bluuebunny/crossref_metadata_2025 huggingface dataset:
Abstract 29: Appropriateness of Percutaneous Coronary Intervention in Patients with Stable Coronary Artery Disease: Department of Veterans Affairs, 2013-2015
Authors: Hess Paul L , Kini Vinay , Liu Wenhui , Roldan Paola , Autruong Patrick , Doll Jacob A , Ho P. Michael , Bradley Steven M
Published: April 2019

Background:
Percutaneous coronary intervention (PCI) for patients with stable coronary artery disease is commonly performed in Veterans Affairs (VA) hospitals. However, the appropriateness of these procedures in contemporary practice is unknown.

Methods:
We performed a multi-center, retrospective study of patients within the VA Clinical Assessment, Reporting, and Tracking (CART) Program with stable coronary artery disease undergoing elective PCI between November 1, 2013, and October 31, 2015. Trained personnel abstracted data on patient symptoms and stress testing results. Using criteria issued by multiple cardiovascular professional societies in 2012, the level of risk indicated by stress testing was adjudicated and PCI appropriateness was assessed. The extent of hospital-level variation in rates of inappropriate PCI was characterized.

Results:
Of 2622 PCIs at 66 hospitals, 800 (30.5%) were classified as appropriate, 1583 (60.4%) were classified as uncertain, and 239 (9.1%) were classified as inappropriate. Inappropriate PCIs were performed in patients with low-risk ischemia on stress testing (n=223/382, 58.4%), with
<
1 classes of antianginal medication (n=235/1936, 12.1%), or without symptoms (n=14/23, 60.9%). Hospital-level variation in the proportion of inappropriate PCIs was observed (
Figure 1:
median hospital rate for inappropriate PCI, 9.3%; interquartile range 6.2%-11.8%).

Conclusions:
In contemporary VA practice, most PCIs were classified as appropriate or uncertain. However, 9.1% were classified as inappropriate with variation across hospitals. These findings may inform ongoing efforts to identify elements of hospital performance and enhance PCI-related quality of care.

Figure 1:
Hospital-Level Variation in Rates of Inappropriate PCI
Abstract 31: Center-specific Variation in Use of Dual Antiplatelet Therapy Prior to Coronary Surgery: an Outcomes Analysis from the Maryland Cardiac Surgery Quality Initiative
Authors: Metkus Thomas S , Holmes Sari D , Alejo Diane , Fonner Clifford E , Mazzeffi Michael , Schena Stefano , Salenger Rawn , Taylor Bradley , Ad Niv , Lawton Jennifer , Whitman Glenn J
Published: April 2019

Background:
Understanding institutional practices and associated outcomes of patients managed with different dual antiplatelet therapy (DAPT) strategies prior to coronary artery bypass grafting (CABG) could inform practice improvement. We hypothesized that, while receipt of DAPT within 5 days prior to CABG would increase risk for postoperative bleeding, there is institutional variation in preoperative DAPT management.

Methods:
A retrospective cohort study was performed using data from the Maryland Cardiac Surgery Quality Initiative (MCSQI), a consortium aggregating data from the 10 hospitals that perform cardiac surgery in Maryland. Isolated CABG patients between 2011 and 2018 were included. The exposure variable of interest was DAPT use within 5 days prior to CABG. The temporal trend in preoperative use of DAPT, heterogeneity in DAPT usage between centers, and perioperative outcomes are reported. The primary outcomes were the STS major morbidity/mortality composite measure and postoperative bleeding events.

Results:
The sample included 13,965 patients, of which 23% (
n
=3,219) received preoperative DAPT within 5 days of surgery. The percentage of CABG patients treated with DAPT within 5 days decreased over time from 26% in 2011 to 15% in 2018 (Figure,
P
<0.001 for trend). There was significant heterogeneity in preoperative DAPT use among centers within the state (Figure,
P
<0.001 for difference in proportions). CABG patients receiving preoperative DAPT were more likely to present with acute MI (49% v 27%,
P
<0.001) and less likely to present electively (19% v 34%,
P
<0.001). The ratio of observed-to-expected STS-defined morbidity/mortality was similar between DAPT (O/E 0.85, 95% CI 0.77-0.92) and non-DAPT groups (O/E 0.84, 95% CI 0.79-0.89). Median transfusion of blood products was higher for the DAPT group (1 [0-4] v 0 [0-3],
P
<0.001). In adjusted models, preoperative DAPT was associated with greater odds of reoperation for bleeding (OR=1.38,
P
=0.017) and transfusion of ≥2 PRBC units (OR=1.27,
P
<0.001).

Conclusion:
Many isolated CABG patients in the state of Maryland are treated with DAPT within 5 days prior to CABG with notable variation between centers. Given the associated risk of postoperative bleeding, standardized management of preoperative DAPT therapy could improve post-CABG outcomes.
Abstract 35: Developing a Systematic Process for Evaluating Heart Failure (HF) Patients Presenting to the Emergency Department: The Code HF Project
Authors: Hejjaji Vittal , Scholes Alison M , Khariton Yevgeniy , Kennedy Kevin , Dean Evelyn , Barrios Joseph , Spertus John A
Published: April 2019

Introduction:
It can be difficult in patients with heart failure (HF) who present to the emergency department (ED) with shortness of breath to decide who warrants admission and who can be safely sent home. At our institution, there was great variability across different ED physician’s admission rates (66%-100%). To address this, we developed an evidence-based protocol to support more consistent evaluation and implemented the program with the help of a multi-disciplinary team. Here, we discuss the process of development.

