bluuebunny/crossref_metadata_2025 huggingface dataset:
A Rare Case of Unilateral Morning Glory Disc Anomaly in a Patient with Turner Syndrome: Report and Review of Posterior Segment Associations
Authors: Sahni Dev R. , Wallace Michael , Kanhere Mansi , Al Saif Hind , Couser Natario
Published: June 2018

Turner syndrome is a common sex chromosome disorder affecting females. The disorder is caused by a partial loss, complete absence, or structural abnormality of one X chromosome. The clinical presentation is broad and ranges from the classic phenotype to minimal clinical manifestations. Ocular abnormalities associated with the syndrome are common. Reports describing abnormal eye features in individuals with Turner syndrome generally involve refractive errors (myopia or hyperopia), strabismus, and external or anterior segment abnormalities including hypertelorism, epicanthal folds, and ptosis. Posterior ocular segment anomalies involving the optic nerve and retina in Turner syndrome have been rarely reported. We report a rare presentation of an 11-year-old female with Turner syndrome and unilateral morning glory disc anomaly.
A Case of Parkinson’s Disease with No Lewy Body Pathology due to a Homozygous Exon Deletion in Parkin
Authors: Johansen Krisztina Kunszt , Torp Sverre Helge , Farrer Matthew J. , Gustavsson Emil K. , Aasly Jan O.
Published: June 2018

Parkinson’s disease (PD) is a clinical diagnosis based on the presence of cardinal motor signs, good response to levodopa, and no other explanations of the syndrome. Earlier diagnostic criteria required autopsy for a definite diagnosis based on neuronal loss in the substantia nigra pars compacta (SNpc) and the presence of Lewy bodies and neurites. Here, we present a patient who developed parkinsonism around the age of 20, with an excellent response to levodopa who, at age 65, received bilateral STN deep brain stimulation (DBS). The patient died at age 79. The autopsy showed severe neuronal loss in the SN without any Lewy bodies in the brainstem or in the hemispheres. Genetic screening revealed a homozygous deletion of exon 3-4 in the Parkin gene. In this case report we discuss earlier described pathological findings in Parkin cases without Lewy body pathology, the current diagnostic criteria for PD, and their clinical relevance.
Prognostic Factors and Survival in Primary Central Nervous System Lymphoma: A Population-Based Study
Authors: Shan Yudong , Hu Yilan
Published: June 2018

Objective. This study sought to explore the prognostic factors in a large retrospective cohort of patients with primary central nervous system lymphoma (PCNSL) from the Surveillance, Epidemiology, and End Results database. Methods. There were 5903 patients with PCNSL who had complete clinical information and were identified in the Surveillance, Epidemiology, and End Results program between 1973 and 2014. The epidemiology, therapeutic measures, and clinical characteristics were listed as descriptive statistics. They were grouped into 4 categories: immunocompetent individual with diffuse large B cell lymphoma (DLBCL), immunocompetent individual with non-DLBCL, immunocompromised individual with DLBCL, and immunocompromised individual with non-DLBCL based on different subtypes and immunological status. Survival analysis was conducted with Cox regression models. Results. Different demographics and clinical characteristics were identified as independent factors in different groups. In survival analysis, for patients with DLBCL, chemotherapy involving treatments was associated with the most favorable survival. Received-only radiation could be considered as a primary treatment in immunocompetent patients with non-DLBCL. These differences were statistically significant (P<0.05). Conclusion. PCNSL patients treated with appropriate chemotherapy treatments may receive stable tumor control.
Update in the Early Management and Reperfusion Strategies of Patients with Acute Ischemic Stroke
Authors: Mendez Aldo A. , Samaniego Edgar A. , Sheth Sunil A. , Dandapat Sudeepta , Hasan David M. , Limaye Kaustubh S. , Hindman Bradley J. , Derdeyn Colin P. , Ortega-Gutierrez Santiago
Published: June 2018

Acute ischemic stroke (AIS) remains a leading cause of death and long-term disability. The paradigms on prehospital care, reperfusion therapies, and postreperfusion management of patients with AIS continue to evolve. After the publication of pivotal clinical trials, endovascular thrombectomy has become part of the standard of care in selected cases of AIS since 2015. New stroke guidelines have been recently published, and the time window for mechanical thrombectomy has now been extended up to 24 hours. This review aims to provide a focused up-to-date review for the early management of adult patients with AIS and introduce the new upcoming areas of ongoing research.
Full‐Scale Tests for Assessing Blasting‐Induced Vibration and Noise
Authors: Lee Chung-Won , Kim Jiseong , Kang Gi-Chun
Published: June 2018

Vibration and noise problems caused by a number of construction processes, specifically blasting for infrastructure development, are becoming important because of their civil appeal. In this study, a square root equation (SRE) with a 95% confidence level was proposed for predicting blasting‐induced vibration through full‐scale test blasting, and the vibration value predicted from this equation was located between the values predicted from the USBM (US Department of Interior, Bureau of Mines), NOF (Nippon Oil & Fats Co., Ltd.), and MCT (Ministry of Construction and Transportation) equations. Additionally, by comparing the measured noise level at full‐scale test blasting with the calculated noise levels from several noise prediction equations, it was determined that the noise level predicted by the ONECRC equation had the best agreement with the measured results. However, in cases where blasting includes tunnel excavation, simultaneous measurement of vibration and noise is required to prevent damage to the surrounding facilities.
Melanoma Mimicking Malignant Peripheral Nerve Sheath Tumor with Spread to the Cerebellopontine Angle: Utility of Next-Generation Sequencing in Diagnosis
Authors: Fox Hanson Katie , Birinyi Paul , Walker Ronald , Raptis Constantine , Chernock Rebecca , Coppens Jeroen , Schwetye Katherine E.
Published: June 2018

