bluuebunny/crossref_metadata_2025 huggingface dataset:
Routine-Dose and High-Dose Icotinib in Patients with Advanced Non–Small Cell Lung Cancer Harboring EGFR Exon 21-L858R Mutation: the Randomized, Phase II, INCREASE Trial
Authors: Li Xi , Zhang Li , Jiang Da , Wang Yan , Zang Aimin , Ding Cuimin , Zhao Min , Su Wuyun , Zhang Yan , Zhong Diansheng , Wu Jin , Zhang Cuiying , An Guangyu , Hu Xingsheng , Cheng Gang , Wang Huaqing , Li Yongqun , He Xiaohui , Liu Junli , Liang Li , Ding Lieming , Mao Li , Zhang Shucai
Published: February 2020

Purpose:

Our primary purpose is to explore safety and efficacy of high-dose icotinib in comparison with routine-dose icotinib in patients with non–small cell lung cancer (NSCLC) harboring 21-L858R mutation.

Patients and Methods:

Patients with treatment-naïve, EGFR-mutant (21-L858R or exon 19 deletion at 2:1) NSCLC were enrolled. Patients with 21-L858R mutation were randomized to receive routine-dose icotinib (125 mg, thrice daily; L858R-RD) or high-dose icotinib (250 mg, thrice daily; L858R-HD), whereas patients with exon 19 deletion received only routine-dose icotinib (19-Del-RD) until progression, death, or unacceptable toxicity. The primary endpoint was median progression-free survival (mPFS), assessed by an independent review committee.

Results:

From May 2015 to November 2017, 253 patients (86 in L858R-RD; 90 in L858R-HD; and 77 in 19-Del-RD) were enrolled. The mPFS in L858R-HD group was similar to that in 19-Del-RD group (12.9 months and 12.5 months, respectively) and was significantly longer than that in L858R-RD group [12.9 months vs. 9.2 months, hazard ratio (HR): 0.75; 95% confidence interval (CI), 0.53–1.05]. A longer but statistically nonsignificant mPFS was observed between 19-Del-RD and L858R-RD groups (12.5 months vs. 9.2 months, HR: 0.80; 95% CI, 0.57–1.13). A higher objective response rate (ORR) was observed in L858R-HD group compared with L858R-RD group (73% vs. 48%), also between 19-Del-RD and L858R-RD groups (75% vs. 48%). Similar incidences of grade 3/4 toxicities were observed among the three treatment groups.

Conclusions:

High-dose icotinib improved mPFS and ORR in patients with NSCLC harboring 21-L858R mutation with acceptable tolerability, which could be a new therapeutic option for this patient population.
The Immune Microenvironment and Neoantigen Landscape of Aggressive Salivary Gland Carcinomas Differ by Subtype
Authors: Linxweiler Maximilian , Kuo Fengshen , Katabi Nora , Lee Mark , Nadeem Zaineb , Dalin Martin G. , Makarov Vladimir , Chowell Diego , Dogan Snjezana , Ganly Ian , Hakimi A. Ari , Wong Richard J. , Riaz Nadeem , Ho Alan L. , Chan Timothy A. , Morris Luc G.T.
Published: February 2020

Purpose:

Salivary gland carcinomas (SGC) are rare, aggressive cancers with high rates of recurrence and distant metastasis. These factors, and a lack of active systemic therapies, contribute to poor clinical outcome. Response rates with immune checkpoint blockade have been low, although clinical data remain sparse. To improve the efficacy of therapies, a more comprehensive understanding of relevant molecular alterations and immunologic processes is needed.

Experimental Design:

To characterize the immune microenvironment and neoantigen landscape of SGCs, we performed RNA sequencing (RNA-seq) in 76 tumors representing the three most lethal histologies: adenoid cystic carcinoma (ACC), myoepithelial carcinoma (MECA), and salivary duct carcinoma (SDC). We analyzed transcriptomic profiles, tumor-infiltrating immune cell populations, and measures of T-cell activation/dysfunction. In 37 cases also undergoing exome sequencing, we analyzed somatic mutations and neoantigens.

