) and Government of Ewatini (GoE) social protection interventions targeting COVID-impact mitigation for older persons are analysed within the context of resource constraint challenges. Social security programmes initiated by the GoE and GoZ are analysed while noting emerging milestones and gaps. Finally, pathways for the roles of social workers are proposed.
Microcellular structure assisted phase transformation of polyvinylidene fluoride/titanium dioxide nanocomposites
Authors: Sun Yu-Chen , D’Cunha Jennifer , Naguib Hani E
Published: July 2020

A novel nanocomposite foam with microcellular structures based on poly(vinylidene fluoride) (PVDF) and titanium dioxide (TiO2) was fabricated by the combination of melt compounding and supercritical carbon dioxide (scCO2) foaming. To improve its dielectric performance, silane modified and unmodified titanium dioxide nanoparticles were added as reinforcing fillers at low weight percentages (0.5, 1, and 5 wt%) during the melt blending process. It was found that the incorporation of nanoparticles had a strong influence on cell morphology. As a result, the foaming process significantly altered the dielectric, and mechanical properties of the composite foams. The dielectric constants of the composite foams were no longer frequency dependent while tan delta was lowered at least by a factor of 10. Furthermore, the porous structure generated by foaming also assisted the α-to-β phase transformation of the PVDF matrix in a way similar to mechanical stretching. Such method is superior to other phase transformation techniques since β-phase PVDF can be produced in bulk geometries instead of a thin film configuration.
Part II: On Surviving the Viral Hermeneutics of COVID-19
Authors: DuBose Todd
Published: July 2020

This description is a follow up to the piece, “When COVID-19 Meets Pandemic Hope: Existential Care of, and in, the Impossible,” and offers my own personal lived experience of my partner and I surviving COVID-19. I also offer commentary on the danger of hermeneutical violence and the healing power of hermeneutical reframe.
Migration and the politics of ‘the human’: confronting the privileged subjects of IR
Authors: Squire Vicki
Published: July 2020

In what ways has migration as a field of scholarship contributed to the discipline of International Relations (IR)? How can migration as a lived experience shed light on international politics as a field of interconnections? And how might migration as a political and analytical force compel IR to confront its privileged subjects? This article addresses these questions by focusing specifically on precarious migration from the Global South to the Global North. It shows how critical scholars refuse the suggestion that such migrations pose a ‘global challenge’ or problem to be resolved, considering instead how contemporary practices of governing migration effectively produce precarity for many people on the move. It also shows how critical works point to longer standing racialised dynamics of colonial violence within which such governing practices are embedded, to emphasise both the limitations of liberal humanitarianism as well as the problematic politics of ‘the human’ that this involves. By building on the insights of anti-racist, indigenous and postcolonial scholarship, critical scholars of migration are well placed to draw attention to the privileging of some subjects over others in the study and practice of international politics. The article argues that engaging IR while rejecting the orthodoxies on which the discipline is built remains critical for such works in order to advance understanding of the silences and violences of contemporary international politics.
Asymmetric impact of renewable and non-renewable energy on economic growth in Pakistan: New evidence from a nonlinear analysis
Authors: Abbasi Kashif , Jiao Zhilun , Shahbaz Muhammad , Khan Arman
Published: July 2020

This paper explores the asymmetric relationship between renewable energy consumption, non-renewable energy, and terrorism on economic growth of Pakistan. We applied a novel econometric cointegration method known as a nonlinear autoregressive distributed lag modeling (NARDL). Our empirical findings indicate that positive and negative changes have a significant long-run asymmetric relationship between renewable energy, and terrorism on economic growth. We also found a negative and significant effect of non-renewable energy consumption on economic growth. To keep our environment clean and free of emissions, the study specifies policies that rely on renewable energy sources to boost economic growth. However, reduces terrorism has a positive impact on economic growth in the long-run and shows as an influential tool to combat terrorism in Pakistan. These novel results will help policy-makers and government officials to understand better the role of renewable energy and economic growth in Pakistan's development.
The Effect of Employee Desire and Employee Engagement on Organizational Performance: Evidence from ICT Sector in Kerala, India
Authors: Sabu V.G.  , Manoj M.
Published: July 2020

This study analyses the multivariate effect of employee desire (ED) and employee engagement (EE) on organizational performance (OP). The data were collected from 352 executive employees belonging to public and private information and communications technology (ICT) sector organizations in Kerala, India. The stratified random sampling technique was applied for selecting the samples and the data were collected using a structured questionnaire. The structural equation modeling (SEM) technique was applied to study the causal linkage among the variables. The analysis revealed that OP is positively influenced by ED and EE. The study further confirms the mediation effect of EE in the relationship between ED and OP. The effects are statistically significant. The study furnishes beneficial inputs for practising managers, which can encourage EE and strengthen OP.

