bluuebunny/crossref_metadata_2025 huggingface dataset:
A modelização como ferramenta complementar no ensino de Teoria da Comunicação
Authors: Ferraz Luiz Marcelo Robalinho
Published: June 2018

O objetivo deste artigo é discutir a experiência de modelagem realizada na disciplina de Teoria da Comunicação II dos cursos de Jornalismo e Rádio, TV e Internet da Universidade Federal de Juiz de Fora. Através da elaboração de uma escultura que refletisse a ideia de comunicação, a proposta da dinâmica foi fazer os alunos articularem a concepção criada com os conceitos da disciplina. Pensando no dialogismo no aspecto discursivo e na dimensão participativa e transformadora da prática comunicativa, a produção de um significado em comum buscou aproximá-los das teorias e dar-lhes condições para refletir criticamente sobre a importância do papel da comunicação.
A temática ambiental nos projetos de pesquisa e extensão do curso de jornalismo das universidades do Piauí
Authors: Sousa Elinara Soares Barros de , Carvalho Denis Barros de , Berti Orlando Maurício de Carvalho
Published: June 2018

Esta pesquisa analisa como a temática ambiental aparece nos projetos de pesquisa e extensão elaborados pelos docentes dos cursos de jornalismo das duas universidades públicas piauienses: Universidade Estadual do Piauí (Uespi) e Universidade Federal do Piauí (UFPI). Para tanto, pesquisou-se a produção dos professores nesses dois eixos e percebeu-se que há lacunas na formação dos jornalistas nessas duas universidades, não só quanto à questão ambiental como a outras temáticas e possibilidades existentes aos alunos nos eixos pesquisa e extensão. Percebeu-se ainda a necessidade de interferência da gestão superior em incentivar maior produção, principalmente de projeto de extensão nas duas instituições. Nota-se que, apesar dessas constatações, a questão ambiental está contemplada no currículo dos cursos de jornalismo no país como tema transversal.
Educomunicação, paradigma indispensável à renovação curricular no ensino básico no Brasil
Authors: Soares Ismar de Oliveira
Published: June 2018

Este artigo discute a indispensabilidade da prática educomunicativa na implementação de uma reforma curricular que leve em conta as demandas por uma educação cidadã que privilegie a formação para o exercício do direito universal à expressão e à comunicação. Toma como objeto de análise a versão definitiva da Base Nacional Comum Curricular (BNCC) do MEC, aprovada em dezembro de 2017, observando a natureza das premissas que abrem perspectivas para a inclusão da educação midiática como prática de interesse para o sistema educativo. O artigo lembra, finalmente, a expectativa criada pelo documento oficial quando prevê a atuação, no âmbito escolar, de curadorias e mediações especializadas para o tratamento de temas para os quais ainda não existam docentes especificamente formados. Entende-se que esse dispositivo abre caminho para a presença do especialista em Educomunicação nos quadros profissionais de atendimento à educação básica.
Capacitação docente baseada no letramento em marketing: resultados de uma pesquisa
Authors: Bethônico Jônio Machado , Coscarelli Carla Viana
Published: June 2018

Resumo: Este artigo apresenta a metodologia e os resultados de uma investigação que objetivou caracterizar e entender a opinião dos docentes sobre um curso de letramento em marketing, a fim de verificar a aceitação da proposta e seus impactos na formação profissional dos participantes. A disciplina, ministrada para quatro turmas entre 2016 e 2017, visou à conscientização dos professores sobre a centralidade e a complexidade atuais do consumo e sobre as ações de comunicação de marketing em sua multiplicidade de formatos, conteúdos e mídias. O curso objetivou também transformar esses conteúdos em propostas didáticas, trabalhando com atividades de leitura e produção textual a fim de contribuir para a formação de leitores-consumidores críticos nas escolas. Trinta e três alunos da disciplina responderam a questionários, e a análise de suas respostas revelou que os estudantes consideraram a abordagem didática positiva e a temática importante e pertinente.
Accommodation for Paul’s Entourage
Authors: Stanton Greg
Published: June 2018

The practicalities of accommodation for Paul’s entourage as it travelled around the Mediterranean have been little studied. The entourage could comprise at least nine co-workers, to whom should be added several slaves, since even under house arrest in Rome Paul had a personal assistant, who was definitely a slave, and an amanuensis. Such an entourage required hosts with large houses and there are hints in Acts that small business entrepreneurs and other hosts did have substantial dwellings. In Rome it seems that Paul paid for accommodation in relatively spacious quarters, allowing for a team of seven people (plus slaves) and sometimes a crowd of visitors; however, the term µίσθωµα probably does not refer to Paul’s rented lodgings but to payment of their cost. Greek traditions on hospitality provide a context into which the generosity of Paul’s hosts fits well.
Phototactic behaviour and the role of light in host transmission of Bursaphelenchus xylophilus
Authors: Xia Zhitao , Bai Liqun , Sheng Bicheng , Zhang Xingyao , Schütz Stefan , Yu Hongshi , Hu Jiafu
Published: June 2018

