bluuebunny/crossref_metadata_2025 huggingface dataset:
Atherosclerotic Cardiovascular Disease Risk Prediction in Disaggregated Asian and Hispanic Subgroups Using Electronic Health Records
Authors: Rodriguez Fatima , Chung Sukyung , Blum Manuel R. , Coulet Adrien , Basu Sanjay , Palaniappan Latha P.
Published: July 2019

Background

Risk assessment is the cornerstone for atherosclerotic cardiovascular disease (
ASCVD
) treatment decisions. The Pooled Cohort Equations (
PCE
) have not been validated in disaggregated Asian or Hispanic populations, who have heterogeneous cardiovascular risk and outcomes.

Methods and Results

We used electronic health record data from adults aged 40 to 79 years from a community‐based, outpatient healthcare system in northern California between January 1, 2006 and December 31, 2015, without
ASCVD
and not on statins. We examined the calibration and discrimination of the
PCE
and recalibrated the equations for disaggregated race/ethnic subgroups. The cohort included 231 622 adults with a mean age of 53.1 (SD 9.7) years and 54.3% women. There were 56 130 Asian (Chinese, Asian Indian, Filipino, Japanese, Vietnamese, and other Asian) and 19 760 Hispanic (Mexican, Puerto Rican, and other Hispanic) patients. There were 2703 events (332 and 189 in Asian and Hispanic patients, respectively) during an average of 3.9 (SD 1.5) years of follow‐up. The
PCE
overestimated risk for
NHW
s, African Americans, Asians, and Hispanics by 20% to 60%. The extent of overestimation of
ASCVD
risk varied by disaggregated racial/ethnic subgroups, with a predicted‐to‐observed ratio of
ASCVD
events ranging from 1.1 for Puerto Rican patients to 1.9 for Chinese patients. The
PCE
had adequate discrimination, although it varied significantly by race/ethnic subgroups (C‐indices 0.66–0.83). Recalibration of the
PCE
did not significantly improve its performance.

Conclusions

Using electronic health record data from a large, real‐world population, we found that the
PCE
generally overestimated
ASCVD
risk, with marked heterogeneity by disaggregated Asian and Hispanic subgroups.
Patients with Lesions to Left Prefrontal Cortex (BA 9 and BA 10) Have Less Entrenched Beliefs and Are More Skeptical Reasoners
Authors: Goel Vinod , Marling Miriam , Raymont Vanessa , Krueger Frank , Grafman Jordan
Published: July 2019

The effect of prior beliefs on reasoning and decision-making is a robust, poorly understood phenomenon, exhibiting considerable individual variation. Neuroimaging studies widely show the involvement of the left pFC in reasoning involving beliefs. However, little patient data exist to speak to the necessity and role of the left pFC in belief-based inference. To address this shortcoming, we tested 102 patients with unilateral focal penetrating traumatic brain injuries and 49 matched controls. Participants provided plausibility ratings (plausible/implausible) to simple inductive arguments and (separately) strength of believability ratings of the conclusion to those same arguments. A voxel-based lesion symptom mapping analysis identified 10 patients, all with lesions to the left pFC (BA 9 and BA 10) as rating significantly fewer arguments with highly believable conclusions as “plausible,” compared with all other patients. Subsequent analyses, incorporating the right hemisphere homologue of these patients ( n = 12) and normal controls ( n = 24), revealed patients with lesions to left pFC found fewer arguments plausible in the high believable than either of these groups, and there was no difference in the behavioral scores of the right pFC patients and normal controls. Further analysis, utilizing the belief ratings as the dependent measure, revealed a Group × Belief Rating interaction, with left pFC patients having less intense beliefs about the conclusions of moderately believable and highly believable arguments. We interpreted these results to indicate that lesions to left pFC (BA 9, BA 10) increase incredulity and make these patients more skeptical reasoners. The former can partially, but not fully, explain the latter. The other relevant factor may be that unilateral left pFC lesions disrupt hemispheric equilibrium and allow for an increased inhibitory role of the right pFC. We speculate that individual differences in belief bias in reasoning in the normal population may be a function of individual differences in the left and right pFC interactional dynamics.
The Camels of Charles the Bald
Authors: Ottewill-Soulsby Samuel
Published: July 2019

This article investigates a previously neglected aspect of diplomatic relations between the Carolingians and the Umayyads of al-Andalus, the camels sent by Emir Muḥammad I to Charles the Bald, King of the West Franks, in 865. In addition to being placed within a diplomatic and historiographical context, the meaning of these animals needs to be understood within the traditions both of the donor and the recipient. The unusual nature of camels for both al-Andalus and Francia is explored. For both Muḥammad and Charles and their respective courts, camels would have been resonant of eastern monarchy, strengthening a claim to parity with other Islamic rulers for the former, while contributing to Charles’s presentation of himself as a Solomonic king.
Did Descartes Die of Poisoning?
Authors: Ebert Theodor
Published: July 2019