Cutaneous spindle cell malignancy is associated with a broad differential diagnosis, particularly in the absence of a known primary melanocytic lesion. We present an unusually challenging patient who presented with clinical symptoms involving cranial nerves VII and VIII and a parotid-region mass, which was S100-positive while lacking in melanocytic pigment and markers. Over a year after resection of the parotid mass, both a cutaneous primary lentigo maligna melanoma and a metastatic CP angle melanoma were diagnosed in the same patient, prompting reconsideration of the diagnosis in the original parotid-region mass. Next-generation sequencing of a panel of cancer-associated genes demonstrated 19 identical, clinically significant mutations as well as a high tumor mutation burden in both the parotid-region and CP angle tumors, indicating a metastatic relationship between the two and a melanocytic identity of the parotid-region tumor.
Assimilation of Doppler Radar Data and Its Impact on Prediction of a Heavy Meiyu Frontal Rainfall Event
Authors: Li Hongli , Xu Xiangde , Hu Yang , Xiao Yanjiao , Wang Zhibin
Published: June 2018

Operational Doppler radar observations have potential advantages over other above-surface observations when it comes to assimilation for mesoscale model simulations with high spatial and temporal resolution. To improve the forecast of a heavy frontal rainfall event that occurred in the Yangtze-Huaihe River Basin from 4 July to 5 July 2014 in China, operational radar observations are assimilated by the Local Analysis and Prediction System (LAPS). Radar reflectivity data are used primarily in the LAPS cloud analysis procedure, which retrieves the number of hydrometeors and adjusts the moisture and cloud fields. Radial velocity data are analyzed through the LAPS wind analysis-based successive correction method. A new correction method is developed to correct three-dimensional radar reflectivity data based on hourly surface rain gauge observations. The performance of the correction method is demonstrated by assimilating radar reflectivity observations into LAPS. Experiments with different radar data assimilation are examined. Results show that the assimilation of radar data can effectively correct the background errors and improve the heavy rainfall forecast. The simulated intensity, pattern, and temporal evolution of the heavy rainfall event are better improved with radar reflectivity assimilation, especially when the correction method is implemented to correct radar observations.
Characterization and Etiopathogenic Approach of Pediatric Renal Biopsy Patients in a Colombian Medical Center from 2007-2017
Authors: Prada Rico Mayerly , Rodríguez Cuellar Carmen Inés , Fernandez Hernandez Monica , González Chaparro Luz Stella , Prado Agredo Olga Lucía , Gastelbondo Amaya Ricardo
Published: June 2018

Introduction. Renal biopsy is the principal instrument to evaluate the diagnosis and prognosis of children with kidney disease. There are relatively few studies establishing epidemiology of its findings in the pediatric population. Methods. A descriptive study was conducted to describe characteristics of pediatric patients who had undergone a renal biopsy over the last 10 years in a national reference center, trying to accomplish an etiopathogenic approach of biopsy findings. Results. 241 patients were included. Most frequent indications were nephrotic syndrome (34.1%) and systemic disease with renal involvement (30.2%). The most prevalent biopsy diagnosis was glomerulonephritis (44%) and among these patients, glomerulonephritis mediated by immune complexes was the most frequent pathogenic type (90.5%). When the biopsy was indicated for proteinuria plus hematuria and systemic disease with renal involvement, the most frequent biopsy diagnosis was glomerulonephritis (60 and 85%, respectively). For isolated hematuria, the predominant biopsy diagnosis was inherited diseases of the glomerular basement membrane (70%) and for nephrotic syndrome, podocytopathy (82%). Glomerulonephritis was more frequent in patients older than 10 yrs (65%) and the rate of postbiopsy major complications was low (1.2%). Conclusion. Immune complex glomerulonephritis was the most frequent histological finding, differing from previous reports. To our knowledge this is the first description that classifies biopsy findings according to the probable pathogenic mechanism.
Effects of Folpet, Captan, and Captafol on Human Aromatase in JEG-3 Cells
Authors: Ge Hongshan , Chen Lanlan , Su Ying , Jin Chunyan , Ge Ren-Shan
Published: June 2018

Background: Estradiol, produced by aromatase (CYP19A1), is very important for reproduction. Folpet, captan, and captafol belong to the phthalimide class of fungicides. They are used to protect the leaves of plants or fruits. They could be endocrine disruptors and may disrupt CYP19A1 activity. Methods: In the present study, we investigated the effects of folpet, captan, and captafol on estradiol production and human CYP19A1 activity in JEG-3 cells. Results: Folpet, captan, and captafol decreased estradiol production in JEG-3 cells in a concentration-dependent manner. Folpet, captan, and captafol inhibited human CYP19A1 with inhibitory concentration (IC50) values of 3.55, 10.68, and 1.14 μmol/L respectively. These chemicals competitively inhibited human CYP19A1. Molecular docking simulation analysis showed that they tended to bind to the steroid-binding pocket of the CYP19A1. However, the required concentrations may not be relevant to the negligible systemic exposures in humans to these chemicals. Conclusion: Folpet, captan, and captafol are potential inhibitors of human CYP19A1.
Etoricoxib and Diclofenac Might Reduce the Risk of Dementia in Patients with Osteoarthritis: A Nation-Wide, Population-Based Retrospective Cohort Study
Authors: Xue Yu-Hao , Peng Yu-Shin , Ting Hsin-Fu , Peijer Hsieh Jason , Huang Yu-Kai , Wang Yu-Hsun , Chiou Jeng-Yuan , Wei James Cheng-Chung
Published: June 2018

