bluuebunny/crossref_metadata_2025 huggingface dataset:
Acute Subdural Hemorrhage Associated With Both Metastatic Adenocarcinoma of the Dura and Minor Head Trauma
Authors: Julson Janet R. , Weiland Timothy , Kemp Walter L.
Published: August 2018

While reportedly a relatively common finding at the autopsy of decedents with metastatic neoplasms, dural metastases are infrequently described in the medical literature and only 55 cases of subdural hemorrhage associated with dural metastases have been described, with only one of these cases associated with head trauma. We report a 50-year-old incarcerated male who died as the result of acute and chronic subdural hemorrhage associated with recent minor head trauma and dural metastases, which were most likely of pancreatic origin. He had sustained a fall, possibly due to a seizure in his jail cell, developed an acute subdural hemorrhage, and died, necessitating an autopsy. Metastatic tumor in the dura and other organs was identified upon histologic examination and found to be CK7 and CK20 positive and TTF-1 and CDX2 negative, consistent with a pancreatic adenocarcinoma. In addition, marantic endocarditis was identified, which can occur in individuals with mucinous tumors, such as a pancreatic neoplasm. This case report offers the second description of a subdural hemorrhage occurring in association with both dural metastases and recent head trauma and confirms the importance of histologic examination of the subdural hemorrhage and adjacent dura at autopsy for reasons other than just timing of the event.
Pancreatic Islet Hyperplasia
Authors: Weinand Jared , Kemp Walter L.
Published: August 2018

It has been estimated that up to four million Americans have used anabolic-androgenic steroids (AAS) to increase muscle mass – either for improved athletic performance, enhanced personal appearance, or both. While the pathologic effects of supra-physiologic doses of AAS have been well-described for some organ systems, such as the cardiovascular system, the effects on other organ systems are less well-described; for example, there is a dearth of knowledge in the medical literature regarding the effects of recreational use of AAS on the islet cells of the endocrine pancreas. As pancreatic islet hyperplasia has previously been described in the literature in a group of patients receiving long-term AAS treatment for Fanconi anemia, it is reasonable to suggest that the use of AAS by bodybuilders could produce the same (or similar) histologic changes. We present a case that offers support for the association of anabolic-androgenic steroid use and pancreatic islet hyperplasia.
Comparing the Effectiveness of Four Different Design Media in Communicating Desired Performance Outcomes With Clinical End Users
Authors: Wingler Deborah , Machry Herninia , Bayramzadeh Sara , Joseph Anjali , Allison David
Published: August 2018

Objective:

The purpose of this study was to compare the effectiveness of four different design communication media in helping clinical end users understand spatial and functional information and in supporting their ability to provide design feedback.

Background:

It is critical to involve clinical end users early in the design process to test design solutions and ensure the design of a new healthcare facility supports their ability to deliver high-quality care. Traditional architectural design communication media such as floor plans and perspectives can be challenging for clinical design team members to understand. Physical and virtual mock-ups are becoming more popular as design communication media. However, nominal evidence exists comparing the effectiveness of different design media in supporting clinical end-user engagement and contribution during the design process.

Method:

An exploratory, qualitative study was conducted with clinical end users to evaluate the effectiveness of four different media commonly used in design communication.

Results:

Traditional architectural representations convey limited useful information to clinical end users, impacting the amount and type of feedback they can provide. More immersive media, such as physical and virtual mock-ups, support an increasingly holistic understanding of proposed design solutions, inciting more design solutions that range from the inclusion and exclusion of design features to location, position, and functionality of those features.

Conclusions:

When used in combination, each media can contribute to eliciting clinical end-user feedback at varying scales. The overall preference and higher effectiveness in eliciting design feedback from clinical end users highlights the importance of physical mock-up in communicating healthcare design solutions.
Octogenarian women with acute coronary syndrome present frailty and readmissions more frequently than men
Authors: Vicent Lourdes , Ariza-Solé Albert , Alegre Oriol , Sanchís Juan , López-Palop Ramón , Formiga Francesc , González-Salvado Violeta , Bueno Héctor , Vidán María T , Díez-Villanueva Pablo , Abu-assi Emad , Martínez-Sellés Manuel
Published: August 2018

Background:

A worse prognosis has been reported among women with acute coronary syndrome compared to men. Our aim was to address the role of frailty and sex in the management and prognosis of elderly patients with non-ST-segment elevation acute coronary syndrome.

Methods:

A prospective registry in 44 Spanish hospitals including patients aged 80 years and older with non-ST-segment elevation acute coronary syndrome. Frailty assessment was performed using the FRAIL scale.

Results:

Of a total of 535 patients, 207 (38.7%) were women. Mean age was 84.8±4.0 years, similar in men and women. A prior history of coronary artery disease was more common in men (146, 44.9%) than in women (46, 22.2%), P<0.001. Frailty was less frequent in men (65, 20.2%) than in women (77, 37.8%), P<0.001. Female sex was an independent predictor of death/hospitalisation (hazard ratio (HR) 1.7, 95% confidence interval (CI) 1.1–2.4) and of hospitalisation at 6 months (HR 1.6, 95% CI 1.04–2.4). In men, compared to non-frail patients, both a prefrail status (HR 3.47, 95% CI 1.22–9.89) and frailty (HR 3.19, 95% CI 1.08–9.43) were independently associated with higher mortality. In women only frailty was independently associated with higher mortality (HR 5.68, 95% CI 1.91–16.18, compared to prefrailty or robustness). Frailty was associated with readmissions in men (HR 3.34, 95% CI 1.79–6.22) but not in women.