The paper discusses the circumstances of the fatal illness and the death of René Descartes in 1650 at the French embassy in Stockholm. It considers the hitherto available evidence, in particular the main medical documents: two letters, the first written in Dutch by Descartes’ servant, Henri Schluter, the second written in Latin by the Dutch doctor Johann van Wullen. English translations of these two documents are given respectively in Appendix 1 and Appendix 3 of this paper. Other documents, letters by the French ambassador, Pierre Chanut, or the report in the Descartes biography by Adrien Baillet, are also discussed. An analysis of the documentary evidence indicates a high probability that Descartes was poisoned with arsenic on two occasions, on February 2nd and again on February 8th, the second poisoning proving to be fatal. The paper then discusses the questions of ‘whodunnit’ and why.
PREFACE: Proceedings of the 14th International Symposium on Trichoptera
Authors: VSHIVKOVA TATYANA S. , MORSE JOHN C.
Published: July 2019

The 14th International Symposium on Trichoptera was held 2–7 July 2012 in Vladivostok, Russia (Primorsky Territory or “Primorye”). The idea of carrying out the Symposium in Vladivostok was completely supported by participants in the previous 13th Symposium in Poland (Bialowieża) 27 June 2009. One of the main arguments in favor of this venue was that the Far Eastern region of Russia, and in particular Primorye, is one of the world’s most interesting biogeographical areas.
Variability of Intraseasonal Oscillations and Synoptic Signals in Sea Surface Salinity in the Bay of Bengal
Authors: Trott Corinne B. , Subrahmanyam Bulusu , Roman-Stork Heather L. , Murty V. S. N. , Gnanaseelan C.
Published: July 2019

Intraseasonal oscillations (ISOs) significantly impact southwest monsoon precipitation and Bay of Bengal (BoB) variability. The response of ISOs in sea surface salinity (SSS) to those in the atmosphere is investigated in the BoB from 2005 to 2017. The three intraseasonal processes examined in this study are the 30–90-day and 10–20-day ISOs and 3–7-day synoptic weather signals. A variety of salinity data from NASA’s Soil Moisture Active Passive (SMAP) and the European Space Agency’s (ESA’s) Soil Moisture and Ocean Salinity (SMOS) satellite missions and from reanalysis using the Hybrid Coordinate Ocean Model (HYCOM) and operational analysis of Climate Forecast System version 2 (CFSv2) were utilized for the study. It is found that the 30–90-day ISO salinity signal propagates northward following the northward propagation of convection and precipitation ISOs. The 10–20-day ISO in SSS and precipitation deviate largely in the northern BoB wherein the river runoff largely impacts the SSS. The weather systems strongly impact the 3–7-day signal in SSS prior to and after the southwest monsoon. Overall, we find that satellite salinity products captured better the SSS signal of ISO due to inherent inclusion of river runoff and mixed layer processes. CFSv2, in particular, underestimates the SSS signal due to the misrepresentation of river runoff in the model. This study highlights the need to include realistic riverine freshwater influx for better model simulations, as accurate salinity simulation is mandatory for the representation of air–sea coupling in models.
The Extreme Precipitation Index (EPI): A Coupled Dynamic–Thermodynamic Metric to Diagnose Midlatitude Floods Associated with Flow Reversal
Authors: Milrad Shawn M. , Atallah Eyad H. , Gyakum John R. , Isphording Rachael N. , Klepatzki Jonathon
Published: July 2019

The extreme precipitation index (EPI) is a coupled dynamic–thermodynamic metric that can diagnose extreme precipitation events associated with flow reversal in the mid- to upper troposphere (e.g., Rex and omega blocks, cutoff cyclones, Rossby wave breaks). Recent billion dollar (U.S. dollars) floods across the Northern Hemisphere midlatitudes were associated with flow reversal, as long-duration ascent (dynamics) occurred in the presence of anomalously warm and moist air (thermodynamics). The EPI can detect this potent combination of ingredients and offers advantages over model precipitation forecasts because it relies on mass fields instead of parameterizations. The EPI’s dynamics component incorporates modified versions of two accepted blocking criteria, designed to detect flow reversal during the relatively short duration of extreme precipitation events. The thermodynamic component utilizes standardized anomalies of equivalent potential temperature. Proof-of-concept is demonstrated using four high-impact floods: the 2013 Alberta Flood, Canada’s second costliest natural disaster on record; the 2016 western Europe Flood, which caused the worst flooding in France in a century; the 2000 southern Alpine event responsible for major flooding in Switzerland; and the catastrophic August 2016 Louisiana Flood. EPI frequency maxima are located across the North Atlantic and North Pacific mid- and high latitudes, including near the climatological subtropical jet stream, while secondary maxima are located near the Rockies and Alps. EPI accuracy is briefly assessed using pattern correlation and qualitative associations with an extreme precipitation event climatology. Results show that the EPI may provide potential benefits to flood forecasters, particularly in the 3–10-day range.
The use of torus palatinus in the identification of unknown skeletal remains
Authors: Gupta Avneesh , Rizor Leann , Saul Julie , Kesha Kilak , Berman Gary
Published: July 2019

Torus palatinus (TP) is a benign, bony outgrowth located on the hard palate. Variation in this trait occurs, ranging from absent to a protuberance several millimeters in length. If a TP becomes too large, it can interfere with daily activities and thus warrant medical attention. This case utilised the unique morphology of a TP after surgical invention to identify the unknown skeletal remains of a woman missing for six years. Even though there is still much unknown regarding the aetiology, occurrence and prevalence of TP, this study demonstrates the usefulness of anatomical variants in the identification of unknown skeletal remains.
Time delay compensation for nonlinear bilateral teleoperation: A motion prediction approach
Authors: Shen Shaobo , Song Aiguo , Li Tao , Li Huijun
Published: July 2019