JEL Code: M54
Lethal diquat poisoning manifesting as central pontine myelinolysis and acute kidney injury: A case report and literature review
Authors: Xing Jihong , Chu Zhe , Han Dongfeng , Jiang Xiaoming , Zang Xiuxian , Liu Yajie , Gao Song , Sun Lichao
Published: July 2020

Diquat is a nonselective herbicide that is used as a contact and preharvest desiccant to control terrestrial and aquatic vegetation. Increasing numbers of cases of diquat poisoning have recently been reported. Organs commonly affected by diquat poisoning include the kidney, liver, and lung. Neurological involvement of diquat poisoning is relatively rare. A 21-year-old man ingested 100 mL of diquat (20 g/100 mL) 5 hours before admission. Fifteen minutes after ingestion, he developed nausea and vomiting. The patient was sent to the emergency intensive care unit, and gastric lavage was performed. Continuous renal replacement therapy and continuous venovenous hemodiafiltration with hemoperfusion were performed, and methylprednisolone was administered. Five days after admission, the patient developed disturbance of consciousness and positive bilateral Babinski signs. Head computed tomography demonstrated hypodensity in the pons. At 11 days after admission, brain magnetic resonance imaging showed acute pontine demyelination. At 15 days after admission, the patient died of multiple organ dysfunction syndrome. We encountered a case of diquat poisoning with central pontine myelinolysis and acute kidney injury. This case highlights the clinical value of neuroimaging examination for early diagnosis of central pontine myelinolysis.
Multidisciplinary team approach for Merkel cell carcinoma: the European Institute of Oncology experience with focus on radiotherapy
Authors: Zerini Dario , Patti Filippo , Spada Francesca , Fazio Nicola , Pisa Eleonora , Pennacchioli Elisabetta , Prestianni Pierpaolo , Cambria Raffaella , Pepa Matteo , Grana Chiara Maria , Bonomo Guido , Funicelli Luigi , Jereczek-Fossa Barbara Alicja , Orecchia Roberto
Published: July 2020

Objective:

To review the therapeutic strategy in Merkel cell carcinoma (MCC) treated with radiotherapy (RT) discussed in a multidisciplinary tumour board.

Methods:

Clinical records of patients with a diagnosis of MCC and with an indication to undergo RT at the European Institute of Oncology between 2003 and 2018 were reviewed retrospectively.

Results:

Twenty-six patients were included in the analysis (median age 65 years, range 42–87). Nineteen received adjuvant RT, 4 exclusive RT, and the remainder palliative RT. Intensity-modulated RT was used in 13 cases, a 3D conformal technique in 11 cases, and stereotactic RT in 2 cases. No major toxicities were recorded. The median relapse-free survival (RFS) after adjuvant RT was 20.5 months, while for unknown primary MCC, it was 23 months. In the adjuvant setting, median polyomavirus-positive RFS was 21.5 months (range 1–49) and median polyomavirus-negative RFS was only 14 months (range 4–45). Overall, RFS of polyomavirus-positive and polyomavirus-negative patients was 10.5 and 8 months, respectively. After adjuvant RT, only 1 out of 10 patients had a recurrence in the RT field. At the time of data collection, 16 patients were alive with no evidence of disease, 1 patient was alive with advanced status of disease, 8 patients died of disease progression, and 1 patient died of other causes.

Conclusions:

The management of unknown primary and polyomavirus-positive cases, which had a better prognosis in our series, may benefit from a multidisciplinary approach, given the limited data available regarding optimal treatment.
Comparative Evaluation of Fluoride Release From Chemically Cured and Light-Cured Orthodontic Bonding Agents and Surface Alteration of Enamel: An in vitro Study
Authors: Barik Ashish Kumar , Duggal Ritu
Published: July 2020

Introduction: Fluoride is known to reduce demineralization and enhance remineralization which is desirable around orthodontic brackets.

Material and methods: This study was carried out to determine the rate of fluoride release, fluoride content of enamel, and surface alteration of enamel from orthodontic bonding agents. Thirty extracted maxillary first premolars were divided into 2 groups of 15 teeth each. Group A—teeth were bonded with a chemically cured orthodontic bonding agent containing fluoride (Rely-a-Bond, Reliance, Itasca) and group B—teeth were bonded with a light-cured orthodontic bonding agent containing fluoride (Light Bond Reliance, Itasca). All individual sample teeth were used to estimate fluoride release and fluoride content of enamel. The same samples were also used to evaluate enamel surface alterations. The rate of fluoride release from the above 2 orthodontic bonding agents were measured in artificial saliva on day 1, 2, 3, 4, 5, 6, 7, 14, 30, 60, and 90. The fluoride content of the enamel was evaluated on day “0” and day “90” of bonding. The samples were also evaluated for the surface changes in enamel using scanning electron microscope (SEM).

