bluuebunny/crossref_metadata_2025 huggingface dataset:
The influence of democracy on emissions and energy efficiency in America: New evidence from quantile regression analysis
Authors: Chou Li-Chen , Zhang Wan-Hao , Wang Meng-Ying , Yang Fu-Ming
Published: October 2019

This study explores whether the development of democracy can significantly affect CO2 emissions and the energy efficiencies in the countries. Database reference from Freedom House, Polity IV project and World Development Indicator was applied to analyze the relationship between the democracy development, CO2 emissions and the energy efficiency of 26 countries in America from the year 1990 to 2013. Empirical result shows that the deepening democracy has a significant impact on the reduction of national CO2 emissions and brings a positive influence on energy efficiency. The further application of quantile regression also indicates that the influence of democratization on CO2 emissions and countries' energy efficient scores is significant. The empirical results may reflect the reduction of emission or the improvement of energy efficient outcome from the enhancement of democratic institution.
Factor Xa inhibitors for preventing recurrent thrombosis in patients with antiphospholipid syndrome: a longitudinal cohort study
Authors: Sato T , Nakamura H , Fujieda Y , Ohnishi N , Abe N , Kono M , Kato M , Oku K , Bohgaki T , Amengual O , Yasuda S , Atsumi T
Published: October 2019

Objective

The objective of this study was to clarify the efficacy and safety of factor Xa inhibitors for antiphospholipid syndrome patients in real world utilization.

Methods

This is a retrospective cohort study comprised of all consecutive patients with antiphospholipid syndrome in our department over a period of 28 years. Patients treated with factor Xa inhibitors were extracted from the cohort. As a control group, patients treated with warfarin were selected from the same cohort with matched age, gender, coexistence of systemic lupus erythematosus, and the presence of antiplatelet therapy, after which we used a propensity score for each of the risk factors as an additional covariate in multivariate Cox proportional hazard regression. The primary endpoint was set as thrombotic and hemorrhagic event-free survival for five years.

Results

Among 206 patients with antiphospholipid syndrome, 18 had a history of anti-Xa therapy (five rivaroxaban, 12 edoxaban, one apixaban). Fourteen out of 18 patients on anti-Xa therapy had switched to factor Xa inhibitors from warfarin. Event-free survival was significantly shorter during anti-Xa therapy than that during warfarin therapy (hazard ratio: 12.1, 95% confidence interval: 1.73–248, p = 0.01) ( Figure 1(a) ). Similarly, event-free survival in patients treated with factor Xa inhibitors was significantly shorter compared with controls (hazard ratio: 4.62, 95% confidence interval: 1.54–13.6, p = 0.0075). In the multivariate Cox proportional hazard model, event-free survival in patients with anti-Xa therapy remained significantly shorter (hazard ratio: 11.9, 95% confidence interval: 2.93–56.0, p = 0.0005).

Conclusions

Factor Xa inhibitors may not be recommended for antiphospholipid syndrome.
Risk factors of infection-associated mortality in children with lupus nephritis in under-resourced areas
Authors: Rianthavorn P , Prurapark P
Published: October 2019

Introduction

Treatment of lupus nephritis class III, IV and V with immunosuppressive therapy increases patient survival but poses a risk of infection-related mortality. This study was conducted to evaluate risk factors for fatal infection in children with lupus nephritis in under-resourced areas.

Methods

Medical records of patients, who were admitted to a tertiary-care university-based hospital from January 2002 to July 2018 with the diagnosis of systemic lupus erythematosus, were reviewed. Only patients aged less than 18 years with lupus nephritis and documented infection were included in the study. The primary outcome was infection-associated mortality. The logistic regression model was used to identify independent variables associated with fatal infection. Predicted probabilities of infection-related mortality adjusted for factors significant in multivariate analysis were calculated using marginal effects at representative values.

Results

Infection-related deaths occurred in 27 of 179 patients (15.1%). Hospital-acquired infections occurred in 72 of 375 episodes of hospital admissions (19.2%) and 13 hospital-acquired infections (18.1%) resulted in fatal infection. Invasive fungal infections were the leading cause of death (44.4%) and pulmonary infections were the predominant site (55.5%). Haemoglobin levels and glomerular filtration rates were significantly lower in deceased versus surviving patients. Percentages of patients with hospital-acquired infections, invasive fungal infections and pulmonary infections were significantly higher in deceased than surviving patients. Urine protein, the neutrophil-to-lymphocyte ratio, cumulative methylprednisolone dose and daily prednisolone dose were significantly higher in deceased than surviving patients. In multivariate analysis, a neutrophil-to-lymphocyte ratio more than 20, invasive fungal infections and high daily prednisolone dose were independently predictive of fatal infection with adjusted odds ratio of 3.02 (95% confidence interval 1.02–8.97, p = 0.04), 15.08 (95% confidence interval 4.72–48.24, p < 0.001) and 1.03 (95% confidence interval 1.01–1.06, p = 0.04), respectively. A high daily prednisolone dose intensified the impact of invasive fungal infections and high neutrophil-to-lymphocyte ratio on predicted probability of infection-associated mortality.

