bluuebunny/crossref_metadata_2025 huggingface dataset:
Exosomes from Nischarin-Expressing Cells Reduce Breast Cancer Cell Motility and Tumor Growth
Authors: Maziveyi Mazvita , Dong Shengli , Baranwal Somesh , Mehrnezhad Ali , Rathinam Rajamani , Huckaba Thomas M. , Mercante Donald E. , Park Kidong , Alahari Suresh K.
Published: January 2019

Exosomes are small extracellular microvesicles that are secreted by cells when intracellular multivesicular bodies fuse with the plasma membrane. We have previously demonstrated that Nischarin inhibits focal adhesion formation, cell migration, and invasion, leading to reduced activation of focal adhesion kinase. In this study, we propose that the tumor suppressor Nischarin regulates the release of exosomes. When cocultured on exosomes from Nischarin-positive cells, breast cancer cells exhibited reduced survival, migration, adhesion, and spreading. The same cocultures formed xenograft tumors of significantly reduced volume following injection into mice. Exosomes secreted by Nischarin-expressing tumors inhibited tumor growth. Expression of only one allele of Nischarin increased secretion of exosomes, and Rab14 activity modulated exosome secretions and cell growth. Taken together, this study reveals a novel role for Nischarin in preventing cancer cell motility, which contributes to our understanding of exosome biology.

Significance:

Regulation of Nischarin-mediated exosome secretion by Rab14 seems to play an important role in controlling tumor growth and migration.

See related commentary by McAndrews and Kalluri, p. 2099
WNT/β-catenin Pathway Activation Correlates with Immune Exclusion across Human Cancers
Authors: Luke Jason J. , Bao Riyue , Sweis Randy F. , Spranger Stefani , Gajewski Thomas F.
Published: January 2019

Purpose:

The T-cell-inflamed phenotype correlates with efficacy of immune-checkpoint blockade, whereas non-T-cell-inflamed tumors infrequently benefit. Tumor-intrinsic WNT/β-catenin signaling mediates immune exclusion in melanoma, but association with the non-T-cell-inflamed tumor microenvironment in other tumor types is not well understood.

Experimental Design:

Using The Cancer Genome Atlas (TCGA), a T-cell-inflamed gene expression signature segregated samples within tumor types. Activation of WNT/β-catenin signaling was inferred using three approaches: somatic mutations or somatic copy number alterations (SCNA) in β-catenin signaling elements including CTNNB1, APC, APC2, AXIN1, and AXIN2; pathway prediction from RNA-sequencing gene expression; and inverse correlation of β-catenin protein levels with the T-cell-inflamed gene expression signature.

Results:

Across TCGA, 3,137/9,244 (33.9%) tumors were non-T-cell-inflamed, whereas 3,161/9,244 (34.2%) were T-cell-inflamed. Non-T-cell-inflamed tumors demonstrated significantly lower expression of T-cell inflammation genes relative to matched normal tissue, arguing for loss of a natural immune phenotype. Mutations of β-catenin signaling molecules in non-T-cell-inflamed tumors were enriched three-fold relative to T-cell-inflamed tumors. Across 31 tumors, 28 (90%) demonstrated activated β-catenin signaling in the non-T-cell-inflamed subset by at least one method. This included target molecule expression from somatic mutations and/or SCNAs of β-catenin signaling elements (19 tumors, 61%), pathway analysis (14 tumors, 45%), and increased β-catenin protein levels (20 tumors, 65%).

Conclusions:

Activation of tumor-intrinsic WNT/β-catenin signaling is enriched in non-T-cell-inflamed tumors. These data provide a strong rationale for development of pharmacologic inhibitors of this pathway with the aim of restoring immune cell infiltration and augmenting immunotherapy.

See related commentary by Dangaj et al., p. 2943
PRMT5-mediated H4R3sme2 Confers Cell Differentiation in Pediatric B-cell Precursor Acute Lymphoblastic Leukemia
Authors: Mei Mei , Zhang Ruidong , Zhou Zhong-Wei , Ying Zhengzhou , Wang Jincheng , Zhang Han , Zheng Huyong , Bao Shilai
Published: January 2019

Purpose:

Little is known about the function of histone arginine methylation in acute lymphoblastic leukemia (ALL). The objective was to evaluate whether protein arginine methyltransferase 5 (PRMT5) plays a role in pediatric ALL and to determine the possible mechanism of epigenetic regulation.

Experimental Design:

We used bone marrow samples from patients with pediatric ALL, the Nalm6 cell line, mature B-cell lines, and mouse xenograft models to evaluate the function of PRMT5 in ALL tumorigenesis.

Results:

This study showed that PRMT5 and the symmetric dimethylation of H4R3 (H4R3sme2) were upregulated in most initially diagnosed (n = 15; 100%) and relapsed (n = 4; 75%) bone marrow leukemia cells from patients with pediatric B-cell precursor ALL (BCP-ALL) and were decreased when the disease was in remission (n = 15; 6.7%). Downregulation of H4R3sme2 by PRMT5 silencing induced BCP-ALL cell differentiation from the pre-B to immature B stage, whereas overexpressed PRMT5 with enhanced H4R3sme2 promoted human mature B cells to dedifferentiate back to the pre-B II/immature B stages in vitro. High PRMT5 expression enhanced the proportion of CD43+/B220+/sIgM− B leukocytes in recipient mice. CLC and CTSB were identified as potential target genes of PRMT5 in BCP-ALL cells and were inhibited by H4R3sme2 in gene promoters.