The pine wood nematode (PWN) Bursaphelenchus xylophilus is the causal agent of pine wilt disease (PWD). To understand the light influence on PWN, we investigated its phototactic behaviour. Our data indicated the mixed population of propagative PWN had a positive response to red, orange, yellow, green, blue and white lights, but a weak negative response to violet. For age-synchronised propagative nematodes, however, phototactic behavioural features changed with development. Interestingly, the dispersal fourth-stage juveniles (JIV) showed negative response to all tested lights, which was almost completely the reverse of the propagative fourth-stage juveniles (J4). Further bioassays proved that green, blue and white lights suppressed the host transmission of dispersal JIV from vector beetle to healthy pine branches. Our results revealed that night could be the peak of host transmission. With the results of previous studies, we speculate volatiles from the host tree and light may play pull-and-push roles to accelerate the host transmission of B. xylophilus.
“I am Finished”
Authors: Green Chris
Published: June 2018

Psalm 88 is unrelentingly dark; it is the only one of the lament psalms that does not turn at some point to praise. How are we to read it? First, primarily, we should read it christologically—as witness to the experience of Christ. Read in this way, the Psalms give us insight into the passion narrative. Second, we should ask how the text matters for us as Pentecostals. It calls us away from triumphalism, requiring us to take seriously the experience of god-forsakenness, and forcing us to reimagine our core beliefs and practices.
The Role Played by External Case Law in Promoting the Legitimacy of International Criminal Court Decisions
Authors: Nicholson Joanna
Published: June 2018

International criminal courts and tribunals (ICTs) often refer to jurisprudence from other ICTs when reaching a decision. This can help increase the legitimacy of their decision-making. This article focuses on the International Criminal Court (ICC) and examines when the ICC may refer to the decisions from other courts; when it in fact does so; when it has chosen to deviate from the decisions of other ICTs; and how this has affected the legitimacy of its decisions. The ICC has generally been mindful in its approach towards referring to jurisprudence from other ICTs, but has not been afraid to deviate from it on occasion in decisions concerning both substantive and procedural law. The article argues that where possible the Court should interpret the law in line with other ICTs’ decisions. This will help increase the legitimacy both of the Court’s own decisions and the field of ICL as a whole.
Due Diligence and UN Support for African Union Security Forces
Authors: Burke Róisín
Published: June 2018

Complicity by UN military peacekeepers in sexual abuse and sexual exploitation (‘SEA’) has been in the lime light in academic, practice and policy circles for many years now. Recent scandals involving sexual violence and abuse by peacekeepers in the Central African Republic and failures to respond are proving the catalyst for major reforms being discussed and implemented currently at UN level. There are numerous legal complexities, difficulties and flaws with the legal framework, policies and systems presently in place. Less considered are the parallel regulatory frameworks operative, or not operative, in the context of peacekeeping done beyond the remit of the United Nations or by those not deployed under its command and control. The fact remains that SEA is also prevalent across these peace operations but very little focus has been placed on these by academics or practitioners alike. Increasingly the UN is likely to rely on regional bodies in conducting peace operations falling outside its SEA regulatory framework. This may leave local populations vulnerable to unregulated or poorly regulated acts of sexual abuse and exploitation by peacekeepers. This paper seeks to address a gap in the literature in examining this regulatory space, focusing on the African Union’s (‘AU’s’) policy and regulatory frameworks governing its personnel deployed to peace operation environments in so far as they appear to exist. In doing so, it will reflect on the relationship this has to the UN’s Human Rights Due Diligence Policy on United Nations Support to Non-United Nations Security Forces, and the increasing reliance on AU regional peace operations, and re-hatting of forces.
Gendarmeries in Multinational Operations
Authors: Friesendorf Cornelius
Published: June 2018

It has been argued that the deployment of gendarmerie forces can help establish public order and security in international interventions. However, little is known empirically about gendarmeries in multinational operations. This article examines the Italian Carabinieri in post-war Bosnia-Herzegovina, post-war Kosovo, and war-time Afghanistan. It shows that in these missions, the Carabinieri were able and willing to carry out a variety of activities, including crowd management, arrests, and the training of host state police, and that the gendarmeries flexibly adapted to the respective mission context. However, the article also points at limitations of gendarmerie operations and identifies knowledge gaps relating to the activities and the effects of such operations. The debate on, and practice of, militarized police intervention in war-torn countries would benefit from the systematic collection of data and information. Unfortunately, such collection faces significant challenges.
Can You Pay for Peace?
Authors: Wade Lila
Published: June 2018

Financing mechanisms are central to the operational efficacy of peace operations, yet current analysis of peacebuilding finance is atomistic, focusing on one domain, such as coordination or financing. To address the need for deeper understanding of how financing modalities affect peacebuilding outcomes, this paper identifies the trade-offs and opportunities of different financing schema across the lifespan of a peace operation. In order to parse the linkages between financing and outcomes, this paper examines: (1) control of donor funds within a transitional state; (2) budgeting for coordination and alignment; (3) promoting partnerships and participation through funding modalities; and (4) funding ‘quick impact’ projects to bridge the periods of immediate relief and long-term development. With reference to peacebuilding operations in Liberia after the 2003 Accra Comprehensive Peace Agreement, this analysis highlights numerous innovations and experiments in the financing of peace operations, examining the advantages and disadvantages inherent in different approaches.
Effect of Leaf Age and Cultivation under Shade Nets on the Ionome and Leaf Disorders in Phlox paniculata
Authors: Nirit Bernstein , Gutman Sara , Rivka Rosenberg
Published: June 2018