Conclusions:

In octogenarians with acute coronary syndrome female sex was independently associated with death/hospitalisation at 6 months. Frailty was more common in women and was a predictor of poor prognosis. In men prefrailty also predicted a poor prognosis.
Pulmonary Embolism While on Aspirin for Venous Thromboembolism Prophylaxis After Total Knee Arthroplasty
Authors: Roman Francisco , Allen Jay-Sheree , Wurm Heather Catherine , MacLaughlin Kathy
Published: August 2018

A 62-year-old Caucasian man with past medical history significant for coronary artery disease, status post drug eluting stent to the left anterior descending artery 10 years prior, was admitted for elective total right knee arthroplasty. His intraoperative course was uneventful, and he was discharged on hospital day 2 on aspirin 325 mg twice daily for 6 weeks for venous thromboembolism (VTE) prophylaxis. Three weeks later the patient developed chest pain shortly after an approximately 1-hour flight and presented to a local emergency department where computed tomography angiogram showed pulmonary emboli involving segmental and subsegmental pulmonary arteries bilaterally. He was transitioned from aspirin 325 mg twice a day to rivaroxaban 15 mg twice daily for 21 days, with a plan to transition to 20 mg daily to complete a 3-month course. He returned to his primary care physician 6 days after discharge with questions about his current anticoagulation therapy as well as the regimen he was on prior to the pulmonary embolism. Two major organizations, The American Academy of Orthopedic Surgeons and The American College of Chest Physicians, provide recommendations for VTE prophylaxis, but they differ regarding the preferred pharmacologic modality and duration. Although the goal is to provide optimal patient care, lack of guideline consensus may lead to different postoperative recommendations. It is important for clinicians to discuss with their patients the pharmacologic options available for VTE prophylaxis, how organizations differ in their recommendations, and the limitations of these pharmacologic agents.
Ravulizumab (ALXN1210) in patients with paroxysmal nocturnal hemoglobinuria: results of 2 phase 1b/2 studies
Authors: Röth Alexander , Rottinghaus Scott T. , Hill Anita , Bachman Eric S. , Kim Jin Seok , Schrezenmeier Hubert , Terriou Louis , Urbano-Ispizua Álvaro , Wells Richard A. , Jang Jun Ho , Kulasekararaj Austin G. , Szer Jeff , Aguzzi Rasha , Damokosh Andrew I. , Shafner Lori , Lee Jong Wook
Published: August 2018

Key Points

Ravulizumab provided rapid and sustained reduction in complement-mediated hemolysis at dosing intervals up to 12 weeks. Patients receiving higher trough exposures experienced greater frequency of LDH normalization, with no episodes of breakthrough hemolysis.
Sick pets as potential reservoirs of antibiotic-resistant bacteria in Singapore
Authors: Hartantyo Sri Harminda Pahm , Chau Man Ling , Fillon Laurent , Ariff Ahmad Zhafir Bin Mohamad , Kang Joanne Su Lin , Aung Kyaw Thu , Gutiérrez Ramona Alikiiteaga
Published: August 2018

An analysis of 186 diagnostic reports collected from a veterinary clinic in Singapore between 2014 to 2016 showed that sick companion animals can carry bacteria that are of significance to human health. Among the 186 specimens submitted, 82 showed polymicrobial growth (45%, 82/186) and in total, 359 bacteria were isolated. Of the 359 bacteria reported, 45% (162/359) were multi-drug resistant and 18% (66/359) were extended-spectrum-beta-lactamase species. Resistance to broad-spectrum antibiotics were also observed among individual species. Namely, methicillin-resistance among Staphylococcus pseudintermedius (63%, 32/51) and Staphylococcus aureus (50%, 4/8); fluoroquinolone-resistance among Escherichia coli (40%, 17/42) and carbapenem-resistance among Klebsiella pneumoniae (7%, 2/30) were noted. Our analysis suggests that sick pets may contribute to the pool of clinically relevant antibiotic-resistant bacteria and play a role in the spread of antibiotic resistance in Singapore. A more extensive study to better understand the extent of distribution and the factors affecting transmission of antibiotic-resistant bacteria to and from pets is necessary.
Automatic traveltime inversion via sparse decomposition of seismic data
Authors: Feng Bo , Wang Huazhong , Wu Ru-Shan
Published: August 2018

We have developed an automatic traveltime inversion (ATI) method to estimate the macrovelocity model from reflection seismic data. First, we extract the kinematic information (i.e., source/receiver ray parameters, traveltime, and source/receiver coordinates) of locally coherent events using a sparse-decomposition method. And then we evaluate a new strategy to calculate the reflection traveltime residual based on a ray-intersection criterion, eliminating the influence of seismic amplitude to the estimation of the traveltime residual. The velocity model can be updated iteratively by minimizing the traveltime residual functional with a gradient-based method. To obtain a smooth gradient free of artifacts, we first estimate the high-wavenumber components of the functional gradient with a total variation (TV) regularization method and then subtract it from the full gradient. Because the reflection traveltime residual calculation and velocity update are fully automated procedures, the proposed traveltime inversion method is referred to as ATI. We determine with 2D synthetic and field examples that ATI does not need a good starting model. Furthermore, it requires neither low-frequency seismic data nor long-offset acquisition. Nevertheless, the proposed traveltime residual calculation strategy is only valid for the 2D case, which limits its 3D applicability. We explore a possible solution for 3D extension.
Automatic blind deconvolution with Toeplitz-structured sparse total least squares
Authors: Kazemi Nasser
Published: August 2018