Methods:
An ED physician led a team of cardiologists, nurses, educators, administrators and researchers to identify key considerations in the ED management of patients with HF and to create a feasible protocol for implementation (Figure). A central feature of this approach is the use of a prospectively validated Emergency Heart Failure Mortality Risk Grade (EHMRG) score and agreement that patients with a <1% 7-day mortality would be eligible for discharge if their symptoms rapidly improved and close follow up could be arranged. Iterative improvements to the protocol and its execution with the electronic medical record (EMR) were made to improve our primary process measure, use in all eligible patients.

Results:
Despite education at provider meetings and integration within the EMR, over the first year of implementation across all four EDs within the network, only 12% of eligible patients were managed by Code HF, with marked variability across EDs (0-20% of eligible patients) and physicians (0-80%). Further opportunities to improve adoption were elicited from providers and included different presentations within the EMR, creation of a standing order, integration of the predicted risk into ED notes and regular feedback of use and outcomes associated with the Code HF program.

Conclusion:
Implementing an evidence-based, sustainable strategy for systematically evaluating and managing patients with HF presenting to the ED has been challenging, but offers the opportunity to deliver more efficient, patient-centered care. Iterative improvements informed by providers and tailored to our local context is leading to increased protocol use among ED physicians.
Using mHealth Tools to Improve Access and Coverage of People With Public Health Insurance and High Cardiovascular Disease Risk in Argentina: A Pragmatic Cluster Randomized Trial
Authors: Beratarrechea Andrea , Abrahams‐Gessel Shafika , Irazola Vilma , Gutierrez Laura , Moyano Daniela , Gaziano Thomas A.
Published: April 2019

Background

Control of cardiovascular disease (
CVD
) risk factors is suboptimal in Argentina, despite the government's provision of free blood pressure and cholesterol‐lowering medications for people without private insurance. We assessed whether community health workers’ use of an integrated
mH
ealth tool encourages patients to attend visits at primary care clinics to improve
CVD
risk management in 2 provinces of Argentina.

Methods and Results

We conducted a pragmatic cluster randomized trial, with primary care clinics randomly assigned to intervention or control. Eligible people were aged 40 to 79 years, lived in the catchment area of primary care clinics, possessed a mobile phone for personal use, had public health coverage, and a 10‐year
CVD
risk ≥10%. In the control arm, community health workers screened for
CVD
risk using a paper‐based tool and encouraged high‐risk people to present to the primary care clinics for care. In the intervention arm, community health workers used the
mH
ealth tool to calculate
CVD
risk and confirm a scheduled physician appointment. Primary outcomes were the proportion of participants who attended a baseline visit and completed at least 1 follow‐up, respectively. We enrolled 755 people (376 interventions; 379 controls). Intervention participants were significantly more likely to complete baseline visits (49.4% versus 13.5%,
P
value 0.0008) and follow‐up visits (31.9% versus 7.7%;
P
value 0.0041). The use of chronic medication and current smoking were significant predictors of primary outcomes.

Conclusions

Use of
mH
ealth tools identifies patients at high
CVD
risk in their home, increases the likelihood of participating in chronic
CVD
risk factor management, and strengthens referrals.

Clinical Trial Registration

URL
:
http://www.clinicaltrials.gov
. Unique identifier:
NCT
02913339.
Sciapodinae from the Himalayan region with description of nine new species from Tibet (Diptera: Dolichopodidae)
Authors: TANG CHUFEI , ZHU YAJUN , YANG DING
Published: April 2019

The Himalayan region now includes 67 species in seven genera of Sciapodinae, including nine new species (Amblypsilopus acuminatus sp. nov., A. liangi sp. nov., A. liratus sp. nov., A. marginatus sp. nov., A. medogensis sp. nov., A. quinquepetalus sp. nov., Plagiozopelma fornicata sp. nov., P. trilobata sp. nov., Sciapus zewoiensus sp. nov.). Six species are reported from the Himalayan region for the first time: A. baoshanus Yang, A. didymus Yang, A. hubeiensis Yang & Yang, A. imitans (Becker), A. liui Zhu & Yang, and P. medivittatum Bickel & Wei. Chrysosoma insensibile Yang is re-assessed and transferred to Amblypsilopus, new combination. Amblypsilopus sinensis Yang & Yang, 2003 is proposed as a new synonym of A. subabruptus Bickel & Wei, 1996. This is the first time Sciapus Zeller is reported from the Himalayan region. Keys to genera and species of Sciapodinae occurring in the Himalayas are provided. The distribution of Sciapodinae in the Himalayas is discussed.
The sharpshooter genus Aguana: taxonomic notes, two new species from Brazil, the female of A. imbricata, and updated key (Hemiptera: Cicadellidae: Cicadellini)
Authors: MEJDALANI GABRIEL , DOMAHOVSKI ALEXANDRE C. , CAVICHIOLI RODNEY R.
Published: April 2019

