bluuebunny/crossref_metadata_2025 huggingface dataset:
Refugees and Their Displaced Documents of Identity
Authors: Sriraman Tarangini
Published: May 2019

This chapter begins by posing the question, how did the Indian state classify refugees as poor, displaced, and lower caste and how did it create the material infrastructure of identifying welfare beneficiaries? The Partition, which brought in its wake a sea of displaced populations that deluged both countries, threw up conundrums of identification that straddled the philosophical and the feasible, the material and the intangible. Given that there were no pre-existing genres of recognizing the refugee figure so alien to the memory of the colonial state, civic and rehabilitation authorities had no choice but to accept and privilege alternative or ‘collateral evidence’ that emerged from the makeshift documents and narrated itineraries of refugees and refugee associations. While focusing its inquiries on a smaller universe of those disparagingly termed ‘refugee squatters’ in post-Partition Delhi and their housing claims, the present chapter seeks to show how refugee knowledge and popular practices of self-recognition were salient to the fashioning of identification documents.
The Indian Information Technology Sector
Authors: Fernandez Marilyn
Published: May 2019

The theoretical and empirical context for the analyses of caste reproduction in Indian IT is outlined. A perfect storm of events, the Y2K hysteria, the abundant skilled labour, the extant technology infrastructure in India, and the east-west time difference that led to the bourgeoning IT sector were reviewed. The globalization paradox of Indian IT, the extant evidence of multi-layered inequalities, and the growing political and public backlash against quotas or set-aside privileges for SC/ST/OBCs present a volatile mix. Theoretically speaking, streamlined merit is used to create appropriate difference between IT merit and the earmarked or reservation merit. But that IT merit skills, even of the pure kind, is deeply embedded but obscured, in the social and economic privileges of the dominant castes and classes and the holistic merit requirements of a globalized sector open up spaces for hidden caste privileges to filter through and colour pure merit with caste undertones.
Information Technology Education
Authors: Fernandez Marilyn
Published: May 2019

The seeds of the Merit-Caste debate in the merit IT culture making project are sown early in secondary and higher technical education. The ‘blood sport’ in technical education has been fuelled by another perfect storm of events; the growing popularity of technical education and jobs, expansion of IT educational options through government resourced technical institutions, grievances about the never-ending shelf life of reservations, and perception of limited ‘unreserved seats’ in quality institutions of higher learning coupled with the expensive privatized options have added fuel to the antagonistic competition. In the final analyses, just as both public and private technical higher education institutions are the sites where IT merit is culturally constructed, they also become ideal sites for deconstructing the merit culture making project and revealing the project’s caste foundations.
Two Conceptions of the City
Authors: Guerrieri Pilar Maria
Published: May 2019

This chapter compares the plan put forward in 1912, during the colonial period, with the one approved after Independence in 1962. It demonstrates that both plans bear foreign influences; in the first case British, in the second American. The city that came after 1947, rather than being a centre of power and administration, was designed to be a residential city. New Delhi was planned based on the ideal of the Garden City and the City Beautiful movements. By contrast, the city imagined after Independence follows the principles of zoning and functional separation. It is particularly interesting how despite the strong foreign influences some of those English architects working in Delhi had tried to go beyond utopia and tie a link with the pre-existing city of Shahjahanabad and imagined architecture based on the observation of traditional typologies.
Sedition and Western Liberal Democracies
Authors: Singh Anushka
Published: May 2019

The second chapter leads to separate inquiries into the political history of the law of sedition in the three western liberal democracies, namely, England, USA, and Australia, based upon legislations, judicial trials, targets of the law and its relationship with counterterror legislations. In each country, there is one specific moment in relation to sedition that gains prominence through the course of study. The chapter offers a framework of three specific moments, namely, ‘abolition’, ‘restriction’, ‘modernization’, which most effectively define the place of sedition in that particular country.
Resistance, Suppression, and Patriotism
Authors: Singh Anushka
Published: May 2019

This chapter discusses the idea of sedition from its inception within the legal code by the colonial regime and the different meanings that it acquired within colonial India. It proposes that the idea of sedition within colonial India took shape within two different discourses: the judicial and the political. These two discourses are treated as two frameworks to look at the different meanings, deployments and the politics of sedition, through a detailed study of the use of the law and various trials related to it. Subsequently it tries to see how the colonized subjects responded to the concept of sedition within the two discourses to conclude what sedition meant in colonial times. The focus of the chapter is on the early trials involving the nationalists and the emerging idea of sedition as political resistance.
Conclusion
Authors: Singh Anushka
Published: May 2019

The life of a law exists both within and beyond the statute books and courts’ interpretations. This assertion has been made in this work in the exploration of the journey of the law of sedition primarily at three levels—the first concerns itself with analysing the language of the law of sedition; the second, with studying the judicial discourse on sedition; and the third pertains to interrogating the quotidian aspects of law as it unfolds on the ground. While this work offers a focused study on Indian democracy at all these levels, it has broadened its scope by including experiences from the liberal democracies of the west in its analysis. This work has used sedition as a lens to probe the fate of political speech in liberal democracies which claim to give constitutional and legal protection of varying degrees to the right to free speech, of which political speech and the right to dissent are extensions. Despite the claims to protection, the working of such democracies has shown that the freedom of speech in relation to political speeches particularly has always been in danger. The liberal-democratic space has continued to shrink for dissident voices despite the progression of liberal democracies towards free speech jurisprudence and annulment or modification of laws related to sedition....
Conceptualizing Escalation Dynamics in South Asia
Authors: Jacob Happymon
Published: May 2019