Given the noise-corrupted seismic recordings, blind deconvolution simultaneously solves for the reflectivity series and the wavelet. Blind deconvolution can be formulated as a fully perturbed linear regression model and solved by the total least-squares (TLS) algorithm. However, this algorithm performs poorly when the data matrix is a structured matrix and ill-conditioned. In blind deconvolution, the data matrix has a Toeplitz structure and is ill-conditioned. Accordingly, we develop a fully automatic single-channel blind-deconvolution algorithm to improve the performance of the TLS method. The proposed algorithm, called Toeplitz-structured sparse TLS, has no assumptions about the phase of the wavelet. However, it assumes that the reflectivity series is sparse. In addition, to reduce the model space and the number of unknowns, the algorithm benefits from the structural constraints on the data matrix. Our algorithm is an alternating minimization method and uses a generalized cross validation function to define the optimum regularization parameter automatically. Because the generalized cross validation function does not require any prior information about the noise level of the data, our approach is suitable for real-world applications. We validate the proposed technique using synthetic examples. In noise-free data, we achieve a near-optimal recovery of the wavelet and the reflectivity series. For noise-corrupted data with a moderate signal-to-noise ratio (S/N), we found that the algorithm successfully accounts for the noise in its model, resulting in a satisfactory performance. However, the results deteriorate as the S/N and the sparsity level of the data are decreased. We also successfully apply the algorithm to real data. The real-data examples come from 2D and 3D data sets of the Teapot Dome seismic survey.
Removing the stability limit of the explicit finite-difference scheme with eigenvalue perturbation
Authors: Gao Yingjie , Zhang Jinhai , Yao Zhenxing
Published: August 2018

The explicit finite-difference scheme is popular for solving the wave equation in the field of seismic exploration due to its simplicity in numerical implementation. However, its maximum time step is strictly restricted by the Courant-Friedrichs-Lewy (CFL) stability limit, which leads to a heavy computational burden in the presence of small-scale structures and high-velocity targets. We remove the CFL stability limit of the explicit finite-difference scheme using the eigenvalue perturbation, which allows us to use a much larger time step beyond the CFL stability limit. For a given time step that is within the CFL stability limit, the eigenvalues of the update matrix would be distributed along the unit circle; otherwise, some eigenvalues would be distributed outside of the unit circle, which introduces unstable phenomena. The eigenvalue perturbation can normalize the unstable eigenvalues and guarantee the stability of the update matrix by using an arbitrary time step. The update matrix can be preprocessed before the numerical simulation, thus retaining the computational efficiency well. We further incorporate the forward time-dispersion transform (FTDT) and the inverse time-dispersion transform (ITDT) to reduce the time-dispersion error caused by using an unusually large time step. Our numerical experiments indicate that the combination of the eigenvalue perturbation, the FTDT method, and the ITDT method can simulate highly accurate waveforms when applying a time step beyond the CFL stability limit. The time step can be extended even toward the Nyquist limit. This means that we could save many iteration steps without suffering from time-dispersion error and stability problems.
Two-parameter prestack seismic inversion of porosity and pore-structure parameter of fractured carbonate reservoirs: Part 2 — Applications
Authors: Zhang Tingting , Zhang Ruifeng , Tian Jianzhang , Lu Lifei , Qin Fengqi , Zhao Xianzeng , Sun Yuefeng
Published: August 2018

Fractures and fracture-related dissolution pores, as well as cavities, molds, and vugs, provide the major conduit and/or storage space for hydrocarbons in the deeply buried carbonate hill of Hexiwu field, Bohai Bay Basin. The fractured reservoir generally has lower porosity but better permeability than moldic/vuggy reservoir, and it consists of the major part of the buried-hill slope and buried-hill internal reservoirs. The conventional method of characterizing carbonate reservoirs, however, often mixes these two types of reservoirs together because they both have low acoustic impedance and low bulk modulus. The rock-physics analysis of two field wells indicates that a pore-structure parameter defined in a rock-physics model, the so-called Sun model, can help to distinguish the fractured reservoir zones together with porosity. Fractured zones usually have porosity of less than 5% and a pore-structure parameter of greater than six, whereas moldic/vuggy reservoirs of higher porosity have a pore-structure parameter of less than six. Field-scale application demonstrates that simultaneous prestack seismic inversion for the porosity and pore-structure parameter enables 3D mapping of fractured reservoir zones in the buried carbonate hills. It also provides an analog of detecting fractures and/or fracture-related pores in deeply buried carbonates in similar geologic settings.
President's Page
Authors: House Nancy
Published: August 2018

By the time this column reaches you, you will have experienced a year of my term as SEG president, and the incoming Board of Directors members will have been announced. I've had about 24 months to reflect on the past and present of our society and profession in a way I never imagined. I'm happy to report that the rebuild effort and the analysis of job tasks we cataloged to begin the process of creating a certification program for petroleum geophysicists have been turned into action. Under the direction of previous SEG presidents John Bradford and most recently Bill Abriel, SEG has reiterated its basic mission of advancing the science of applied geophysics and reorganized the programs and committees within SEG to enable Board members and committee chairs to better execute the wishes of our members.
Seismic Soundoff
Authors: Geary Andrew
Published: August 2018

The following is an excerpt from SEG's Seismic Soundoff podcast. The episode features Lev Vernik discussing his book Seismic Petrophysics in Quantitative Interpretation. Listen to the full episode at https://seg.org/podcast/post/4218 .
Can We Use Administrative Data to Accurately Identify Patients Who Receive a Prostate Biopsy?
Authors: Lavallée Luke T. , Breau Rodney H. , Fergusson Dean , Walsh Cynthia , van Walraven Carl
Published: August 2018

Purpose

Administrative health data can be a valuable resource for health research. Because these data are not collected for research purposes, it is imperative that the accuracy of codes used to identify patients, exposures, and outcomes is measured.