Conclusions:

We demonstrate that enhanced PRMT5 promotes BCP-ALL leukemogenesis partially by the dysregulation of B-cell lineage differentiation. H4R3sme2 and PRMT5 may serve as potential sensitive biomarkers of pediatric BCP-ALL. Suppression of the activation of PRMT5 may offer a promising therapeutic strategy against pediatric BCP-ALL.
Successful Treatment with Taxane-Based Chemotherapy in Advanced Sebaceous Carcinoma: A Case Report and Literature Review
Authors: Ota Shuji , Sakamoto Takahiko , Ochiai Ryosuke , Haruyama Terunobu , Ishihara Masashi , Natsume Maika , Fukasawa Yoko , Tanzawa Shigeru , Usui Ryo , Honda Takeshi , Ichikawa Yasuko , Watanabe Kiyotaka , Sasajima Yuko , Mizota Atsushi , Seki Nobuhiko
Published: January 2019

For sebaceous carcinoma (SC), a rare malignant tumor, no standard chemotherapy regimen for patients with distant metastasis has been studied. We experienced a case of eyelid SC with multiple lung metastases that responded to combination chemotherapy with carboplatin and paclitaxel with 11-month progression-free survival (PFS). This patient also responded to second-line treatment with docetaxel, another taxane, with 7-month PFS, resulting in at least 18 months of survival at the time of reporting. This report shows that taxane-based chemotherapy may be effective for advanced SC, for which no standard therapy has been established.
Prolonged Hyperglycemia and Renal Failure after Primary Percutaneous Coronary Intervention
Authors: Izkhakov Elena , Rozenbaum Zach , Margolis Gilad , Khoury Shafik , Keren Gad , Shacham Yacov
Published: January 2019

Background: There are limited data regarding the effect of long-standing hyperglycemia on the occurrence of acute kidney injury (AKI) in ST segment elevation myocardial infarction (STEMI) patients undergoing primary percutaneous coronary intervention (PCI). Methods: We retrospectively studied 723 STEMI patients undergoing primary PCI. Patients were stratified into two groups according to glycated hemoglobin (HbA1c) levels as a marker of prolonged hyperglycemia: those with HbA1c < 7% and those with HbA1c ≥7%. Medical records were reviewed for the occurrence of AKI. Results: HbA1c levels ≥7% were found in 225/723 (31%) of patients. The occurrence of AKI was significantly higher among patients with HbA1c levels ≥7% (32/225, 14%) compared to patients with HbA1c levels < 7% (32/498, 6%; p = 0.001). Patients with chronic kidney disease (CKD) and HbA1c ≥7% had an eight-fold increase in the incidence of AKI compared to patients with HbA1c < 7% and no CKD (32 vs. 4%). In a multivariable regression model, HbA1c ≥7% was independently associated with AKI (OR 1.92, 95% CI 1.09–3.36, p = 0.02). Conclusion: HbA1c ≥7% was associated with a higher likelihood of AKI in STEMI patients treated with primary PCI.
O Museu dos Chapéus
Authors: Menezes Diego Matheus Oliveira de
Published: January 2019

Sobre o destino dos chapéus e das cabeças que os sustentam.
Antonio Candido e o romance de 30
Authors: Amado Roberto
Published: January 2019

Reflexões sobre o romance de 30 baseadas em textos diversos de Antonio Candido sobre a literatura praticada no decênio e das circunstâncias políticas, sociais e culturais que a tornou uma expressão referencial da cultura brasileira
Dissociation between Private and Social Counterfactual Value Signals Following Ventromedial Prefrontal Cortex Damage
Authors: Bault Nadège , di Pellegrino Giuseppe , Puppi Martina , Opolczynski Gaëlle , Monti Alessia , Braghittoni Davide , Thibaut Florence , Rustichini Aldo , Coricelli Giorgio
Published: January 2019

Individuals learn by comparing the outcome of chosen and unchosen actions. A negative counterfactual value signal is generated when this comparison is unfavorable. This can happen in private as well as in social settings—where the foregone outcome results from the choice of another person. We hypothesized that, despite sharing similar features such as supporting learning, these two counterfactual signals might implicate distinct brain networks. We conducted a neuropsychological study on the role of private and social counterfactual value signals in risky decision-making. Patients with lesions in the ventromedial prefrontal cortex (vmPFC), lesion controls, and healthy controls repeatedly chose between lotteries. In private trials, participants could observe the outcomes of their choices and the outcomes of the unselected lotteries. In social trials, participants could also see the other player's choices and outcome. At the time of outcome, vmPFC patients were insensitive to private counterfactual value signals, whereas their responses to social comparison were similar to those of control participants. At the time of choice, intact vmPFC was necessary to integrate counterfactual signals in decisions, although amelioration was observed during the course of the task, possibly driven by social trials. We conclude that if the vmPFC is critical in processing private counterfactual signals and in integrating those signals in decision-making, then distinct brain areas might support the processing of social counterfactual signals.
Review of species of Limotettix (Scleroracus) Van Duzee, 1894 (Homoptera: Auchenorrhyncha: Cicadellidae: Deltocephalinae) of the fauna of Russia with description of a new cryptic species from Sakhalin
Authors: TISHECHKIN DMITRI YU.
Published: January 2019