This chapter serves as the theoretical and conceptual basis of the book. The chapter discusses the classical views on escalation, followed by an analysis of the various debates on India–Pakistan escalation dynamics. The chapter thereafter examines the traditional understanding of the India–Pakistan escalation ladder. The chapter concludes by highlighting the missing link in the traditional understanding of the India–Pakistan escalation ladder, that is, the potency of ceasefire violations (CFVs) to trigger bilateral escalation. In short, the chapter argues that that escalation can and do begin from local factors rather than due to central directives, something the existing literature on South Asian escalation does not account for.
(Mis)managing the Border
Authors: Jacob Happymon
Published: May 2019

This chapter examines the management of the India–Pakistan border with particular reference to the border in Jammu and Kashmir (J&K). The chapter begins with a brief discussion of the various terminologies used in the context of the India–Pakistan border. It provides a historical overview of the early role played by the United Nations (UN) monitoring group in helping the management of the India–Pakistan borders in J&K as well as the occasional, though minor, reworking of the border that took place between India and Pakistan in the 1950s and 1960s. The chapter then outlines the various border management practices and mechanisms used by India and Pakistan in managing the International Border (IB) and the Line of Control (LoC). The chapter provides a technical and historical background to understanding the occurrence of CFVs on the LoC and IB in J&K.
Provisioning of Education and Health in Public–Private Partnership (PPP) Mode
Authors: Mathur Kuldeep
Published: May 2019

This chapter illustrates the consequences of privatization and public–private partnerships in delivering education and health services in India. The reasons for using PPPs in providing physical infrastructure are very different from the ones for their use in the social sector. In both kinds of services, no single mode of PPP is implemented and experimentation has been widely undertaken. PPPs pose challenges of inclusion and affordability in the health and education sectors. Significantly, the chapter also underlines that the private sector hesitates to enter partnerships where profitability is low. It concludes that the regulatory mechanisms are ineffective as conceived at present.
Gujarat in the History of the Indian Ocean
Authors: Subramanian Lakshmi
Published: May 2019

This chapter takes a stock taking exercise of the history writing on Gujarat and Indian maritime history over the last five decades. It identifies the major shifts and emphases that mark the nature of historical knowledge. What these hold for the discipline of history in general and how these inflect the case study of Gujarat in particular are examined. The intention of such a stock taking exercise is also to consider the importance of recovering and reading new and local archives and of incorporating new methods into standard historical work. The author also explores the most significant shifts that have emerged in the recent historiography of the Indian Ocean and of maritime Gujarat: study of law and piracy and Muslim seafaring and sailing practices in the western Indian Ocean.
Adjusting Output to Demand
Authors: Manzar Nishat
Published: May 2019

Contemporary sources reveal that volume of trade between India and Europe multiplied in the seventeenth century with the energetic participation of the Dutch and the English Companies. They were quite organized regarding schedule of shipping, negotiating the prices, engaging the artisans and brokers, maintaining good relations with the authorities, and so on. Very early, they realized that investment in textiles would be of great benefit for them. In view of tremendous competition, weavers were engaged through brokers and were provided with musters to prepare pieces according to certain specifications. Pieces were to be printed and given a fine finish. There were always complains about the behaviour of these groups. Interestingly, most of the complaints registered against any of the groups of artisans were about weavers, washers, and painters. In turn, they too protested frequently against their exploitation. Here an attempt is made to understand the equation between the artisans, service providers, brokers, and merchants.
Anti-Realism, Value, Perspectivism
Authors: Leiter Brian
Published: May 2019

If all value judgments arise from affective responses, what are the implications for judgments about epistemic value and Nietzsche’s naturalism? The chapter offers a new reading of perspectivism: while all expressions of knowledge depend on “will” or “affect,” evolutionary pressures select in favor of some of these affects, such that most “creatures like us” converge on many epistemic values, albeit not all. Beyond that baseline, the “Busy World Hypothesis” reminds us that which objects of cognition command our attention is influenced by our other affects and interests, which determines what we come to know about the world. Nietzsche emerges as an anti-realist about epistemic value, as well as moral value, defending something like the old Stevensonian view that where people share attitudes, reasoning about what one ought to do and believe is possible; where people do not share attitudes, reasoning is not possible and only force prevails in a dispute.
Introduction
Authors: Leiter Brian
Published: May 2019

Moral psychology, for purposes of this volume, encompasses issues in metaethics, philosophy of mind, and philosophy of action, including questions concerning the objectivity of morality, the relationship between moral judgment and emotion, the nature of the emotions, free will, and moral responsibility, and the structure of the mind as that is relevant to the possibility of moral action and judgment. Nietzsche’s “naturalism” is introduced and explained, and certain confusions about its meaning are addressed. An overview of the volume follows
Double Standards
Authors: Weatherson Brian
Published: May 2019

This chapter wraps up three loose ends from the discussion of normative externalism in ethics. It argues that there is nothing wrong with hypocrisy; in any case where hypocritical action seems wrong, some other feature of the act explains the wrongness. It argues that the problem of inter-theoretic value comparisons is not as big a problem for the internalist as is sometimes suggested, since everyone has to solve this problem. And it describes the parts of the bundle of views I call normative externalism, and sets out which of them are more central, or more peripheral, to the bundle.
Circles, Epistemic and Benign
Authors: Weatherson Brian
Published: May 2019