Patients and Methods

Code sensitivity was determined by identifying a cohort of men with histologically confirmed prostate cancer in the Ontario Cancer Registry and linking them to the Ontario Health Insurance Plan (OHIP) to determine whether a prostate biopsy code had been claimed. Code specificity was estimated using a random sample of patients at The Ottawa Hospital for whom a prostate biopsy code was submitted to OHIP. A simulation model, which varied the code false-positive rate, true-negative rate, and proportion of code positives in the population, was created to determine specificity under a range of combinations of these parameters.

Results

Between 1991 and 2012, 97,369 of 148,669 men with histologically confirmed prostate cancer in the Ontario Cancer Registry had a prostate biopsy code in OHIP within 1 week of their diagnosis (code sensitivity, 86.0%). This increased significantly over time (63.8% in 1991 to 87.9% in 2012). The false-positive rate of the code for index prostate biopsies was 1.9%. The simulation model found that the code specificity exceeded 95% for first prostate biopsy but was lower for secondary biopsies because of more false positives. False positives primarily were related to placement of fiducial markers for patients who received radiotherapy.

Conclusion

Administrative data in Ontario can accurately identify men who receive a prostate biopsy. The code is less accurate for secondary biopsy procedures and their sequelae.
Elevated Troponin I Levels in Diabetic Ketoacidosis Without Obstructive Coronary Artery Disease
Authors: Manikkan Ajaydas T
Published: August 2018

Elevated troponin levels have been observed in a wide spectrum of patients who do not have ischemic heart disease, including nonacute coronary syndrome and cardiovascular and noncardiovascular conditions. The cases of two patients with diabetic ketoacidosis who had elevated troponin levels in the absence of coronary artery disease are presented. This clinical scenario can pose a diagnostic dilemma for the physician. The objective of the present report is to highlight the mechanism of troponin elevation in patients with diabetic ketoacidosis, in addition to the clinical and prognostic significance of this finding.
Cardiac Risk of Noncardiac Surgery After Percutaneous Coronary Intervention With Second-Generation Drug-Eluting Stents
Authors: Smith Bradford B. , Warner Matthew A. , Warner Nafisseh S. , Hanson Andrew C. , Smith Mark M. , Rihal Charanjit S. , Gulati Rajiv , Bell Malcolm R. , Nuttall Gregory A.
Published: August 2018

BACKGROUND:

Noncardiac surgery (NCS) following percutaneous coronary intervention (PCI) with stenting is sometimes associated with major adverse cardiac events (MACEs). Second-generation drug-eluting stents (DES) were developed to decrease the incidence of MACE seen with bare metal and first-generation DES.

METHODS:

The medical records of all adult patients who underwent second-generation DES placement between July 29, 2008 and July 28, 2011 followed by NCS between September 22, 2008 and July 1, 2013 were reviewed. All episodes of MACE following surgery were recorded.

RESULTS:

A total of 282 patients (74.8% male) were identified who underwent NCS after PCI with second-generation DES. MACE occurred in 15 patients (5.3%), including 11 deaths. The incidence of MACE changed significantly with time from PCI to NCS: 17.1%, 10.0%, 0.0%, and 3.1% for patients undergoing NCS at 0–90, 91–180, 181–365, and ≥366 days, respectively. Compared with those having NCS ≥366 days after PCI, the odds ratio for MACE (95% confidence interval) was 6.4 (1.9 to 21.3) at 0–90 days and 3.4 (0.8 to 15.3) at 91–180 days. Seven days prior to NCS, 146 (52%) patients were on dual antiplatelet therapy (DAPT), 106 (38%) were on aspirin, and 30 (11%) did not receive antiplatelet therapy. Excessive surgical bleeding occurred in 19 cases (6.7%). While observed bleeding rates were lowest in those not receiving antiplatelet therapy, there were no statistically significant differences based on the presence or absence of antiplatelet therapy (3% [1/30] for no antiplatelet therapy compared to 6% [6/106] for aspirin monotherapy and 8% [12/146] for DAPT; Fisher exact test: P = .655).