The genus Aguana Melichar, 1926 previously included only two species from the Atlantic Forest of Southeastern Brazil. Here we provide a revised diagnosis for the genus and describe two new Brazilian species and the female of A. imbricata (Signoret, 1854). The new taxa are A. picinguaba sp. nov. (states of Rio de Janeiro, São Paulo, and Santa Catarina) and A. spitzi sp. nov. (State of São Paulo). Aguana species are very similar to one another externally and can be distinguished mainly by features of the male terminalia (especially of the aedeagus) and female sternite VII. A key to males and females of the genus is added (except the female of A. russata Young, 1977).
Mecomera Audinet-Serville, 1839 (Dermaptera: Spongiphoridae): proposal of new diagnosis, descriptions and illustrations of all three-known species
Authors: HELEODORO RAPHAEL AQUINO , ALVES-OLIVEIRA JOÃO RAFAEL , RAFAEL JOSÉ ALBERTINO
Published: April 2019

Mecomera Audinet-Serville, 1839 (Spongiphoridae: Sparattinae) is a neotropical genus with three species: M. brunnea Audinet-Serville, M. chacoensis (Borelli) and M. reichardti Brindle. By comparing specimens of the three Mecomera species (types and ordinary material) to their respective original descriptions and drawings, it was determined that the descriptions are over-simplified and the drawings are not fully accurate. To prevent future identification problems, new diagnosis, descriptions and images of the external body and male genitalia of the three Mecomera species are provided.
Developing Machine Learning Models to Predict Roadway Traffic Noise: An Opportunity to Escape Conventional Techniques
Authors: Ali Khalil Mohamad , Hamad Khaled , Shanableh Abdallah
Published: April 2019

Accurate prediction of roadway traffic noise remains challenging. Many researchers continue to improve the performance of their models by either adding more variables or improving their modeling algorithms. In this research, machine learning (ML) modeling techniques were developed to predict roadway traffic noise accurately. The ML techniques applied were: regression decision trees, support vector machine, ensembles, and artificial neural network. The parameters of each of these models were fine-tuned to achieve the best performance results. In addition, a state-of-the-art hybrid feature-selection technique has been employed to select a minimum set of input features (variables) while maintaining the accuracy of the developed models. By optimizing the number of features used in the model, the resources needed to develop and utilize a model to predict roadway noise would be less, hence decreasing the development cost. The proposed approach has been applied to develop a free-field roadway traffic noise model for Sharjah City in the United Arab Emirates. The best developed ML model was compared with a conventional regression model which was developed earlier under the same conditions. The cross-validated results clearly indicate that the best ML model outperformed the regression modeling. The performance of the ML model was also assessed after reducing the number of its input features based on the outcome of the feature-selection algorithm; the model performance was slightly affected. This result emphasizes the importance of considering only features that greatly influence the roadway traffic noise.
Substitution from Air to High-Speed Rail: The Case of Amsterdam Airport
Authors: Kroes Eric , Savelberg Fons
Published: April 2019

In this paper we present the results of a study that aims to establish the potential for high-speed train travel as a substitute for short distance air travel at Amsterdam Airport. We investigated the 13 most important destinations that offer direct flights to and from Amsterdam Airport. Almost 40% of the air passengers travelling to/from these destinations are transfer passengers. Empirical evidence reveals that high-speed trains dominate the market for journeys of 2 hours or less, such as between Paris and Brussels. However, trains claim only a tiny market share of journeys longer than 5 to 6 hours; air travel dominates that market segment. Using these findings, we developed a model to estimate the substitution of air travel with high-speed train travel. The explanatory variables in this model are travel time, daily departure options, fares, and the inconvenience associated with transferring at airports. In a “minimum” scenario, we predict that in 2030 high-speed trains could replace approximately 1.9 million air journeys. This calculation is based on feasible reductions of train travel times and increased train frequencies for part of the rail network. In this scenario, Amsterdam–London accounts for more than three-quarters of the predicted substitution. In a “maximum” scenario, substitution could increase up to 3.7 million air journeys per year, provided that inconveniences for passengers when transferring at airports from plane to train are resolved and train ticket fares are reduced by 20%. These two scenarios imply a reduction of 2.5 to 5% of all flights to/from Amsterdam Airport in 2030.
Powder-epoxy resin/glass fabric composites with reduced flammability
Authors: Oliwa Rafał , Oleksy Mariusz , Czech-Polak Justyna , Płocińska Magdalena , Krauze Sławomir , Kowalski Maciej
Published: April 2019

This study investigates the possible enhancement of flame resistance in powder-epoxy resin/glass fabric composites. For this purpose, the halogen-free flame retardants containing phosphorous, nitrogen and aluminium were used. The total content of the fillers did not exceed 25 wt%. The laminates assessed for flame retardancy were designed specifically to be used as components of seats in public transport. Thermal resistance of the laminates and the surfaces of partially burned composites were also examined using thermogravimetric and scanning electron microscopy/energy-dispersive x-ray spectroscopy analyses, respectively. On the basis of the obtained results, it was found that the highest flame resistance (V-0 class, minimum oxygen concentration = 35.5% and maximum average rate of heat emission = 38.5 kW/m2 at an incident heat flux of 50 kW/m2) was identified in the laminates with matrix comprising 15 wt% aluminium diethyl phosphinate and 10 wt% melamine polyphosphate. In turn, the laminates with the matrix containing ammonium polyphosphate as the main component achieved only the V-1 flammability class.
College Campus Sexual Assault and Female Students With Disabilities
Authors: Campe Margaret I.
Published: April 2019