Results:

SDCs exhibited high levels of immune infiltration, with corresponding higher levels of T-cell dysfunction, and higher mutational load. In contrast, ACCs were characterized by an immune-excluded microenvironment, the presence of M2-polarized macrophages and myeloid-derived suppressor cells, and very low mutational load. MECAs were more heterogeneous, with both immune-low and immune-high phenotypes represented. Across all SGCs, levels of immune infiltration were associated with mutation- and fusion-derived neoantigens, and with aggressive clinical behavior.

Conclusions:

These findings provide new insights into the immune microenvironment and neoantigen landscape of SGCs, showing that mechanisms of immune escape appear to differ by histology. These data nominate potential immunologic vulnerabilities and may help guide the next steps of investigation in precision immunotherapy for these difficult-to-treat cancers.
Detecting Proteomic Indicators to Distinguish Diabetic Nephropathy from Hypertensive Nephrosclerosis by Integrating Matrix-Assisted Laser Desorption/Ionization Mass Spectrometry Imaging with High-Mass Accuracy Mass Spectrometry
Authors: Smith Andrew , Iablokov Vadim , Mazza Mariafrancesca , Guarnerio Sonia , Denti Vanna , Ivanova Mariia , Stella Martina , Piga Isabella , Chinello Clizia , Heijs Bram , van Veelen Peter A. , Benediktsson Hallgrimur , Muruve Daniel A. , Magni Fulvio
Published: February 2020

Introduction: Diabetic nephropathy (DN) and hypertensive nephrosclerosis (HN) represent the most common causes of chronic kidney disease (CKD) and many patients progress to ­end-stage renal disease. Patients are treated primarily through the management of cardiovas­cular risk factors and hypertension; however patients with HN have a more favorable outcome. A noninvasive clinical approach to separate these two entities, especially in hypertensive patients who also have diabetes, would allow for targeted treatment and more appropriate resource allocation to those patients at the highest risk of CKD progression. Meth­ods: In this preliminary study, high-spatial-resolution matrix-assisted laser desorption/ion­ization (MALDI) mass spectrometry imaging (MSI) was integrated with high-mass accuracy MALDI-FTICR-MS and nLC-ESI-MS/MS analysis in order to detect tissue proteins within kidney biopsies to discriminate cases of DN (n = 9) from cases of HN (n = 9). Results: Differences in the tryptic peptide profiles of the 2 groups could clearly be detected, with these becoming even more evident in the more severe histological classes, even if this was not evident with routine histology. In particular, 4 putative proteins were detected and had a higher signal intensity within regions of DN tissue with extensive sclerosis or fibrosis. Among these, 2 proteins (PGRMC1 and CO3) had a signal intensity that increased at the latter stages of the disease and may be associated with progression. Discussion/Conclusion: This preliminary study represents a valuable starting point for a future study employing a larger cohort of patients to develop sensitive and specific protein biomarkers that could reliably differentiate between diabetic and hypertensive causes of CKD to allow for improved diagnosis, fewer biopsy procedures, and refined treatment approaches for clinicians.
Indication and Prognostic Significance of Conversion Surgery in Patients with Liver Metastasis from Gastric Cancer
Authors: Arigami Takaaki , Matsushita Daisuke , Okubo Keishi , Kawasaki Yota , Iino Satoshi , Sasaki Ken , Noda Masahiro , Kita Yoshiaki , Mori Shinichiro , Kurahara Hiroshi , Maemura Kosei , Yanagita Shigehiro , Uenosono Yoshikazu , Ishigami Sumiya , Natsugoe Shoji
Published: February 2020