This paper addresses the time delay compensation problem for nonlinear teleoperation system. A novel motion prediction approach is proposed based on a state observer with a cascade structure. The actual positions of master robot are estimated on the slave side by using delayed information of measurements. The prediction errors remain bounded under an appropriate set of assumptions for the system uncertainties. Moreover, an essential theorem for slave controller design is proposed to demonstrate performance recovery of the closed-loop system with cascade observer. By using the predictions, the forward time delay is effectively compensated when we design the controller of slave robot. Simulations are performed to verify the effectiveness of proposed method. The prediction results are highlighted through comparing with other two kinds of cascade predictors.
Entry and Stability of Cross-National Marriages in the United States
Authors: Ryabov Igor , Zhang Yuanting
Published: July 2019

As more and more people move across borders, marriage is becoming an increasingly global affair. Yet cross-national marriage (CNM) migration has not received the scholarly attention it deserves. The present study examines the characteristics and marital stability of unions between U.S. nationals and their foreign-born (FB) spouses residing in the United States. Two data sources were used in the analysis—the American Community Survey (ACS) and the Survey of Income and Program Participation (SIPP). Our results indicated that, after controlling for race/ethnicity, socioeconomic background and marital history, marriages between U.S. nationals and their FB spouses who entered the United States as adults were less stable than unions between two native-born (NB) spouses. Compared with non-Hispanic Whites, Asian and Hispanic U.S. nationals were more prone to marry FB spouses. We also found that husband NB–wife FB marriages seemed to fare better than wife NB–husband FB types.
Toxicologic Pathology Forum*: Opinion on Designation of Adverse and Nonadverse Histopathological Findings in Toxicity Studies: The Pathologist’s Dilemma
Authors: Gopinath Chirukandath , Mowat Vasanthi
Published: July 2019

In this opinion piece, we discuss some proposed principles for designating adversity and nonadversity of histopathological changes. The suggested approach categorizes the classes of findings noted in toxicity studies with illustrations and examples and suggests adversity or nonadversity for each class, in the authors’ opinions, with rationales. Although the suggestions and examples offered in this opinion piece are generally in agreement with Society of Toxicologic Pathology best practices guideline on adversity, the authors suggest and highlight occasional divergences and differences of opinion. This is because making an adversity call is a complex and challenging topic that is difficult to simplify. Some of the challenges in deciding on adversity are discussed, especially those related to making an adversity call on a histopathological finding in isolation, based on the nature and extent of severity. The authors demonstrate some of these situations with examples. Finally, the authors suggest, in contrast to the guidelines, occasional use of a separate category for findings that are less easily classified.

[Box: see text]
An exploratory study of friendship characteristics and their relations with hedonic and eudaimonic well-being
Authors: Anderson Austen R. , Fowers Blaine J.
Published: July 2019

Friendships are an important source of happiness, well-being, physical health, and longevity. Researchers have often linked unidimensional friendship quality to life satisfaction and positive affect, which are hedonic forms of well-being. Aristotle presented an expanded view of friendship with three general characteristics: Utility, Pleasure, and Virtue. Following his theory, we expected Pleasure and Utility characteristics to be primarily related to hedonic well-being (HWB). In contrast, we expected Virtue characteristics to be more strongly related to eudaimonic well-being (EWB), which includes meaning, personal growth, and positive relationships in this study. This exploratory study assessed Aristotle’s theory about friendship and well-being with 375 participants. Two exploratory structural equation models were tested. There was an indirect relationship between Utility characteristics and HWB through Help Received. A friend’s Virtue characteristics had an indirect relationship with EWB through the reliability of the friendship. These findings indicate that friendship characteristics related to utility and virtue friendships appear to have differential implications for understanding the role of friends in happiness and flourishing.
Social by Default: Characterizing the Social Functions of the Resting Brain
Authors: Meyer Meghan L.
Published: July 2019

Social-neuroscience research has identified a set of medial frontoparietal brain regions that reliably engage during social cognition. At the same time, cognitive-neuroscience research has shown that these regions comprise part of the default network, so named because they reliably activate during mental breaks by default. Although the anatomical similarity between the social brain and the default brain is well documented, why this overlap exists remains a mystery. Does the tendency to engage these regions by default during rest have particular social functions, and if so, what might these be? Here, it is suggested that the default network performs two critical social functions during rest: social priming and social consolidation. These constructs will be defined, recently published empirical findings that support them will be reviewed, and directions for future research on the topic will be proposed.
Legal and Policy Responses to Vaccine-Preventable Disease Outbreaks
Authors: Barraza Leila , Reiss Dorit , Freeman Patricia
Published: July 2019

Laws and policies are vital tools in preventing outbreaks and limiting the further spread of disease, but they can vary in content and implementation. This manuscript provides insight into challenges in responding to recent vaccine-preventable disease outbreaks by examining legislative changes in California, policy changes on certain university campuses, and the laws implicated in a measles outbreak in Minnesota.
Emerging Public Health Law and Policy Issues Concerning State Medical Cannabis Programs
Authors: Tilburg William C. , Hodge James G. , Gourdet Camille
Published: July 2019