College campus sexual assault is well-documented as a pervasive problem among U.S. colleges and universities, with female college students at the greatest risk. Although more than 30 years of research has been dedicated to uncovering college campus sexual assault and identifying risk factors for victimization, few studies have looked at the relationship between female students with disabilities and college campus sexual assault victimization. The present study uses data from the female respondents ( N = 22,828) of the American College Health Association’s Fall 2016 National College Health Assessment (ACHA-NCHA) to explore the relationship between female college campus sexual assault victimization and disability status. The analysis finds that disability status produces significantly greater increased odds for sexual assault than other commonly cited risk factors such as binge drinking, drug use, or Greek affiliation. Specifically, female students with disabilities are at increased odds for any type of sexual assault compared with female students without disabilities (odds ratio [OR] = 1.96; p < .001). This increases when looking at specific types of assault. Female students with disabilities were over 100% more likely to experience completed assaults (OR = 2.34; p < .001), attempted assaults, (OR = 2.03; p < .001), and relationship assaults (OR = 2.22; p < .001) compared to female students without disabilities. Analysis also indicates differences in other significant independent variables when sexual assault status is broken down into categories of completed sexual assaults, attempted sexual assaults, and relationship sexual assaults. In addition, the types of disability showing significance vary between the different types of assault. These findings have important policy implications for campus violence prevention and intervention and suggest multiple avenues for further research.
Bureaucratic contacts and their impact on citizen satisfaction with local government agencies: The influence of expectation
Authors: Wang Feng , Jun Kyu-Nahm , Wang Lili
Published: April 2019

This study investigates key aspects of administrative process in citizen contacts with local government agencies and their impact on citizen satisfaction with those agencies in an institutional context of limited accountability and channels for obtaining information of public service outcomes and performance. Using survey data collected in a Chinese city district, we examine the effect of administrative processes—the quality and results of citizens’ bureaucratic contacts—on their satisfaction with local police departments and the role of citizens’ expectation in this relationship. The findings indicate that both quality and results of bureaucratic contacts are significantly related to citizen satisfaction. Additionally, the relationships of citizen satisfaction and bureaucratic contacts are moderated by citizens’ expectation on the performance of local government agencies. The results suggest that using proper communication strategies, which help shape citizen expectation, and improving citizens’ experiences in the administrative processes are important practices that could increase citizen satisfaction.
Application of Udwadia–Kalaba approach to semi-active suspension control of a heavy-duty truck
Authors: Huang Kang , Xian Yuan-Jie , Li Chen-Ming , Qiu Ming-Ming
Published: April 2019

As an important component of the chassis system, the vehicle suspension plays a significant role in vehicle comfort, stability, and safety. In dynamic modeling of a semi-active suspension, traditional method is a complicated process, the actuator force is difficult to solve. In the process of model simplification, the influence of the vehicle-axle and balanced shift quality on the vehicle dynamics is not considered. For this reason, applying the Udwadia–Kalaba approach to dynamic modeling and control for a three-axle semi-active truck suspension can establish a simple and accurate equivalent discrete system. By fixing the displacement and acceleration of the body, the simulation is conducted with real excitations between the road and six wheels, and the actuator control forces of the semi-active suspension are obtained under the constraint by applying the Udwadia–Kalaba approach. The contrast in the analysis results from the Udwadia–Kalaba approach and the traditional Lagrange multiplier method indicate that the Udwadia–Kalaba equation can obtain the semi-active suspension actuator forces without introducing additional Lagrange multipliers and that the actuator forces acquired with the Udwadia–Kalaba approach are equal to those of the traditional Lagrange multiplier method.
The Perils of Service Contract Divestment: When and Why Customers Seek Revenge and How It Can Be Attenuated
Authors: Haenel Christina M. , Wetzel Hauke A. , Hammerschmidt Maik
Published: April 2019

Profitability considerations lead service providers to divest from customer service contracts, either by service contract demotion (cutting back services) or by service contract termination (ending service provision). Such initiatives have been associated with customer revenge. The pressing question for practitioners is which divestment approach has a stronger or weaker effect on customer revenge. Drawing on justice and appraisal theories, the authors suggest that the answer depends on customers’ predivestment satisfaction and on the provision of financial compensation or apology. Three experiments and a critical incident study reveal that for previously satisfied customers, service termination entails a stronger effect on customer revenge, while for previously dissatisfied customers, service demotion entails a stronger effect. The findings further demonstrate that offering financial compensation or an apology can mitigate or exacerbate the effect, highlighting the need to align these divestment handling instruments with the divestment approach chosen and customers’ predivestment satisfaction. The findings also show that the effect can be explained by customer anger. Overall, this article provides guidance on how to divest whom in order to mitigate detrimental effects.
Intraocular pressure control after trans-scleral intraocular lens fixation in glaucoma patients
Authors: Belkin Avner , Einan-Lifshitz Adi , Mathew David J , Sorkin Nir , Buys Yvonne M , Trope Graham E , Rootman David S
Published: April 2019

Background:

Intraocular lens fixation surgery is associated with fluctuations in intraocular pressure. This may be significantly relevant in glaucoma patients.

Objectives:

To assess short- and medium-term intraocular pressure control after trans-scleral intraocular lens fixation surgery in glaucoma patients.

Methods:

The charts of all glaucoma patients who underwent trans-scleral intraocular lens fixation surgery with at least 6 months follow-up by a single surgeon between the years 2004 and 2017 were reviewed. Primary outcomes were intraocular pressure at 1 day and 6 months after surgery. Secondary outcome measures were hypotensive medication use and the need for further intraocular pressure lowering interventions.