CONCLUSIONS:

The incidence of MACE in patients with second-generation DES undergoing NCS was 5.3% and was highest in the first 180 days following DES implantation. The rate of excessive surgical bleeding was 6.7% with the highest observed rate in those on DAPT. However, differences by the presence or absence of antiplatelet therapy were not significant, and future large observational studies will be necessary to further define bleeding risk with continued DAPT.
Risk Factors, Etiologies, and Screening Tools for Sepsis in Pregnant Women: A Multicenter Case–Control Study
Authors: Bauer Melissa E. , Housey Michelle , Bauer Samuel T. , Behrmann Sydney , Chau Anthony , Clancy Caitlin , Clark Erin A. S. , Einav Sharon , Langen Elizabeth , Leffert Lisa , Lin Stephanie , Madapu Manokanth , Maile Michael D. , McQuaid-Hanson Emily , Priessnitz Kristina , Sela Hen Y. , Shah Anuj , Sobolewski Paul , Toledo Paloma , Tsen Lawrence C. , Bateman Brian T.
Published: August 2018

BACKGROUND:

Given the significant morbidity and mortality of maternal sepsis, early identification is key to improve outcomes. This study aims to evaluate the performance characteristics of the systemic inflammatory response syndrome (SIRS), quick Sequential [Sepsis-related] Organ Failure Assessment (qSOFA), and maternal early warning (MEW) criteria for identifying cases of impending sepsis in parturients. The secondary objective of this study is to identify etiologies and risk factors for maternal sepsis and to assess timing of antibiotics in patients diagnosed with sepsis.

METHODS:

Validated maternal sepsis cases during the delivery hospitalization from 1995 to 2012 were retrospectively identified at 7 academic medical centers in the United States and Israel. Control patients were matched by date of delivery in a 1:4 ratio. The sensitivity and specificity of SIRS, qSOFA, and MEW criteria for identifying sepsis were calculated. Data including potential risk factors, vital signs, laboratory values, and clinical management were collected for cases and controls.

RESULTS:

Eighty-two sepsis cases during the delivery hospitalization were identified and matched to 328 controls. The most common causes of sepsis were the following: chorioamnionitis 20 (24.4%), endometritis 19 (23.2%), and pneumonia 9 (11.0%). Escherichia coli 12 (14.6%), other Gram-negative rods 8 (9.8%), and group A Streptococcus 6 (7.3%) were the most commonly found pathogens. The sensitivities and specificities for meeting criteria for screening tools were as follows: (1) SIRS (0.93, 0.63); (2) qSOFA (0.50, 0.95); and (3) MEW criteria for identifying sepsis (0.82, 0.87). Of 82 women with sepsis, 10 (12.2%) died. The mortality rate for those who received antibiotics within 1 hour of diagnosis was 8.3%. The mortality rate was 20% for the patients who received antibiotics after >1 hour.

CONCLUSIONS:

Chorioamnionitis and endometritis were the most common causes of sepsis, together accounting for about half of cases. Notable differences were observed in the sensitivity and specificity of sepsis screening tools with the highest to lowest sensitivity being SIRS, MEW, and qSOFA criteria, and the highest to lowest specificity being qSOFA, MEW, and SIRS. Mortality was doubled in the cohort of patients who received antibiotics after >1 hour. Clinicians need to be vigilant to identify cases of peripartum sepsis early in its course and prioritize timely antibiotic therapy.
Fiscal Foundations of Inflation: Imperfect Knowledge
Authors: Eusepi Stefano , Preston Bruce
Published: August 2018

This paper proposes a theory of the fiscal foundations of inflation based on imperfect knowledge and learning. Because imperfect knowledge breaks Ricardian equivalence, the scale and composition of the public debt matter for inflation. High and moderate duration debt generates wealth effects on consumption demand that impairs the intertemporal substitution channel of monetary policy: aggressive monetary policy is required to anchor inflation expectations. Counterfactual experiments conducted in an estimated model reveal that the US economy would have been substantially more volatile over the Great Inflation and Great Moderation periods if US debt levels had been those observed in Italy or Japan. (JEL D84, E31, E32, E52, E62, H63)
International Reserves and Rollover Risk
Authors: Bianchi Javier , Hatchondo Juan Carlos , Martinez Leonardo
Published: August 2018

We study the optimal accumulation of international reserves in a quantitative model of sovereign default with long-term debt and a risk-free asset. Keeping higher levels of reserves provides a hedge against rollover risk, but this is costly because using reserves to pay down debt allows the government to reduce sovereign spreads. Our model, parameterized to mimic salient features of a typical emerging economy, can account for significant holdings of international reserves, and the larger accumulation of both debt and reserves in periods of low spreads and high income. We also show that income windfalls, improved policy frameworks, and an increase in the importance of rollover risk imply increases in the optimal holdings of reserves that are consistent with the upward trend in reserves in emerging economies. It is essential for our results that debt maturity exceeds one period. (JEL E21, E43, F32, F34, H63)
A Price Theory of Multi-Sided Platforms: Reply
Authors: Weyl E. Glen
Published: August 2018

I appreciate the clarification of my work by Tan and Wright, regret the confusing way my equations were labeled, and intended them to be interpreted in the manner they suggest is correct. (JEL D42, D85, L12, L14)
Recent advances in understanding the role of FOXO3
Authors: Stefanetti Renae J. , Voisin Sarah , Russell Aaron , Lamon Séverine
Published: August 2018

The forkhead box O3 (FOXO3, or FKHRL1) protein is a member of the FOXO subclass of transcription factors. FOXO proteins were originally identified as regulators of insulin-related genes; however, they are now established regulators of genes involved in vital biological processes, including substrate metabolism, protein turnover, cell survival, and cell death. FOXO3 is one of the rare genes that have been consistently linked to longevity in in vivo models. This review provides an update of the most recent research pertaining to the role of FOXO3 in (i) the regulation of protein turnover in skeletal muscle, the largest protein pool of the body, and (ii) the genetic basis of longevity. Finally, it examines (iii) the role of microRNAs in the regulation of FOXO3 and its impact on the regulation of the cell cycle.
Visceral leishmaniasis (Kala-azar) in Qom Province, Iran: Report of two cases
Authors: Zanjirani Farahani Leyli , Saghafipour Abedin , Mohebali Mehdi , Akhoundi Behnaz , Raufi Hedayatollah
Published: August 2018