Introduction: This population-based cohort study investigates the association between osteoarthritis (OA) and dementia as well as the connection between NSAIDs and dementia. Methods: We chose the samples from the Taiwan Longitudinal Health Insurance Database and then divided them into two groups, which were then matched 1: 1 by propensity score. The first group was the OA group that contained patients with newly diagnosed OA and the second group was the non-OA group. We used the χ2 test, Student t test, Kaplan-Meier analysis, and Cox proportional hazard model for different purposes. Results: The prevalence of dementia in the OA group was higher than that in the non-OA group. The adjusted hazard ratio of the former was 1.42 (95% CI, 1.30–1.54). We also found that etoricoxib and diclofenac might reduce the incidence of dementia. Conclusion: Patients with OA might have a higher risk of dementia. Both etoricoxib and diclofenac might lower the risk of dementia in patients with OA.
A Volumetric Analysis of the Vocal Tract Associated with Laryngectomees Using Acoustic Reflection Technology
Authors: Ng Manwa L. , Yan Nan , Chan Venus , Chen Yang , Lam Paul K.Y.
Published: June 2018

Objective: Previous studies of the laryngectomized vocal tract using formant frequencies reported contradictory findings. Imagining studies of the vocal tract in alaryngeal speakers are limited due to the possible radiation effect as well as the cost and time associated with the studies. The present study examined the vocal tract configuration of laryngectomized individuals using acoustic reflection technology. Subjects and Methods: Thirty alaryngeal and 30 laryngeal male speakers of Cantonese participated in the study. A pharyngometer was used to obtain volumetric information of the vocal tract. All speakers were instructed to imitate the production of /a/ when the length and volume information of the oral cavity, pharyngeal cavity, and the entire vocal tract were obtained. The data of alaryngeal and laryngeal speakers were compared. Results: Pharyngometric measurements revealed no significant difference in the vocal tract dimensions between laryngeal and alaryngeal speakers. Conclusion: Despite the removal of the larynx and a possible alteration in the pharyngeal cavity during total laryngectomy, the vocal tract configuration (length and volume) in laryngectomized individuals was not significantly different from laryngeal speakers. It is suggested that other factors might have affected formant measures in previous studies.
Diagnosis and Management of Systemic Endemic Mycoses Causing Pulmonary Disease
Authors: Salzer Helmut J.F. , Burchard Gerd , Cornely Oliver A. , Lange Christoph , Rolling Thierry , Schmiedel Stefan , Libman Michael , Capone Domenico , Le Thuy , Dalcolmo Margareth P. , Heyckendorf Jan
Published: June 2018

Systemic endemic mycoses cause high rates of morbidity and mortality in certain regions of the world and the real impact on global health is not well understood. Diagnosis and management remain challenging, especially in low-prevalence settings, where disease awareness is lacking. The main challenges include the variability of clinical presentation, the fastidious and slow-growing nature of the fungal pathogens, the paucity of diagnostic tests, and the lack of options and toxicity of antifungal drugs. Coccidioidomycosis and paracoccidioidomycosis are restricted to the Americas only, and while histoplasmosis and blastomycosis also occur predominantly in the Americas, these mycoses have also been reported on other continents, especially in sub-Saharan Africa. Talaromycosis is endemic in tropical and subtropical regions in South-East Asia and southern China. Systemic endemic mycoses causing pulmonary disease are usually acquired via the airborne route by inhalation of fungal spores. Infections can range from asymptomatic or mild with flu-like illnesses to severe pulmonary or disseminated diseases. Skin involvement is frequent in patients with paracoccidioidomycosis, blastomycosis, sporotrichosis, and talaromycosis and manifests as localized lesions or diffuse nodules in disseminated disease, but can also occur with other endemic mycoses. Culture and/or characteristic histopathology from clinical samples is the diagnostic standard for endemic mycoses. Immunological assays are often not available for the diagnosis of most endemic mycoses and molecular amplification methods for the detection of fungal nucleic acids are not standardized at present. The first-line treatment for mild to moderate histoplasmosis, paracoccidioidomycosis, blastomycosis, sporotrichosis, and talaromycosis is itraconazole. Severe illness is treated with amphotericin B. Patients with severe coccidioidomycosis should receive fluconazole. Treatment duration depends on the specific endemic mycosis, the severity of disease, and the immune status of the patient, ranging between 6 weeks and lifelong treatment.
Towards an Optimized Use of Ocular Corticosteroids: EURETINA Award Lecture 2017
Authors: Behar-Cohen Francine
Published: June 2018