Results:

Eleven eyes of 10 patients were included in the analysis. Mean follow-up post intraocular lens fixation surgery was 54.6 months. Mean intraocular pressure before, 6 months, and last follow-up after intraocular lens fixation surgery was 15.8 ± 5.3 mmHg (range 10.6–25.3), 13.5 ± 3.8 mmHg (range 8–21, p = 0.2), and 11.8 ± 5.6 (range 6–21, p = 0.09) on a mean of 2.3 ± 1.6, 2 ± 1.6 (p = 0.23), and 1.7 ± 1.5 (p = 0.08) hypotensive medications, respectively. A pressure spike was noted in 5 of the 11 eyes on the first post-operative day (mean spike 15.2 mmHg, range 6–23). Four of 11 eyes in the study (36%) needed additional interventions to control intraocular pressure by the 6-month point. One eye required the addition of two classes of topical medications, one eye required laser trabeculoplasty, and two eyes required trabeculectomy.

Conclusion:

Over a third of glaucomatous eyes required a change in the management of their disease in the early post-operative period. Close follow-up of patients undergoing trans-scleral intraocular lens fixation surgery is warranted.
Police discretion, organizational characteristics, and traffic stops: An analysis of racial disparity in illinois
Authors: Nowacki Jeffrey S. , Spencer Tyrell
Published: April 2019

An important source of racial disparity in policing is traffic enforcement. The level of discretion afforded to officers for traffic enforcement is generally greater than it is for other policing decisions. One way to control misuse of discretion is through minority representation, which is the extent that the racial composition of the police agency matches that of the local community. Using data from the Illinois Department of Transportation (IDOT) and the 2013 Law Enforcement Management and Administrative Statistics (LEMAS), this study examines how social context and police organizational variables (e.g., minority representation) relate to enforcement outcomes. We find that organizational measures, including minority representation, relate to written citations and consent search requests. Moreover, non-white population size conditions the effect of minority representation on traffic stops and citations. These results highlight the importance of accounting for both social context and organizational characteristics when research examines discretionary police behavior.
Struggling with/against the unintentional reproduction of power structures in participatory research: Using reconstructive horizon analysis
Authors: Call-Cummings Meagan , Hauber-Özer Melissa , Ross Karen
Published: April 2019

Shared power and democratic decision making are core epistemological commitments of participatory action research. Scholars who engage in participatory action research with youth seek to share ownership and disrupt adult/child or knower/learner binaries traditional in the Global North, in which adults are the active agents who own and transfer knowledge to children, who remain in a passive role. Yet, we have noticed during several of our projects with youth that, despite our best efforts, these knower/learner binaries can be reproduced with younger coresearchers as we exhibit care in the form of protection and provision of security. In this article, we examine three scenes from our recent youth participatory action research projects using reconstructive horizon analysis to surface and explore backgrounded validity claims that highlight the tensions between our efforts to democratize the research process and our commitment to an ethic of care for those with whom we engage in participatory knowledge production. We suggest that explicit attention to these tensions as part of the inquiry process is important for making participatory research with youth a more equitable endeavor and to build the validity of such work.
Establishing an indwelling peritoneal catheter as a standard procedure for hospitalized patients with ascites: Retrospective data on feasibility, effectiveness and safety
Authors: Stratmann Katharina , Fitting Daniel , Zeuzem Stefan , Bojunga Jörg , Trebicka Jonel , Friedrich-Rust Mireen , Dultz Georg
Published: April 2019

Background

The use of an indwelling peritoneal catheter system in hospitalized patients with ascites could facilitate patient management by the prevention of repetitive abdominal paracentesis. Despite these possible benefits, the use of indwelling catheters is not widely established.

Objective

This retrospective study aimed to evaluate the feasibility, effectiveness and safety of the use of an indwelling catheter for ascites drainage in the clinical routine.

Methods

This retrospective study included all indwelling peritoneal catheter placements in our department in hospitalized patients with cirrhosis between 2014 and 2017.

Results

A total of 324 indwelling catheter placements for ascites in 192 hospitalized patients with cirrhosis were included. The catheter (7F, 8 cm) was placed ultrasound‐assisted bed‐side on the hospital ward. The technical success rate of the catheter placement was 99.7% (323/324). In 17.5% (64/324) the catheter was placed to optimize ascitic drainage prior to an abdominal intervention (e.g. transjugular intrahepatic portosystemic shunt). The median time of catheter retention was 48 hours (8–168 hours) and the median cumulative amount of drained ascites 8000 ml (550–28,000). The most common adverse event was acute kidney injury (49/324, 15.1%); the risk was particularly higher in patients with a Model for End‐Stage Liver Disease (MELD) score ≥ 16 (p = 0.028; odds ratio 2.039). Ascitic fistula after catheter removal was observed in 9.6% (31/324). Catheter‐related infections occurred in 4.3% (14/324), and bleeding was documented in three cases (0.8%) with one major bleeding (0.3%).