Objective: Chemotherapy is generally recommended as the first-line standard treatment in patients with liver metastasis from gastric cancer. However, the clinical impact of surgical treatment remains unclear in responders after chemotherapy. The present study aimed to investigate the tumor response and prognosis after chemotherapy and to assess the clinical indication of conversion surgery in responders. Methods: The study retrospectively reviewed the clinical data of 44 patients with liver metastasis from gastric cancer who were treated with chemotherapy between February 2002 and January 2019. These patients were classified into progressive disease (PD) and non-PD groups according to tumor response. Results: Among the 44 patients, 7 and 26 had peritoneal dissemination and ≥5 had metastatic liver nodules. Additionally, 15 and 29 patients had PD and non-PD, respectively. Surgical treatment was significantly correlated with tumor response (p < 0.0321). Prognostic differences between the PD and non-PD groups were significant (p < 0.0001). Moreover, gastrectomy and hepatectomy were significantly correlated with the number of liver metastases (≥5 vs. <5, respectively) in the non-PD group (p = 0.0025 and p = 0.0169, respectively). The 3-year survival rates among patients with non-PD undergoing both gastrectomy and hepatectomy (n = 6), gastrectomy alone (n = 7), and nonsurgical treatments (n = 16) were 100, 66.7, and 0%, respectively (p = 0.0026). Multivariate analysis identified peritoneal dissemination as an independent prognostic factor (p = 0.0225). Conclusion: Our preliminary results suggest that conversion surgery for gastric cancer with liver metastasis might be clinically indicated in chemotherapy responders with <5 metastatic liver nodules and without peritoneal dissemination.
Artemisia Pollen Extracts Exposed to Diesel Exhaust Enhance Airway Inflammation and Immunological Imbalance in Asthmatic Mice Model
Authors: Chen Ying , Han Li , Zhou Yan , Yang Ling , Guo Yin-Shi
Published: February 2020

Background: Vehicle-induced air pollution may increase the prevalence and severity of asthma. Pollens are important sources of outdoor allergens associated with asthma. Outdoor pollution may influence the structure of pollen grains, resulting in enhanced immune reactions. Objective: This study aims to investigate the impact that artemisia pollen extracts exposed to diesel emissions (APEDE) may induce – allergic airway inflammation, pulmonary pathology and immune imbalance – in mice. Methods: Sixty male Balb/c mice were equally randomized into 5 groups, sensitized with 30 μL artemisia pollen extracts (APE) or APEDE adsorbed on 2 mg aluminum hydroxide gel by intraperitoneal injection on day 0, 7, 14, and 22, and challenged intranasally once per day with 30 μL APE or APEDE from day 29 to 36. The controlling group used phosphate-buffered saline as control. Results: In mice immunized and challenged by APEDE, the clinical phenotype of eosinophils, neutrophils in bronchoalveolar lavage fluid (BALF), tracheal wall thickness, airway smooth muscle thickness and airway resistance increased significantly. Pathophysiological parameters such as interleukin (IL)-17A and tumour necrosis factor-α production in BALF and serum, and the ratio of Th17/Treg cells in CD4+ cells increased significantly, while IL-10 in BALF and serum and the ratio of Treg cells decreased significantly. It was further found that the expression of oxidative stress marker 3-nitrotyrosine (3-NT) and the activation of nuclear factor kappa B (NF-κB) were significantly increased. The correlation analysis showed that the expression of 3-NT was positively correlated with the activation of NF-κB. Conclusion: Our findings suggested that pollens exposed to diesel exhaust enhance allergic responses, which may contribute to an increased prevalence of allergic diseases in urban environments with serious exhaust emissions.
Antinociceptive Efficacy of Retigabine and Flupirtine for Gout Arthritis Pain
Authors: Zhang Fan , Liu Shuna , Jin Lu , Tang LiangQinDaoErJi , Zhao Xu , Yang Tianshuo , Wang Yiyue , Huo Binghui , Liu Ruiyu , Li Han
Published: February 2020