Conclusions

Prevention of invasive fungal infections and minimization of daily prednisolone should be emphasized in routine clinical practice of children with lupus nephritis in under-resourced areas to achieve better survival. Children with lupus nephritis and a high neutrophil-to-lymphocyte ratio should be under cautious surveillance for infection.
Secondary acute angle closure attack as an initial presentation of a novel type of systemic lupus erythematosus
Authors: Sun H -S , Kong X -Y , Bai Y -Y , Li M , Hu N -W
Published: October 2019

Background

We report a rare case of secondary acute angle closure attack because of lupus choroidopathy and accompanying polyserositis, as an initial presentation of a novel type of systemic lupus erythematosus in a 44-year-old woman.

Case presentation

The patient complained of eyelid oedema and chemosis with bilateral severe loss of visual acuity. Systemic lupus erythematosus was diagnosed based on malar rash, polyserositis, proteinuria and positive antibody titers for antinuclear antibodies, anti-DNA, antinucleosome antibodies and ribosomal RNP. Subsequently, secondary bilateral acute angle closure caused by choroidal effusions with lupus choroidopathy was diagnosed. A month after steroid and immunosuppressive drug therapy, the patient’s intraocular pressure and visual acuity returned to normal. During the subsequent year, the secondary acute angle closure did not recur and polyserositis remained under control.

Conclusions

Bilateral, secondary acute angle closure attack due to SLE choroidopathy can be an initial presentation of SLE, which is often accompanied by polyserositis. Prompt and aggressive high doses of steroids and immunosuppressive therapy are strongly recommended.
Small and Medium Enterprises Export by Indian Regions: Uncovering the Role of Spatial Factors
Authors: Husain Tareef
Published: October 2019

The present study uncovers the critical regional factors essentially responsible for inter-state small and medium enterprises (SMEs) export differences. In this context, this study is useful from the perspective of regional/local policy implications, as it is focused on critical regional determinants of SMEs’ export. Based on a wide range of interconnected theories, this study designs an analytical framework comprising a set of regional factors, which are proposed to have a significant impact on export capabilities of local SMEs. The empirical results indeed confirm the relation significantly. States with larger and productive SMEs are more successful in export activities. Likewise, Indian states may enhance their SMEs’ export by focusing on regional factors such as market, skill and power generation capacity.

JEL Classification: F12, F14, R12
Olanzapine as a rescue antiemetic in hematopoietic stem cell transplant
Authors: Monson Taylor , Greer Devon , Kreikemeier Emily , Liewer Susanne
Published: October 2019

Background

Chemotherapy-induced nausea and vomiting occurs in up to 80% of patients undergoing chemotherapy treatment and is associated with a deterioration in quality of life. Olanzapine is an atypical antipsychotic antagonist blocking a variety of neurotransmitters in the nausea and vomiting pathophysiology.

Objectives

The primary objective of this study is to determine whether olanzapine is associated with improved breakthrough nausea and vomiting in patients undergoing hematopoietic stem cell transplant. Secondary outcomes include number of documented emesis episodes, an evaluation of patient oral intake, and number of rescue antiemetic agents administered after olanzapine initiation.

Methods

This is a retrospective cohort review examining the effects of olanzapine for the treatment of breakthrough nausea and vomiting following hematopoietic stem cell transplant. Patients undergoing autologous or allogeneic hematopoietic stem cell transplant between January 2014 and October 2017 were included.

Results

A total of 150 patients were included in the study. Olanzapine use was associated with a complete response in 30% of patients for breakthrough chemotherapy-induced nausea and vomiting (p < 0.0001). An improvement in nausea (p < 0.0001) and vomiting (p = 0.02) was also observed in patients. Olanzapine administration was associated with lower as needed antiemetic usage (p < 0.0001) as well as fewer emesis episodes (p < 0.0001) but had no effect on oral intake (p = 0.13).

Conclusions

Olanzapine was associated with significant improvements in breakthrough nausea and vomiting control while reducing the number of emesis episodes and required antiemetic doses in the hematopoietic stem cell transplant population. Olanzapine may be beneficial in optimizing antiemetic regimens for breakthrough chemotherapy-induced nausea and vomiting control in patients undergoing hematopoietic stem cell transplant.
The omnivore turn in cultural production: Case study of China’s Rainbow Chamber Singers
Authors: Luo Mengyu
Published: October 2019

Previous studies on China’s cultural production have concentrated on the tension between state and individual creativity, overlooking the more dynamic and popular expression in China’s complicated cultural market, especially in this information age. This article is inspired by the omnivore–univore argument in cultural consumption and argues there is a similar omnivore turn among China’s independent cultural producers. Drawing on a case study of the Rainbow Chamber Singers (RCS), this article provides a new dimension and perspective to examine omnivore production in China’s ‘unconventional’ chamber choir. Data from the RCS’s music, lyrics, performances, the conductor Jin Chengzhi’s interviews (first-hand and second-hand), and the author’s own participant observation of the RCS’s concerts will be combined and elaborated. This article contends that the RCS adapts to creative thinking from creative industries and blurs conceptual boundaries between state/individual, art/commerce, and highbrow/lowbrow. The process also contributes to forming a participatory culture in the arena of classical chamber music.
American lesbians are not French women: heterosexual French feminism and the Americanisation of lesbianism in the 1970s
Authors: Eloit Ilana
Published: October 2019