If we reject level-crossing principles, some apparently circular reasoning becomes licensed. This looks like a problem for normative externalism. This chapter responds to the problem. The response takes some time, because it turns out there are many different ways to understand what it is for reasoning to be circular. The ultimate argument is that for every such way, either it is not problematic, or normative externalism does not license it. But there is no quick proof of this; each way to understand circular reasoning has to be treated separately. The chapter ends with a discussion of the Problem of Easy Knowledge, and of the norms for proper testing of measuring devices.
Screening and Regresses
Authors: Weatherson Brian
Published: May 2019

Sometimes a class of evidence can screen off other evidence. That is, sometimes possessing evidence of one kind can make it the case that other facts, facts which would usually be of evidential significance, are not in fact significant. This chapter starts with an argument that many philosophers have assumed that evidence of what one judges screens off the evidential significance of the reasons that judgment is based on. It then argues that these philosophers have gotten things back to front. There is a true principle around here, but it is the other way around: reasons a judgment is based on screens off the evidential significance of that very judgment. I argue this principle must be true, because it is the only motivated way to stop some problematic regresses.
Explaining Evil in Plato, Euripides, and Seneca
Authors: Kamtekar Rachana
Published: May 2019

Plato distinguishes two kinds of explanation: rational explanation of an agent’s practical reasoning leading to the selection of an action as a reasonable means to a good end, and dispositional explanation, given in terms of the agency that is such as to bring about an action of a given sort. Rational explanation seeks completion in the explainer’s recognition of the agent’s end as a good and the agent’s means as reasonable, which confers intelligibility on the action; dispositional explanation is a fallback when the explainer cannot see the agent’s end as good or means as reasonable—as is the case with evil. This claim is illustrated in Euripides’s and Seneca’s Medea plays.
Dante on the Evil of Treachery
Authors: Stump Eleonore
Published: May 2019

Dante is a superb Thomist; and, in his Divine Comedy, he puts flesh on Aquinas’s sophisticated philosophical and theological views by means of an allegory with novelistic elements. In the Inferno, Dante the traveler exemplifies the way in which to do well what the sinner in hell did horribly. The punishment of the sinner shows the ugliness of a particular evil, and the actions of Dante the traveler show something powerfully good that is the alternative, the near neighbor, of the evil. By this twinned means, the nature of the seven deadly sins is vividly exposed, and true goodness and love, opposed to all the seven deadly sins, is illuminated and poignantly depicted. Furthermore, Dante is not only a superb Thomist and an insightful philosopher in his own right, but he incarnates the philosophy in narrative; and that makes all the difference in the world to his ability to give us insight into evil.
Generation of Yellow Flowers of the Japanese Morning Glory by Engineering Its Flavonoid Biosynthetic Pathway toward Aurones
Authors: Hoshino Atsushi , Mizuno Takayuki , Shimizu Keiichi , Mori Shoko , Fukada-Tanaka Sachiko , Furukawa Kazuhiko , Ishiguro Kanako , Tanaka Yoshikazu , Iida Shigeru
Published: May 2019

Wild-type plants of the Japanese morning glory (Ipomoea nil) produce blue flowers that accumulate anthocyanin pigments, whereas its mutant cultivars show wide range flower color such as red, magenta and white. However, I. nil lacks yellow color varieties even though yellow flowers were curiously described in words and woodblocks printed in the 19th century. Such yellow flowers have been regarded as ‘phantom morning glories’, and their production has not been achieved despite efforts by breeders of I. nil. The chalcone isomerase (CHI) mutants (including line 54Y) bloom very pale yellow or cream-colored flowers conferred by the accumulation of 2′, 4′, 6′, 4-tetrahydoroxychalcone (THC) 2′-O-glucoside. To produce yellow phantom morning glories, we introduced two snapdragon (Antirrhinum majus) genes to the 54Y line by encoding aureusidin synthase (AmAS1) and chalcone 4′-O-glucosyltransferase (Am4′CGT), which are necessary for the accumulation of aureusidin 6-O-glucoside and yellow coloration in A. majus. The transgenic plants expressing both genes exhibit yellow flowers, a character sought for many years. The flower petals of the transgenic plants contained aureusidin 6-O-glucoside, as well as a reduced amount of THC 2′-O-glucoside. In addition, we identified a novel aurone compound, aureusidin 6-O-(6″-O-malonyl)-glucoside, in the yellow petals. A combination of the coexpression of AmAS1 and Am4′CGT and suppression of CHI is an effective strategy for generating yellow varieties in horticultural plants.
Sex determination and gene expression in Daphnia magna exposed to juvenile hormone
Authors: Wuerz Maggie , Whyard Steve , Loadman Nancy L , Wiegand Murray D , Huebner Judith D
Published: May 2019