Visual leaf damage symptoms affect plant and flower development. A variety of physiological leaf symptoms are induced by environmental and growing conditions, including light intensity during cultivation and the nutrition status of the leaves. In the present study, we studied effects of leaf age, leaf ionome, and shade factor during cultivation (20% and 47% shade – under shade nets), on the development of leaf disorders in two cultivars of Phlox paniculata. The leaf ionome of both cultivars changed with leaf age, and varied between cultivars. The percentage of shade applied during cultivation by shade nets, had a minor effect on the leaf ionome, and it did not affect the type and severity of the leaf disorders that developed on the plants, nor the stage of development of their appearance. The ionome of young leaves and mature leaves that were affected by a purple spotting disorder was similar to that of ‘healthy’-looking leaves, demonstrating that this disorder is not related to the nutritional status of the tissue. Our results further excluded leaf age, plant age, plant trimming and shade factor during cultivation (by shade nets) as inducers of the purple spots disorder. This study is first to explore the ionome of Phlox paniculata and in relation to leaf age, physiological leaf disorders and shade factor during cultivation.
How Well Can a Climate Model Simulate an Extreme Precipitation Event: A Case Study Using the Transpose-AMIP Experiment
Authors: Li Jian , Chen Haoming , Rong Xinyao , Su Jingzhi , Xin Yufei , Furtado Kalli , Milton Sean , Li Nina
Published: June 2018

A high-impact extreme precipitation event over the Yangtze River valley (YRV) in the midsummer of 2016 is simulated using the Climate System Model of Chinese Academy of Meteorological Sciences (CAMS-CSM). After validation of the model’s capability in reproducing the climatological features of precipitation over the YRV, the Transpose Atmospheric Model Intercomparison Project (T-AMIP)–type experiment, which runs the climate model in the weather forecast mode, is applied to investigate the performance of the climate model in simulating the spatial and temporal distribution of rainfall and the related synoptic circulation. Analyses of T-AMIP results indicate that the model realistically reproduces the heavy rainfall centers of accumulated precipitation amount along the YRV, indicating that the climate model has the ability to simulate the severity of the extreme event. However, the frequency–intensity structure shows similar biases as in the AMIP experiment, especially the underestimation of the maximum hourly intensity. The simulation of two typical heavy rainfall periods during the extreme event is further evaluated. The results illustrate that the model shows different performances during periods dominated by circulation systems of different spatial scales. The zonal propagation of heavy rainfall centers during the first two days, which is related to the eastward movement of the southwest vortex, is well reproduced. However, for another period with a smaller vortex, the model produces an artificial steady heavy rainfall center over the upwind slope of the mountains rather than the observed eastward movement of the precipitation centers.
Artificial bee colony algorithm–optimized error minimized extreme learning machine and its application in short-term wind speed prediction
Authors: Tian Zhongda , Wang Gang , Li Shujiang , Wang Yanhong , Wang Xiangdong
Published: June 2018

In order to improve the prediction accuracy of short-term wind speed, a short-term wind speed prediction model based on artificial bee colony algorithm optimized error minimized extreme learning machine model is proposed. The extreme learning machine has the advantages of fast learning speed and strong generalization ability. But many useless neurons of incremental extreme learning machine have little influences on the final output and, at the same time, reduce the efficiency of the algorithm. The optimal parameters of the hidden layer nodes will make network output error of incremental extreme learning machine decrease with fast speed. Based on the error minimized extreme learning machine, artificial bee colony algorithm is introduced to optimize the parameters of the hidden layer nodes, decrease the number of useless neurons, reduce training and prediction error, achieve the goal of reducing the network complexity, and improve the efficiency of the algorithm. The error minimized extreme learning machine prediction model is constructed with the obtained optimal parameters. The stability and convergence property of artificial bee colony algorithm optimized error minimized extreme learning machine model are proved. The practical short-term wind speed time series is used as the research object and to verify the validity of the prediction model. Multi-step prediction simulation of short-term wind speed is carried out. Compared with other prediction models, simulation results show that the prediction model proposed in this article reduces the training time of the prediction model and decreases the number of hidden layer nodes. The prediction model has higher prediction accuracy and reliability performance, meanwhile improves the performance indicators.
The Effects of Voice System Design Components on Driver Workload
Authors: Getty Douglas , Biondi Francesco , Morgan Shae D. , Cooper Joel M. , Strayer David L.
Published: June 2018

In-vehicle voice control systems are standard in most new vehicles. However, despite auditory-vocal interaction allowing drivers to keep their hands on the steering wheel and eyes on the forward roadway, recent findings indicate the potential for these systems to increase levels of workload and lead to lengthy interaction times. Although many studies have examined the distraction potential of interacting with in-vehicle voice control systems, more research is needed to understand the relationship between different system design components and workload. In this study, we investigate the role of system delay, system accuracy, and menu depth in determining the overall level of demand and interaction times on eight different 2017 model-year vehicles. Voice system accuracy was measured via playback of a pre-recorded sample of voice commands through a studio monitor mounted near the headrest. Menu depth and system delay were calculated by measuring, respectively, the number of interaction steps and total system processing time required to access common infotainment functions. These measures were validated through linear and multiple regression analyses with workload and task time collected in an on-road study. We found system delay and system accuracy to be significant predictors of task time and subjective measures of workload from the NASA Task Load Index and the Driving Activity Load Index. A In addition to providing valuable information on the role of separate voice control system design components on resulting levels of workload, these results extend past research by generalizing findings to multiple current auditory-vocal systems.
Absence of Axoglial Paranodal Junctions in a Child With CNTNAP1 Mutations, Hypomyelination, and Arthrogryposis
Authors: Conant Alexander , Curiel Julian , Pizzino Amy , Sabetrasekh Parisa , Murphy Jennifer , Bloom Miriam , Evans Sarah H. , Helman Guy , Taft Ryan J. , Simons Cas , Whitehead Matthew T. , Moore Steven A. , Vanderver Adeline
Published: June 2018