Thirty-four states, the District of Columbia, and Puerto Rico have legalized medical cannabis. While no two state medical cannabis programs are alike, public health concerns related to advertising, packaging and labeling, pesticide use, scientific research, and the role of medical cannabis in the opioid crisis are emerging across the country. This article examines these issues, the policy approaches states are adopting to protect patients and the public, and an assessment of the underlying federal legal landscape.
The Supply of Hospital Care to Minority and Low-Income Communities and the Hospital Readmission Reduction Program
Authors: Gaskin Darrell J. , Zare Hossein , Delarmente Benjo A.
Published: July 2019

To determine if the Centers for Medicare and Medicaid Services Hospital Readmission Reduction Program reduced hospital discharges for penalized conditions in minority and low-income communities, we used hospital discharge data for 2006 and 2013 from Arizona, California, Colorado, Florida, New Jersey, New York, North Carolina, and Wisconsin and readmission data from the Medicare Hospital Compare website. Negative binomial regression was used for 6,564 zip codes for each year to estimate the association between the expected penalty for an excess readmission in the hospital service area and the number of hospital discharges for penalized conditions (acute myocardial infarction, congestive heart failure, and pneumonia) for zip codes. The results showed that the expected penalty for excess readmissions had a negative association with the number of discharges for acute myocardial infarction, congestive heart failure, and pneumonia. The negative association increased with the percentage of minority residents but not with the poverty rate.
Medical assistance in dying: implications for health systems from a scoping review of the literature
Authors: Fujioka Jamie K. , Mirza Raza M. , Klinger Christopher A. , McDonald Lynn P.
Published: July 2019

Objective

Medical assistance in dying (MAiD) is the medical provision of substances to end a patient’s life at their voluntary request. While legal in several countries, the implementation of MAiD is met with ethical, legislative and clinical challenges, which are often overshadowed by moral discourse. Our aim was to conduct a scoping review to explore key barriers for the integration of MAiD into existing health systems.

Methods

We searched electronic databases (CINAHL, Embase, MEDLINE, and PsycINFO) and grey literature sources from 1990 to 2017. Studies discussing barriers and/or challenges to implementing MAiD from a health system’s perspective were included. Full-text papers were screened against inclusion/exclusion criteria for article selection. A thematic content analysis was conducted to summarize data into themes to highlight key implementation barriers.

Results

The final review included 35 articles (see online Appendix 1). Six categories of implementation challenges emerged: regulatory (n = 26), legal (n = 15), social (n = 9), logistical (n = 9), financial (n = 3) and compatibility with palliative care (n = 3). Within four of the six identified implementation barriers (regulatory, legal, social and logistical) were subthemes, which described barriers related to legalizing MAiD in more detail.

Conclusion

Despite multiple challenges related to its implementation, MAiD remains a requested end-of-life option, requiring careful examination to ensure adequate integration into existing health services. Comprehensive models of care incorporating multidisciplinary teams and regulatory oversight alongside improved clinician education may be effective to streamline MAiD services.
Immigration Detention as Social Defence: Policing ‘Dangerous Mobility’ in Italy
Authors: Campesi Giuseppe , Fabini Giulia
Published: July 2019

Drawing on an empirical study, this article explores the role of immigration detention in Italy by analysing the way a specific rhetoric of ‘dangerousness’ has developed and is being used within the framework of immigration enforcement policies. Our argument is that immigration detention has been transformed into an instrument of crime prevention and ‘social defence’, and that this transformation is fuelled by the central position that the legal categories of ‘risk’ and ‘danger’ have assumed in the regulation of the return procedure. The article contends that immigration law enforcement agencies can make use of immigration detention as a flexible control tool to manage what are perceived as the most problematic populations in urban areas, thus practising a policy of selective enforcement that while not explicitly built along racial and ethnic lines, clearly discriminates among migrants according to their ‘social marginality’ or supposed ‘social dangerousness’.
Resisting gentrification: The theoretical and practice contributions of social work
Authors: Thurber Amie , Krings Amy , Martinez Linda S , Ohmer Mary
Published: July 2019

Gentrification is changing the landscape of many cities worldwide, exacerbating economic and racial inequality. Despite its relevance to social work, the field has been conspicuously absent from scholarship related to gentrification. This paper introduces the dominant view of gentrification (a political economic lens), highlighting its contributions and vulnerabilities, then introduces four case studies that illuminate the distinct contributions of social work to broaden the ways in which gentrification is theorized and responded to within communities.

Findings

When gentrification is analyzed exclusively through a political economy lens, researchers, policy makers, and practitioners are likely to focus on changes in land and home values, reducing the adverse effects of gentrification to a loss of affordable housing. A singular focus on affordable housing risks paying insufficient attention to racial struggle, perpetuating damage-based views of poor people and neighborhoods, and obfuscating political, social, and cultural displacements. Social work practice—including social action group work, community organizing, community development, and participatory research and planning—offers a holistic approach to understanding, resisting, and responding to gentrification and advance equitable development in the city.