Visceral leishmaniasis (VL) is a fatal parasitic zoonotic worldwide disease, which transmits to humans by the infected Phlebotomine sand fly bite. The common form of VL in Iran is the Mediterranean type with the causative agent of Leishmania infantum, whose main reservoirs are stray and domesticated dogs. The disease has several endemic foci in Iran, mostly seen among children under the age of 10, living in rural areas and nomadic tribes. The first cases of Kala-Azar in Qom province, central Iran, were reported in the year 2001, from the villages of Ghahan district. After conducting VL control strategies in the area, no new cases of the disease had been reported until recently. The cases described here are two 2-year-old girls, living in the urban parts of Qom province, one of whom did not have a history of traveling to known endemic areas of the disease. The patients were admitted to hospital in 2016-2017, complaining from recurrent fever with unrecognized reason, associated with decreased appetite and weight loss. Disease follow-up demonstrated anemia and splenomegaly, which led to diagnosis of VL, and both patients are now fully recovered. VL was presumed to be controlled in Qom province but the present cases indicate that possible VL existence remains in the region. Therefore, urgent studies and periodic monitoring are needed to identify potential reservoirs of VL in the area.
epiflows: an R package for risk assessment of travel-related spread of disease
Authors: Moraga Paula , Dorigatti Ilaria , Kamvar Zhian N. , Piatkowski Pawel , Toikkanen Salla E. , Nagraj VP , Donnelly Christl A. , Jombart Thibaut
Published: August 2018

As international travel increases worldwide, new surveillance tools are needed to help identify locations where diseases are most likely to be spread and prevention measures need to be implemented. In this paper we present epiflows, an R package for risk assessment of travel-related spread of disease. epiflows produces estimates of the expected number of symptomatic and/or asymptomatic infections that could be introduced to other locations from the source of infection. Estimates (average and confidence intervals) of the number of infections introduced elsewhere are obtained by integrating data on the cumulative number of cases reported, population movement, length of stay and information on the distributions of the incubation and infectious periods of the disease. The package also provides tools for geocoding and visualization. We illustrate the use of epiflows by assessing the risk of travel-related spread of yellow fever cases in Southeast Brazil in December 2016 to May 2017.
Case Report: Post obstructive pulmonary edema (POPE) Type II following elective adenotonsillectomy requiring novel use of high frequency oscillatory ventilation (HFOV)
Authors: Moser Joanna J. , O'Connell Meghan , McAllister Debbie L.
Published: August 2018

This case report describes a previously healthy 14 year-old patient undergoing elective outpatient adenotonsillectomy that was complicated by acute postoperative pulmonary edema requiring 12 hours of high frequency oscillatory ventilation (HFOV) support.  We describe the clinical findings that led us to this rare diagnosis and management of post obstructive pulmonary edema (POPE) Type II, a rare but recognized complication following the surgical relief of an upper airway obstruction. This case is unique in that no previously published case report or review of POPE Type II has described the need for HFOV support.
Leveraging existing program data for routine efficiency measurement in Zambia
Authors: Homan Rick , Bratt John , Marchand Gregory , Kansembe Henry
Published: August 2018

Background: As donor contributions for HIV/AIDS stagnate globally, national governments must seek ways to improve use of existing resources through interventions to drive efficiency at the facility level.  But program managers lack routinely available information on unit expenditures at points of care, and higher-level planners are unable to assess how resources are used throughout the health system.  Thus, managers cannot measure current levels of technical efficiency, and are unable to evaluate effectiveness of interventions to increase technical efficiency.

Methods: FHI 360 developed the Routine Efficiency Monitoring System (REMS), a relational database that leverages existing budget, expenditure and output data to produce quarterly site-level estimates of unit expenditure per service.  Along with the Government of the Republic of Zambia (GRZ) and implementation partner Avencion, we configured REMS to measure technical efficiency of Ministry of Health resources used to deliver HIV/AIDS services in 326 facilities in 17 high-priority districts in Copperbelt and Central Provinces.  REMS allocation algorithms were developed through facility assessments and key informant interviews with MoH staff.  Existing IFMIS and DHIS-2 data streams provide recurring flows of expenditure and output data needed to estimate service-specific unit expenditures.  Trained users access REMS output through user-friendly dashboards delivered through a web-based application. 

Results: District health management teams are using REMS to identify “outlier” facilities to test performance improvement interventions.  Provincial and national planners are using REMS to seek savings and ensure that resources are directed to geographic and programmatic areas with highest need.  REMS can support reimbursement for social health insurance and provide time-series data on facility-level costs for modeling purposes.

Conclusions:  REMS gives managers and planners substantially-improved data on how programs transform resources into services.  The GRZ is seeking funding to expand REMS nationally, covering all major disease areas.  Improved technical efficiency supports the goal of a sustainable HIV/AIDS response.
Cost per insertion and couple year of protection for post-partum intrauterine devices and implants provided during service scale-up in Kigali, Rwanda
Authors: Wall Kristin M. , Ingabire Rosine , Allen Susan , Karita Etienne
Published: August 2018

Introduction: In two high-volume government hospitals, their two affiliated health facilities, and two additional health facilities, we developed and implemented post-partum intrauterine device (PPIUD) and post-partum (PP) implant promotions and service delivery procedures between May and July 2017 in Kigali, Rwanda. Between August 2017 and July 2018, 9,073 pregnant women received PPIUD/PP implant promotions who later delivered in one of our selected facilities. Of those, 2,633 had PPIUDs inserted, and 955 had PP implants inserted.