This article examines the ways in which 1970s French feminists who participated in the Women’s Liberation Movement (Mouvement de libération des femmes – MLF) wielded the spectre of lesbianism as an American idiosyncrasy to counteract the politicisation of lesbianism in France. It argues that the erasure of lesbian difference from the domain of French feminism was a necessary condition for making ‘woman’ an amenable subject for incorporation into the abstract unity of the French nation, wherein heterosexuality is conceived as a democratic crucible where men and women harmoniously come together and differences are deemed divisive. Looking at the history of feminism from the standpoint of a lesbian perspective reveals unforeseen continuities between French ‘feminist’ and ‘anti-feminist’ genealogies insofar as they rest on common heterosexual and racial foundations. Finally, the article demonstrates that the alleged un-Frenchness ascribed to the word ‘lesbian’ in the 1970s feminist movement spectrally returned in the 1990s when the word ‘gender’ was, in its turn, deemed radically foreign to the French culture by feminist researchers. Fiercely reactionary constituencies against the legalisation of same-sex marriage have more recently taken up this rhetorical weapon against sexual and racial minorities.
Undeclared Versus Declared: Who Is More Likely to Graduate?
Authors: Spight David B.
Published: October 2019

Increasing graduation rates continues to be a high priority for administrators at many institutions of higher education. With longitudinal data from a large research university in the Western United States, the purpose of this study was to examine the potential relationship between matriculating with or without a major declared and degree completion. There exists a perception that an early decision about a major is an integral step in ensuring students graduate. Previous research about undeclared students and degree completion, however, is lacking and dated. Conceptually framed within Astin’s ( 1993 ) input–environment–output model, logistic regression analyses were conducted using institutional records for the Fall 2010 cohort of 4,489 full-time enrolled, first time in college students. Matriculating as undeclared versus declared was not found to increase, or decrease, the likelihood of graduating in 4 years. With 6-year rates, however, undeclared students were more likely to graduate.
Provisional Stenting Using the Zilver PTX Drug-Eluting Stent After Drug-Coated Balloon Angioplasty: Initial Experience From the Double Drug Dose “3D” Study
Authors: Fanelli Fabrizio , Cannavale Alessandro , Citone Michele , Santoni Mariangela , Gazzetti Marianna , Falcone Gian Marco , Miele Vittorio
Published: October 2019

Purpose: To explore the provisional use of a drug-eluting stent (DES) after suboptimal drug-coated balloon (DCB) angioplasty in complex, calcified femoropopliteal lesions. Materials and Methods: A prospective, single-center, investigator-initiated pilot study enrolled 15 patients (mean age 71.3 years; 9 men) with symptomatic stenosis (n=6) or occlusion (n=9) of the native superficial femoral and/or proximal popliteal arteries who experienced suboptimal DCB dilation despite postdilation. Lesion characteristics were evaluated with computed tomography angiography and duplex ultrasound confirmed by intravascular ultrasound. Follow-up included clinical and imaging evaluations as well as blood tests to monitor inflammatory markers. Endpoints included systemic inflammation, acute/chronic thrombosis, aneurysm formation, and mortality. Results: Provisional stenting was required for residual stenosis >50% in 4 cases and flow-limiting dissection in 11. Provisional spot stenting was done using the Zilver PTX DES. Clinical improvement was observed in all cases. After 24-month follow-up all patients were alive and in good clinical condition. One- and 2-year primary patency rates were 93.3% and 92.9%, respectively; secondary patency was 100%. Restenosis required reintervention in 2 cases. No local or systemic complications or toxicity were observed due to the use of a double dose of paclitaxel. No significant increase in any inflammation marker was observed in the perioperative period, and no aneurysm formation was seen over 24 months of follow-up. Conclusion: Combined DCB plus DES therapy seems to be safe and correlated with high primary patency following suboptimal angioplasty. Larger studies are required to confirm the safety and efficacy of this approach.
The Relationship Between Cytokine Production, CSF2RA, and IL1R2 Expression in Mammary Adenocarcinoma, Tumor Histopathological Parameters, and Lymph Node Metastasis
Authors: Autenshlyus Alexander , Arkhipov Sergey , Mikhailova Elena , Marinkin Igor , Arkhipova Valentina , Varaksin Nikolay
Published: October 2019

Objective:

The aim of this study was to evaluate the relationship between cytokine production, GM-CSF receptor (CSF2RA), and IL-1 receptor (IL1R2) expression in mammary adenocarcinoma and their association with it histopathological parameters and lymph node metastasis.

Methods:

We analyzed tumor biopsy samples (cultured in vitro) from 50 women (aged 43-75) with invasive ductal mammary adenocarcinomas. Enzyme-linked immunosorbent assay method the concentrations of interleukin 2, interleukin 6, interleukin 8, interleukin 10, interleukin 17, interleukin 18, interleukin 1β, interleukin 1Ra, tumor necrosis factor α, interferon γ, granulocyte colony-stimulating factor, granulocyte macrophage colony-stimulating factor, and vascular endothelial growth factor A were determined in culture supernatants. The expression of CSF2RA and IL1R2 in tumor biopsy was evaluated by immunohistochemical method.