Conclusion

The placement of an indwelling catheter for repetitive ascitic drainage in hospitalized patients with cirrhosis can be established in the clinical routine, facilitating patient management. High‐MELD patients especially have to be monitored for acute kidney injury.
Surgical management of urolithiasis in octogenarians
Authors: Whiting Danielle , Arican Irem , Farrag Khaled , Anjum Faqar , Sriprasad Seshadri , Nariculam Joseph
Published: April 2019

Objective:

The objective of this study was to report the outcomes of octogenarians undergoing surgical treatment for urolithiasis.

Materials and methods:

We performed a retrospective review of patients aged over 80 years who underwent surgical management for urolithiasis over 8.5 years. Data was collected for patient demographics, procedure, stone size, position, composition and clearance, urine cultures, complications and length of stay.

Results:

Sixty patients had 111 surgical procedures: 89 elective procedures (80.2%) and 22 emergency procedures (19.8%). Median age was 83 years (81–85), ASA grade 3 and stone size 8 mm (6–10). Clinical presentation was varied, with only 17 patients (28.3%) presenting with ureteric colic/flank pain. Ureterorenoscopy was performed in 74 procedures (66.7%). A ureteric stent was left in 91 procedures (82.0%). The median length of stay for the emergency patients was 6 nights (3–9.5 nights) and for the elective patients was 1 night (1–3 nights). The complication rate varied depending on the primary procedure performed. The overall complication rate was 19.8%: three (2.7%) Clavien I (urinary retention); 11 (9.9%) Clavien II (blood transfusion/urinary tract infection/urosepsis); two (1.8%) Clavien IIIb (stent insertion/bleeding); three (2.7%) Clavien IV (urosepsis) and three (2.7%) Clavien V (two patients urosepsis and one patient pneumonia). The stone-free rate was 68.3%.

Conclusion:

Octogenarian patients with urolithiasis have a variable presentation, and in patients with sepsis of unknown origin urolithiasis should be considered. We demonstrate that surgical treatment, in particular ureterorenoscopy, can be safely and effectively performed in octogenarians with appropriate surgical planning. Level of evidence: 4 Case series
How Russian Rap on YouTube Advances Alternative Political Deliberation: Hegemony, Counter-Hegemony, and Emerging Resistant Publics
Authors: Denisova Anastasia , Herasimenka Aliaksandr
Published: April 2019

The late 2010s have seen the unprecedented rise of Russian rap culture on YouTube. This study delves into the unexplored area of the relationship between rap music, politics, and the Internet audience in Russia. It focuses on the analysis of the production of the most popular rap videos—their narratives, power relations, and socio-political themes, as well as the prevailing patterns in the discussion on socio-political issues by the YouTube audience. The study brings three contributions that identify the power relations in the Russian society that manifest in the field of rap music. First, the Russian-speaking users demonstrate a high level of criticality toward the pro-Kremlin rap music on YouTube and challenge the lies of propaganda rap. Second, pro-government rappers follow the Soviet authoritarian ethos and praise belonging to the collective of elites, while liberal ones adhere to the individual responsibility. Third, we demonstrate the prevalence of patriarchal gender values, including macho politics and unquestioned sexism, which are representative of gender politics in the country. This article proves the importance of socio-political commentary on YouTube and points to the rap videos as the popular hubs for the socio-political debates. Users flow to rap videos and utilize the comment section to have their say on the political context and power relations rather than the music, to engage with others, and to contribute to the emerging collective debate. The comment sections on these rap videos have a unique value for the Russian users who exploit them as the negotiation space in the void of other platforms for social dialogue in Russia.
Metabolic reprogramming and redox adaptation in sorafenib‐resistant leukemia cells: detected by untargeted metabolomics and stable isotope tracing analysis
Authors: You Xin , Jiang Weiye , Lu Wenhua , Zhang Hui , Yu Tiantian , Tian Jingyu , Wen Shijun , Garcia‐Manero Guillermo , Huang Peng , Hu Yumin
Published: April 2019

Background

Internal tandem duplications (ITD) within the juxtamembrane domain of FMS‐like tyrosine kinase 3 (FLT3) represent a poor prognostic indicator in acute myeloid leukemia (AML). Therapeutic benefits of tyrosine kinase inhibitors, such as sorafenib, are limited due to the emergence of drug resistance. While investigations have been conducted to improve the understanding of the molecular mechanisms underlying the resistance to this FLT3 inhibitor, a profile of cell functioning at the metabolite level and crosstalk between metabolic pathways has yet to be created. This study aimed to elucidate the alteration of metabolomic profile of leukemia cells resistant to the FLT3 inhibitor.

Methods

We established two sorafenib‐resistant cell lines carrying FLT3/ITD mutations, namely the murine BaF3/ITD‐R and the human MV4‐11‐R cell lines. We performed a global untargeted metabolomics and stable isotope‐labeling mass spectrometry analysis to identify the metabolic alterations relevant to the therapeutic resistance.

Results

The resistant cells displayed fundamentally rewired metabolic profiles, characterized by a higher demand for glucose, accompanied by a reduction in glucose flux into the pentose phosphate pathway (PPP); and by an increase in oxidative stress, accompanied by an enhanced glutathione synthesis. We demonstrated that the highest scoring network of altered metabolites in resistant cells was related to nucleotide degradation. A stable isotope tracing experiment was performed and the results indicated a decrease in the quantity of glucose entering the PPP in resistant cells. Further experiment suggested that the inhibition of major enzymes in the PPP consist of glucose‐6‐phosphate dehydrogenase deficiency (G6PD) in the oxidative arm and transketolase (TKT) in the non‐oxidative arm. In addition, we observed that chronic treatment with sorafenib resulted in an increased oxidative stress in FLT3/ITD‐positive leukemia cells, which was accompanied by decreased cell proliferation and an enhanced antioxidant response.