Illustrated descriptions of 10 species of Limotettix (Scleroracus) of the fauna of Russia with data on host plants, male calling signals, and distribution are given. L. (S.) falco sp. n. from Southern Sakhalin is described, the synonymy L. (S.) transversus (Fallén, 1826) = Scleroracus fasciatus Kuoh, 1985, syn. n. is established. Evolution of the subgenus in Palearctic, and acoustic communication channels segregation in L. (Scleroracus) are discussed.
Description of a new Chaetopelma (Araneae, Theraphosidae) species from Crete and a re-description of Macrothele cretica Kulczyński, 1903 (Araneae, Macrothelidae)
Authors: CHATZAKI MARIA , KOMNENOV MARJAN
Published: January 2019

The family Theraphosidae is recorded from Greece for the first time with the description of a new species, Chaetopelma lymberakisi sp. n. Also, the male of Macrothele cretica Kulczyński, 1903 is re-described and the female of the same species is described for the first time.
Gamma Drop Size Distribution Assumptions in Bulk Model Parameterizations and Radar Polarimetry and Their Impact on Polarimetric Radar Moments
Authors: Schinagl Katharina , Friederichs Petra , Trömel Silke , Simmer Clemens
Published: January 2019

A suitable formulation of the rain drop size distribution (DSD) is a prerequisite for a successful assimilation of radar polarimetric information on rain into a numerical weather prediction model. Popular DSD parameterizations in two-moment bulk microphysics schemes use relations between the so-called mean-mass diameter and the DSD shape parameter μ, in order to prevent overly strong size sorting in the models. In radar polarimetry constrained-gamma DSDs with empirical relations between the shape and scale parameter are commonly used. This study compares the different DSD formulations and highlights the differences. Synthetic polarimetric radar observations for X band (9.39 GHz) and S band (3 GHz) were calculated from the different DSDs using the T-matrix method. Depending on the constraint that is assumed for the DSDs, the polarimetric moments exhibit quite different dependencies on the mean diameter, which are particularly striking for differential reflectivity ZDR. To successfully assimilate observed polarimetric moments into atmospheric models, formulations—possibly more flexible than those investigated in this study—have to be found that sufficiently represent microphysical processes and at the same time are consistent with empirical relations derived from disdrometer and radar polarimetric measurements.
Defining the Northeast Monsoon of India
Authors: Misra Vasubandhu , Bhardwaj Amit
Published: January 2019

This study introduces an objective definition for onset and demise of the northeast Indian monsoon (NEM). The definition is based on the land surface temperature analysis over the Indian subcontinent. It is diagnosed from the inflection points in the daily anomaly cumulative curve of the area-averaged surface temperature over the provinces of Andhra Pradesh, Rayalseema, and Tamil Nadu located in the southeastern part of India. Per this definition, the climatological onset and demise dates of the NEM season are 6 November and 13 March, respectively. The composite evolution of the seasonal cycle of 850-hPa winds, surface wind stress, surface ocean currents, and upper-ocean heat content suggest a seasonal shift around the time of the diagnosed onset and demise dates of the NEM season. The interannual variations indicate onset date variations have a larger impact than demise date variations on the seasonal length, seasonal anomalies of rainfall, and surface temperature of the NEM. Furthermore, it is shown that warm El Niño–Southern Oscillation (ENSO) episodes are associated with excess seasonal rainfall, warm seasonal land surface temperature anomalies, and reduced lengths of the NEM season. Likewise, cold ENSO episodes are likely to be related to seasonal deficit rainfall anomalies, cold land surface temperature anomalies, and increased lengths of the NEM season.
The Relationship Between Serum Endocan Level and Aortic Elastic Properties in Patients With Newly Diagnosed Essential Hypertension
Authors: Çelik Mustafa , Sökmen Erdoğan , Sivri Serkan , Uçar Cahit , Nar Rukiye , Erer Murat
Published: January 2019

Endothelial dysfunction plays role in the generation of both essential hypertension (EH) and aortic stiffness. We evaluated the relationship between serum endocan level and aortic elastic properties (AEPs) assessed with the aortic strain, aortic distensibility, and aortic stiffness index by echocardiography. Newly diagnosed EH patients (n = 67) and controls (n = 70) were included in the study. The EH group was subdivided into stage 1 and 2 EH groups. A higher endocan level was found in the EH group, compared to the controls (34.2 ± 13.0 vs 24.1 ± 7.3 ng/mL, respectively, P < .001). All the AEP parameters were worse in the EH group, compared to the controls. Further, endocan levels correlated with aortic distensibility ( r = −0.305, P < .001) and aortic strain ( r = −0.181, P = .038), but not with aortic stiffness index ( r = 0.162, P = .064) in the whole study population. Aortic elastic properties deteriorate and serum endocan level increases in patients with EH. Moreover, serum endocan level shows a correlation with deteriorated AEPs, and hence may a surrogate marker of escalating aortic stiffness in patients with newly diagnosed EH.
Can e-books support low SES parental mediation to enrich children’s vocabulary?
Authors: Korat Ofra , Shneor Daphna
Published: January 2019