Results:

We showed that the “cytokine profile” of a tumor (the ability of tumor cells and its microenvironment to produce different cytokines) is very individual. It has been shown that the features of the cytokine profile of the mammary adenocarcinoma are important for the formation and realization of the metastatic potential of the mammary adenocarcinoma. We found correlations between some histopathological parameters of mammary adenocarcinoma and coefficients KGM-CSF/CSF2RA and KIL-1β/IL1R2, which are the ratios of concentrations of granulocyte macrophage colony-stimulating factor and interleukin -1β to expression of CSF2RA and IL1R2, respectively. KGM-CSF/CSF2RA positively correlated with highly differentiated cells, and KIL-1β/IL1R2 positively correlated with the number of mitoses, poorly differentiated cells, and a number of lymph nodes with metastases. KGM-CSF/CSF2RA positively correlated with the concentrations of interleukin 6, interleukin 8, interleukin 1Ra, and granulocyte colony-stimulating factor. KIL-1β/IL1R2 positively correlated with concentrations of interleukin 1β and interferon γ and negative correlated with the concentrations of vascular endothelial growth factor A and tumor necrosis factor α. It is shown that KIL-1β/IL1R2 can be considered as a prognostic indicator predicting the probability of mammary adenocarcinoma metastasis to regional lymph nodes.

Conclusions:

The ratios of granulocyte macrophage colony-stimulating factor and interleukin 1β cytokines, produced in tumor, to the expression of CSF2RA and IL1R2 depend on levels of interleukin 6, interleukin 8, tumor necrosis factor α, interferon γ, granulocyte colony-stimulating factor, and vascular endothelial growth factor A and are important factors affecting the progression and metastasis of the breast cancer.
A location-constrained crowdsensing task allocation method for improving user satisfaction
Authors: Chen Huihui , Guo Bin , Yu Zhiwen , Chen Liming
Published: October 2019

Mobile crowdsensing is a special data collection manner which collects data by smart phones taken by people every day. It is essential to pick suitable workers for different outdoor tasks. Constrained by participants’ locations and their daily travel rules, they are likely to accomplish light outdoor tasks by their way without extra detours. Previous researchers found that people prefer to accomplish a certain number of tasks at a time; thus, we focus on assigning light outdoor tasks to workers by considering two optimization objectives, including (1) maximizing the ratio of light tasks for different workers and (2) maximizing the worker’s satisfaction on assigned tasks. This task allocation problem is a non-deterministic polynomial-time-hard due to two reasons, that is, tasks and workers are many-to-many relationships and workers move from different places to different places. Considering both optimization objectives, we design the global-optimizing task allocation algorithm, which greedily selects the most appropriate participant until either no participant can be chosen or no tasks can be assigned. For the purpose of emulating real scenarios, different scales of maps, tasks, and workers are simulated to evaluate algorithms. Experimental results verify that the proposed global-optimizing method outperforms baselines on both maximization objectives.
Infinitely variable transmission with orbital pulleys
Authors: Cervantes-Culebro Hector , Cruz-Villar Carlos Alberto , Palma-Marrufo Orlando
Published: October 2019

The purpose of this article is to propose an infinite variable transmission with orbital pulleys, which consists of two parallel transmission systems. The system comprises a planetary gear set and a continuously variable transmission. The principle of operation of the infinite variable transmission proposed in this article is based on the actuation of one half-sided pulley, which has a translational movement in a direction, and the same amount of movement is reproduced by the other half-sided orbital pulley in reverse to secure that the length of the belt remains constant. The fixed constant horizon enables the infinite variable transmission to change the transmission ratio from negative values to positive passing through zero in a continuous manner without using a clutch or interrupting the system. The dynamic model and prototype of the infinite variable transmission with orbital pulleys are developed for designing, controlling, and validating purposes. The model is obtained using the Euler–Lagrange methodology, and it is experimentally validated by comparing the proposed model with the experimental measures. The infinite variable transmission with orbital pulleys is controlled under different conditions; the experimental results show that the proposed design of infinite variable transmission provides robustness to maintain constant speeds at the output to changes at the input velocity.
More severe cold intolerance is associated with worse sensory function after peripheral nerve repair or decompression
Authors: Cesim Özge B. , Öksüz Çiğdem
Published: October 2019

The aim of the study is to investigate the correlation between cold intolerance and sensory function after repair of nerve transection or decompression of peripheral neuropathy in the upper extremity. We included patients with abnormal cold sensitivity who had a score of 30 or more in the Cold Intolerance Symptom Severity Questionnaire. There were 30 individuals after surgery to repair nerve transection and 30 with compression neuropathy, aged between 18–65 years. We used the Cold Intolerance Symptom Severity Questionnaire to evaluate cold intolerance and the Rosen Score to evaluate sensory function. There was a significant negative correlation between cold intolerance and sensory function in both peripheral nerve transections and compression neuropathies. We conclude that greater cold intolerance is associated with worse sensory function in peripheral nerve injuries. Interventions for sensory function in cold intolerance treatment may reduce the severity of cold intolerance.