Introduction: Gout arthritis is an inflammatory disease characterized by severe acute pain. The goal of pharmacological gout arthritis treatments is to reduce pain, and thereby increase the patient’s quality of life. The Kv7/M channel activators retigabine and flupirtine show analgesic efficacy in animal models of osteoarthritic pain. We hypothesized that these drugs may also alleviate gout arthritis pain. Objective: To determine the effects of retigabine and flupirtine on pain behavior associated with monosodium urate (MSU)-induced gout arthritis. Methods: The gout arthritis model was established with an intra-articular injection of MSU into the right ankle joint, animals were treated with retigabine or flupirtine, and pain-related behaviors were assessed. Results: Retigabine and flupirtine significantly increased the mechanical threshold and prolonged the paw withdrawal latency in a rat model of gout arthritis pain in a dose-dependent manner. The antinociceptive effects of retigabine and flupirtine were fully antagonized by the Kv7/M channel blocker XE991. Conclusion: Retigabine and flupirtine showed antinociceptive effects for MSU-induced gout pain at different times during pain development.
ОЦІНКА СТАНУ ЗДОРОВ’Я ТА РІВНЯ ФІЗИЧНОГО РОЗВИТКУ СТУДЕНТІВ ЛУЦЬКОГО БАЗОВОГО МЕДИЧНОГО КОЛЕДЖУ
Authors: Romanyuk A. V. , Reha N. I. , Hospodarskyi I. Ya.
Published: February 2020

У статті наведено дані про стан здоров’я та рівень фізичного розвитку студентів Луцького базового медичного коледжу на основі оцінки проби Руф’є та наявності хронічних захворювань з метою надання ефективних рекомендацій щодо зміцнення здоров’я студентів.
Risk Factors for Heart Failure
Authors: Lawson Claire A. , Zaccardi Francesco , Squire Iain , Okhai Hajra , Davies Melanie , Huang Weiting , Mamas Mamas , Lam Carolyn S.P. , Khunti Kamlesh , Kadam Umesh T.
Published: February 2020

Background:

There are multiple risk factors for heart failure, but contemporary temporal trends according to sex, socioeconomic status, and ethnicity are unknown.

Methods:

Using a national UK general practice database linked to hospitalizations (1998–2017), 108 638 incident heart failure patients were identified. Differences in risk factors among patient groups adjusted for sociodemographic factors and age-adjusted temporal trends were investigated using logistic and linear regression.

Results:

Over time, a 5.3 year (95% CI, 5.2–5.5) age difference between men and women remained. Women had higher blood pressure, body mass index, and cholesterol than men (
P
<0.0001). Ischemic heart disease prevalence increased for all to 2006 before reducing in women by 0.5% per annum, reaching 42.7% (95% CI, 41.7–43.6), but not in men, remaining at 57.7% (95% CI, 56.9–58.6; interaction
P
=0.002). Diabetes mellitus prevalence increased more in men than in women (interaction
P
<0.0001). Age between the most deprived (74.6 years [95% CI, 74.1–75.1]) and most affluent (79.9 [95% CI, 79.6–80.2]) diverged (interaction
P
<0.0001), generating a 5-year gap. The most deprived had significantly higher annual increases in comorbidity numbers (+0.14 versus +0.11), body mass index (+0.14 versus +0.11 kg/m
2
), and lower smoking reductions (−1.2% versus −1.7%) than the most affluent. Ethnicity trend differences were insignificant, but South Asians were overall 6 years and the black group 9 years younger than whites. South Asians had more ischemic heart disease (+16.5% [95% CI, 14.3–18.6]), hypertension (+12.5% [95% CI, 10.5–14.3]), and diabetes mellitus (+24.3% [95% CI, 22.0–26.6]), and the black group had more hypertension (+12.3% [95% CI, 9.7–14.8]) and diabetes mellitus (+13.1% [95% CI, 10.1–16.0]) but lower ischemic heart disease (−10.6% [95% CI, −13.6 to −7.6]) than the white group.