Applications

By exploring social work practice that amplifies residents’ and change makers’ efforts, advances existing community organizing, produces new insights, builds inter-neighborhood and interdisciplinary collaborations, and facilitates social action and policy change, this paper helps community practitioners to reimagine the role of social work research and practice in gentrifying neighborhoods.
A numerical study of an acoustic–hydrodynamic system exhibiting an intermittent prelude to instability
Authors: Kamin Manu , Mathew Joseph , Sujith RI
Published: July 2019

A model problem comprising two subsytems (acoustic and hydrodynamic), both admitting unsteady flows, has been studied using numerical simulations. Simulations capture all key features observed in an experiment with a similar configuration, and reveal the differences in flow field evolution that manifest as an intermittent prelude to instability in this nonlinear system, coupling acoustic and hydrodynamic phenomena. The system consists of a uniform flow that enters a long duct and leaves through an orifice into the atmosphere. The duct supports acoustic modes, while the shear layer at the boundary of the jet emerging from the orifice can develop into a train of vortices. Over some range of inflow velocities that support a stable operation, duct acoustic modes and shear layer breakup result in aperiodic, small amplitude pressure fluctuations. As the flow rate is increased, fluctuations become essentially periodic and have much larger amplitudes. This transition from a quiescent to a (so-called) whistling state occurs over a range of flow rates and is characterized by intermittent, moderately large, aperiodic fluctuations. As in the experiment, the aperiodic time series from the quiescent state is found to be multifractal; multifractality is then lost as the flow transitions to whistling. Simulation flow fields reveal differences in the development of vortices in the bounding shear layer, and near the orifice walls, that give rise to the large changes in pressure fluctuations, as well as the intermittent behavior that precedes whistling.
Technical Adequacy of Procedural and Conceptual Algebra Screening Measures in High School Algebra
Authors: Genareo Vincent R. , Foegen Anne , Dougherty Barbara J. , DeLeeuw William W. , Olson Jeannette , Karaman Dundar Ruveyda
Published: July 2019

Although algebra often functions as a gatekeeper to higher-level mathematics courses and higher education admissions, few quality measures exist for assessing conceptual understanding. This study explored the technical adequacy of three procedural and two conceptual algebra screening measures. We administered three rounds of assessments throughout an algebra course to 2,021 secondary students of 31 teachers in three states. Assessments included procedural and conceptual screening measures and additional criterion measures: teacher ratings of students’ algebra proficiency, course grades, results of two project-specific algebra proficiency exams, and state test scores. Descriptive and correlation analyses were used to investigate measure scores, alternate-form and test–retest reliability, concurrent validity, and predictive validity. Procedural measure results indicated high levels of reliability ( r = .72–.99), and moderate concurrent and predictive validity ( r = .36–.64; .36–.58). The conceptual measures produced moderate to low levels of validity ( r = .10–.44). The procedural measure results suggest they may be suitable for use as screening measures, pending further revision and diagnostic testing, while the conceptual measures did not produce acceptable results for current implementation. The findings contributed to measure redesigns to bolster their use as mathematics proficiency assessments with algebra students.
Islamic State’s quest for legitimacy: An analysis of IS media frames in Dabiq magazine
Authors: Ubayasiri Kasun
Published: July 2019

This article focuses on the media frames of legitimization presented by the Islamist militant group the Islamic State (IS) in their English-language magazine Dabiq to justify their occupation and expansion in Iraq and Syria between June 2014 and July 2017. It argues that, similar to any other militant group, IS faced challenges in establishing, sustaining and projecting legitimacy of both the organization and its militant actions. Focusing on IS narrative frames of legitimacy in Dabiq, this article looks at how the group constructed frame hierarchies that built upon widely accepted higher-order meta-frames of Islamic belief and Westphalian devolution of state power, to lever support for lower-order frames that are of strategic advantage to IS. The author agues such narratives of legitimacy were vital in IS’s attempt to undermine the authority of the sovereign states they occupied, and were necessary to challenge the monopoly of state violence in order to legitimize its own use of strategic violence both inside the self-proclaimed caliphate and in its expansion.
Media dependency, selective exposure and trust during war: Media sources and information needs of displaced and non-displaced Syrians
Authors: Melki Jad , Kozman Claudia
Published: July 2019

Using the Syrian war as a case study, this article examines the theoretical frameworks of media dependency and selective exposure during the war. Through a survey of 2,192 Syrians living in Syria, Lebanon, Jordan, and Turkey during the conflict, the study examined the media needs and trust of four groups of Syrians: non-displaced, internally displaced, externally displaced living inside refugee camps, and externally displaced living outside refugee camps. The study aimed to understand how these four groups trust and rely on different media sources to meet their information needs.
The impact of comorbidities on mortality among men and women with COPD: report from the OLIN COPD study
Authors: Sawalha Sami , Hedman Linnea , Backman Helena , Stenfors Nikolai , Rönmark Eva , Lundbäck Bo , Lindberg Anne
Published: July 2019

Background:

Comorbidities probably contribute to the increased mortality observed among subjects with chronic obstructive pulmonary disease (COPD), but sex differences in the prognostic impact of comorbidities have rarely been evaluated in population-based studies. The aim of this study was to evaluate the impact of common comorbidities, cardiovascular disease (CVD), diabetes mellitus (DM), and anxiety/depression (A/D), on mortality among men and women with and without airway obstruction in a population-based study.

Methods:

All subjects with airway obstruction [forced expiratory volume in 1 second (FEV1)/(forced) vital capacity ((F)VC) <0.70, n = 993] were, together with age- and sex-matched referents, identified after examinations of population-based cohorts in 2002–2004. Spirometric groups: normal lung function (NLF) and COPD (post-bronchodilator FEV1/(F)VC <0.70) and additionally, LLN-COPD (FEV1/(F)VC <lower limit of normal). Mortality data was collected until December 2015.