Since their discovery, glucocorticoids (GCs) have been extensively used for the treatment of ocular diseases because of their anti-inflammatory, anti-edematous and angiostatic properties. Various GCs have been synthetized to optimize their beneficial anti-inflammatory effects and reduce their effects on sodium retention, identified as a mineralocorticoid effect, leading to a potency and specificity grading of the different GCs. However, the side effects, specificity and potency of GCs are highly tissue specific. Because the eye is a confined organ, local GC administration can reduce the systemic undesirable and severe side effects but does not protect from potential local toxicity and side effects, which are dose-dependent, influenced by the disease stage and by genetic and epigenetic susceptibility. GCs can potentially induce retinal cell death through non-classical pathways such as paraptosis and non-caspase-dependent apoptosis that could be undetectable when using classical toxicology tests. To reduce the risks of toxicity, therapeutic lower doses of GCs are desirable and can be achieved using optimized methods of administration such as transscleral iontophoresis or polymeric implants. In the retina, glucocorticoid receptor (GR) and mineralocorticoid receptor (MR) expression is regulated by disease conditions such as ocular inflammation. Activation of the MR pathway by its specific ligand, aldosterone, or by illicit GC occupation can cause retinal edema, subretinal fluid accumulation, and choroidal vasodilation and leakage, suggesting that central serous chorioretinopathy could benefit from MR antagonist. A better understanding of the MR/GR balance in the ocular tissue and the differential effects of their activation in the different ocular cells is still required to envisage an optimized use of GCs for the treatment of different ocular disease conditions.
Breast Cancer in a Lagos Facility: Implications for the Institution of a Cancer Screening Programme
Authors: Ikeri Nzechukwu Zimudo , Oguntunde Olubanji Ajibola , Igbokwe Uche , Abdulkareem Fatimah Biade , Banjo Adekunbiola Aina
Published: June 2018

Objective: There are significant epidemiological and biological differences between breast cancer in blacks and whites which have wide-reaching implications for the institution of an effective cancer screening programme in Nigeria. The aim of this study was to describe the clinicopathologic features of breast cancer diagnosed in our facility and to discuss their implications for cancer screening. Methods: A retrospective review of the forms, slides, and results of breast cancer cases received in our facility over an 8-year period was carried out, as well as a systematic review of the characteristics of breast cancer in Nigeria, Africa, the US, and the UK. Result: A total of 832 cancers were seen with a mean age of 49 years. Most cases (97%) were invasive ductal carcinomas not otherwise specified, high grade (41.9%), and unassociated with ductal carcinoma in situ (52.3%). Triple-negative tumors were the commonest immunohistochemical type seen (42.1%), and these were less likely to have an intraductal component (p = 0.0048). Luminal-type tumours were more likely to be low grade (p = 0.0005). The majority of cases presented in advanced stages with no statistically significant difference among the different immunohistochemical subtypes (p = 0.7949). Conclusion: The significant epidemiological and biological differences between breast cancer in Lagos and in western populations are important for the establishment of an effective breast cancer screening programme uniquely tailored for the Nigerian population.
Inflammation: A Contributor to Depressive Comorbidity in Inflammatory Skin Disease
Authors: Farzanfar Delaram , Dowlati Yekta , French Lars E. , Lowes Michelle A. , Alavi Afsaneh
Published: June 2018

The prevalence of affective disorders such as depression and anxiety is particularly high in patients with autoimmune diseases, including inflammatory skin diseases such as psoriasis, atopic dermatitis, and hidradenitis suppurativa. A dysregulated immune response has been linked to the precipitation of depression in many patient populations. However, studies examining the extent to which the underlying skin disease inflammatory processes contribute to depression and a subsequent decline in quality of life are limited. The published literature over the past 5 years was reviewed for evidence of a relationship between depression and inflammatory processes in the context of skin pathology. The findings, particularly the evidence from interventional clinical trials of targeted anti-cytokine therapies, suggest that pro-inflammatory cytokines associated with several skin diseases may be causally linked with the coexistent depressive symptomology.
Long-Term Cholic Acid Therapy in Zellweger Spectrum Disorders
Authors: Heubi James E. , Setchell Kenneth D.R. , Bove Kevin E.
Published: June 2018

Zellweger spectrum disorders (ZSDs), a subgroup of peroxisomal biogenesis disorders, have a generalized defect in peroxisome function. Liver disease in ZSDs has been linked to accumulation of C27-bile acid intermediates due to the lack of peroxisomal β-oxidation of these intermediates to form primary C24-bile acids. Oral treatment with primary bile acid, cholic acid (CA), inhibits formation of hepatotoxic C27-bile acids by restoring normal physiologic feedback inhibition on bile acid synthesis. We present the long-term CA treatment and liver-related outcomes for 3 pediatric patients with ZSDs who have received CA treatment for ≥15 years. Ongoing CA treatment was associated with stabilized liver function, as shown by serum biochemistries and liver histopathology, and no treatment-related adverse effects were observed. All 3 patients have attended regular school with classroom accommodations and attained a good quality of life. Our patient outcomes suggest that early and ongoing CA therapy may sustain liver function in patients with ZSDs.
Effective Desensitization to Tocilizumab in Delayed Hypersensitivity Reaction
Authors: Cortellini Gabriele , Mascella Fabio , Simoncelli Margherita , Lippolis Domenico , Focherini Maria Cristina , Cortellini Fabio , Cherubini Chiara , Gavioli Barbara , Ballardini Giorgio
Published: June 2018