Conclusions:

Population groups show distinct risk factor trend differences, indicating the need for contemporary tailored prevention programs.
Taxonomy and bioacoustics of Meconematinae (Orthoptera: Tettigoniidae)
from Laguna (Philippines: Luzon)
Authors: TAN MING KAI , JIN XING-BAO , BAROGA-BARBECHO JESSICA B. , YAP SHERYL A.
Published: February 2020

Katydids from the subfamily Meconematinae sing at ultrasonic frequencies. Owing that many of them are nocturnal, elusive and low in abundance (since they are predatory), there is a dearth of information on these katydids and their bioacoustics, especially for species in the understudied yet mega-diverse Southeast Asia. Recent orthopteran surveys in Laguna, Luzon Island in the Philippines led to the discovery of two interesting Meconematinae katydids. Based on the collection, we describe a new species of Phisidini: Neophisis (Indophisis) montealegrei sp. nov. We also describe the male for the first time and redescribe the female of Asiophlugis philippina. The ultrasonic calling songs of both Meconematinae are also recorded, analysed and described here.
Systematic notes on Sinacroneuria Yang & Yang, 1995 (Plecoptera: Perlidae), with descriptions of two new species from China
Authors: SIVEC IGNAC , STARK BILL P.
Published: February 2020

Two previously unrecognized species of Sinacroneuria Yang & Yang, 1995 are formally described from Chinese specimens collected in Fujian Province. In addition, S. orientalis Yang & Yang, 1995 type of the genus, is a synonym of Kamimuria flavata Navás, 1933, however K. flavata is a secondary homonym of Perla (Kamimuria) flavata Navás, 1924 and is invalid. A checklist of valid Sinacroneuria species is provided.
Description of two calls of Eleutherodactylus rubrimaculatus (Anura: Eleutherodactylidae) in Chiapas, Mexico
Authors: MENDOZA-HENAO ANGELA M. , HERNÁNDEZ-AUSTRIA RAQUEL , LÓPEZ-VELÁZQUEZ ALDO , PARRA-OLEA GABRIELA
Published: February 2020

Frogs of the genus Eleutherodactylus are direct developing frogs grouped into five subgenera and 192 species, with a geographic distribution primarily centered in the Caribbean (Padial et al. 2014). Eleutherodactylus species inhabit a variety of environments such as tropical and temperate forests, and scrub, where they occupy different microhabitats including caves, floors rich in leaf litter, cracks and cavities of limestone and volcanic outcrops (Reyes-Velasco et al. 2015). Mexico harbors 33 species of Eleutherodactylus (AmphibiaWeb 2018), most of them distributed in central-western and southwestern Mexico (Reyes-Velasco et al. 2015).
A General Structure and High-Performance Dual-Edge Triggered Level Converting Flip–Flop Based on BiCMOS
Authors: Zhao Xianghong , Zhao Jieyu , Cai WeiMing
Published: February 2020

Dual supply voltage scheme provides very effective solution to cut down power consumption in digital integrated circuits design, where level converting flip–flops (LCFF) are the key component circuits. In this paper, a new general structure and design method for dual-edge triggered
LCFF based on BiCMOS is proposed, according to that PNP-PNP-DELCFF and NPN-NPN-DELCFF are designed. The experiments carried out by Hspice using TSMC 180 nm show proposed circuits have correct logic functions. Compared to counterparts, proposed PNP-PNP-DELCFF gains improvements of 6.7%, 96.0%,
86.0% and 28.5% in D-Q Delay, 50.0%, 16.0%, 12.6% and 10.8% in product of delay and power (PDP), respectively. NPN-NPN-DELCFF gains improvements of 5.1%, 93.0%, 83.2% and 26.5% in D-Q Delay, 39.7%, 7.9%, 5.0% and 3.4% in PDP, respectively. Furthermore, proposed circuits have better drive ability.
North Atlantic Circulation Regimes and Heat Transport by Synoptic Eddies
Authors: Ruggieri Paolo , Alvarez-Castro M. Carmen , Athanasiadis Panos , Bellucci Alessio , Materia Stefano , Gualdi Silvio
Published: February 2020