Leukodystrophies and genetic leukoencephalopathies are a heterogeneous group of heritable disorders that affect the glial-axonal unit. As more patients with unsolved leukodystrophies and genetic leukoencephalopathies undergo next generation sequencing, causative mutations in genes leading to central hypomyelination are being identified. Two such individuals presented with arthrogryposis multiplex congenita, congenital hypomyelinating neuropathy, and central hypomyelination with early respiratory failure. Whole exome sequencing identified biallelic mutations in the CNTNAP1 gene: homozygous c.1163G>C (p.Arg388Pro) and compound heterozygous c.967T>C (p.Cys323Arg) and c.319C>T (p.Arg107*). Sural nerve and quadriceps muscle biopsies demonstrated progressive, severe onion bulb and axonal pathology. By ultrastructural evaluation, septate axoglial paranodal junctions were absent from nodes of Ranvier. Serial brain magnetic resonance images revealed hypomyelination, progressive atrophy, and reduced diffusion in the globus pallidus in both patients. These 2 families illustrate severe progressive peripheral demyelinating neuropathy due to the absence of septate paranodal junctions and central hypomyelination with neurodegeneration in CNTNAP1-associated arthrogryposis multiplex congenita.
Role of Insulin-like Growth Factor 1 Receptor Signaling in Stem Cell Stemness and Therapeutic Efficacy
Authors: Teng Chiao-Fang , Jeng Long-Bin , Shyu Woei-Cherng
Published: June 2018

Evidence has emerged that stem cells represent a promising therapeutic tool for tissue engineering and regenerative medicine. Thus, identifying functional markers for selecting stem cells capable of superior self-renewal and pluripotency (or multipotency) and maintaining stem cell identity under appropriate culture conditions are critical for guiding the use of stem cells toward clinical applications. Many investigations have implicated the insulin-like growth factor 1 receptor (IGF1R) signaling in maintenance of stem cell characteristics and enhancement of stem cell therapy efficacy. IGF1R-expressing stem cells display robust pluripotent or multipotent properties. In this review, we summarize the essential roles of IGF1R signaling in self-renewal, pluripotency (or multipotency), and therapeutic efficacy of stem cells, including human embryonic stem cells, neural stem cells, cardiac stem cells, bone marrow mesenchymal stem cells, placental mesenchymal stem cells, and dental pulp mesenchymal stem cells. Modifying IGF1R signaling may thus provide potential strategies for maintaining stem cell properties and improving stem-cell-based therapeutic applications.
Energy-based assessment of brittle fracture in VO-notched polymer specimens under combined compression-shear loading conditions
Authors: Majidi HR , Ayatollahi MR , Torabi AR , Zaheri A
Published: June 2018

This research presents some experimental, numerical, and theoretical results on brittle fracture of disk-type test specimens weakened by V-notches with end-holes under mixed mode I/II loading with negative mode I contributions. First, 54 fracture tests are conducted on VO-notched Brazilian disk specimens made of the general-purpose polystyrene under mixed mode I/II loading with negative mode I contributions. Then, two energy-based brittle fracture criteria, namely the averaged strain energy density and averaged strain energy density based on the equivalent factor concept are proposed to predict the experimentally obtained fracture loads of the tested general-purpose polystyrene specimens. Additionally, the fracture initiation angles of the tested VO-notched Brazilian disk specimens are predicted by using averaged strain energy density criterion. The finite element analyses, as well as the experimental observations, show that although brittle fracture in the specimens under mixed mode I/II loading takes place from the applied load side of the notch border by local tensile stresses, the notch bisector line and the other sides of the notch border sustain compressive stresses. In fact, this phenomenon states the concept of mixed mode I/II loading with negative mode I contributions. Finally, it is shown that good agreement exists between the experimental results and the theoretical predictions of the two energy-based fracture criteria.
Behavioral, Pharmacokinetic, and Cardiovascular Evaluation of Candidate Oximes in African Green Monkeys
Authors: Moffett Mark C. , McDonough John H. , McMonagle Joseph D. , Myers Todd M.
Published: June 2018