Daphnia spp. cycle between asexual and sexual reproduction depending on environmental conditions. Under favorable conditions, female offspring are produced, resulting in rapid population expansion; in less favorable conditions, males are produced, initiating the sexual portion of their lifestyle. Although mediated by environmental cues, sex determination is ultimately dependent on the expression of Doublesex genes, Dsx1 and Dsx2, in Daphnia. We exposed Daphnia magna to juvenile hormone III (JHIII), an insect hormone often mimicked by agricultural insecticides. Juvenile hormone (JH) and JH analogues disrupt the insect endocrine system, inhibiting reproduction; these chemicals pose an environmental threat to non-target organisms by leaching into surrounding waters. When Daphnia are exposed to JH or JH analogues, it causes a premature shift from asexual to sexual reproduction. We showed that Dsx1 is upregulated throughout vitellogenesis in female D. magna producing male offspring and Dsx2 is upregulated during late vitellogenesis, suggesting that both Dsx1 and Dsx2 contribute to male sex determination. In addition, Dsx2 expression increases during sexual maturation in male D. magna, suggesting that it also plays a role in spermatogenesis. In addition, exposure to JHIII decreased reproductive output, slowed growth and prematurely shifted D. magna reproductive strategy to the sexual portion of their lifecycle.
Knowledge Spillovers through Networks of Scientists
Authors: Zacchia Paolo
Published: May 2019

In this article, I directly test the hypothesis that interactions between inventors of different firms drive knowledge spillovers. I construct a network of publicly traded companies in which each link is a function of the relative proportion of two firms’ inventors who have former patent collaborators in both organizations. I use this measure to weigh the impact of R&D performed by each firm on the productivity and innovation outcomes of its network linkages. An empirical concern is that the resulting estimates may reflect unobserved, simultaneous determinants of firm performance, network connections, and external R&D. I address this problem with an innovative IV strategy, motivated by a game-theoretic model of firm interaction. I instrument the R&D of one firm’s connections with that of other firms that are sufficiently distant in network space. With the resulting spillover estimates, I calculate that among firms connected to the network the marginal social return of R&D amounts to approximately 112% of the marginal private return.
Mechanized Method to Inoculate Field Soil to Evaluate Fusarium Crown Rot of Wheat
Authors: Smiley Richard W.
Published: May 2019

Assessments of Fusarium crown rot are often made in field trials inoculated with Fusarium pseudograminearum or F. culmorum. Factors affecting the efficiency of two inoculation procedures were evaluated. Pulverized Fusarium-colonized wheat plus oat grain inoculum mixed with the wheat seed caused more seedling damping-off compared with equal rates of colonized whole millet seeds placed 2 cm above the wheat seed. Both inoculation systems increased the incidence and severity of crown rot. The efficiency of F. pseudograminearum-colonized millet seed inoculum was not reduced when wheat seed was treated with difenoconazole. Crown rot in inoculated plots became greater when starter fertilizer was applied with or below the wheat seed and when soil below the wheat seed was disrupted by a seed drill with an opener that creates a groove or trench directly below the seed. No biologically important associations were detected between whiteheads and other measures of crown rot, grain yield, or grain test weight. The millet seed inoculation system was the most efficient for wheat production systems in the semiarid U.S. Pacific Northwest.
Determining the Soilborne Pathogens Associated with Root Rot Disease Complex of Dry Bean in Michigan
Authors: Jacobs Janette L. , Kelly James D. , Wright Evan M. , Varner Gregory , Chilvers Martin I.
Published: May 2019

In Michigan, yield reduction as a result of diminished plant vigor owing to root rot is a major constraint associated with dry bean production and is exacerbated when fields have a history of short crop rotations. Replanting can be necessary when flooding, poor seed germination, or cool soil temperatures result in poor plant establishment, which may be compounded by increased disease pressure. To identify which soilborne pathogens are associated with root rot disease complex on dry bean and to determine their prevalence, a survey was conducted from 2014 to 2018. Dry beans with root rot symptoms were obtained from 39 field locations in 10 counties in Michigan. Rotted roots were washed, potential pathogens were cultured, and isolates were putatively identified into the major pathogen groups based on morphology. Additional identification was conducted with sequencing of the internal transcribed spacer of rDNA for oomycetes and Rhizoctonia and the translation elongation factor 1-α gene for Fusarium isolates. Among the 1,034 isolates obtained, Fusarium (54%) was recovered at the highest prevalence, and oomycetes and Rhizoctonia exhibited a consistent presence, ranging across years from 11 to 30.2% and from 9.3 to 41.8%, respectively. This survey provided baseline information on the prevalence of critical soilborne pathogens of dry bean in Michigan. In the future, additional genetic markers will be utilized to further identify organisms, a species characterization will be conducted to assess pathogenicity and virulence, and dry bean germplasm will be screened for resistance.
Deletion of the Nonribosomal Peptide Synthetase Gene nps1 in the Fungus Clonostachys rosea Attenuates Antagonism and Biocontrol of Plant Pathogenic Fusarium and Nematodes
Authors: Iqbal Mudassir , Dubey Mukesh , Broberg Anders , Viketoft Maria , Jensen Dan Funck , Karlsson Magnus
Published: May 2019