This study examines whether an e-book with a dictionary could support parents’ mediation of new words during shared book reading, more than the child’s independent reading of an e-book with and without a dictionary. The participants included 128 kindergartners and 64 mothers who were randomly divided into four groups: independent reading of the e-book with a dictionary; joint mother–child reading of the e-book without a dictionary; joint mother–child reading of the e-book with a dictionary, and independent reading of the e-book without a dictionary (control). For each target word, the dictionary presented (1) word meaning, (2) word meaning within the story context, and (3) a combined meaning. Pre- and posttests included receptive and expressive understanding of the dictionary words. E-books were read four times. Reading the e-book with a dictionary and maternal mediation was the most effective for receptive and expressive word learning, followed by independent reading with the dictionary. Mothers who read the e-book with a dictionary mediated at a higher level than mothers who read without a dictionary. The intervention contributed to advancement in learning new words beyond children’s initial vocabulary level. The research implications are presented in the discussion.
Relationship stigma and well-being among adults in interracial and same-sex relationships
Authors: Rosenthal Lisa , Deosaran Ashleigh , Young DaSean L. , Starks Tyrel J.
Published: January 2019

Stigmatization of interracial and same-sex relationships persists, with negative consequences for relationship functioning and mental health. We extended past research to examine consequences of relationship stigma from different sources (family, friends, public) for well-being (anxiety, depressive symptoms, overall self-rated health), potential buffers (egalitarianism, dyadic coping), and possible mediated pathways (to overall self-rated health through anxiety and/or depressive symptoms). Among 467 U.S. adults in interracial and/or same-sex relationships, relationship stigma from friends was associated with greater depressive symptoms. Being in a same-sex relationship moderated the associations of relationship stigma from family with anxiety and depressive symptoms. Egalitarianism moderated the association of relationship stigma from public with anxiety symptoms, and dyadic coping moderated the association of relationship stigma from family with depressive symptoms. Relationship stigma from friends was also indirectly associated with poorer overall self-rated health through the mechanism of greater depressive symptoms. Findings support that relationship stigma may have adverse consequences for individual well-being. Further, egalitarianism and dyadic coping may be buffers. More research is important to identify how to support the increasing numbers of individuals in stigmatized relationships.
Evaluation of disinfection processes for water heater devices used for extracorporeal life support
Authors: Shrimpton Nicole Y R
Published: January 2019

The Maquet Heater Unit 35 (HU35) is widely used to maintain patient body temperature during extracorporeal life support. Water is used as a medium for heat transfer though it also provides a medium for the growth of pathogens. Thus, the use of a heating unit presents a risk for transmission of water-borne pathogens in critically ill patients. Recently, a Mycobacterium chimaera outbreak in cardiac surgery has been linked to the production of bioaerosols by heater-cooler devices. Consequently, manufacturers have revised cleaning recommendations, with significant impact on staff, budget and environment. Heterotrophic plate counts (HPC) and non-tuberculous mycobacterium growth were assessed following three disinfection processes over a 16-month period. It was found that water quality was acceptable in HU35s when disinfecting with a lower concentration of Chloramine-T than currently recommended, provided exposure of the device to potential pathogens was minimised by the use of a 0.2 μm water filter.
Factors predictive for early and late mortality after surgical repair for Stanford A acute aortic dissection
Authors: Merkle Julia , Sabashnikov Anton , Liebig Lisa , Weber Carolyn , Eghbalzadeh Kaveh , Liakopoulos Oliver , Zeriouh Mohamed , Kuhn-Régnier Ferdinand , Wahlers Thorsten
Published: January 2019

Objectives:

The aim of this study was to evaluate independent risk factors predictive for mortality of patients with Stanford A acute aortic dissection.

Methods:

From January 2006 to March 2015, a total of 240 consecutive patients diagnosed with acute Stanford A acute aortic dissection underwent surgical aortic repair in our center. After analysis of pre- and perioperative variables, univariate logistic and multivariate logistic regression analyses were performed for mortality of patients. Subsequently, Kaplan–Meier estimation analysis of short- and long-term survival of these variables was carried out.

Results:

Primary entry tear in descending aorta (odds ratio = 4.71, p = 0.021), preoperative international normalized ratio higher than 1.2 (odds ratio = 7.36, p = 0.001), additional coronary artery bypass grafting (odds ratio = 3.39, p = 0.003), cannulation in ascending aorta (odds ratio = 3.22, p = 0.005), preoperative neurological coma (odds ratio = 3.30, p = 0.003), and reduced perfusion (odds ratio = 2.91, p = 0.006) as well as prolonged reperfusion time (odds ratio = 3.36, p = 0.002) showed to be independent predictors for early mortality as well as for late mortality (hazard ratio of all variables p < 0.05). Kaplan–Meier survival estimation analysis with up to 9-year-follow-up in terms of these risk factors showed significantly poorer short- and long-term survival (log-rank and Breslow test all p < 0.05).

Conclusion:

Our study revealed that early and late mortality of patients with Stanford A acute aortic dissection surgery was significantly influenced by preoperative and perioperative variables as independent predictors especially of variables displaying coronary, cerebral, and visceral malperfusion. Also, short- and long-term survival of patients was significantly poorer in terms of these risk factors.
Application of continuous epidural anesthesia in transforaminal lumbar endoscopic surgery: a prospective randomized controlled trial
Authors: Xu Tiantong , Tian Rong , Qiao Pan , Han Zhihua , Shen Qingfeng , Jia Yutao
Published: January 2019

Objective

This study aimed to compare intraoperative lower back pain and leg pain, surgical time, and intraoperative X-ray dose in patients offered local infiltration anesthesia or continuous epidural anesthesia for transforaminal endoscopic spine system (TESSYS) surgery.