Conclusions

Our data regarding comparative metabolomics characterized a distinct metabolic and redox adaptation that may contribute to sorafenib resistance in FLT3/ITD‐mutated leukemia cells.
Clinical Prognostic Factors and Outcome in Pediatric Osteosarcoma: Effect of Delay in Local Control and Degree of Necrosis in a Multidisciplinary Setting in Lebanon
Authors: Abou Ali Bilal , Salman Mayssa , Ghanem Khaled M. , Boulos Fouad , Haidar Rachid , Saghieh Said , Akel Samir , Muwakkit Samar A. , El-Solh Hassan , Saab Raya , Tamim Hani , Abboud Miguel R.
Published: April 2019

PURPOSE

Outcomes in pediatric osteosarcoma have dramatically improved over the past few decades, with overall survival rates of 70% and 30% for patients with localized and metastatic disease, respectively.

PATIENTS AND METHODS

We retrospectively reviewed clinical characteristics and outcomes of 38 patients treated between 2001 and 2012 at a single institution in Lebanon. All patients received a uniform three-drug chemotherapy regimen consisting of cisplatin, doxorubicin, and methotrexate. Ifosfamide and etoposide were added to the adjuvant treatment regimen in case of metastatic disease and/or poor degree of tumor necrosis (< 90%).

RESULTS

After a median follow-up of 61 months (range, 8 to 142 months), patients with localized disease had 5-year overall and event-free survival rates of approximately 81% and 68%, respectively, whereas for metastatic disease, they were approximately 42%. The most common primary site was the long bones around the knee (n = 34; 89.5%). Six patients (15.8%) had metastatic disease to lungs, and three (7.9%) had synchronous multifocal bone disease with lung metastases. Adverse prognostic factors included nonlower extremity sites, metastasis, poor degree of necrosis, and delay of more than 4 weeks in local control. In bivariable analysis, only degree of necrosis was a prognostic predictor for survival and disease recurrence.

CONCLUSION

Treatment of pediatric osteosarcoma in a multidisciplinary cancer center in Lebanon resulted in survival similar to that in developed countries. Delay in local control was associated with worse outcome. The only statistically significant inferior outcome predictor was poor degree of necrosis at the time of local control.
Potentially Avoidable Hospital Readmissions in Patients With Advanced Cancer
Authors: Johnson P. Connor , Xiao Yian , Wong Risa L. , D'Arpino Sara , Moran Samantha M.C. , Lage Daniel E. , Temel Brandon , Ruddy Margaret , Traeger Lara N. , Greer Joseph A. , Hochberg Ephraim P. , Temel Jennifer S. , El-Jawahri Areej , Nipp Ryan D.
Published: April 2019

PURPOSE:

Patients with cancer often prefer to avoid time in the hospital; however, data are lacking on the prevalence and predictors of potentially avoidable readmissions (PARs) among those with advanced cancer.

METHODS:

We enrolled patients with advanced cancer from September 2, 2014, to November 21, 2014, who had an unplanned hospitalization and assessed their patient-reported symptom burden (Edmonton Symptom Assessment System) at the time of admission. For 1 year after enrollment, we reviewed patients’ health records to determine the primary reason for every hospital readmission and we classified readmissions as PARs using adapted Graham’s criteria. We examined predictors of PARs using nonlinear mixed-effects models with binomial distribution.

RESULTS:

We enrolled 200 (86.2%) of 232 patients who were approached. For these 200 patients, we reviewed 277 total hospital readmissions and identified 108 (39.0%) of these as PARs. The most common reasons for PARs were premature discharge from a prior hospitalization (30.6%) and failure of timely follow-up (28.7%). PAR hospitalizations were more likely than non-PAR hospitalizations to experience symptoms as the primary reason for admission (28.7% v 13.0%; P = .001). We found that married patients were less likely to experience PARs (odds ratio, 0.30; 95% CI, 0.15 to 0.57; P < .001) and that those with a higher physical symptom burden were more likely to experience PARs (odds ratio, 1.03; 95% CI, 1.01 to 1.05; P = .012).

CONCLUSION:

We observed that a substantial proportion of hospital readmissions are potentially avoidable and found that patients’ symptom burdens predict PARs. These findings underscore the need to assess and address the symptom burden of hospitalized patients with advanced cancer in this highly symptomatic population.
СОВРЕМЕННЫЙ WEB НА ПРИМЕРЕ СОЗДАНИЯ ПРОСТОГО МЕНЕДЖЕРА ЗАДАЧ
Authors: Badykov Ilnar Vasilovich , Khamidullin Marat Raisovich
Published: April 2019