Secondary metabolites produced by biological control agents may influence the outcome of their interactions with plant pathogenic microorganisms and plants. In the present study, we investigated the role of the nonribosomal peptide synthetase gene nps1 expressed by the biocontrol fungus Clonostachys rosea. A gene expression analysis showed that nps1 was induced during confrontations with the plant pathogenic fungus Botrytis cinerea. Gene deletion strains of nps1 displayed increased growth rates and conidiation. However, the nematicidal activity of culture filtrates from C. rosea Δnps1 strains was significantly weaker than that from wild-type filtrates (P ≤ 0.001); after 24 h of incubation with culture filtrates from nps1 deletion strains, only 13 to 33% of a mixed community of nematodes were dead compared with 42% of nematodes incubated with wild-type culture filtrates. The Δnps1 strains also showed reduced biocontrol efficacy during pot experiments, thus failing to protect wheat seedlings from foot rot disease caused by the plant pathogenic fungus Fusarium graminearum. Furthermore, C. rosea Δnps1 strains were not able to reduce populations of plant-parasitic nematodes in soil or in roots of wheat as efficiently as the wild-type strain. Both C. rosea wild-type and Δnps1 strains increased the dry shoot weight and shoot length of wheat by 20 and 13%, respectively. We showed that NPS1, a putative nonribosomal peptide synthetase encoded by nps1, is a biocontrol factor, presumably by producing a hitherto unknown nonribosomal peptide compound with antifungal and nematicidal properties that contributes to the biocontrol properties of C. rosea.
Is the Caprini Score Predictive of Venothromboembolism Events in Orthopaedic Fracture Patients?
Authors: Dashe Jesse , Parisien Robert L. , Pina Matthew , De Giacomo Anthony F. , Tornetta Paul
Published: May 2019

Objective:

Explore the validity of the Caprini Score in orthopaedic patients with lower-extremity fractures.

Design:

Retrospective cohort study.

Setting:

Level I trauma academic medical center.

Patients/Participants:

Eight hundred forty-eight patients with lower-extremity fractures from 2002 to 2015 with exclusion criteria: minors, follow-up less than 30 days.

Intervention:

Stratify patients into 2 groups: high-risk (pelvic and acetabular fractures) and low-risk groups (isolated foot and ankle fractures).

Main Outcome:

Caprini Score, fracture classification, length of follow-up, deep vein thrombosis (DVT) chemoprophylaxis, and venothromboembolism (VTE) events [DVT and/or pulmonary embolism (PE)] diagnosed with objective testing.

Results:

Eight hundred forty-eight patients (499 M; 349 F) 18–93 years of age (average 43.7) with average body mass index of 29. Three hundred high-risk and 548 low-risk patients with no differences in demographics with average follow-up of 288 days. There were 33 (3.9%) VTE events, which were more common in the high-risk group (8%: 9 DVT, 15 PE) than the low-risk group (1.6%: 8 DVT, 1 PE) (P < 0.0001). The cutoff that best-predicted VTE events based on receiver-operating curves was 12 (c = 0.74) in the high-risk group, 11 (c = 0.79) in the low-risk group, and 12 (c = 0.83) overall.

Conclusion:

There was a significant lower VTE rate found in the low-risk group, but the Caprini prediction model was not significantly different between the 2 groups. This displays that patient factors play a large role in the development of VTE events independent of injury type. The Caprini score may help identify patients who may require increased protection.

Level of Evidence:

Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.
Managing Today’s Workforce to Meet Tomorrow’s Challenges
Authors: Webb Patricia Golden
Published: May 2019

Healthcare is facing a world of change. New regulations, rapid advances in information technology, shifts in payment from volume to value, consumer demands for better access to care, increased public scrutiny of outcomes, patient safety concerns, and business consolidation all add increasing degrees of difficulty to the work that healthcare leaders do. Effective management of a diverse workforce can make a significant impact on all of these challenges.

This article covers four aspects of workforce management: talent, leadership, technology, and culture. Each is described, along with tactics to address it. The recommendations are based on both my research of human capital management and my experience as a senior human resource officer and healthcare executive, now with the nation’s third-largest nonprofit health system, Catholic Health Initiatives.
Considerations Around Predicting Physician Assistant National Certifying Exam Scores From PACKRAT®: A Multiprogram Study
Authors: Honda Trenton , Barry Carey , Buchs Shalon R. , Garbas Breann L. , Hibbard Susan T. , McLellan Alison , Riethle Theresa , Swanchak Lori E.
Published: May 2019

Purpose

The Physician Assistant Clinical Knowledge Rating and Assessment Tool (PACKRAT®) is a known predictor of performance on the Physician Assistant National Certifying Exam (PANCE). It is unknown, however, whether these associations (1) vary across programs; (2) differ by PACKRAT metrics (first-year [PACKRAT 1], second-year [PACKRAT 2], and composite score [arithmetic mean of PACKRAT 1 and PACKRAT 2]); or (3) are modified by demographic or socioeconomic variables.

Methods

Linear and logistic hierarchical regression models (HRMs) were used to evaluate associations between PACKRAT metrics and (1) continuous PANCE scores and (2) odds of low PANCE performance (LPP), respectively. Likelihood ratio tests were used to evaluate differences in associations between programs and effect modification by demographic and socioeconomic variables. Receiver operating characteristic (ROC) curves were used to examine the sensitivity, specificity, positive predictive values, and negative predictive values for various PACKRAT metrics/cut points. Models were adjusted for demographic and socioeconomic variables. The PACKRAT scores were standardized for each year to the national mean and SD.

Results

Adjusted HRMs across 5 programs (n = 1014) found the composite score to have the strongest association, with a 10-percentile–point increase associated with a 22-point (95% confidence interval [CI]: 19–26) increase in PANCE score. The composite score also strongly predicted decrements in odds of LPP (odds ratio: 0.46; 95% CI: 0.38–0.55). Hierarchical regression models and ROC curves identified significant variability in associations among programs. Effect modification was not observed by any investigated variable.