Meridional transport of heat by transient atmospheric eddies is a key component of the energy budget of the middle- and high-latitude regions. The heat flux at relevant frequencies is also part of a dynamical interaction between eddies and mean flow. In this study we investigate how the poleward heat flux by high-frequency atmospheric transient eddies is modulated by North Atlantic weather regimes in reanalysis data. Circulation regimes are estimated via a clustering method, a jet-latitude index, and a blocking index. Heat transport is defined as advection of moist static energy. The focus of the analysis is on synoptic frequencies but results for slightly longer time scales are reported. Results show that the synoptic eddy heat flux is substantially modulated by midlatitude weather regimes on a regional scale in midlatitude and polar regions. In a zonal-mean sense, the phases of the North Atlantic Oscillation do not significantly change the high-latitude synoptic heat flux, whereas Scandinavian blocking and the Atlantic ridge are associated with an intensification. A close relationship between high-latitude (midlatitude) heat flux and Atlantic jet speed (latitude) is found. The relationship between extreme events of synoptic heat flux and circulation regimes is also assessed and reveals contrasting behaviors in the polar regions. The perspective that emerges complements the traditional view of the interaction between synoptic eddies and the extratropical flow and reveals relationships with the high-latitude climate.
Summer Water Vapor Sources in Northeast Asia and East Siberia Revealed by a Moisture-Tracing Atmospheric Model
Authors: Piao Jinling , Chen Wen , Chen Shangfeng , Gong Hainan , Zhang Qiong
Published: February 2020

Previous studies found a seesaw pattern of summer precipitation between northeast Asia and east Siberia on an interannual time scale, which is associated with an eastward-propagating atmospheric wave train over Eurasia and corresponding water vapor transport circulations. Using a general circulation model with an embedded water-tagging module, the main water vapor sources of the two regions, as well as the relative contributions of each source region to the total precipitation for both the climatological mean and interdecadal variation, are further compared in this study. The model simulation results show that local evaporation, the Pacific Ocean, and East Asia are the dominant moisture sources for northeast Asian precipitation. In contrast, for east Siberia, moisture mainly originates from the Pacific Ocean, northeast Asia, west Siberia, and local evaporation. This suggests that the local evaporation and Pacific Ocean are both crucial to the moisture supply of the two regions, implying the important roles of the land processes and adjacent oceanic sources. In addition, northeast Asia appears to be the major moisture source for east Siberia, whereas east Siberia has weak impacts on the moisture input for northeast Asia. Further analysis finds that the model simulation can capture interdecadal changes in summer precipitation over the two regions around the late 1990s. This interdecadal change is mainly manifested in the moisture supplies from the Pacific Ocean, North Atlantic Ocean, and east Siberia, which suggests a link with the circulation anomalies under the combined impacts of the Pacific decadal oscillation and the Atlantic multidecadal oscillation.
Restratification at a California Current Upwelling Front. Part II: Dynamics
Authors: Johnson Leah , Lee Craig M. , D’Asaro Eric A. , Wenegrat Jacob O. , Thomas Leif N.
Published: February 2020