Level of evidence: III
Business models for flight-centric air traffic control
Authors: Zeki Engin , de Matos Paula Leal , Purves Kirsteen , Gibellini Marco
Published: October 2019

This article explores the impact that flight-centric air traffic control (ATC), a concept under development, has on ATC market structure and ATC business models. Flight-centric operations bring forth changes in how the stakeholders adapt their roles to the emerging ATC market. We compared current ATC and market structures with the emerging flight-centric concept and analyzed the market changes in structure and competition from the emergence of flight-centric operations using Porter’s five forces model. Four potential business models for flight-centric ATC are identified and described: current air navigation service providers adapt, vertical integration by airlines, new ATC providers, and the network manager as capacity-demand manager. In the final chapter, we briefly describe the future regulation of the market for flight-centric operations. We conclude that new concepts and technologies, such as flight-centric operations, create the necessary dynamics for change in the current market structure by unbundling of the market.
Who Sees Corruption? The Bases of Mass Perceptions of Political Corruption in Latin America
Authors: Canache Damarys , Cawvey Matthew , Hayes Matthew , Mondak Jeffery J.
Published: October 2019

The capacity of citizens to see political corruption where it exists and to link such perceptions to evaluations of public officials constitutes an important test of political accountability. Although past research has established that perceived corruption influences political judgments, much less is known regarding the critical prefatory matter of who sees corruption. This article develops a multifaceted theoretical framework regarding the possible bases of perceived corruption. Experiential factors – personal experience and vicarious experience with bribery – mark the starting point for our account. We then incorporate psychological dispositions that may colour judgments about corruption and that may strengthen or weaken the links between experiences and perceptions. Expectations derived from this framework are tested in a series of multi-level models, with data from over 30,000 survey respondents from 17 nations and 84 regions in the Americas.
The Effectiveness of a Music and Dance Program on the Task Engagement and Inclusion of Young Pupils on the Autism Spectrum
Authors: Stamou Athina , Roussy Arielle Bonneville , Ockelford Adam , Terzi Lorella
Published: October 2019

Inclusion has been a contested concept affecting policy and practice in education for many decades, particularly for individuals on the autism spectrum. Due to the challenges that autistic pupils may face in forming social relationships, they are at a greater risk of isolation and exclusion. This study explored whether music and dance can promote the inclusion of autistic children aged 5–8 years, attending mainstream schools, through participation in a novel music and dance program. A total of 42 pupils (seven autistic), in seven groups, took part in the 6-week program. Engagement on task and physical proximity were used as proxy measures of inclusion. Video observation was used for the collection and analysis of the data. The findings suggest that music is a strong motivational factor for autistic participants and promotes engagement on task. Music and dance have been found to enhance physical contact and cooperation in the group, thus promoting acceptance and inclusion. Implications for practice and directions for further research are discussed.
Evaluation of a Community-Based Self-Management Program to Increase Access to Rehabilitation for People Living with HIV
Authors: Solomon Patricia , Salbach Nancy Margaret , O’Brien Kelly Kathleen , Nixon Stephanie , Baxter Larry , Gervais Nicole
Published: October 2019

We qualitatively evaluated a novel educational program to help people living with HIV understand the role of rehabilitation, facilitate access to rehabilitation, and promote self-management of chronic disease in Canada. The program incorporated components of self-efficacy, client-centered care, peer education, and problem-based learning. Delivery of the community-engaged program was viewed as feasible and acceptable; however, a flexible delivery model was deemed important. Perceived learning was related to rehabilitation, advocacy, and taking responsibility for one’s health. A co-leader model and access to online resources were strengths. Future work should assess the ability to apply advocacy knowledge and skills to access rehabilitation services.
Long-term outcome after ischemic stroke in relation to comorbidity – An observational study from the Swedish Stroke Register (Riksstroke)
Authors: Sennfält Stefan , Pihlsgård Mats , Petersson Jesper , Norrving Bo , Ullberg Teresa
Published: October 2019

Purpose

Comorbidity in stroke is common, but comprehensive reports are sparse. We describe prevalence of comorbidity and the prognostic impact on mortality and functional outcome in a large national ischemic stroke cohort.

Methods

We used outcome data from a long-term follow-up survey conducted in 2016 by the Swedish Stroke Register (Riksstroke). Those included in the study were 11 775 pre-stroke functionally independent patients with first-ever ischemic stroke followed up at three months and 12 months (all patients), and three years (2013 cohort) or five years (2011 cohort). Pre-stroke comorbidity data for 16 chronic conditions were obtained from the Swedish National Patient Register, the Swedish Prescribed Drugs Register and the Riksstroke register. Individuals were grouped according to number of conditions: none (0), low (1), moderate (2–3) or high (≥4). Co-occurrence was analysed using hierarchical clustering, and multivariable analyses were used to estimate the prognostic significance of individual conditions.

Results

The proportion of patients without comorbidity was 24.8%; 31.8% had low comorbidity; 33.5% had moderate comorbidity and 9.9% had high comorbidity. At 12 months, the proportion of poor outcome (dead or dependent: mRS ≥3) was 24.8% (no comorbidity), 34.7% (low), 45.2% (moderate) and 59.4% (high). At five years, these proportions were 37.7%, 50.3%, 64.3%, and 81.7%, respectively. There was clustering of cardiovascular conditions and substantial negative effects of dementia, kidney, and heart failure.