Methods: Here, we detail the expenditures during the implementation from the payer perspective (including both the implementation costs and the cost of contraceptive methods) and estimate the cost per PPIUD insertion, PP implant insertion, and couple years of protection (CYP) for PPIUD and PP implant users. Research costs for formative work were excluded.

Results: A total of $74,147 USD was spent on the implementation between August 2017 and July 2018. The largest expense (34% of total expenses) went toward personnel, including doctoral-level, administrative, data management and nurse counseling staff. Training for PPIUD and implant providers and promoters comprised 8% of total expenses. Recruitment and reimbursements comprised 6% of expenses. Costs of implants to the government comprised 12% of the expenses, much higher than the cost of IUDs (1%). Costs per insertion were $25/PPIUDs and $77/PP implant. Costs per CYP were $5/PPIUDs and $20/PP implant.

Conclusion: The PPIUD/PP implant service implementation provided services at a low cost per insertion and CYP. Understanding the cost per PPIUD/PP implant inserted and CYP can help to inform the cost of scaling up PPIUD/PP implant service implementation activities and resource allocation decision-making by the Rwandan Ministry of Health.
Using nominal group technique to inform the development of a self-management app for patients with relapsed myeloma
Authors: Cormican Orlaith , Dowling Maura
Published: August 2018

Background: The nominal group technique (NGT) allows stakeholders to directly generate items for needs assessment. The objective was to demonstrate the use of NGT to inform the development of a healthcare app in patients with relapsed myeloma. Healthcare professionals with experience in the care of patients with relapsed/refractory myeloma were invited to participate.

Methods: One NGT group was conducted. In the group, health care professionals working in haematology were asked to vote anonymously in order of highest priority, on symptoms previously highlighted by relapsed/refractory myeloma patients in four focus groups.

Results: A total of 18 healthcare professionals working in the area of haematology participated in the NGT discussion; consultants (n=6), haematology registrars (n=2), specialist nurses [Advanced Nurse Practitioner/Clinical Nurse Specialist] (haematology) (n=3), staff nurse (n=1), and “other” health care professionals (n=6). Participants ranged in experience of working with myeloma patients from 2 years to over 27 years. The symptoms voted in highest priority were: Pain, Fatigue, Peripheral Neuropathy, Infection Risk and Steroid Induced Side Effects.

Conclusions: The NGT was an efficient method for obtaining information to inform a healthcare app.
Vibration of the plant substrate generated by workers' stridulation during fungus garden cultivation in Atta laevigata (Smith) (Hymenoptera: Formicidae)
Authors: Carlos Amanda Aparecida , Diniz Eduardo Arrivabene , Da Silva Sandra Verza , Bueno Odair Correa
Published: August 2018

Abstract. The communication between leaf-cutting ants occurs through chemical interactions and sound, which are important processes in the complex social system of these organisms. Studies have focused on the characterization and importance of stridulation and vibration of the substrate for ants in general. However, for leaf-cutting ant species, little information is available about the characterization and the function of vibration of the substrate during preparation and incorporation of plant material into the symbiotic fungus by workers. Therefore, the objective of the present study was to describe the vibration in Eucalyptus leaves generated by the stridulation of Atta laevigata (Smith) workers during processing and incorporation of the plant material into the symbiotic fungus, and to discuss its possible function. Vibrational signals were recorded with a laser vibrometer. The amplitudes of the emitted signals varied according to the behaviors performed, that is, each behavior showed a characteristic amplitude. Thus, the vibration in the leaves probably can aid in the efficiency of these ants during the processing of the vegetal material for the incorporation in its symbiont.Vibração do substrato vegetal gerada pela estridulação de operárias durante o cultivo do fungo em Atta laevigata (Smith) (Hymenoptera: Formicidae)Resumo. A comunicação entre as formigas cortadeiras ocorre por meio da interação química e do som, processos importantes no complexo sistema social destes organismos. Existem vários estudos enfocando a caraterização e a importância da estridulação e vibração do substrato para as formigas em geral. Contudo, pouco se tem descrito para as espécies de formigas cortadeiras sobre a caracterização e função da vibração do substrato durante o preparo e a incorporação do material vegetal pelas operárias no fungo simbionte. Assim, o presente trabalho descreveu a vibração nas folhas de Eucalyptus sp. gerada pela estridulação das operárias de Atta laevigata (Smith) durante o processamento e incorporação destas folhas no fungo simbionte, além de interpretar sua possível função. Os sinais vibratórios foram gravados com um vibrômetro a laser. As amplitudes dos sinais emitidos variaram conforme os comportamentos executados, ou seja, cada comportamento apresentou uma amplitude característica. Desse modo, a vibração nas folhas provavelmente pode auxiliar na eficiência dessas formigas durante o processamento do material vegetal para a incorporação no seu simbionte.
Respostas eletroantenográficas e comportamentais de abelhas africanizadas, Apis mellifera (Linnaeus), ao feromônio de Nasanov e ao óleo essencial de capim-limão
Authors: Pires Patricia Daniela da Silva , Sant'Ana Josué , Bisotto-de-Oliveira Ricardo
Published: August 2018