A coordinated multiplatform campaign collected detailed measurements of a restratifying surface intensified upwelling front within the California Current System. A companion paper outlined the evolution of the front, revealing the importance of lateral advection at tilting isopycnals and increasing stratification in the surface boundary layer with a buoyancy flux equivalent to 2000 W m−2. Here, observations were compared with idealized models to explore the dynamics contributing to the stratification. A 2D model combined with a reduced form of the horizontal momentum equations highlight the importance of transient Ekman dynamics, turbulence, and thermal wind imbalance at modulating shear in the boundary layer. Specifically, unsteady frictional adjustment to the rapid decrease in wind stress created vertically sheared currents that advected horizontal gradients to increase vertical stratification on superinertial time scales. The magnitude of stratification depended on the strength of the horizontal buoyancy gradient. This enhanced stratification due to horizontal advection inhibited nighttime mixing that would have otherwise eroded stratification from the diurnal warm layer. This underscores the importance of near-surface lateral restratification for the upper ocean buoyancy budget on diel time scales.
Evaluating Warm and Cold Rain Processes in Cloud Microphysical Schemes Using OLYMPEX Field Measurements
Authors: Naeger Aaron R. , Colle Brian A. , Zhou Na , Molthan Andrew
Published: February 2020

Field observations from the Olympic Mountain Experiment (OLYMPEX) around western Washington State during two atmospheric river (AR) events in November 2015 were used to evaluate several bulk microphysical parameterizations (BMPs) within the Weather Research and Forecasting (WRF) Model. These AR events were characterized by a prefrontal period of stable, terrain-blocked flow with an abundance of cold rain over the lowland region followed by less stable, unblocked flow with more warm rain, and a shift in the largest precipitation amounts to over the windward Olympic slopes. Our WRF simulations underpredicted the precipitation by 19%–36% in the Morrison (MORR) and Thompson (THOM) BMPs and 10%–23% in the predicted particle properties (P3) BMP, with the largest underpredictions over the windward slopes during the more convective, unblocked flow conditions. Several important processes related to the BMPs led to the differences in simulated precipitation. First, the prognostic single ice category parameterization in the P3 scheme promoted a more realistic evolution of rimed particles and larger cold rain production, which led to the lowest underpredictions in precipitation among the schemes. Second, efficient melting processes associated with the production of nonspherical ice and snow in the P3 and THOM BMPs, respectively, promoted a more realistic transition to rain fall speeds within the warm layer compared to the spherical snow assumption in MORR. Last, all BMPs underpredict the contribution of warm rain processes to the surface precipitation, particularly during the unblocked flow period, which may be partly explained by too weak condensational and collisional growth processes due to the neglect of turbulence parameterizations within the schemes.
Prolific Lightning and Thunderstorm Initiation over the Lake Victoria Basin in East Africa
Authors: Virts Katrina S. , Goodman Steven J.
Published: February 2020

The Lake Victoria basin of East Africa is home to over 30 million people, over 200 000 of whom are employed in fishing or transportation on the lake. Approximately 3000–5000 individuals are killed by thunderstorms yearly, primarily by outflow winds and resulting large waves. Prolific lightning activity and thunderstorm initiation in the basin are examined using continuous total lightning observations from the Earth Networks Global Lightning Network (ENGLN) for September 2014–August 2018. Seasonal shifts in the intertropical convergence zone produce semiannual lightning maxima over the lake. Diurnally, solar heating and lake and valley breezes produce daytime lightning maxima north and east of the lake, while at night the peak lightning density propagates southwestward across the lake. Cluster analysis reveals terrain-related thunderstorm initiation hot spots northeast of the lake; clusters also initiate over the lake and northern lowlands. The most prolific clusters initiate between 1100 and 1400 LT, about 1–2 h earlier than the average cluster. Most daytime thunderstorms dissipate without reaching Lake Victoria, and annually 85% of clusters producing over 1000 flashes over Lake Victoria initiate in situ. Initiation times of prolific Lake Victoria clusters exhibit a bimodal seasonal cycle: equinox-season thunderstorms initiate most frequently between 2200 and 0400 LT, while solstice-season thunderstorms initiate most frequently from 0500 to 0800 LT, more than 12 h after the afternoon convective peak over land. More extreme clusters are more likely to have formed over land and propagated over the lake, including 36 of the 100 most extreme Lake Victoria thunderstorms. These mesoscale clusters are most common during February–April and October–November.
Is Crime Bad for Your Health? The Link Between Delinquent Offending and Cardiometabolic Risk
Authors: Schwartz Joseph A. , Savolainen Jukka , Granger Douglas A. , Calvi Jessica L.
Published: February 2020