Results:

In COPD, the prevalence of CVD and DM was higher in men, whereas the prevalence of A/D was higher in women. The cumulative mortality was significantly higher in COPD than NLF, and higher in men than women in both groups. Among women with COPD, CVD and A/D but not DM increased the risk of death independent of age, body mass index, smoking habits, and disease severity, whereas among men DM and A/D but not CVD increased the risk for death. When the LLN criterion was applied, the pattern was similar.

Conclusion:

There were sex-dependent differences regarding the impact of comorbidities on prognosis in COPD. Even though the prevalence of CVD was higher in men, the impact of CVD on mortality was higher in women, and despite higher prevalence of A/D in women, the impact on mortality was similar in both sexes. The reviews of this paper are available via the supplemental material section.
Total cholesterol/HDL-cholesterol ratio discordance with LDL-cholesterol and non-HDL-cholesterol and incidence of atherosclerotic cardiovascular disease in primary prevention: The ARIC study
Authors: Quispe Renato , Elshazly Mohamed B , Zhao Di , Toth Peter P , Puri Rishi , Virani Salim S , Blumenthal Roger S , Martin Seth S , Jones Steven R , Michos Erin D
Published: July 2019

Aims

The total cholesterol (TC)/high-density lipoprotein (HDL) cholesterol ratio may carry additional information not available in more commonly used single cholesterol measures. Analysis of discordance between lipid parameters might help assess the impact of such additional information on the risk of atherosclerotic cardiovascular disease. We aimed to investigate the role of the TC/HDL-cholesterol ratio in determining atherosclerotic cardiovascular disease risk when discordant with low-density lipoprotein (LDL) cholesterol and non-HDL-cholesterol.

Methods

We studied 14,403 Atherosclerosis Risk in Communities (ARIC) study participants who were free of atherosclerotic cardiovascular disease at baseline. TC/HDL-cholesterol discordance with LDL-cholesterol (estimated by the novel Martin/Hopkins method) and non-HDL-cholesterol was assessed at five visits and determined by being at or above the median for each lipid parameter. We constructed Cox proportional hazard models to estimate the risk for incident atherosclerotic cardiovascular disease events associated with each lipid concordance/discordance category using a time-varying approach.

Results

Mean age of participants was 54.1 years, 56% women and 25% black. There were 2634 atherosclerotic cardiovascular disease events over a median (interquartile range) follow-up of 24.2 (16.0–25.4) years. Among individuals with LDL-cholesterol and non-HDL-cholesterol less than the median, 26% and 21% had discordant TC/HDL-cholesterol at or above the median, respectively. These individuals had a 24% (hazard ratio (HR) 1.24, 95% confidence interval (CI) 1.09, 1.41) and 29% (HR 1.29, 95% CI 1.13, 1.46) greater risk of incident atherosclerotic cardiovascular disease, respectively, compared to those with TC/HDL-cholesterol less than the median after multivariable adjustment. In individuals with diabetes with LDL-cholesterol or non-HDL-cholesterol less than the median, discordant TC/HDL-cholesterol at or above the median was more prevalent at 48% and 38%, respectively.

Conclusion

Clinically significant discordance exists between TC/HDL-cholesterol, available from the standard lipid profile, and the routinely used non-HDL-cholesterol and LDL-cholesterol. Such discordance may help inform atherosclerotic cardiovascular disease risk management, particularly in individuals with diabetes in whom discordance is more common.
Optimal Cooperative Learning Grouping to Improve Medical University Students’ English Competencies
Authors: Liao Hung-Chang , Li Yi-Chang , Wang Ya-huei
Published: July 2019

The study proposed an optimal cooperative learning grouping technique to facilitate medical university students’ English learning process, considering their complementary competencies. A quasi-experimental design was adopted to evaluate the feasibility of using the grouping technique. TOEIC (Test of English for International Communication) pretest and posttest were given to both the experimental group (32 students) and the control group (31 students) before and after a 16-week intervention. After the intervention, the posttest results showed that the experimental group had significantly higher mean scores than the control group. As for effect sizes, there were moderate effects on listening, reading, and writing competencies and a large effect on speaking competency. The results confirm that the proposed optimal cooperative learning grouping technique is effective for improving students’ English learning. In other words, the grouping method considering students’ complementary competencies is worth recommending for cooperative learning.
Analyzing the obstruction effects of obstacles on light pollution caused by street lighting system in Cambridge, Massachusetts
Authors: Li Xiaojiang , Duarte Fábio , Ratti Carlo
Published: July 2019

Artificial light has transformed urban life, enhancing visibility, aesthetics, and increasing safety in public areas. However, too much unwanted artificial light leads to light pollution, which has a negative effect on public health and urban ecosystems, as well as on the aesthetic and cultural meanings of the night sky. Some of the factors interfering with the estimation of light pollution in cities are urban features, such as the presence of trees, road dimensions, and the physical characteristics of buildings. In this study, we proposed a simplified model for unwanted upward light coming from street luminaires based on a building height model and the publicly accessible Google Street View images. We simulated and analyzed the obstruction effects of different street features on the light pollution caused by the street lighting system in Cambridge, Massachusetts. By providing quantitative information about the connections between the streetscape features and the amount of unwanted upward artificial light, this study provides reference values to inform policies aimed at curbing light pollution.
A Systems Approach to Project Stakeholder Management: Fuzzy Cognitive Map Modeling
Authors: Sperry Richard C. , Jetter Antonie J.
Published: July 2019