Oxime reactivators are critical antidotes after organophosphate pesticide or nerve agent poisoning, directly restoring the function of inhibited acetylcholinesterase. In the continuing search for more broad-spectrum acetylcholinesterase reactivators, this study evaluated one of the leading next-generation oxime reactivators: methoxime, (1,1′-trimethylene bis[4-(hydroxyimino)methyl]pyridinium dichloride (MMB-4). The pharmacokinetics of both salts of MMB-4 (dichloride [2Cl] and dimethanesulphonate [DMS]) were characterized across a range of relevant doses (19, 58, and 116 µmol/kg, intramuscular) in a nonhuman primate model (male African green monkeys), and only subtle differences were observed between the salts. Additionally, the behavioral and cardiovascular safety of these MMB-4 salts was compared directly to other available oximes (HI-6 2Cl, HI-6 DMS, and pyridine-2-aldoxime chloride (2-PAM Cl)) at comparable projected doses. Automated operant behavioral tests were used to examine attention, motivation, visual discrimination, concept execution, and fine motor coordination after high doses of all oxime salts, and of all oximes studied, only the highest dose of 2-PAM Cl (447 µmol/kg) disrupted behavioral performance. Likewise, the effects of a range of doses of MMB-4 2Cl or DMS, HI-6 2Cl or DMS, or 2-PAM Cl on cardiovascular parameters were measured in African green monkeys implanted with telemetry devices. Only a small transient decrease in pulse pressure was observed following administration of the highest dose of MMB-4 DMS (116 µmol/kg). Thus, MMB-4 salts, up to the 9× equivalent of a projected autoinjector dose in humans, did not produce behavioral or cardiovascular toxicity in African green monkeys in the current study, and the pharmacokinetic parameters were orderly and predictable.
Blood Products Transfusion and Mid-Term Outcomes of Lung Transplanted Patients Under Extracorporeal Membrane Oxygenation Support
Authors: Pettenuzzo Tommaso , Faggi Giulio , Di Gregorio Guido , Schiavon Marco , Marulli Giuseppe , Gregori Dario , Rea Federico , Ori Carlo , Feltracco Paolo
Published: June 2018

Introduction:

Extracorporeal membrane oxygenation (ECMO) is considered a reliable technique in lung transplantation requiring cardiorespiratory support. However, the impact of this technology on blood product transfusion rate and outcomes compared to off-pump lung transplantation has been rarely investigated.

Methods:

Between January 2012 and June 2015, 52 elective adult lung transplants were performed at our institution. Of these, 15 recipients required intraoperative venoarterial extracorporeal support and 37 did not. We compared blood product consumption and other outcome variables between the 2 groups.

Results:

We found comparable in-hospital (86.7% vs 97.3%, P = .14) and 6-month (86.7% vs 91.9%, P = .56) survival between patients with and without extracorporeal support, respectively. Survival at 30 days was lower in the ECMO group (86.7% vs 100%, P = .02). Although patients who underwent ECMO received more intraoperative transfusions, postoperative transfusion rate was similar between the 2 groups. The ECMO group experienced longer mechanical ventilation (median 3 vs 2 days, P = .02) and intensive care unit stay (median 7 vs 5 days, P = .02), besides more cardiogenic shock and deep vein thrombosis. However, we observed no difference in other major and minor in-hospital complications and 6-month complications.

Conclusions:

In our experience, despite the higher need for intraoperative transfusions, lung transplantation performed with ECMO support is comparable to the off-pump procedure as to short-term survival and outcomes.
Plecanatide: a new guanylate cyclase agonist for the treatment of chronic idiopathic constipation
Authors: Rao Satish S.C.
Published: June 2018

Chronic constipation affects millions of Americans, consumes significant healthcare resources, and significantly affects quality of life (QOL). Recently, several new treatment options have become available for the treatment of constipation, including intestinal secretagogues such as lubiprotone, and linaclotide, prokinetics such as prucalopride, and bile acid transporter antagonists. Plecanatide is the newest of the secretagogue class of compounds that has been approved by the US Food and Drug Administration for the treatment of adults with chronic idiopathic constipation (CIC) in the USA. It is a guanylate cyclase agonist, and a 16 amino acid synthetic peptide that is a structural analog of human uroguanylin. Two large randomized, double-blind, placebo-controlled studies assessed the efficacy and safety of plecanatide in CIC patients (Rome III). Both doses of plecanatide, 3 mg and 6 mg resulted in a significantly greater percentage of patients who were durable overall complete spontaneous bowel movement (CSBM) responders (primary endpoint) compared with those who received placebo (plecanatide 3 mg, 21.0%; plecanatide 6 mg, 19.5%; placebo, 10.2%; p < 0.001 for each drug dose versus placebo). Plecanatide treatment also significantly reduced the severity of other CIC symptoms (straining effort, stool consistency, bloating). Also, plecanatide-treated patients reported high levels of satisfaction and improved QOL and desire to continue treatment. The rate of treatment-emergent adverse events with plecanatide was low, including rates of diarrhea (5%). Plecanatide is a luminally acting secretagogue that is efficacious and safe for the treatment of CIC. This article provides an overview of plecanatide in the management of adults with CIC.
Physical activity, sedentary behaviour and risk of oesophago‐gastric cancer: A prospective cohort study within UK Biobank
Authors: Kunzmann Andrew T , Mallon Kristian P , Hunter Ruth F , Cardwell Chris R , McMenamin Úna C , Spence Andrew D , Coleman Helen G
Published: June 2018

Background

Few observational studies have assessed the role of physical activity in oesophago‐gastric cancer risk.

Objective

This prospective cohort study aimed to assess the association between physical activity and risk of oesophageal or gastric cancer.