Conclusion

Comorbidity is common and has a strong impact on mortality and functional outcome. Our results highlight the need for health systems to shift focus to a comprehensive approach in stroke care that includes multimorbidity as a key component.
Exploring Gender Diversity in IT and CS Departments Within 3 Private Universities in Erbil City
Authors: Abulrahman Mohammad Salim , Khalilov Savriddin
Published: October 2019

The number of information technology (IT) jobs is increasing dramatically in Iraq. This has produced an increased need for IT graduates than before. On the other hand, most IT and computer science (CS) departments in private universities are seeing small numbers of females in their courses. This indicates that these private universities have failed in attracting a sufficient percentage of female students. In this article, we explore the gender gap in IT and CS departments at 3 private universities: Tishk, Cihan, and Bayan, using 3 data sets related to the 2017 to 2018 academic year. The research design is descriptive and primary data were collected using personal observations made by the authors over the past 2 years. By analyzing these data sets, we can discover important issues such as students’ diversity in computing departments. For example, we find that a gender gap does not clearly exist in the IT department of Tishk University, while it’s more obvious in CS departments of Bayan and Cihan Universities. This finding implies that there is a need for some initiatives to attract women to IT and CS departments and to more investigate the gender gap in computing within the higher education level. These findings may also be relevant to the computing programs at other large public universities.
Pediatric ALL relapses after allo-SCT show high individuality, clonal dynamics, selective pressure, and druggable targets
Authors: Hoell Jessica I. , Ginzel Sebastian , Kuhlen Michaela , Kloetgen Andreas , Gombert Michael , Fischer Ute , Hein Daniel , Demir Salih , Stanulla Martin , Schrappe Martin , zur Stadt Udo , Bader Peter , Babor Florian , Schuster Friedhelm , Strahm Brigitte , Alten Julia , Moericke Anja , Escherich Gabriele , von Stackelberg Arend , Thiele Ralf , McHardy Alice C. , Peters Christina , Bornhauser Beat , Bourquin Jean-Pierre , Krause Stefan , Enczmann Juergen , Meyer Lüder Hinrich , Eckert Cornelia , Borkhardt Arndt , Meisel Roland
Published: October 2019

Key Points

Pediatric ALL relapses after allogeneic stem cell transplantation display highly diverse, dynamic and patient-individual genetic lesions. Nine of 10 relapsing pediatric transplant recipients present with genetic alterations for which novel targeted therapies are available.
Role of the coagulation system in the pathogenesis of sickle cell disease
Authors: Nasimuzzaman Md , Malik Punam
Published: October 2019

Sickle cell disease (SCD) is an inherited monogenic red blood cell disorder affecting millions worldwide. SCD causes vascular occlusions, chronic hemolytic anemia, and cumulative organ damage such as nephropathy, pulmonary hypertension, pathologic heart remodeling, and liver necrosis. Coagulation system activation, a conspicuous feature of SCD that causes chronic inflammation, is an important component of SCD pathophysiology. The key coagulation factor, thrombin (factor IIa [FIIa]), is both a central protease in hemostasis and thrombosis and a key modifier of inflammation. Pharmacologic or genetic reduction of circulating prothrombin in Berkeley sickle mice significantly improves survival, ameliorates vascular inflammation, and results in markedly reduced end-organ damage. Accordingly, factors both upstream and downstream of thrombin, such as the tissue factor–FX complex, fibrinogen, platelets, von Willebrand factor, FXII, high-molecular-weight kininogen, etc, also play important roles in SCD pathogenesis. In this review, we discuss the various aspects of coagulation system activation and their roles in the pathophysiology of SCD.
Hepatic thrombopoietin gene silencing reduces platelet count and breast cancer progression in transgenic MMTV-PyMT mice
Authors: Shirai Toshiaki , Revenko Alexey S. , Tibbitts Justin , Ngo Anh T. P. , Mitrugno Annachiara , Healy Laura D. , Johnson Jennifer , Tucker Erik I. , Hinds Monica T. , Coussens Lisa M. , McCarty Owen J. T. , Monia Brett P. , Gruber András
Published: October 2019

Key points

Antisense oligonucleotide targeting of hepatic THPO gene expression reduces platelet count within the hemostatic range in mice and baboons. THPO gene silencing suppresses spontaneous metastatic mammary gland carcinoma progression in transgenic MMTV-PyMT mice.
Association between the HLA-DRB1*03:01-DQB1*02:01 haplotype and PF4/heparin antibodies
Authors: Zhang Ray , Duffy Brian F. , Lange Vinzenz , Eby Charles S. , Liu Chang
Published: October 2019

Key Points

HLA-DRB1*03:01-DQB1*02:01 haplotype patients develop higher anti–platelet factor 4/heparin (PF4/H) levels following IV heparin exposure. HLA-restricted antigen presentation may play a role in the formation of anti-PF4/H antibodies.
Similar outcomes of alemtuzumab-based hematopoietic cell transplantation for SAA patients older or younger than 50 years
Authors: Sheth Vipul Sharad , Potter Victoria , Gandhi Shreyans A. , Kulasekararaj Austin Gladston , de Lavallade Hugues , Muus Petra , Pagliuca Antonio , Rice Carmel F. M. , Mehra Varun , Grimaldi Francesco , Inam Shafqat , Barber Linda D. , Mufti Ghulam J. , Marsh Judith C.
Published: October 2019

Key Points

GRFS is similar between older and younger patients using FCC conditioning but comorbidities impact on outcome of SAA HSCT. Immunomodulatory B lymphocytes potentially contribute to control of alloreactivity and low GVHD after FCC HSCT.
Five-year outcomes of the S1106 study of R-hyper-CVAD vs R-bendamustine in transplant-eligible patients with mantle cell lymphoma
Authors: Kamdar Manali , Li Hongli , Chen Robert W. , Rimsza Lisa M. , Leblanc Michael L. , Fenske Timothy S. , Shea Thomas C. , Barr Paul M. , Phillips Tycel J. , Leonard John P. , Kahl Brad S. , Friedberg Jonathan W. , Smith Sonali M.
Published: October 2019