Projects that make effective use of project stakeholder management (PSM) tend to run smoothly and be successful because stakeholders understand and agree with the project approaches and outcomes. Projects with ineffective stakeholder management, on the other hand, frequently experience delays and cost overruns or may even be terminated. To date, project teams have limited methodological support for PSM: Existing methods are dominantly static and internally focused, making it difficult to manage so-called external stakeholders, who are not under the authority of the project manager. This work aims to improve PSM practice by closing the methodological gap. We developed a novel decision-support methodology, based on Fuzzy Cognitive Map (FCM) modeling that leverages stakeholders’ public comments to anticipate the project’s impacts on them and to make conflicts between stakeholder interests and project objectives transparent. A demonstration of the method is provided using a single case—namely, a longitudinal case study at Bonneville Power Administration (BPA), a federal agency that provides power to the Pacific Northwest.
Combining gene mutation with gene expression analysis improves outcome prediction in acute promyelocytic leukemia
Authors: Lucena-Araujo Antonio R. , Coelho-Silva Juan L. , Pereira-Martins Diego A. , Silveira Douglas R. , Koury Luisa C. , Melo Raul A. M. , Bittencourt Rosane , Pagnano Katia , Pasquini Ricardo , Nunes Elenaide C. , Fagundes Evandro M. , Gloria Ana B. , Kerbauy Fábio , de Lourdes Chauffaille Maria , Bendit Israel , Rocha Vanderson , Keating Armand , Tallman Martin S. , Ribeiro Raul C. , Dillon Richard , Ganser Arnold , Löwenberg Bob , Valk P. J. M. , Lo-Coco Francesco , Sanz Miguel A. , Berliner Nancy , Rego Eduardo M.
Published: July 2019

Luceno-Araujo et al use assays of mutations associated with myeloid malignancy to propose an integrative prognostic score for acute promyelocytic leukemia (ISAPL) in patients treated with all-trans retinoic acid and anthracycline-based therapy. They demonstrate that the ISAPL is superior for predicting outcomes and identifying patients who may benefit from alternative therapies to maximize their chance of a cure.
Early progression as a predictor of survival in marginal zone lymphomas: an analysis from the FIL-NF10 study
Authors: Luminari Stefano , Merli Michele , Rattotti Sara , Tarantino Vittoria , Marcheselli Luigi , Cavallo Federica , Varettoni Marzia , Bianchi Benedetta , Merli Francesco , Tedeschi Alessandra , Cabras Giuseppina , Re Francesca , Visco Carlo , Torresan Delamain Marcia , Cencini Emanuele , Spina Michele , Ferrero Simone , Ferrari Angela , Deodato Marina , Mannina Donato , Annibali Ombretta , Rago Angela , Orsucci Lorella , Defrancesco Irene , Frigeni Marco , Cesaretti Marina , Arcaini Luca
Published: July 2019

Marginal zone lymphomas (MZLs) are indolent nonfollicular B-cell lymphomas (INFLs) and have heterogeneous clinical behavior. Recently, time to progression of disease at 24 months (POD24) was identified to stratify overall survival (OS) in follicular non-Hodgkin lymphoma and in INFL. Here, we examined the ability of POD24 to predict subsequent OS in a large, international cohort of MZL as part of the NF10 prospective international registry headed by Fondazione Italiana Linfomi (FIL). POD24 was only calculated for MZL patients requiring immediate therapy and was defined as experiencing lymphoma progression within 24 months from diagnosis. Among the 1325 patients enrolled in the NF10 study, we identified 321 patients with MZL for whom immediate therapy was planned right after lymphoma diagnosis. Overall, POD24 was confirmed in 59 patients (18%). Three-year OS for patients with POD24 was 53% with a hazard ratio of 19.5 (95% confidence interval, 8.4-45) compared with patients without POD24 (3-year OS, 95%). Association of POD24 with OS was confirmed for the subgroup of splenic and extranodal MZLs. Assessment of POD24 stratifies subsequent outcome in MZL and identifies a high-risk population. This trial was registered at www.clinicaltrials.gov as #NCT02904577.
Sporadic and endemic Burkitt lymphoma have frequent FOXO1 mutations but distinct hotspots in the AKT recognition motif
Authors: Zhou Peixun , Blain Alex E. , Newman Alexander M. , Zaka Masood , Chagaluka George , Adlar Filbert R. , Offor Ugonna T. , Broadbent Casey , Chaytor Lewis , Whitehead Amber , Hall Amy , O’Connor Hettie , Van Noorden Susan , Lampert Irvin , Bailey Simon , Molyneux Elizabeth , Bacon Chris M. , Bomken Simon , Rand Vikki
Published: July 2019