Methods

A cohort of 359,033 adults aged 40–69 years were identified from the UK Biobank, which recruited participants between 2006 and 2010. Adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) for the associations between self‐reported levels of physical activity and screen‐based sedentary behaviour and risk of oesophageal and gastric cancer were calculated using Cox proportional hazards models.

Results

During eight years of follow‐up (mean = 5.5), 294 oesophageal cancer and 217 gastric cancer cases were identified. Physical activity and screen‐based sedentary behaviour levels were not associated with overall oesophago‐gastric cancer risk. However, when compared with low levels, high physical activity levels were associated with a significantly reduced risk of gastric non‐cardia cancer (HR 0.58, 95% CI 0.37–0.95). Moderate physical activity levels were associated with a 38% reduced risk of oesophageal adenocarcinoma (HR 0.62, 95% CI 0.43–0.89), although no dose‐response association was apparent.

Conclusion

Moderate, rather than high, physical activity levels were associated with the strongest reductions in oesophageal adenocarcinoma risk in this large UK prospective cohort.
IgA nephropathy in African Americans: uncommon but possible
Authors: Koratala Abhilash , Clapp William L , Esprit Don H , Tantravahi Jogiraju
Published: June 2018

Though IgA nephropathy is relatively uncommon in African Americans, our case serves as a reminder that it needs to be considered in the differentials when these patients present with proliferative glomerulonephritis.
Prediction of Acute Kidney Injury With a Machine Learning Algorithm Using Electronic Health Record Data
Authors: Mohamadlou Hamid , Lynn-Palevsky Anna , Barton Christopher , Chettipally Uli , Shieh Lisa , Calvert Jacob , Saber Nicholas R. , Das Ritankar
Published: June 2018

Background:

A major problem in treating acute kidney injury (AKI) is that clinical criteria for recognition are markers of established kidney damage or impaired function; treatment before such damage manifests is desirable. Clinicians could intervene during what may be a crucial stage for preventing permanent kidney injury if patients with incipient AKI and those at high risk of developing AKI could be identified.

Objective:

In this study, we evaluate a machine learning algorithm for early detection and prediction of AKI.

Design:

We used a machine learning technique, boosted ensembles of decision trees, to train an AKI prediction tool on retrospective data taken from more than 300 000 inpatient encounters.

Setting:

Data were collected from inpatient wards at Stanford Medical Center and intensive care unit patients at Beth Israel Deaconess Medical Center.

Patients:

Patients older than the age of 18 whose hospital stays lasted between 5 and 1000 hours and who had at least one documented measurement of heart rate, respiratory rate, temperature, serum creatinine (SCr), and Glasgow Coma Scale (GCS).

Measurements:

We tested the algorithm’s ability to detect AKI at onset and to predict AKI 12, 24, 48, and 72 hours before onset.

Methods:

We tested AKI detection and prediction using the National Health Service (NHS) England AKI Algorithm as a gold standard. We additionally tested the algorithm’s ability to detect AKI as defined by the Kidney Disease: Improving Global Outcomes (KDIGO) guidelines. We compared the algorithm’s 3-fold cross-validation performance to the Sequential Organ Failure Assessment (SOFA) score for AKI identification in terms of area under the receiver operating characteristic (AUROC).

Results:

The algorithm demonstrated high AUROC for detecting and predicting NHS-defined AKI at all tested time points. The algorithm achieves AUROC of 0.872 (95% confidence interval [CI], 0.867-0.878) for AKI detection at time of onset. For prediction 12 hours before onset, the algorithm achieves an AUROC of 0.800 (95% CI, 0.792-0.809). For 24-hour predictions, the algorithm achieves AUROC of 0.795 (95% CI, 0.785-0.804). For 48-hour and 72-hour predictions, the algorithm achieves AUROC values of 0.761 (95% CI, 0.753-0.768) and 0.728 (95% CI, 0.719-0.737), respectively.

Limitations:

Because of the retrospective nature of this study, we cannot draw any conclusions about the impact the algorithm’s predictions will have on patient outcomes in a clinical setting.

Conclusions:

The results of these experiments suggest that a machine learning–based AKI prediction tool may offer important prognostic capabilities for determining which patients are likely to suffer AKI, potentially allowing clinicians to intervene before kidney damage manifests.
3-D retina organoids
Authors: Mazerik Jessica N , Becker Steven , Sieving Paul A
Published: June 2018

Across scientific disciplines, 3-D organoid culture systems offer platforms to integrate basic research findings with clinical care. The National Eye Institute mounted a $1.1 million 3-D Retina Organoid Challenge. Organoids developed through the Challenge will be valuable resources for drug screening, disease modeling, and precision and regenerative medicine.
Training, executive, attention and motor skills (TEAMS) training versus standard treatment for preschool children with attention deficit hyperactivity disorder: a randomised clinical trial
Authors: Vibholm Helle Annette , Pedersen Jesper , Faltinsen Erlend , Marcussen Michael H. , Gluud Christian , Storebø Ole Jakob
Published: June 2018

Objective

This study compared the effectiveness of manualised training, executive, attention, and motor skills (TEAMS) training versus standard treatment in preschool children with attention deficit hyperactivity disorder (ADHD). We conducted a randomised parallel group, single-blinded, superiority trial. The primary outcome was ADHD symptoms and the secondary outcome was functionality. Parents and primary school teachers assessed outcomes at pretreatment, posttreatment, and at one, three, and 6 months follow-up.