We present tocilizumab desensitization of a 47-year-old woman affected by rheumatoid arthritis with full body delayed erythematous urticarial reaction. Skin test for tocilizumab gave cutaneous reaction after 6 h at 20 mg/mL. The schedule of desensitization was then adapted for non-immediate reaction. We prepared a desensitization procedure reaching the cumulative dose of 516 mg in 5 weeks. After 6 months, the repetition of skin tests had a negative result, with demonstration of tolerance induction. Today the patient has good control of the disease.
Signet Ring Cell Carcinoma of Unknown Primary Complicated with Pulmonary Tumor Thrombotic Microangiopathy and Krukenberg Tumor
Authors: Tanaka Masahide , Takahashi Koichiro , Kurihara Yuki , Yamamoto-Rikitake Mihoko , Ogusu Shinsuke , Hirakawa Haruki , Sadamatsu Hironori , Komiya Kazutoshi , Nakamura Tomomi , Sueoka-Aragane Naoko
Published: June 2018

Pulmonary tumor thrombotic microangiopathy (PTTM) is a rare disease that shows hypoxia with severe pulmonary hypertension related to malignant tumor. Diagnosis is difficult due to rapid clinical progression and the need to demonstrate pathological findings from lung biopsy. A 64-year-old woman visited our hospital with hypoxia and pulmonary hypertension. Diffuse granular shadows in the centrilobular area and ground-glass shadows in both lungs and left ovarian tumor were found on radiological imaging. PTTM was suspected, but pulmonary artery blood aspiration by right cardiac catheter failed to detect cancer cells. We could not obtain lung or ovary biopsies because of hypoxia or pulmonary hypertension. The patient died due to respiratory failure. Signet ring cell carcinoma of unknown primary, PTTM, and Krukenberg tumor were diagnosed on autopsy. Since early diagnosis facilitates adequate treatment, physicians should not miss the opportunity for biopsy in cases of suspected PTTM.
Identification of Prognostic Value of Rs3735590 Polymorphism in 3’-Untranslated Region (3’-UTR) of Paraoxonase 1 (PON-1) in Chronic Obstructive Pulmonary Disease Patients who Received Coronary Artery Bypass Grafting (CABG)
Authors: Lv Min , Sun Dajun , Chen Libo
Published: June 2018

Background/Aims: In the treatment of serious and symptomatic coronary heart disease (CHD), coronary artery bypass grafting (CABG) is a frequently utilized intervention. In addition, the risk of CHD is strongly associated with the low activity of paraoxonase-1 (PON1), whose 3’-UTR harbors an rs3735590 polymorphism. The aim of this study was to investigate whether the rs3735590 polymorphism could be used as a prognosis marker in chronic obstructive pulmonary disease (COPD) patients undergoing CABG. In addition, the hypothesis, i.e., the rs3735590 polymorphism may be involved in the regulation of PON1 gene expression via modulating its interaction with miRNAs, was tested in this study. Methods: 292 patients diagnosed with COPD and treated with CABG were recruited for this study. Genomic DNA was extracted from clinical samples, and real-time quantitative PCR and Western-blot were used to measure the expression of miR-616 and PON1 in liver cells of different genotypes. Results: 292 COPD patients were divided into three groups according to their genotypes, i.e., rs3735590: CC (212), TC (75), and TT (5), respectively (TC and TT were merged in one group of T carriers for statistical analyses). Patients with the CC genotype were associated with a shorter event-free survival time as compared to patients with the T genotypes. In addition, PON1 was confirmed as a direct target gene of miR-616, while experiments with primary cells of different genotypes showed that miR-616 inhibited the expression of PON1 in CC cells. On the contrary, rs3735590 impaired such inhibitory effect of miR-616 in TT cells. Conclusion: The rs3735590 polymorphism of PON1 acts as a prognostic biomarker in COPD patients treated by CABG.
Outcomes Associated With Apixaban Use in Patients With End-Stage Kidney Disease and Atrial Fibrillation in the United States
Authors: Siontis Konstantinos C. , Zhang Xiaosong , Eckard Ashley , Bhave Nicole , Schaubel Douglas E. , He Kevin , Tilea Anca , Stack Austin G. , Balkrishnan Rajesh , Yao Xiaoxi , Noseworthy Peter A. , Shah Nilay D. , Saran Rajiv , Nallamothu Brahmajee K.
Published: June 2018

Background:

Patients with end-stage kidney disease (ESKD) on dialysis were excluded from clinical trials of direct oral anticoagulants for atrial fibrillation (AF). Recent data have raised concerns regarding the safety of dabigatran and rivaroxaban, but apixaban has not been evaluated despite current labeling supporting its use in this population. The goal of this study was to determine patterns of apixaban use and its associated outcomes in dialysis-dependent patients with ESKD and AF.

Methods:

We performed a retrospective cohort study of Medicare beneficiaries included in the United States Renal Data System (October 2010 to December 2015). Eligible patients were those with ESKD and AF undergoing dialysis who initiated treatment with an oral anticoagulant. Because of the small number of dabigatran and rivaroxaban users, outcomes were only assessed in patients treated with apixaban or warfarin. Apixaban and warfarin patients were matched (1:3) based on prognostic score. Differences between groups in survival free of stroke or systemic embolism, major bleeding, gastrointestinal bleeding, intracranial bleeding, and death were assessed using Kaplan–Meier analyses. Hazard ratios (HRs) and 95% CIs were derived from Cox regression analyses.