Conclusions

The composite score had the largest magnitudes of association with PANCE scores and odds of LPP. The significant difference in association identified between programs suggests that the predictive ability of the exam is not uniform. The lack of effect modification by demographic and socioeconomic variables suggests that associations do not significantly differ by these metrics.
Prediction of acute kidney injury: the ratio of renal resistive index to semiquantitative power Doppler ultrasound score—a better predictor?
Authors: Zhi Hai Jun , Zhao Jing , Nie Shen , Ma Yun Jie , Cui Xiao Ya , Zhang Meng , Li Yong
Published: May 2019

This study aimed to explore the diagnostic performance of the ratio of renal resistive index (RRI) to semiquantitative power Doppler ultrasound (PDU) score in predicting acute kidney injury (AKI) 3 in critically ill patients.

This study was a prospective, observational study that included 101 critically ill patients. RRI and semiquantitative PDU score were measured within 6 hours following admission to the intensive care unit (ICU). The ratio of RRI to PDU (RRI/PDU) was calculated as follows: RRI / PDU. If PDU score was 0, the RRI/PDU was 1. Meanwhile, AKI was defined according to the Kidney Disease Improving Global Outcomes criteria.

Median RRI/PDU was 0.234 (0.190, 0.335) in patients with AKI 0–2 and 0.636 (0.411, 0.738) in patients with AKI 3 (P < .001). As assessed by the area under the receiver operator characteristic curves (AUC), RRI/PDU performed best in diagnosing AKI 3 [AUC = 0.935 (95% CI: 0.868–0.974)]. Optimal cuto for RRI/PDU was > 0.37, and the sensitivity and specificity were 90.5% and 90.0%, respectively. In 93 patients, except for 8 patients with a PDU score of 0, the AUC of RRI/PDU [0.938 (95% CI: 0.868–0.977)] was superior to the PDU score (0.905 [95% CI: 0.826–0.956], P = .133), RRI [0.782 (95% CI: 0.684–0.861), P = .016], serum creatinine [0.801 (95% CI: 0.705–0.877), P = .017], or 6 hours AKI stage (0.876 [95% CI: 0.791–0.935], P = .110) in predicting AKI 3 on D5.

In our study, RRI, PDU score, RRI/PDU, and 6 hours AKI stage were useful in predicting AKI 3. Furthermore, RRI/PDU may be a better predictor of AKI 3.
Effect of grape seed proanthocyanidin extract on hard exudates in patients with non-proliferative diabetic retinopathy
Authors: Moon Sang Woong , Shin Yong Un , Cho Heeyoon , Bae So Hyun , Kim Ha Kyoung
Published: May 2019

Purpose:

To evaluate the efficacy and safety of orally administered grape seed proanthocyanidin extract (GSPE) in patients with non-proliferative diabetic retinopathy (NPDR).

Methods:

In this randomized (1:2:2), multicentre, double-blind trial, patients (n = 124; age: 40–78 years) were administered placebo, calcium dobesilate (CD; 750 mg/d), or GSPE (150 mg/d) orally for up to 12 months. All patients had retinal thickening with hard exudates (HEs) that met predefined criteria; the median best-corrected visual acuity was 0.8, as assessed using the Snellen visual acuity card. The main outcome measure was an improvement in HEs by at least 1 grade on a 10-grade severity scale. This was evaluated using fundus photography over 1 year.

Results:

The rate of improvement in the HE severity was higher in the GSPE group than in the CD group. No statistically significant difference existed among the study groups in optical coherence tomography parameters, such as central subfield macular thickness and total macular volume (TMV). However, in the GSPE group, TMV after 9 months of treatment was significantly decreased compared with that at baseline. The GSPE group showed a significantly greater improvement in HE severity than did the placebo or CD group. Four cases in the GSPE group and 2 in the CD group were determined to have developed potential treatment-related adverse reactions, which were all gastrointestinal in nature.

Conclusions:

Oral GSPE therapy for 1 year improved HEs in patients with NPDR. The efficacy of GSPE for HEs was higher than that of oral CD in the study patients.
Effect of neoadjuvant chemotherapy followed by radical surgery for FIGO stage IB2/IIA2 cervical cancer
Authors: Zhao Hui , He Yue , Zhu Li-Rong , Wang Jian-Liu , Guo Hong-Yan , Xu Ting , Wang Yi-Qin , Yao Ying , Wu Yu-Mei
Published: May 2019

This study compared the efficacy of neoadjuvant chemotherapy (NACT) followed by radical surgery (RS) vs primary surgical treatment (PST) in patients diagnosed with International Federation of Gynecology and Obstetrics (FIGO) stage IB2/IIA2 cervical cancer.

Data of 303 cervical cancer patients who received primary therapy for stage IB2/IIA2 cervical cancer at 7 medical centers in Beijing, China between January 1, 2009 and December 31, 2016 and followed through December 31, 2017 were collected retrospectively. The response rates, surgical characteristics, and overall survival (OS) durations of patients who received NACT followed by RS were compared to those of patients who received PST.

An improved short-term complete response rate was observed among patients who received intra-arterial chemotherapy compared with patients who had intravenous chemotherapy (18.3% vs 4.1%, P
difference = .020). Patients who received NACT were more likely to undergo laparoscopic surgery and to have a lower blood loss volume (555.4 ± 520.2 ml vs PST, 682.5 ± 509.8 ml; P = .036) and increased estimated operative time (249.9 ± 101.9 vs PST, 225.1 ± 76.5 min; P = .022). No differences in high-risk factors (HRFs), the effects of supplemental treatment, or 5-year OS were observed between patients who received NACT and PST.