Results

In total, 67 children (aged 3–6 years) were randomised. In the TEAMS group, 32 out of 33 (97%) participants completed the total 8-week program, compared with only 7 out of 26 (27%) in the control group. The repeated-model analyses showed no significant change between the two interventions for ADHD symptoms and functionality levels over time. The mean difference in ADHD symptoms between TEAMS versus standard treatment at posttreatment was 2.18 points (95% confidence interval − 8.62 to 13.0; trial sequential analysis-adjusted confidence interval − 19.3 to 23.7).

Trial registration Clinical Trials identifier: NCT01918436 (Retrospectively registered). Registered on 7 August 2013.
Controlling translucency by UV printing on a translucent object
Authors: Takatani Tsuyoshi , Fujita Koki , Tanaka Kenichiro , Funatomi Takuya , Mukaigawa Yasuhiro
Published: June 2018

UV printer, a digital fabrication tool, can print 2D patterns on 3D objects consisting of various materials by using UV inks which immediately dry through being exposed to ultraviolet light. In general use, the translucency of the materials is removed by printing a matte white layer. On the other hand, we propose a method to control the translucency of a printed object by rather utilizing both of the translucency of the materials and inks without printing the white layer. A key is to fuse two different manners: example based and physics based. We apply Kubelka’s layer model with few measurements to render the translucency and then build a lookup table between a combination of factors in print and the fabricated translucency. The lookup table is used for finding the best combination to represent an input query about translucency. The rendering method is quantitatively evaluated, and in experiments, we show the proposed system can control the translucency through replicating appearance.
Emerging Strategies in Systemic Therapy for the Treatment of Melanoma
Authors: Ascierto Paolo A. , Flaherty Keith , Goff Stephanie
Published: June 2018

Recent years have seen major improvements in survival of patients with advanced melanoma with the advent of various novel systemic immunotherapies and targeted therapies. As our understanding of these agents and their various mechanisms of action improves, even more impressive outcomes are being achieved through use of various combination strategies, including the combining of different immunotherapies with one another as well as with other modalities. However, despite the improved outcomes that have been achieved in advanced melanoma, responses to treatment are heterogeneous and may not always be durable. Additional advances in therapy are required, and several emerging strategies are a focus of interest. These include the investigation of several new immunotherapy and/or targeted therapy combinations, such as checkpoint inhibitors (anti–PD-1/anti–CTLA-4) with other immunotherapies (e.g., indoleamine 2,3 dioxygenase [IDO] inhibitors, antilymphocyte activation 3 [anti–LAG-3], histone deacetylase [HDAC] inhibitors, Toll-like receptor 9 [TLR-9] agonists, antiglucocorticoid-induced tumor necrosis factor receptor [anti-GITR], pegylated interleukin-2 [IL-2]), combined targeted therapies (e.g., MEK and CDK4/6 coinhibition), and combined immunotherapy and targeted therapy (e.g., the triplet combination of BRAF/MEK inhibition with anti–PD-1s). The identification of novel therapeutic targets in the MAP kinase pathway also offers opportunities to improve outcomes by overcoming de novo and acquired resistance to BRAF/MEK inhibition (e.g., the development of ERK inhibitors). In addition, adoptive cell transfer, the infusion of large numbers of activated autologous lymphocytes, may have a potential role in patients whose disease has progressed after immunotherapy. Taken together, these new approaches offer further potential to increase systemic treatment options and improve long-term outcomes for patients with advanced melanoma.
Novel Quantitative Imaging for Predicting Response to Therapy: Techniques and Clinical Applications
Authors: Bera Kaustav , Velcheti Vamsidhar , Madabhushi Anant
Published: June 2018

The current standard of Response Evaluation Criteria in Solid Tumors (RECIST)–based tumor response evaluation is limited in its ability to accurately monitor treatment response. Radiomics, an approach involving computerized extraction of several quantitative imaging features, has shown promise in predicting as well as monitoring response to therapy. In this article, we provide a brief overview of radiomic approaches and the various analytical methods and techniques, specifically in the context of predicting and monitoring treatment response for non–small cell lung cancer (NSCLC). We briefly summarize some of the various types of radiomic features, including tumor shape and textural patterns, both within the tumor and within the adjacent tumor microenvironment. Additionally, we also discuss work in delta-radiomics or change in radiomic features (e.g., texture within the nodule) across longitudinally interspersed images in time for monitoring changes in therapy. We discuss the utility of these approaches for NSCLC, specifically the role of radiomics as a prognostic marker for treatment effectiveness and early therapy response, including chemoradiation, immunotherapy, and trimodality therapy.
Lifestyle Modifications and Policy Implications for Primary and Secondary Cancer Prevention: Diet, Exercise, Sun Safety, and Alcohol Reduction
Authors: LoConte Noelle K. , Gershenwald Jeffrey E. , Thomson Cynthia A. , Crane Tracy E. , Harmon Gil E. , Rechis Ruth
Published: June 2018