FOXO1 has an oncogenic role in adult germinal center–derived lymphomas, in which mutations, predominately within the AKT recognition motif, cause nuclear retention of FOXO1, resulting in increased cell proliferation. To determine the prevalence and distribution of FOXO1 mutations in pediatric Burkitt lymphoma (BL), we sequenced a large number of sporadic and endemic BL patient samples. We report a high frequency of FOXO1 mutations in both sporadic and endemic BL at diagnosis, occurring in 23/78 (29%) and 48/89 (54%) samples, respectively, as well as 8/16 (50%) cases at relapse. Mutations of T24 were the most common in sporadic BL but were rare in endemic cases, in which mutations of residue S22, also within the AKT recognition motif, were the most frequent. FOXO1 mutations were almost always present in the major tumor cell clone but were not associated with outcome. Analysis of other recurrent mutations reported in BL revealed that FOXO1 mutations were associated with mutations of DDX3X and ARID1A, but not MYC, TCF3/ID3, or members of the phosphatidylinositol 3-kinase signaling pathway. We further show common nuclear retention of the FOXO1 protein, irrespective of mutation status, suggesting alternative unknown mechanisms for maintaining FOXO1 transcriptional activity in BL. CRISPR/Cas9 knockout of FOXO1 in an endemic cell line produced a significant decrease in cell proliferation, supporting an oncogenic role for FOXO1 in endemic BL. Thus, FOXO1 is frequently mutated in both sporadic and endemic BL and may offer a potential therapeutic target for pediatric BL patients worldwide.
Viagenpumatucel-L (HS-110) plus nivolumab in patients with advanced non-small cell lung cancer (NSCLC).
Authors: Morgensztern Daniel , Bazhenova Lyudmila , Waqar Saiama Naheed , McDermott Lori , Hutchins Jeff , Harb Wael A. , Velcheti Vamsidhar , Cohen Roger B.
Published: July 2019

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Background: Viagenpumatucel-L (HS-110) is an allogeneic cellular vaccine derived from a human lung adenocarcinoma (AD) cell line transfected with the gp96-Ig fusion protein. DURGA is a multi-cohort study evaluating the combination of HS-110 and immune checkpoint blockers (ICBs) in patients with advanced NSCLC. Here we report the initial two cohorts with the combination of HS-110 and nivolumab. Methods: Patients (pts) with previously treated NSCLC received 1 X 107 HS-110 cells weekly for the first 18 weeks and nivolumab 3 mg/kg or 240 mg every 2 weeks until intolerable toxicity or tumor progression. Tissue was tested at baseline for PD-L1 expression (≥ 1% or < 1%) and tumor infiltrating lymphocytes (TILs). TIL high was defined by more than 10% CD8+ lymphocytes in the tumor stroma. Pts in cohort A had never received, and pts in cohort B had received, prior ICBs. The primary objectives were safety and objective response rates (ORR). Results: As of the August 2018 data cut-off, there were 43 pts enrolled into cohort A (40 AD and 3 squamous cell carcinoma [SCC]) and 18 pts in cohort B (15 AD and 3 SCC). In cohort A, 14 pts (32.6%) were TIL high, 13 (30.2%) TIL low and 16 (37.2%) TIL unknown. ORR, disease control rate (DCR), median progression-free survival (PFS) and 1 year PFS were 18.6%, 48.8%, 1.9 months and 23.9% respectively in cohort A, with median follow up of 432 days. ORR, DCR, and PFS were 22%, 50% and 2.2 months respectively in cohort B, with median follow up of 43 days. The median overall survival (mOS) was not reached in either cohort. In cohort A, TIL low at baseline was associated with increased mOS compared to TIL high (not reached vs 13.8 months, hazard ratio [HR] 0.23, 95% CI 0.068-0.81, p = 0.04). There were no differences in mOS according to PD-L1 status in cohort A (p = 0.82). 57 (93%) pts experienced at least one adverse event (AE), of which 39 (64%) were grade 1 or 2. The most common AEs were fatigue (31%), cough and diarrhea (19.7% each). There were 2 grade 5 AEs (3.3%) caused by pulmonary embolism and tumor progression, neither considered to be treatment related. Conclusions: The combination of HS-110 and nivolumab is safe with encouraging preliminary efficacy data. The study is ongoing and additional populations are being explored. Clinical trial information: NCT02439450.
Nivolumab treatment in advanced non-small cell lung cancer (NSCLC): Retrospective analysis of real-life data in the Hospital Universitario Reina Sofía (HURS).
Authors: GarcÃa DurÃ¡n Carmen , Moreno-Vega Alberto L. , Sánchez Mauriño Pedro , López-González Javier , Barneto - Aranda Isidoro C. , De La Haba Juan , Aranda Aguilar Enrique
Published: July 2019

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Background: Recently, nivolumab has been approval as 2nd-line treatment of non-small cell lung cancer (NSCLC) in our country. Data regarding its effectiveness or safety in real-life setting are publishing daily. Methods: 27 patients with advanced NSCLC treated with nivolumab at HURS between February 2016 to November 2017, were evaluated for survival (overall survival OS, progression-free survival PFS), time to treatment failure (TTF), treatment discontinuation due to toxicity and demographics/clinicopathological characteristics, using SPSS v 8.0. Results: Median age was 62 years; 77,8% males. At closing data, 25,9% of patients were still receiving nivolumab treatment. 51,9 % had finished treatment due to disease progression and 7,4% to toxicity. 25,9% patients continued others chemotherapies schedules. Mean of cycles received was 11. 51,8% presented ORR to nivolumab (78% PR). The median TTF at nivolumab was 3 months. The median progression-free survival (PFS) was 6.93 months (6,2 months in the squamous histology vs 9,42 in adenocarcinoma). The median OS was 22.6 months. Neutrophil-lymphocyte ratio in a complete blood count did not decrease during nivolumab treatment in any patients (p < 0.05, McNemar test), no relation to survival rates (with a cut-off of 5 and 3). Conclusions: Effectiveness (OS and PFS) of nivoumab were high in our patients, slightly better than those observed with similar characteristics included in clinical trials. We have not found predictive survival markers.