Our findings indicate that patients who received NACT for FIGO stage IB2/IIA2 cervical cancer were more likely to undergo laparoscopic surgery. These findings have important implications regarding treatment with curative intent for stage IB2/IIA2 cervical cancer and warrant a further analysis of treatment strategies to ensure adequate treatment and patient-centered care.
Effectiveness of sigmoidoscopy for assessing ulcerative colitis disease activity and therapeutic response
Authors: Lin Wei-Chen , Chang Chen-Wang , Chen Ming-Jen , Hsu Tzu-Chi , Wang Horng-Yuan
Published: May 2019

Ulcerative colitis (UC) typically begins in the rectum and progresses proximally in a contiguous fashion without skip lesions. Post-treatment inflammation distribution can change over time. Colonoscopy is unpleasant for the patient and clinical trials often use sigmoidoscopy for evaluation of disease severity. The aim of this study is to evaluate whether sigmoidoscopy is adequate to assess disease activity and therapeutic response as colonoscopy.

We retrospectively reviewed patients who underwent colonoscopy for the initial diagnosis and follow-up by evaluating their mucosal inflammation in our hospital from January 2012 and December 2017.

A total of 69 patients were analyzed. During follow up, the inflamed segment changed post-treatment in 62% (43/69). Extensive UC was common in the changed disease extent group (P < .01). Patients treated with oral mesalazine had a higher rate of changed disease extent (P < .01). The sigmoid segment was the most commonly involved segment, and the rectum was the severely inflamed segment during initial diagnosis and follow-up. According to Mayo endoscopic subscore (MES) in the most severely inflamed colonic and rectosigmoid segment, there were high degrees of correlation in the initial UC diagnosis (r = .90, P < .01) and follow-up (r = .74, P < .01).

Our findings suggest that sigmoidoscopy is effective as colonoscopy for detecting disease activity and evaluating therapeutic response in UC patients during follow-up.
Double stent insertion for combined malignant airway and superior vena cava obstruction
Authors: Ren Jing-Yan , Cao Chi , Fu Yu-Fei , Du Hong-Tao
Published: May 2019

The present study sought to assess the feasibility and effectiveness of double stent insertion as a means of managing combined malignant airway and superior vena cava (SVC) obstruction (CMASO).

From July 2010 to January 2018, twelve consecutive patients with CMASO were treated by double stent insertion (airway and SVC stents) in our centers. We assessed data pertaining to both technical and clinical success rates, as well as to long-term patient outcomes.

The use of double stents (12 airway stents and 19 SVC stents) was technically successful in all study subjects, with a 0 to 92 days period between the 2 stent insertions (mean 27.8 days). Patients did not show evidence of any procedure-related complications. Mean patient Hugh-Jones grades improved from 4.4 ± 0.5 before inserting the airway stent down to 1.2 ± 0.4 following this insertion (P < .001). Mean SVC pressure was reduced from 17.5 ± 2.8 mm Hg before the stent insertion down to 6.7 ± 1.4 mm Hg following this insertion (P < .001). Fifty-six days after insertion, a single patient experienced re-obstruction of their SVC stent. All patients died within the follow-up period, with a median survival time of 113 days for these 12 patients.

This double stent insertion protocol is both effective and safe as a means of offering palliative care to those with CMASO.
Characteristics and outcomes of patients hospitalized with interstitial lung diseases in Spain, 2014 to 2015
Authors: Pedraza-Serrano Fernando , Jiménez-García Rodrigo , López-de-Andrés Ana , Hernández-Barrera Valentin , Sánchez-Muñoz Gema , Puente-Maestu Luis , de-Miguel-Díez Javier
Published: May 2019

To assess characteristics and outcomes of patients hospitalized with interstitial lung diseases (ILD) and to analyze patient's comorbidities, procedures, and in-hospital outcomes.

We identified patients hospitalized with idiopathic pulmonary fibrosis and others ILD such as hypersensitivity pneumonitis, cryptogenic organizing pneumonia, lymphangioleiomyomatosis, pulmonary Langerhans cell histiocytosis, and sarcoidosis in Spain during 2014 and 2015.

We identified 14,565 discharges among patients admitted for ILD in Spain during the study period: idiopathic pulmonary fibrosis (IPF) in 42.32% (n = 6164), sarcoidosis in 37.65% (n = 5484), hypersensitivity pneumonitis in 10.55% (n = 1538), cryptogenic organizing pneumonia in 7.06% (n = 1028), pulmonary Langerhans cell histiocytosis in 1.48% (n = 215), and lymphangioleiomyomatosis in 0.94% (n = 136). The most common associated comorbidities according to those included in the Charlson Comorbidity Index (CCI) were COPD, diabetes, and congestive heart disease. The presence of pulmonary hypertension increased the probability of dying in patients with idiopathic pulmonary fibrosis (OR 1.36; 95%CI 1.06–1.73). Patients with cryptogenic organizing pneumonia had the longest length of hospital stay and the highest percentage of hospital readmissions (23.64%). The highest IHM corresponded to the idiopathic pulmonary fibrosis (14.94%). Computed tomography of the chest was the procedure more used during admissions for ILD.