Methods

A total of 98 patients who received TESSYS treatment for single-segmental lumbar disc herniation were included, and were randomly divided into two groups: group A (49 cases; local infiltration anesthesia) and group B (49 cases; continuous epidural anesthesia). Surgical duration, intraoperative X-ray dose, and visual analog scale (VAS) scores of lower back pain and leg pain before surgery, during surgery, and 48 h after surgery were recorded and compared.

Results

After surgery, the VAS scores of both lower back pain and leg pain decreased in group A, and similar findings were found in group B. Group B had a shorter surgical duration, lower intraoperative X-ray dose, and lower intraoperative VAS scores of lower back pain and leg pain compared with group A.

Conclusion

Compared with local infiltration anesthesia, continuous epidural anesthesia was more effective for pain relief during TESSYS for single-segmental lumbar disc herniation, and also contributed to a shorter surgical duration and lower X-ray exposure.
Pain: Persistent postsurgery and bone cancer-related pain
Authors: Feller Liviu , Khammissa Razia Abdool Gafaar , Bouckaert Michael , Ballyram Raoul , Jadwat Yusuf , Lemmer Johan
Published: January 2019

The generation of neuropathic pain is a complex dynamic process. Factors involved include one or more dysregulated sensory neural pathways; dysregulated activity of specific neurotransmitters, synapses, receptors and cognitive and emotional neural circuits; and the balance between degenerative and regenerative neural events. Risk factors include age, sex, cognition, emotions, genetic polymorphism, previous or ongoing chronic pain conditions and the use of certain drugs. Intense pain experienced before, during and after surgery is a risk factor for the development of central sensitization with consequent persistent postsurgery neuropathic pain. Blockade of N-methyl-D-aspartate receptors with appropriate drugs during and immediately after surgery may prevent persistent postsurgical pain. Most cancers, but particularly malignant metastases in bone, can induce persistent pain. Local factors including direct damage to sensory nerve fibres, infiltration of nerve roots by cancer cells and algogenic biological agents within the microenvironment of the tumour bring about central sensitization of dorsal horn neurons, characterized by neurochemical reorganization with persistent cancer pain. In this article, the clinical features, pathogenesis and principles of management of persistent postsurgery pain and cancer pain are briefly discussed.
A digital image correlation based methodology to characterize formability in tube forming
Authors: Cristino Valentino AM , Magrinho Joao P , Centeno Gabriel , Silva Maria Beatriz , Martins Paulo AF
Published: January 2019

This article describes a methodology to characterize the failure limits by necking and fracture, and to determine the critical value of ductile damage in tube forming. The methodology makes use of digital image correlation, thickness measurements and force–displacement evolutions to obtain the strain loading paths and the strain values at the onsets of failure by necking and fracture. The onset of failure by necking is determined by a new technique that combines the strain and force–displacement evolutions whereas the fracture strains at the cracked regions of the tubes are obtained by a similar technique utilized by the authors in sheet metal forming. Transformation of the strain loading paths from principal strain space into the space of effective strain versus stress-triaxiality allows determining the critical experimental value of ductile damage at the onset of failure by necking. The methodology is applied to tube expansion with circular, elliptical and square cross-section punches and results confirm its importance and helpfulness for researchers and engineers involved in the development and optimization of industrial tube forming processes.
Humanizing Transit Data: Connecting Customer Experience Statistics to Individuals’ Unique Transit Stories
Authors: van Lierop Dea , Eftekhari Jasmine , O’Hara Aislin , Grinspun Yuval
Published: January 2019

Transit agencies often collect valuable information about their customers, through opinion and behavior surveys that assess travel experience and customer needs. The results of these questionnaires can be used to gain a representative snapshot of the behavior and opinions of a transit agency’s customer base. These assessments are often based on large sample sizes and are therefore useful for understanding broad trends related to users’ overall travel experience. However, these large-scale analyses generally do not capture the important and rich nuances that individuals experience while in a transit station, or on-board a train, conventional bus, streetcar, light rail, subway, or a paratransit vehicle. The purpose of this paper is to demonstrate how transit agencies can gain a better understanding of paratransit customers’ experiences during their interactions with paratransit and conventional transit services. Using data from the Toronto Transit Commissions’ paratransit division and the results of in-person customer interviews, a five-step mixed-method approach for mapping paratransit customers’ travel experiences is developed. Specifically, the aggregate analyses of customers’ experiences and opinions which are derived from agency-wide customer satisfaction surveys are combined with the information obtained through in-person discussions. Four example customer journey maps (CJMs) are presented, and findings demonstrate that by using CJMs, transit agencies can gain a broad understanding of their customer base while also understanding the emotions, needs, desires, and stories of individual transit users.
East goes West — West goes East: border crossing and development
Authors: Seidler Christoph
Published: January 2019

In the aftermath of the Nazi era and the Second World War the ‘Bloodlands’ of Eastern Europe including Germany were left with a pervasive and significant loss of empathy. Robi Friedman speaks of the ‘Soldier’s Matrix’ (2015), in which dehumanizing dissociation increases, and empathy, guilt and shame disappear. In the GDR (German Democratic Republic)—under totalitarian and authoritarian conditions—this state of emotional deficit persisted for longer than in the Federal Republic (BRD). Gradually, but only after reunification, could change in the whole of Germany become possible.