Key Points

Five-year follow-up of S1106 demonstrates similar efficacy, MRD negativity, and 5-year survival with RH or RB, but RH was more toxic than RB. RB showed excellent efficacy and survival and less toxicity compared with a cytarabine-based regimen in transplant-eligible MCL patients.
Safety of allogeneic hematopoietic cell transplant in adults after CD19-targeted CAR T-cell therapy
Authors: Shadman Mazyar , Gauthier Jordan , Hay Kevin A. , Voutsinas Jenna M. , Milano Filippo , Li Ang , Hirayama Alexandre V. , Sorror Mohamed L. , Cherian Sindhu , Chen Xueyan , Cassaday Ryan D. , Till Brian G. , Gopal Ajay K. , Sandmaier Brenda M. , Maloney David G. , Turtle Cameron J.
Published: October 2019

Key Points

The toxicity of allo-HCT in patients with prior CAR-T therapy was not higher than what is expected in these high-risk patients. In ALL patients, there seems to be a benefit from earlier utilization of allo-HCT after CAR-T therapy.
Choice of conditioning regimens for bone marrow transplantation in severe aplastic anemia
Authors: Bejanyan Nelli , Kim Soyoung , Hebert Kyle M. , Kekre Natasha , Abdel-Azim Hisham , Ahmed Ibrahim , Aljurf Mahmoud , Badawy Sherif M. , Beitinjaneh Amer , Boelens Jaap Jan , Diaz Miguel Angel , Dvorak Christopher C. , Gadalla Shahinaz , Gajewski James , Gale Robert Peter , Ganguly Siddhartha , Gennery Andrew R. , George Biju , Gergis Usama , Gómez-Almaguer David , Vicent Marta Gonzalez , Hashem Hasan , Kamble Rammurti T. , Kasow Kimberly A. , Lazarus Hillard M. , Mathews Vikram , Orchard Paul J. , Pulsipher Michael , Ringden Olle , Schultz Kirk , Teira Pierre , Woolfrey Ann E. , Saldaña Blachy Dávila , Savani Bipin , Winiarski Jacek , Yared Jean , Weisdorf Daniel J. , Antin Joseph H. , Eapen Mary
Published: October 2019

Key Points

Flu/Cy/ATG and Cy/ATG regimens offer the best survival for matched-sibling BMT. Transplantation in patients aged ≥30 years is associated with higher mortality after matched-sibling and unrelated donor BMT.
Relative difference among 27 functional measures in patients with knee osteoarthritis: an exploratory cross-sectional case-control study
Authors: Vårbakken K. , Lorås H. , Nilsson K. G. , Engdal M. , Stensdotter A. K.
Published: October 2019

Background

To raise the effectiveness of interventions, clinicians should evaluate important biopsychosocial aspects of the patient’s situation. There is limited knowledge of which factors according to the International Classification of Function, Disability, and Health (ICF) are most deviant between patients with knee osteoarthritis (KOA) and healthy individuals. To assist in measures’ selection, we aimed to quantify the differences between patients with KOA and healthy controls on various measures across the ICF dimensions of body function, activity, and participation.

Methods

We performed an exploratory cross-sectional case-control study. In total, 28 patients with mild-to-moderate KOA (mean age 61 years, 64% women) referred by general physicians to a hospital’s osteoarthritis-school, and 31 healthy participants (mean age 55 years, 52% women), volunteered. We compared between-group differences on 27 physical and self-reported measures derived from treatment guidelines, trial recommendations, and trial/outcome reviews. Independent t-test, Chi-square, and Mann-Whitney U test evaluated the significance for continuous parametric, dichotomous, and ordinal data, respectively. For parametric data, effect sizes were calculated as Cohen’s d. For non-parametric data, ds were estimated by p-values and sample sizes according to statistical formulas. Finally, all ds were ranked and interpreted after Hopkins’ scale. An age-adjusted sensitivity-analysis on parametric data validated those conclusions.

Results

Very large differences between patients and controls were found on the Pain numeric rating scale1, the Knee Injury and Osteoarthritis Scale (KOOS, all subscales)2, as well as the Örebro Musculoskeletal psychosocial scale3 (P < 0.0001). Large differences were found on the Timed 10-steps-up-and-down stair climb test4 and Accelerometer registered vigorous-intensity physical activity in daily life5 (P < 0.001). Respectively, these measures clustered on ICF as follows: 1body function, 2all three ICF-dimensions, 3body function and participation, 4activity, and 5participation.

Limitations

The limited sample excluded elderly patients with severe obesity.

Conclusions

Very large differences across all ICF dimensions were indicated for the KOOS and Örebro questionnaires together for patients aged 45–70 with KOA. Clinicians are suggested to use them as means of selecting supplementary measures with appropriate discriminative characteristics and clear links to effective therapy. Confirmative studies are needed to further validate these explorative and partly age-unadjusted conclusions.
Significant risk factors for malignant transformation of ovarian endometrioma during dienogest treatment: a case report and retrospective study
Authors: Honda Michiko , Isono Wataru , Tsuchiya Akira , Saito Ako , Tsuchiya Hiroko , Matsuyama Reiko , Fujimoto Akihisa , Nishii Osamu
Published: October 2019

Background

To determine the prevalence of and risk factors for malignant transformation of ovarian endometrioma during dienogest therapy, which is very rare, we examined multiple cases of malignant transformation of ovarian endometrioma during dienogest therapy and performed a multivariate analysis of the records in our hospital.