IPF was responsible for larger percentage of hospital admission among ILD in our study. In addition, the IHM were higher in IPF patients in comparison with those with other ILD. The most common associated comorbidity in ILD according to those included in the CCI was COPD. Computed tomography of the chest was the procedure more frequently used.
Characteristics, trend, and methodological quality of systematic reviews and meta-analyses in nuclear medicine
Authors: Hong Jung Ui , Kim Jun Ho , Lee Kyung Hee , Lee Minkyung , Hyun In Young , Cho Soon Gu , Kim Yeo Ju , Lee Ha Young , Kim Ga Ram
Published: May 2019

To evaluate the characteristics, trend, and quality of systematic reviews and meta-analyses in nuclear medicine.

We performed a PubMed search to identify systematic reviews and meta-analyses published between 2005 and 2016 in the field of nuclear medicine. The following data were extracted: journal name, impact factor, type of study, topics with cancer type, imaging modalities, authors (number, country, affiliation, presence of nuclear medicine specialists and statisticians, discordance between the first and corresponding authors), funding, methodological quality, methods used for quality assessment, and statistical methods.

We included 185 nuclear medicine articles. Meta-analyses (n = 164; 88.6%) were published about 7 times more frequently than systematic reviews. Oncology was the most commonly studied topic (n = 125, 67.6%). The first authors were most frequently located in China (n = 73; 39.5%). PET was the most commonly used modality (n = 150; 81.1%). Both the number of authors and the ratio of discordance between the first and corresponding authors tended to progressively increase over time.

The mean AMSTAR score increased over time (5.77 in 2005–2008, 6.71 in 2009–2012, and 7.44 in 2013–2016). The proportion of articles with quality assessment increased significantly (20/26 in 2005–2008, 54/65 in 2009–2012, and 79/94 in 2013–2016). The most commonly used assessment tool was quality assessment of diagnostic accuracy studies (n = 85; 54.9%).

The number and quality of systematic reviews and meta-analyses in nuclear medicine have significantly increased over the review period; however, the quality of these articles varies. Efforts to overcome specific weaknesses of the methodologies can provide opportunities for quality improvement.
Prognostic nomogram for adult patients with acute myeloid leukemia
Authors: Chen Cunte , Wang Peipei , Wang Caixia
Published: May 2019

Acute myeloid leukemia (AML) is hematopoietic malignancy. This study was designed to develop an individualized prognostic nomogram to predict cancer-specific survival (CSS) and overall survival (OS) of AML.

The clinical data of AML patients (n = 58,882) diagnosed from 1973 to 2014 were obtained from the Surveillance, Epidemiology, and End Results database. The patients were divided into training cohort (n = 29,441) and validation cohort (n = 29,441). The prognostic nomograms were designed with clinical variables selected by multivariate Cox regression model in training cohort. The concordance index (C-index), calibration curve, and receiver operating characteristic curve were used to assess the performance of the nomograms.

The predictors in nomogram for CSS were AML subtypes, age, sex, region, marital status, and chemotherapy, whereas the predictors for OS were AML subtypes, age, sex, region, race, marital status, and chemotherapy. The C-indexes of the nomograms in internal validation for CSS and OS were 0.712 and 0.703, respectively, whereas the C-indexes in external validation for CSS and OS were 0.712 and 0.705, respectively. The area under the curve of receiver operating characteristic curves for CSS and OS were 0.799 (95% confidence interval: 0.792–0.806) and 0.809 (95% confidence interval: 0.803–0.816), respectively.

The individualized prognostic nomogram could perform relatively accurate prediction of outcome in adult patients with AML.
The hepatic protective effects of tacrolimus as a rinse solution in liver transplantation
Authors: Guo Tao , Lei Junhao , Gao Jiamin , Li Zhen , Liu Zhisu
Published: May 2019

Background:

Tacrolimus was used as a rinse solution against ischaemia-reperfusion injury (IRI) in liver transplantation for years but its protective effects remain controversies.

Methods:

We conducted literature retrieval in electronic databases including MEDLINE, EMBASE and Cochrane Central to identify relevant randomized controlled trials (RCTs) investigating the effects of tacrolimus as a rinse solution in liver transplantation. Postoperative liver function, including alanine aminotransferase (ALT), aspartate aminotransferase (AST) and total bilirubin (TBIL), at postoperative day (POD) 1, 2 and 7 was extracted for pooled estimation. Forest plots were generated to calculate the differences between the groups. The I2 index statistic was used to assess heterogeneity. Publication bias was evaluated using funnel plots and Egger's test.

Results:

Three RCTs including 70 liver transplants were evaluated in this study. Pooled estimation revealed that rinse with tacrolimus in liver transplantation did not provide hepatic protection with respect to postoperative ALT (Test Z = 1.36; P = .175), AST (Test Z = 1.70; P = .090) or TBIL (Test Z = 0.69; P = .490). Sensitivity analysis by excluding extended donor criteria (EDC) livers showed similar results. Funnel plots and Egger's test demonstrated that there was no substantial bias.

Conclusion:

We may tentatively conclude that tacrolimus is ineffective for amelioration of postoperative liver function as a rinse solution in liver transplantation. Nevertheless, there is great space for future research in this area, and the potential clinical value of tacrolimus needs to be further addressed. We are expecting more evidence to support our speculations.