Results:

The study population consisted of 25 523 patients (45.7% women; 68.2±11.9 years of age), including 2351 patients on apixaban and 23 172 patients on warfarin. An annual increase in apixaban prescriptions was observed after its marketing approval at the end of 2012, such that 26.6% of new anticoagulant prescriptions in 2015 were for apixaban. In matched cohorts, there was no difference in the risks of stroke/systemic embolism between apixaban and warfarin (HR, 0.88; 95% CI, 0.69–1.12;
P
=0.29), but apixaban was associated with a significantly lower risk of major bleeding (HR, 0.72; 95% CI, 0.59–0.87;
P
<0.001). In sensitivity analyses, standard-dose apixaban (5 mg twice a day; n=1034) was associated with significantly lower risks of stroke/systemic embolism and death as compared with either reduced-dose apixaban (2.5 mg twice a day; n=1317; HR, 0.61; 95% CI, 0.37–0.98;
P
=0.04 for stroke/systemic embolism; HR, 0.64; 95% CI, 0.45–0.92;
P
=0.01 for death) or warfarin (HR, 0.64; 95% CI, 0.42–0.97;
P
=0.04 for stroke/systemic embolism; HR, 0.63; 95% CI, 0.46–0.85;
P
=0.003 for death).

Conclusions:

Among patients with ESKD and AF on dialysis, apixaban use may be associated with a lower risk of major bleeding compared with warfarin, with a standard 5 mg twice a day dose also associated with reductions in thromboembolic and mortality risk.
How Do States Benefit from Nonstate Governance? Evidence from Forest Sustainability Certification
Authors: Abrams Jesse , Nielsen Erik , Diaz Diana , Selfa Theresa , Adams Erika , Dunn Jennifer L. , Moseley Cassandra
Published: June 2018

Forest sustainability certification is emblematic of governance mechanisms associated with neoliberal state reforms. Despite being conceived as a means of compensating for the unwillingness or inability of states to regulate forest practices, in practice, forest certification has come to entail complex and hybrid relationships between private-sector, civil society, and government actors. Indeed, states have increasingly embraced certification as a means of complementing or even supplanting traditional forms of governmental regulation of the forest sector. Yet processes of neoliberalization imply both an expansion of opportunities for hybrid governance and a weakening of the state capacity that is often needed for successful implementation of certification initiatives. We analyze the complex relationships between neoliberalization, state capacity, and certification through two contrasting cases in Wisconsin, United States, and Entre Ríos, Argentina. Our findings illustrate the tensions within broadly neoliberal and postneoliberal regimes and highlight the persistence of long-standing patterns of state-led environmental governance.
Perceptions of Corruption, Political Distrust, and the Weakening of Climate Policy
Authors: Rafaty Ryan
Published: June 2018

This article presents a theory of the relationship between public perceptions of political corruption and the strength of national climate change mitigation policies, which is then formally tested in a time-series-cross-section analysis of twenty industrialized democracies from 1990 to 2012. The analysis reveals that greater perceptions of corruption are highly and robustly associated with weaker climate policies—especially nonmarket policies—when controlling for relevant political and economic variables. A government perceived by citizens to be “mildly corrupt” but that transitions to “very clean” would be associated with strengthening nonmarket climate policies from levels in Greece to levels in Sweden or from levels in Poland to those in Denmark. Lax market-based climate policies are also significantly linked to greater perceived corruption, but notably, they are robustly associated with the size of domestic energy-intensive, trade-exposed industries, which have received substantial environmental tax exemptions and free allocations even in the greenest, high-trust, low-corruption democracies.
The Transformative Capability of Transparency in Global Environmental Governance
Authors: Ciplet David , Adams Kevin M. , Weikmans Romain , Roberts J. Timmons
Published: June 2018

We develop and apply a new theoretical framework for assessing the transformative capability of transparency in environmental governance. Our framework suggests that as norms related to transparency are recognized and translated into accountability mechanisms, and as these mechanisms are complied with, effects cascade and substantially influence the ability of transparency to transform relationships of inequality. Utilizing the case of climate finance in the United Nations Framework Convention on Climate Change, we find that while a variety of norms underpinning transparency are recognized within the governance architecture, their translation into accountability mechanisms has been weak, and information disclosed by countries is often opaque. This suggests that a focus on enhanced transparency is unlikely to be sufficient for realizing a climate regime that is adequate and equitable. Moreover, transparency should be seen as a terrain of political conflict over the conditions of inequality, employed differently by various coalitions to benefit their respective interests.
The Monetary Value of Bronze Mirrors in the Han Dynasty
Authors: Guo Yanlong
Published: June 2018

This essay investigates the monetary value of bronze mirrors during the Han dynasty. It reevaluates the rhetorical and realistic prices of mirrors reckoned in catties of gold or in coins by engaging the scattered inscriptional evidence, estimated cost of raw materials, and existing studies of the price history of the Han. To achieve this goal, an interdisciplinary strategy is employed, including a close textual reading of recently uncovered inscriptions, a quantitative analysis of weights and diameters of mirrors, and a comparative examination of financial values embedded in various types of objects. As the first empirical study of Han mirrors as commodities, this essay critiques the conventional use of art history criteria for assessing the value of mirrors and unveils a previously suppressed economic feature of these specular discs. It argues that bronze mirrors served as a form of affordable luxury in Han society.
The large carrion beetles (Coleoptera: Silphidae) of Turkey: a review with a new species record
Authors: ÇİFTÇİ DERYA , RŮŽIČKA JAN , HASBENLİ ABDULLAH , ŞAHİN ÜLFET
Published: June 2018