Improved cancer treatments and cancer detection methods are not likely to completely eradicate the burden of cancer. Primary prevention of cancer is a logical strategy to use to control cancer while also seeking novel treatments and earlier detection. Lifestyle modification strategies to improve primary prevention and risk reduction for the development of cancer include choosing a healthy diet with an emphasis on plant sources, maintaining a healthy weight throughout life, being physically active, regularly using sunscreen and wearing protective clothing, limiting sun exposure during the hours of 10 AM to 2 PM, avoiding indoor tanning, and reducing or eliminating alcohol use. In addition to continued use of ongoing education of the public, health care providers, and cancer support communities, other policy and public health efforts should be pursued as well. Examples of supported and successful policy approaches are included in this article, including efforts to limit indoor tanning and improve community-wide interventions to reduce ultraviolet radiation exposure as well as to formally support various alcohol policy strategies including increasing alcohol taxes, reducing alcohol outlet density, improving clinical screening for alcohol use disorders, and limiting youth exposure to alcohol marketing and advertising. These prevention strategies are expected to have the largest impact on the development of melanoma as well as breast, colorectal, head and neck, liver, and esophageal cancers. The impact of these strategies as secondary prevention is less well understood. Areas of additional needed research and implementation are also highlighted. Future areas of needed research are the effects of these modifications after the diagnosis of cancer (as secondary prevention).
The Epigenetic Landscape in the Treatment of Gynecologic Malignancies
Authors: Eskander Ramez N.
Published: June 2018

The care of patients with advanced-stage or recurrent endometrial, ovarian, and cervical cancer remains clinically challenging. Despite the identification of novel therapeutics and advancements in supportive care, survival outcomes have been relatively unchanged over the past decade. In addition to established genomic alterations and the contributions of the tumor microenvironment to cancer progression, epigenetic mechanisms have emerged as important contributors to gynecologic cancer progression. DNA methylation, histone modification, and noncoding RNA expression may be important contributors to disease initiation and progression and may represent novel therapeutic targets. This article reviews the epigenetic landscape of endometrial, ovarian, and cervical cancer, describing the state of the science and discussing potential clinical applications. To date, the role of epigenetic drugs in the treatment of gynecologic cancers remains unclear, although continued progress may inform future treatment modalities.
Implementation of Patient-Reported Outcomes in Routine Medical Care
Authors: Basch Ethan , Barbera Lisa , Kerrigan Carolyn L. , Velikova Galina
Published: June 2018

There is increasing interest to integrate collection of patient-reported outcomes (PROs) in routine practice to enhance clinical care. Multiple studies show that systematic monitoring of patients using PROs improves patient-clinician communication, clinician awareness of symptoms, symptom management, patient satisfaction, quality of life, and overall survival. The general approach includes a brief electronic survey, administered via the Web or an app or an automated telephone system, with alerts to clinicians for concerning or worsening issues. Patients have generally been asked to self-report on a regular basis (remotely between visits and/or at visits), with reminders prompting patients to self-report that are sent via email, text, or automated phone message. More recently, care management pathways for patients and clinicians have been triggered by PRO system alerts. PRO systems may be free-standing, integrated into electronic health record systems or patient portals, or native functionality of an electronic health record. Despite potential benefits, there are challenges with integrating PROs into practice for monitoring patient status, as there are with any modifications to existing clinical processes. These challenges range from administrative to technical to workflow. A session at the 2018 ASCO Annual Meeting was dedicated to the implementation of PROs in clinical practice. The session focused on practical examples of PRO implementations, with honest reflections on barriers and strategies that may be generalizable to other systems looking to implement PROs. Panelists for that session are the authors of this paper, which describes their respective experiences implementing PROs in practice settings.
Beyond Chemotherapy: Checkpoint Inhibition and Cell-Based Therapy in Non-Hodgkin Lymphoma
Authors: Strati Paolo , Patel Shabnum , Nastoupil Loretta , Fanale Michelle A. , Bollard Catherine M. , Lin Adam Y. , Gordon Leo I.
Published: June 2018

Immune-based treatment strategies, such as checkpoint inhibition and chimeric antigen receptor (CAR) T cells, have started a new frontier for treatment in non-Hodgkin lymphoma (NHL). Checkpoint inhibition has been most successful in Hodgkin lymphoma, where higher expression of PD-L1 is correlated with better overall response rate. Combinations of checkpoint inhibition with various chemotherapy or biologics are in clinical trials, with initially promising results and manageable safety profiles. CAR T-cell therapies that target CD19 are a promising and attractive therapy for B-cell NHLs, with a product approved by the US Food and Drug Administration in 2017. Changes in the target, hinge, or costimulatory domain can dramatically alter the persistence and efficacy of the CAR T cells. The ZUMA trials from Kite used CD19-(CD28z) CAR T cells, whereas the TRANSCEND studies from Juno and the JULIET studies from Novartis used CD19-(4-1BBz) CARs. Despite the recent successes with CAR T-cell clinical trials, major concerns associated with this therapy include cytokine release syndrome, potential neurotoxicities, B-cell aplasia, loss of tumor antigen leading to relapse, and cost and accessibility of the treatment. Although first-generation CAR T-cell therapies have failed in solid malignancies, newer second- and third-generation CAR T cells that target antigens other than CD19 (such as mesothelin or B-cell maturation antigen) are being studied in clinical trials for treatment of lung cancer or multiple myeloma. Overall, immune-based treatment strategies have given oncologists and patients hope when there used to be none, as well as a new basket of tools yet to come with further research and development.