In the following text I will review the fragmented state of psychoanalysis in the battered city of Berlin after the Second World War. I describe the predicament of psychoanalysts, who are hopelessly entangled in adaptation processes, fearing the new rulers and dreading their own conscience. Despite their weakened sense of courage, they were however able to create space for freedom of thought. I intend to convey the trajectory of that process.

The GDR history, despite the experience of confinement, is also a story of opening. Specific developments within the borders enabled the preservation as well as the transportation of psychoanalytic thought: some examples can be seen in inpatient forms of psychotherapy, individual psychodynamic therapy and especially the Intended Dynamic Group Psychotherapy (IDG).

The opening of the ‘Wall’ made profound psychoanalytic post-qualification possible, but it came at a cost to the specific developments of the health system in the East.

Within this system group therapists took their own particular path. After several years of cautious rapprochement the founding of BIG (Berlin Institute for Group Analysis) could be negotiated and established in 2003, supported by all Institutes of Berlin belonging to the umbrella organization of the DGPT (German Society for Psychoanalyse, Psychotherapy, Psychosomatic). Nine years later the Deutsche Gesellschaft für Gruppenanalyse und Gruppenpsychotherapie (D3G) consolidated in the merger of several individual groups resulting in a continuous and refreshingly pluralistic cooperation today.

This article will therefore describe a series of societal shifts, transitions, internal and external attempts to heal, that are well reflected within the parallel process visible in the development of group analysis and its practitioners. One example to consider would be the asymmetry between psychoanalytic ‘teachers’ (West) and ‘students’ (East) and the dynamics experienced during professional encounters, which were very particular and rather complicated. However, that is a chapter in itself and will be considered separately.
Change of the parameters of layers in a large-scale grape marc vermicomposting system with continuous feeding
Authors: Částková T , Hanč A
Published: January 2019

The main by-product of wine-making is grape marc. With proper treatment, grape marc may return to the vineyard as a fertiliser. This study deals with the vermicomposting of grape marc in a continuous feeding system in outdoor conditions for more than 12 months. The N-NH4+, dissolved organic carbon (DOC), and N-NH4+/N-NO3- contents were greater in the top layers. The pH value was about 8 in all the layers. The electrical conductivity was the greatest in the bottom layer. The ion-exchange capacity did not modify significantly during vermicomposting. The microbial biomass was the greatest in the upper layer, as well as the number and the biomass of the earthworms. The process of vermicomposting seems to be an ideal way of processing residues from the winemaking industry. This vermicompost has very good properties for use as a fertiliser, and for returning the nutrients and organic matter to the soil, for example, in a vineyard.
Bit coir fiber and sugarcane bagasse fiber reinforced eco-friendly polypropylene composites: Development and property evaluation thereof
Authors: Panicker Arun M , Maria Rose , Rajesh KA , Varghese TO
Published: January 2019

Waste natural fibers, bit coir fiber residue of traditional coir industries, and sugarcane bagasse fibers were subjected to chemical modifications via alkaline steam explosion treatments toward the extraction of reinforcing fibers with better compatibility and reinforcing characteristics in the polymer matrix. The treated fibers were utilized in the fabrication of composites with polypropylene (PP) as the base polymer with the aid of maleic anhydride–grafted PP as the compatibilizer. Percent composition of fiber in the composites was decided to facilitate maximum replacement of the matrix and further applicability in large-scale continuous polymeric production processes. Mechanical, thermal, and morphological characterization of the composites reveals the best composition to be of 30% composition, in the added view of maximum replacement of polymer matrix with the reinforcing filler, retention of requisite properties, reduced cost of manufacture and inventory, and reduction in the carbon footprint per unit dimensions in comparison with the wholly polymer component. The thermal properties of coir fiber-reinforced composites showed good improvement up to 134.5°C increase in onset degradation temperature while retaining matrix properties for sugarcane bagasse-reinforced composites.
Multi-objective lightweight design of the container S-beam based on MNSGA-II with grey relational analysis
Authors: Wang Dengfeng , Wang Shuang
Published: January 2019

A novel bottom corrugated cross-beam (S-beam) structure improved the dynamic and static performance of a container based on the combination of a modified non-dominated sorting genetic algorithm (MNSGA-II) and grey relational analysis. First, a parametric model was established and used to verify the structure’s validity through static physical testing. Eight design variables for the S-beam container structure were also defined according to the parametric model technology. Second, MNSGA-II was used for the multi-objective lightweight optimization design of an S-beam container to obtain the optimal combination of design parameters that are considerably affected by weight reduction under peak bending stress and peak loading deflection as well as first-order natural frequency variations within the allowable range. A set of non-dominated solutions was used to obtain a multi-objective optimization design. Finally, grey relational analysis and grey entropy theory are applied to rank all solutions and determine the best compromise solution. The comparison of the technique for the order of preference by similarity to ideal solution method with grey relational analysis demonstrates the extraordinary reliability and superiority of the latter. In addition, the combined method can achieve a weight reduction of up to 23.54%, which can enhance the utilization of materials and demonstrates the superiority of the combined method relative to the initial model.
Immune reconstitution inflammatory syndrome associated with secondary syphilis: dermatologic, neurologic and ophthalmologic compromise in an HIV patient
Authors: Alcedo Sami , Newby Renee , José Montenegro Juan , Rondan Paola , Arevalo Jorge , Chiappe Alfredo , Soria Jaime
Published: January 2019