A total of 24 species and subspecies of Silphidae (ten belonging to the subfamily Nicrophorinae and 14 to Silphinae) are reported from Turkey. This list combines a literature review with examination of specimens collected in various regions of Turkey, and mostly housed at the Metin Aktaş Zoological Museum of Gazi University, Ankara, Turkey and in the collection of Jan Růžička, Prague, Czech Republic. One species, Silpha olivieri Bedel, 1887, is reported from Turkey for the first time. The occurrence of Nicrophorus sepultor Charpentier, 1825 in Turkey is confirmed, based on abundant recently collected material from north-western Turkey. For several other species, we provide new province records within Turkey. Thanatophilus ferrugatus (Solsky, 1874) is excluded from the Turkish fauna, since the published record was based on misidentification of the similar T. terminatus (Hummel, 1825). We provide a key to adults of species and subspecies known from Turkey, and distribution maps and photographs of all taxa.
Redescription of Heterocerus fausti Reitter, 1879, bona species (Coleoptera, Heteroceridae)
Authors: SAZHNEV ALEXEY S.
Published: June 2018

The validity of Heterocerus fausti Reitter, 1879, previously considered a junior synonym of H. flexuosus Stephens, 1828 has been restored. Its redescription based upon typical material from Caucasus and additional material from Central Asia is given.
Parameters for the Collapse of Turbulence in the Stratified Plane Couette Flow
Authors: van Hooijdonk Ivo G. S. , Clercx Herman J. H. , Ansorge Cedrick , Moene Arnold F. , van de Wiel Bas J. H.
Published: June 2018

We perform direct numerical simulation of the Couette flow as a model for the stable boundary layer. The flow evolution is investigated for combinations of the (bulk) Reynolds number and the imposed surface buoyancy flux. First, we establish what the similarities and differences are between applying a fixed buoyancy difference (Dirichlet) and a fixed buoyancy flux (Neumann) as boundary conditions. Moreover, two distinct parameters were recently proposed for the turbulent-to-laminar transition: the Reynolds number based on the Obukhov length and the “shear capacity,” a velocity-scale ratio based on the buoyancy flux maximum. We study how these parameters relate to each other and to the atmospheric boundary layer. The results show that in a weakly stratified equilibrium state, the flow statistics are virtually the same between the different types of boundary conditions. However, at stronger stratification and, more generally, in nonequilibrium conditions, the flow statistics do depend on the type of boundary condition imposed. In the case of Neumann boundary conditions, a clear sensitivity to the initial stratification strength is observed because of the existence of multiple equilibriums, while for Dirichlet boundary conditions, only one statistically steady turbulent equilibrium exists for a particular set of boundary conditions. As in previous studies, we find that when the imposed surface flux is larger than the maximum buoyancy flux, no turbulent steady state occurs. Analytical investigation and simulation data indicate that this maximum buoyancy flux converges for increasing Reynolds numbers, which suggests a possible extrapolation to the atmospheric case.
Multiscale Atmospheric Overturning of the Indian Summer Monsoon as Seen through Isentropic Analysis
Authors: Chen Xingchao , Pauluis Olivier M. , Leung L. Ruby , Zhang Fuqing
Published: June 2018

This study investigates multiscale atmospheric overturning during the 2009 Indian summer monsoon (ISM) using a cloud-permitting numerical model. The isentropic analysis technique adopted here sorts vertical mass fluxes in terms of the equivalent potential temperature of air parcels, which is capable of delineating the atmospheric overturning between ascending air parcels with high entropy and subsiding air parcels with low entropy. The monsoonal overturning is further decomposed into contributions from three characteristic scales: the basinwide ascent over the Indian monsoon domain, the regional-scale overturning associated with synoptic and mesoscale systems, and the convective-scale overturning. Results show that the convective-scale component dominates the upward mass transport in the lower troposphere while the region-scale component plays an important role by deepening the monsoonal overturning. The spatial variability of the convective-scale overturning is analyzed, showing intense convection over the Western Ghats and the Bay of Bengal while the deepest overturning is localized over northern India and the Himalayan foothills. The equivalent potential temperature in convective updrafts is higher over land than over the ocean or coastal regions. There is also substantial variability in the atmospheric overturning associated with the intraseasonal variability. The upward mass and energy transport increase considerably during the active phases of the ISM. A clear northeastward propagation in the peak isentropic vertical mass and energy transport over different characteristic regions can be found during the ISM, which corresponds to the intraseasonal oscillations of the ISM. Altogether, this study further demonstrates the utility of the isentropic analysis technique to characterize the spatiotemporal variations of convective activities in complex atmospheric flows.
The “Bag Breakup” Spume Droplet Generation Mechanism at High Winds. Part I: Spray Generation Function
Authors: Troitskaya Yu. , Kandaurov A. , Ermakova O. , Kozlov D. , Sergeev D. , Zilitinkevich S.
Published: June 2018