Results: The results showed that (a) chemically cured and light-cured bonding agent showed a dramatic decrease in the concentration of fluoride release from day “1” to day “2,” (b) the concentration of fluoride release kept decreasing from day “1” to day “90” of measurement in both the groups, and (c) SEM of the bracket margins bonded with chemically cured bonding agent and light-cured bonding agent revealed particle depositions of irregular shape and size on day “90.”

Conclusion: Light-cured bonding agent (Light Bond) released higher concentration of fluoride as compared to chemically cured bonding agent (Rely-a-Bond). Light-cured bonding agent (Light Bond) showed higher increase in fluoride content of enamel than chemically cured bonding agent (Rely-a-Bond).
Corporate social responsibility: A supplier-centered perspective
Authors: Lund-Thomsen Peter
Published: July 2020

This article develops a supplier-centered approach to corporate social responsibility (CSR) in global value chains (GVCs) by answering the research question: why are suppliers in the Global South that are integrated into GVCs often highly skeptical of CSR? As CSR constitutes a vague and contested term, we undertake a short review of some of the most dominant CSR conceptions that have emerged in the last 20 years. We argue that these CSR definitions are often framed and promoted by key actors in the Global North, the home of many lead firms, in ways that overlook the unique challenges and broader circumstances faced by suppliers and countries in the Global South. We conclude by combining the key considerations of local suppliers in a more consolidated supplier perspective on CSR in GVCs.
Utilizing Artificial Intelligence for Head and Neck Cancer Outcomes Prediction From Imaging
Authors: Chinnery Tricia , Arifin Andrew , Tay Keng Yeow , Leung Andrew , Nichols Anthony C. , Palma David A. , Mattonen Sarah A. , Lang Pencilla
Published: July 2020

Artificial intelligence (AI)-based models have become a growing area of interest in predictive medicine and have the potential to aid physician decision-making to improve patient outcomes. Imaging and radiomics play an increasingly important role in these models. This review summarizes recent developments in the field of radiomics for AI in head and neck cancer. Prediction models for oncologic outcomes, treatment toxicity, and pathological findings have all been created. Exploratory studies are promising; however, validation studies that demonstrate consistency, reproducibility, and prognostic impact remain uncommon. Prospective clinical trials with standardized procedures are required for clinical translation.
Description of Pharmacogenomic Testing Among Patients Admitted to the Intensive Care Unit After Cardiovascular Surgery
Authors: Peterson Pamela E. , Nicholson Wayne T. , Moyer Ann M. , Arendt Christopher J. , Smischney Nathan J. , Seelhammer Troy G. , Krecke Catherine A. , Haney Rory M. , Yaw Elissa J. , Chlan Linda L.
Published: July 2020

Background:

Pharmacogenomic (PGx) testing has the potential to provide information on specific drug-metabolizing enzymes that may lead to an absence, reduction, or increase in medication effect in patients. There is a paucity of prospective studies examining PGx testing in the intensive care unit (ICU) setting.

Research Aims:

To (1) obtain a PGx panel in a sample of cardiovascular (CV) surgical patients with a planned ICU stay and identify phenotypes, and (2) identify PGx variants that may inform treatment regimens and may warrant prescribing adjustments.

Design and Methods:

Descriptive, single cohort cross-sectional design. Adult (≥18 years) CV patients with an anticipated postoperative ICU stay were enrolled from a large Midwestern tertiary academic medical center. Eligible patients provided informed consent at the time of their CV clinic appointment; PGx testing was then ordered. Pharmacogenomic testing consisted of the Focused Pharmacogenomics panel which included 10 genes and 55 medications.

Results:

Of the 272 patients screened, 100 (68% male) patients completed PGx testing (mean age 66.2 ± 9.6 years, mean Acute Physiology, Age and Chronic Health Evaluation III score 76.1 ± standard deviation). Pharmacogenomic results were available in the medical record within a median of 52.4 hours (interquartile range: 33.4-80.3). Pharmacogenomic testing results identified 5 CYP2C19 poor metabolizers, 26 CYP2C19 rapid metabolizers, 5 CYP2C19 ultrarapid metabolizers, 6 CYP2D6 poor metabolizers, 5 CYP2D6 poor to intermediate metabolizers, and 2 CYP2D6 rapid metabolizers identified. Overall, 98% of patients had actionable or potentially actionable PGx results, including 82% for warfarin, 65% for propafenone, 65% for tramadol, 46% for oxycodone, 45% for metoprolol, 33% for clopidogrel, 32% for proton pump inhibitors, 25% for statins, and 12% for haloperidol.

Conclusions:

A significant portion of patients had identified genetic variants that may warrant changes in medication management during and after CV-ICU stay. It remains to be seen if PGx testing leads to improvements in ICU patient outcomes.