The presentation of syphilis as a manifestation of immune reconstitution inflammatory syndrome in patients with human immunodeficiency virus (HIV) infection is rare and can be associated with the varied clinical expression of unusual syphilitic manifestations. We report a case of immune reconstitution syndrome with dermatologic, ophthalmologic and neurologic compromise of secondary syphilis in a patient with HIV infection.
Cognitive function, depressive symptoms and syphilis in HIV-positive and HIV-negative individuals
Authors: De Francesco Davide , Winston Alan , Underwood Jonathan , Cresswell Fiona V , Anderson Jane , Post Frank A , Williams Ian , Mallon Patrick WG , Sachikonye Memory , Babalis Daphne , Vera Jaime H , Bagkeris Emmanouil , Milinkovic Ana , Sabin Caroline A
Published: January 2019

We evaluated associations between history of syphilis infection and both cognitive function and depressive symptoms in people living with HIV (PLHIV) and comparable HIV-negative controls. Syphilis serological tests, cognitive function and depression were assessed in PLHIV and controls participating in the Pharmacokinetic and Clinical Observations in People Over Fifty study. Cognitive test scores were converted to demographically adjusted T-scores (mean = 50, SD = 10) and then averaged to obtain a global T-score. Severity of depressive symptoms was assessed via the Patient Health Questionnaire-9. Associations of syphilis with global T-scores and depression were assessed using median regression. The 623 PLHIV and 246 HIV-negative controls were predominantly male (89.3% and 66.5%) with median age (interquartile range [IQR]) of 57 (53–63) and 58 (53–63) years, respectively. PLHIV had lower global cognitive T-scores (median [IQR] 48.7 [45.1, 52.1] versus 50.5 [47.0, 53.9], p < 0.001), more severe depressive symptoms (median [IQR] 4 [1, 10] versus 1 [0, 3], p < 0.001) and were more likely to report history of syphilis infection (22.0% versus 8.1%) than controls. There was no significant association between history of syphilis and global cognitive function in either PLHIV (p = 0.69) or controls (p = 0.10). Participants with a history of syphilis had more severe depressive symptoms (median [IQR] 4 [1, 9] versus 2 [0, 8], p = 0.03); however, the association became non-significant (p = 0.62) after adjusting for HIV status and potential confounders. Despite the higher prevalence of syphilis infection in PLHIV, there was no evidence of an association between history of syphilis infection and impaired cognitive function nor depressive symptoms after accounting for potential confounders.
Support for Resettling Refugees: The Role of Fixed Versus Growth Mind-Sets
Authors: Madan Shilpa , Basu Shankha , Rattan Aneeta , Savani Krishna
Published: January 2019

In six studies ( N = 2,340), we identified one source of people’s differential support for resettling refugees in their country—their beliefs about whether the kind of person someone is can be changed (i.e., a growth mind-set) or is fixed (i.e., a fixed mind-set). U.S. and UK citizens who believed that the kind of person someone is can be changed were more likely to support resettling refugees in their country (Studies 1 and 2). Study 3 identified a causal relationship between the type of mind-set people hold and their support for resettling refugees. Importantly, people with a growth mind-set were more likely to believe that refugees can assimilate in the host society but not that they should assimilate, and the belief that refugees can assimilate mediated the relationship between people’s mind-sets and their support for resettling refugees (Studies 4–6). The findings identify an important antecedent of people’s support for resettling refugees and provide novel insights into the science of mind-sets.
Acute effects of lipopolysaccharide (LPS) in kidney of rats and preventive role of vitamin E and sodium selenite
Authors: Ilçe F , Gök G , Pandir D
Published: January 2019

Lipopolysaccharide (LPS) as an endotoxin forms part of the cell wall of gram-negative bacteria and is responsible for initiating an acute inflammation after entering the living tissue. In this study, male rats were divided into eight groups: control group, vitamin E (VE) treatment group (200 mg/kg body weight (b.w.)), sodium selenite (SS) treatment (0.35 mg/kg b.w.) group, VE + SS treatment group (200 + 0.35 mg/kg b.w.), LPS treatment group (10 mg/kg b.w.), LPS + VE (10+200 mg/kg b.w.), LPS + SS treatment (10 + 0.35 mg/kg b.w.), and LPS + SS + VE treatment (10 + 0.35 + 200 mg/kg b.w.) group. Oxidative stress parameters, pathological changes, immunohistochemical analyses, terminal deoxynucleotidyl transferase deoxyuridine triphosphate nick end-labeling (TUNEL) assay, and changes in DNA structure with comet assay of the kidney were investigated at the end 6 h comparatively with the control group. When LPS-treated group was compared with the control group, antioxidant enzyme activities were decreased and malondialdehyde (MDA) levels, changes in histological and DNA structure and apoptosis were increased significantly at the end of 6 h. However, when LPS + SS and/or VE-treated group were compared with the LPS-treated group, superoxide dismutase, catalase, glutathione peroxidase, and glutathione- S-transferase activities were increased and MDA levels were decreased significantly at the end of the treatment period. Light investigations figured out pathological changes in kidneys of LPS- and LPS + SS and/or VE-treated groups. There was a decrease in the number of proliferating cell nuclear antigen-positive cells and an increase in the number of TUNEL-positive apoptotic cells in the wall of the distal and proximal tubules. As a result, it was observed that the combined use of antioxidants was more protective than their use alone against LPS.
Strength and durability of rapid set PVA fiber reinforced LMC for pavement repair
Authors: Kim Ki-Won , Yu Chan , Han Jae-Woong , Park Chan-Gi
Published: January 2019