This paper describes the results of an experimental and theoretical investigation into the mechanisms by which spume droplets are generated by high winds. The experiments were performed in a high-speed wind-wave flume at friction velocities between 0.8 and 1.5 m s−1 (corresponding to a 10-m wind speed of 18–33 m s−1 under field conditions). High-speed video of the air–water interface revealed that the main types of spray-generating phenomena near the interface are “bag breakup” (similar to fragmentation of droplets and jets in gaseous flows at moderate Weber numbers), breakage of liquid ligaments near the crests of breaking surface waves, and bursting of large submerged bubbles. Statistical analysis of these phenomena showed that at wind friction velocities exceeding 1.1 m s−1 (corresponding to a wind speed of approximately 22.5 m s−1), the main mechanism responsible for the generation of spume droplets is bag breakup fragmentation of small-scale disturbances that arise at the air–water interface under the strong wind. Based on the general principles of statistical physics, it was found that the number of bags arising at the water surface per unit area per unit time was dependent on the friction velocity of the wind. The statistics obtained for the bag breakup events and other data available on spray production through this type of fragmentation were employed to construct a spray generation function (SGF) for the bag breakup mechanism. The resultant bag breakup SGF is in reasonable agreement with empirical SGFs obtained under laboratory and field conditions.
Role of Mesoscale Eddies in Modulating the Semidiurnal Internal Tide: Observation Results in the Northern South China Sea
Authors: Huang Xiaodong , Wang Zhaoyun , Zhang Zhiwei , Yang Yunchao , Zhou Chun , Yang Qingxuan , Zhao Wei , Tian Jiwei
Published: June 2018

The role of mesoscale eddies in modulating the semidiurnal internal tide (SIT) in the northern South China Sea (SCS) is examined using the data from a cross-shaped mooring array. From November 2013 to January 2014, an anticyclonic eddy (AE) and cyclonic eddy (CE) pair crossed the westward SIT beam originating in Luzon Strait. Observations showed that, because of the current and stratification modulations by the eddy pair, the propagation speed of the mode-1 SIT sped up (slowed down) by up to 0.7 m s−1 (0.4 m s−1) within the AE’s (CE’s) southern portion. As a result of the spatially varying phase speed, the mode-1 SIT wave crest was clockwise rotated (counterclockwise rotated) within the AE (CE) core, while it exhibited convex and concave (concave and convex) patterns on the southern and northern peripheries of the AE (CE), respectively. In mid-to-late November, most of the mode-1 SIT energy was refracted by the AE away from Dongsha Island toward the north part of the northern SCS, which resulted in enhanced internal solitary waves (ISWs) there. Corresponding to the energy refraction, responses of the depth-integrated mode-1 SIT energy to the eddies were generally in phase at the along-beam-direction moorings but out of phase in the south and north parts of the northern SCS at the cross-beam-direction moorings. From late December to early January, intensified mode-2 SIT was observed, whose energy was likely transferred from the mode-1 SIT through eddy–wave interactions. The observation results reported here are helpful to improve the capability to predict internal tides and ISWs in the northern SCS.
Predictability of Recurrent Weather Regimes over North America during Winter from Submonthly Reforecasts
Authors: Vigaud N. , Robertson A.W. , Tippett M. K.
Published: June 2018

Four recurrent weather regimes are identified over North America from October to March through a k-means clustering applied to MERRA daily 500-hPa geopotential heights over the 1982–2014 period. Three regimes resemble Rossby wave train patterns with some baroclinicity, while one is related to an NAO-like meridional pressure gradient between eastern North America and western regions of the North Atlantic. All regimes are associated with distinct rainfall and surface temperature anomalies over North America. The four-cluster partition is well reproduced by ECMWF week-1 reforecasts over the 1995–2014 period in terms of spatial structures, daily regime occurrences, and seasonal regime counts. The skill in forecasting daily regime sequences and weekly regime counts is largely limited to 2 weeks. However, skill relationships with the MJO, ENSO, and SST variability in the Atlantic and Indian Oceans suggest further potential for subseasonal predictability based on wintertime large-scale weather regimes.
“The Public Doesn’t Understand”: The Self-reinforcing Interplay of Image Discrepancies and Political Ideologies in Law Enforcement
Authors: Patil Shefali V.
Published: June 2018

Drawing on information processing theory, I revisit prior assumptions that not being understood raises challenges for employees, examining how political ideologies powerfully affect how employees who serve the public react to a perceived lack of understanding of the difficulties of their jobs. Using independent expert ratings of 794 body camera videos of 164 police officers across two agencies, I show that a lack of perceived public understanding decreases task performance for liberal-leaning officers but not for conservative-leaning officers. Because liberal-leaning officers seek to form more communal relationships with the public, a perceived lack of public understanding violates their sense of social order, but it merely reaffirms conservative-leaning officers’ beliefs in maintaining an authoritarian distance given the responsibilities and duties they shoulder. I replicate these results using supervisors’ ratings of 82 officers across four agencies and then demonstrate in a time-lagged survey of 184 officers in a single agency that those with stronger conservative beliefs are more likely to believe the public fails to appreciate the difficulties of their jobs. These studies highlight the importance of accounting for people’s beliefs in whether image conflicts should and do arise—and provide insights into the self-reinforcing forces that sustain divides between employees and those they serve.