Resumo. O objetivo do estudo foi avaliar as respostas eletrofisiológicas e comportamentais de abelhas africanizadas, Apis mellifera (Linnaeus), em duas idades, ao feromônio de Nasanov sintético (FNS) e ao óleo essencial de capim-limão (OCL), e verificar a porcentagem de ocupação de enxames em caixas de papelão com iscas de FNS comercial (Swarm Catch Lure®) ou OCL formulado em emulsão de parafina. Foram observadas as respostas eletroantenográficas (mV) e comportamentais de abelhas operárias nutrizes e campeiras (1-5 e 20-30 dias de idade, respectivamente) aos referidos compostos, em olfatômetro de dupla escolha. Os bioensaios de campo foram conduzidos em Eldorado do Sul e Minas do Leão (Brasil, RS), utilizando-se doze caixas com dois caixilhos contendo uma tira de cera alveolada cada e iscadas com OCL ou FNS ou sem tais tratamentos (controle). Não foram observadas diferenças nas respostas eletrofisiológicas e comportamentais entre operárias jovens e velhas submetidas aos voláteis de FNS e OCL. O limiar de resposta para o feromônio foi de 0,1 mg/mL e para o óleo, 10 mg/mL. O feromônio de Nasanov e o óleo de capim-limão desencadearam resposta quimiotáxica positiva nas abelhas. Caixas com FNS atraíram mais enxames que as com OCL e controle.Electroanthenographic and behavioral responses of Africanized bees, Apis mellifera (Linnaeus), to nasanov pheromone and lemongrass essential oilAbstract. The study aimed to evaluate and compare the electrophysiological and behavioral responses of africanized honey bees (workers), Apis mellifera (Linnaeus) at different ages, to synthetic Nasanov pheromone (SNP) and to lemongrass essential oil (LGO), as well as, to verify occupancy percentage of swarms in baited cardboard boxes with SNP commercial (Swarm Catch Lure®) or LGO formulated in paraffin emulsion. Tests were conducted to observe electroantennographic responses (mV) and chemotactic behavior of nurse and forage workers bees (1-5 and 20-30 days old, respectively), to those compounds, in two choice olfactometer. The field bioassay was conducted by using twelve cardboard boxes with two bee wax sheet foundation placed in each frame, baited with SNP or LGO or without these treatments (control), in Eldorado do Sul and Minas do Leão (Brazil, RS). The mean number of swarms found in all treatments, were checked weekly.  It was not observed electrophysiological and behavioral difference responses between young and old workers subjected to SNP and LGO odors. The threshold to Nasanov synthetic pheromone was 0.1 µg/µL and to lemongrass essential oil, 10 µg/µL. Synthetic Nasanov pheromone and lemon grass oil triggered positive chemotaxis in bees. Cardboard boxes with commercial SNP were more attractive to swarms than those baited with LGO and control treatment.
Espécies de Oxysarcodexia (Diptera: Sarcophagidae) associadas a carcaças de suínos (Sus scrofa Linnaeus) expostas em um fragmento de Mata Atlântica no município de Salvador, Bahia
Authors: Lopes Daniele Santos , Oliveira Favízia Freitas de , Mello-Patiu Cátia Antunes de , Pamponet Fernanda Maria , Thé Torriceli Souza
Published: August 2018

Resumo. O gênero Oxysarcodexia é encontrado amplamente associado a carcaças de vertebrados em decomposição, sendo, portanto, considerado de grande importância forense. Desta maneira, o objetivo do presente artigo foi conhecer a fauna de Oxysacordexia que visita carcaças de suínos em decomposição em um fragmento de Mata Atlântica no município de Salvador, Bahia. Para isso, quatro carcaças de suínos em decomposição foram utilizados para atração os insetos e expostas no fragmento florestal durante dois períodos: chuvoso (julho a agosto/2012) e seco (novembro a dezembro/2012). Seis espécies de Oxysarcodexia foram atraídas e colonizaram a carcaça: Oxysarcodexia amorosa (Schiner); Oxysarcodexia diana (Lopes); Oxysarcodexia fringidea Curran & Walley; Oxysarcodexia major Lopes; Oxysarcodexia thornax (Wiedemann); Oxysarcodexia timida (Aldrich). Essas espécies de Oxysarcodexia coletadas mostraram uma aparente preferência pelo período chuvoso e pelas fases finais do processo de decomposição (deterioração avançada e restos).Species of Oxysarcodexia (Diptera: Sarcophagidae) associated with pig carrion (Sus scrofa Linnaeus) exposed in a fragment of Atlantic Forest in Salvador, Bahia Abstract. The genus Oxysarcodexia is widely found in association with decaying vertebrate carcasses and therefore is considered of great forensic importance. Thus, the aim of this paper was to know the Oxysacordexia fauna visiting rotting pig carcasses in an Atlantic Rain Forest fragment in the Municipality of Salvador, Bahia. Four decomposing pigs carcasses were used to attract insects, exposed in a forest fragment for two seasons: rainy (July-August / 2012) and dry (November to December / 2012). Six species of Oxysarcodexia were attracted and colonized the carcasses: Oxysarcodexia amorosa (Schiner); Oxysarcodexia diana (Lopes) ; Oxysarcodexia fringidea Curran & Walley; Oxysarcodexia major Lopes; Oxysarcodexia thornax (Wiedemann); Oxysarcodexia timida (Aldrich). These surveyed Oxysarcodexia species showed an apparent preference for the rainy season and for the final stages of the decomposition process (advanced deterioration and remains).