This study evaluated the strength properties, chloride ion permeability and abrasion resistance of styrene–butadiene latex-modified polyvinyl alcohol (PVA) fibre-reinforced rapid-set cement concrete (LMFRRSC) for application to emergency repair of concrete pavements. Experiments were conducted to measure the compressive strength, flexural strength, splitting tensile strength, bond strength, chloride ion penetration and abrasion resistance of LMFRRSC for variable PVA fibre content (0, 0.05 and 0.10%); test results showed that these test parameters increased with the volume fraction of PVA fibre, satisfying all traffic-opening criteria for emergency concrete pavement repair. The PVA fibre additive effectively minimized crack formation generated as a result of high hydration heat in the early material stages and inhibited fibre ball development. Thus, the addition of PVA fibre enhanced the performance of LMFRRSC for emergency repair of concrete pavements.
The Simple Reality of Our Complex System: The Future of Health Care
Authors: Burwell Sylvia Mathews
Published: January 2019

The incredible complexity of the United States health care system can be connected to three simple outcomes: access, affordability, and quality. We should measure our progress against these three measures. While historic progress on access was made through implementation of the Affordable Care Act, the next area of focus for more results across all three measures is delivery system reform.
Myths, Misperceptions, and Policy Learning: Comparing Healthcare in the United States and Canada
Authors: Marchildon Gregory P. , Cafaro Capri S. , Brown Adalsteinn
Published: January 2019

The U.S. and Canadian health care systems are more similar than is commonly believed. This article debunks some of the powerful myths about these health care systems and opens up the discussion for greater policy learning from both sides of the border. Cross-border comparisons can yield a number of lessons from common policy challenges such as cost control, physician organization and payment, and the organization of health coverage and services for Native Americans and Indigenous Canadians.
Cost-Sharing Reductions, Technocrat Tinkering, and Market-Based Health Policy
Authors: Hoffman Allison K.
Published: January 2019

The Trump Administration has exposed both the durability and vulnerability of the Patient Protection and Affordable Care Act's insurance reforms. One of the Administration's first strikes at “Obamacare” was to discontinue federal government payment of cost-sharing reductions, which insurers pay to low-income enrollees on the exchanges to reduce their out-of-pocket share of medical spending. The states struck back with a clever solution that could hold insurers and enrollees harmless. This article examines this strategy and why, while impressive, it reaffirms larger problems with the ACA's market-based approach to health reform and the need for new pathways forward.
The Irreplaceable Program in an Era of Uncertainty
Authors: Rosenbaum Sara , Taylor Elizabeth
Published: January 2019

In 2017, Medicaid faced a near-death experience, the third of its 53-year history. Its survival and resilience is a testament not just to its size but to the multiple, vital roles Medicaid plays in the health care system, and its ability to adapt to emerging population health needs. It can take an existential threat to make these indispensable qualities clear.
Considering the ACA's Impact on Hospital and Physician Consolidation
Authors: Singer Lawrence E.
Published: January 2019

The Affordable Care Act did not start the consolidation rapidly occurring with hospitals/health systems and medical groups, but it most definitely accelerated the movement to combine. In the last five years, the number and size of consolidations have been at an all-time high. This comment reviews the degree to which consolidation has occurred and explores the key reasons behind these consolidations. It then posits that consolidations should be evaluated in light of the Triple Aim goals of enhancing access to care, reducing cost, and strengthening quality, and looks at the evidence to date in light of these goals.
A methodology for an optimal design of physical parameters, positions, and viscoelastic materials of simple dynamic absorbers for passive vibration control
Authors: Elizabeth de Castro Silva Francielly , Alberto Bavastri Carlos
Published: January 2019

Dynamic vibration absorbers are simple mechanical devices that are attached to a structure aiming at reducing vibration levels. Designing such devices for vibration control of mechanical systems using viscoelastic materials results in low costs, easy construction, and higher efficacy due to their ability to dissipate vibration energy. In this context, the present study aims at developing a methodology for an optimal design of a set of viscoelastic dynamic absorbers considering their natural frequencies, the positions to attach them onto the structure to be controlled, and the viscoelastic materials as variables to be optimized for different working temperatures. The optimal configuration is obtained by applying a hybrid optimization technique, which uses genetic algorithms (considering continuous and discrete variables in the same design vector) aiming at approximating the global minimum point and, subsequently, a nonlinear programming method (simplex based on the Nelder–Mead method) to perform a local search. An example of dynamic absorber design to reduce vibration levels in a one-degree-of-freedom (DOF) system and on a steel plate (multiple-DOFs) is presented. The results show the efficacy of the methodology for passive control of vibrations acting on a broadband of frequencies and different temperatures.