В статье рассматривается процесс создания веб приложения «Менеджер задач». В разработке используются современные веб инструменты. Непосредственно, в самой статье ведется полный разбор написания простейшего менеджера задач, с использованием полного перечня современных технологий. Которые, включают в себя технологии клиентской и серверной стороны. В серверной части будет использоваться полный стек серверного языка, в нашем случае php, и работы с базой данных mysql, используя популярный фреймворк – Laravel. В свою очередь клиентская сторона, будет включать в себя асинхронную работу (без перезагрузки страницы) с серверной стороной, используя джаваскрипт фреймворк – VueJs. Полный стек затрагиваемых технологий будет следующим: Клиентская часть – HTML, CSS, JavaScript, VueJs, также серверная часть – php, Mysql, Laravel. Также, будет краткое знакомство с менеджером зависимостей php-composer. Который имеет возможность скачки пустого первичных файлов для запуска проекта.Цель – создать современное веб приложение.Метод или методология проведения работы: в статье использовались информационно-технические методы, в момент создания приложения.Результаты: получены наиболее информативные способы, создания веб приложения, основанные на полном асинхронном подходе.Область применения результатов: полученные результаты целесообразно применять в созданиях любых веб проектов.
ИДЕОЛОГО-ОБРАЗОВАТЕЛЬНАЯ ЛОГИСТИКА ВО ВНЕШНЕЙ И ВНУТРЕННЕЙ ГОСУДАРСТЕННО-ОБРАЗОВАТЕЛЬНОЙ ПОЛИТИКЕ ВЫСШЕГО ОБРАЗОВАНИЯ И ПОЛИТИКЕ МЯГКОЙ СИЛЫ ФРГ И ФРАНЦУЗСКОЙ РЕСПУБЛИКИ
Authors: Zhitnov Evgeny Aleksandrovich
Published: April 2019

В статье были рассмотрены системы высшего образования ФРГ и Франции, основные направления реформирования систем высшего образования Франции и ФРГ в рамках создания общеевропейской образовательной системы. Статья позволила определить основные направления государственно-национальных особенностей образовательных систем этих двух стран. Перечислены преимущества и недостатки унификации образовательной деятельности; проведена оценка образовательного потенциала Франции и Германии с помощью модели ИОЛ; определено рейтинговое положение этих стран среди наиболее успешных государств в образовательной сфере; показана роль образования Франции и Германии в политике мягкой силы.Целью исследования является анализ основных факторов, влияющих на образовательную политику Французской Республики и ФРГ, выраженной в структурных оценках политики мягкой силы.Задачи исследования:– определить и исследовать основные закономерности, позволяющие выявить условия расширения системы национального образования Французской Республики и ФРГ на другие регионы мира;– исследовать исторический путь развития системы национальных систем образования Французской Республики и ФРГ;– качественно характеризовать степень конкурентоспособности образовательных систем Французской Республики и ФРГ;– конкретизировать ценностные ориентиры национальных образовательных систем, влияющих на формирование политики мягкой силы в ЕС.– разработать методологические основы концепции по оценке государственно-образовательной политики, основанной на количественно-качественной модели идеолого-образовательной логистики, по оценке индекса развития образования.Объект исследования – система государственно-образовательной политики Французской Республики и ФРГ.Предмет исследования – факторы, структуры, системы, модели и основные направления трансформации образовательной политики, выражаемые в политике мягкой силы и распространением ее на другие регионы мира, реализуемые Французской Республикой и ФРГ.Результаты. Результаты работы заключаются в том, что автор сделал попытку создать интегральную модель оценки уровня развития государства, основанной на широком диапазоне различных информативных данных, включающих различные показатели.Область применения результатов. Результаты исследования могут быть использованы в педагогической, экономической, политической деятельностях, где требуется оценить уровень развития государства как в отдельном, так и интегральных аспектах.
Proton Accelerators for Radiation Therapy
Authors: Черняев А. , Chernyaev A. , Кленов Г. , Klenov2 G. , Бушманов Андрей , Bushmanov Andrey , Пряничников А. , Pryanichnikov A. , Белихин М. , Belikhin M. , Лыкова Е. , Lykova E.
Published: April 2019

Purpose: To make an analysis (including statistical data) of accelerator equipment for proton therapy (PT) in Russia and the world; to identify the main trends and directions of development in this area. Material and methods: Currently, proton therapy is developing rapidly in the world. Every year new proton centers are built. The number of commercial companies and research institutes, that are included in this high-tech sector, grows every year. Physicists and doctors together actively develop and introduce new ideas and technologies that are able to increase the efficiency and quality of proton therapy and also make it less costly. This review is an analysis of both publications in refereed publications, and reports made at relevant conferences and seminars. In addition, the data presented in the review are based on the information from the companies-manufacturers of equipment for proton therapy, which is open or provided for non-commercial use, with an indication of the sources. Results: In recent years, the main trends in the development of accelerators for proton therapy are: reducing the size and weight of machines, using of active pencil scanning as a standard method of dose delivering, reducing the time spent by patients in treatment rooms, using modulated radiation intensity in proton therapy. There is a transition from the construction of multi-cabin PT centers with an annual number of patients about 1000 people (due to their high cost and need to have an infrastructure for such big number of patients), to the creation of small-sized single-cabin complexes with an annual flow of several hundred people. Conclusion: Despite proton therapy has a good promotion and popularization activities, it is still an inaccessible method for most cancer patients with the exception of the United States, Japan and Europe. The lack of PT centers, the price per course of treatment, the lack of specialists in this area, and the attitude of most clinicians to PT as an experimental method of treatment is acute. In Russia, proton therapy does not receive enough support, despite the enormous potential and extensive experience that has been used for half a century of using PT. The last open proton center is private, and the only local manufacturer of equipment for PT exists only thanks to foreign contracts. Nevertheless, research and development continues. Moreover, the development is equal to the level of leading countries.