Methods

The medical records of 174 patients who underwent DNGT for the treatment of OMA from June 1, 2011, to May 31, 2018, were reviewed retrospectively with the approval of the Human Ethical Committee of the University of Teikyo Hospital. And we provided one representative case of MT with obtaining written informed consent. To assess the effects of six representative factors, including advanced age, parity, surgical history, and endometrial cyst characteristics (including 3 factors), on the possibility of malignant transformation, we performed a multivariate logistic regression analysis.

Results

Of the 174 cases, 4 were diagnosed with malignant transformation, and these cases are reported. In the multivariate analysis, advanced age (P = 0.0064), nullipara (P = 0.0322), and enlargement (P = 0.0079) showed significant differences for malignant transformation occurrence. All 4 malignant transformation cases were among the 19 patients who had all of these 3 factors.

Conclusions

For a more accurate determination of the treatment approach, a larger sample size will be needed to determine the risk factors for malignant transformation during dienogest therapy.
Convolutional technique for enhancing security in wireless sensor networks against malicious nodes
Authors: Alghamdi Turki Ali
Published: October 2019

Wireless sensor networks (WSNs) comprise tiny devices known as sensors. These devices are frequently employed in short-range communications and can perform various operations such as monitoring, collecting, analyzing, and processing data. WSNs do not require any infrastructure, are reliable, and can withstand adverse conditions. Sensor networks are autonomous structures in which the sensor nodes can enter or leave the network at any time instant. If the entering node is attacker node it will monitor the network operation and can cause security issues in the network that can affect communication. Existing literature presents security improvements in such networks in the form of cryptography, asymmetric techniques, key distribution, and various protocols. However, these techniques may not be effective in the case of autonomous structures and can increase computational complexity. In this paper, a convolutional technique (CT) is proposed that generates security bits using convolutional codes to prevent malicious node attacks on WSNs. Different security codes are generated at different hops and the simulation results demonstrate that the proposed technique enhances network security and reduces computational complexity compared to existing approaches.
An embedded method for gene identification problems involving unwanted data heterogeneity
Authors: Lu Meng
Published: October 2019

Background

Modern applications such as bioinformatics collecting data in various ways can easily result in heterogeneous data. Traditional variable selection methods assume samples are independent and identically distributed, which however is not suitable for these applications. Some existing statistical models capable of taking care of unwanted variation were developed for gene identification involving heterogeneous data, but they lack model predictability and suffer from variable redundancy.

Results

By accounting for the unwanted heterogeneity effectively, our method have shown its superiority over several state-of-the art methods, which is validated by the experimental results in both unsupervised and supervised gene identification problems. Moreover, we also applied our method to a pan-cancer study where our method can identify the most discriminative genes best distinguishing different cancer types.

Conclusions

This article provides an alternative gene identification method that can accounting for unwanted data heterogeneity. It is a promising method to provide new insights into the complex cancer biology and clues for understanding tumorigenesis and tumor progression.
Clinical application of injectable growth factor for bone regeneration: a systematic review
Authors: Kuroda Yutaka , Kawai Toshiyuki , Goto Koji , Matsuda Shuichi
Published: October 2019

Bone regeneration has been the ultimate goal in the field of bone and joint medicine and has been evaluated through various basic research studies to date. Translational research of regenerative medicine has focused on three primary approaches, which are expected to increase in popularity: cell therapy, proteins, and artificial materials. Among these, the local injection of a gelatin hydrogel impregnated with the protein fibroblast growth factor (FGF)-2 is a biomaterial technique that has been developed in Japan. We have previously reported the efficacy of gelatin hydrogel containing injectable FGF-2 for the regenerative treatment of osteonecrosis of the femoral head. Injectable growth factors will probably be developed in the future and gain popularity as a medical approach in various fields as well as orthopedics. Several clinical trials have already been conducted and have focused on this technique, reporting its efficacy and safety. To date, reports of the clinical application of FGF-2 in revascularization for critical limb ischemia, treatment of periodontal disease, early bone union for lower limb fracture and knee osteotomy, and bone regeneration for osteonecrosis of the femoral head have been based on basic research conducted in Japan. In the present report, we present an extensive review of clinical applications using injectable growth factors and discuss the associated efficacy and safety of their administration.
The efficacy of pre-emptive analgesia on pain management in total knee arthroplasty: a mini-review
Authors: Xu Jianda , Li Huan , Zheng Chong , Wang Bin , Shen Pengfei , Xie Zikang , Qu Yuxing
Published: October 2019

Total knee arthroplasty (TKA) is considered a cost-effective and efficacious treatment for patients with end-stage knee arthritis. Meanwhile, TKA has been regarded as one of the most painful orthopaedic surgeries. Pain control after TKA remains a challenging task. Many analgesic innovations are used to reduce the level of pain, but none has been proven to be the optimum choice till now. Multimodal analgesia incorporates the use of analgesic adjuncts with different mechanisms of action to enhance postoperative pain management. This approach is a preferable choice in relieving postoperative pain with minimum side effects. This paper aims to review pre-emptive analgesia for pain management in TKA. We reviewed the application of pre-emptive analgesia, its physiological mechanism, and the techniques.