Specific sources of psychophysiological dysfunction have been identified as a primary mechanism of the association between stress and health, wherein chronic and prolonged exposure to stressors results in downstream negative consequences of stress-linked dysregulation that increase the likelihood of chronic health problems. Factors pertinent to criminological inquiry have been previously identified as sources of physiological dysfunction, but the extent to which offending over the life course operates in a similar manner has yet to be examined. The current study examines the longitudinal association between delinquency and physiological dysfunction in cardiovascular and metabolic functioning (i.e., cardiometabolic risk). The results of longitudinal structural equation models revealed that greater levels of delinquency are associated with higher levels of cardiometabolic risk.
The Role of Tranexamic Acid in the Management of an Acutely Hemorrhaging Patient
Authors: Davis Steven , Nawab Aria , van Nispen Christiaan , Pourmand Ali
Published: February 2020

Background: Acute hemorrhage, both traumatic and nontraumatic, leads to significant morbidity and mortality, both in the United States and globally. Traditional treatment of acute hemorrhage is focused on hemostasis and blood product replacement. Tranexamic acid is an antifibrinolytic agent that may reduce acute hemorrhage through inhibition of plasminogen. Newer research suggests that coagulopathy, specifically fibrinolysis, may contribute significantly to the pathology of acute hemorrhage. Methods: We searched the PubMed database for relevant articles from 2000 to 2018 for the terms “tranexamic acid,” “TXA,” “antifibrinolytic,” “hyperfibrinolysis,” and “coagulopathy.” Our search was limited to studies published in the English language. Results: A total of 53 studies were included in this review. These articles suggest a potential role for tranexamic acid in the management of acute intracranial hemorrhage, epistaxis, hematuria, postpartum hemorrhage, gastrointestinal hemorrhage, and trauma-related hemorrhage. A theoretical risk of thrombotic events following tranexamic acid use exists, though large clinical trials suggest this risk remains exceedingly small. Conclusions: Recent studies suggest a mortality benefit with tranexamic acid following acute hemorrhage. First responders such as emergency medical technicians and emergency department clinicians should consider tranexamic acid as an adjunct therapy in the management of acute, severe traumatic and nontraumatic hemorrhage.
Responding to imposed job redesign: The evolving dynamics of work and identity in restructuring professional identity
Authors: Chen Yaru , Reay Trish
Published: February 2020

How do professionals respond when they are required to conduct work that does not match with their identity? We investigated this situation in an English public services organization where a major work redesign initiative required professionals to engage in new tasks that they did not want to do. Based on our findings, we develop a process model of professional identity restructuring that includes the following four stages: (1) resisting identity change and mourning the loss of previous work, (2) conserving professional identity and avoiding the new work, (3) parking professional identity and learning the new work, and (4) retrieving and modifying professional identity and affirming the new work. Our model explicates the dynamics between professional work and professional identity, showing how requirements for new professional work can lead to a new professional identity. We also contribute to the literature by showing how parking one’s professional identity facilitates the creation of liminal space that allows professional identity restructuring.
Race-Ethnicity, Social Roles, and Mental Health: A Research Update
Authors: Jackson Pamela Braboy , Erving Christy L.
Published: February 2020

Social role involvement engenders sense of purpose and meaning to life, which sustains positive mental health. Racism within American society, however, results in experiences that disadvantage ethnoracial minorities, thus making it likely that social roles do not have universal remunerations. Using the Collaborative Psychiatric Epidemiology Surveys (N = 12,526), this study explores the association between role participation and psychological distress across nine ethnoracial groups. Results indicate that engaging in many roles is associated with better mental health for all ethnoracial groups. However, the combination of social roles has distinct effects for certain groups. We discuss the implications of the study findings for medical sociology, in general, and the social roles literature, in particular.
Psychometric Properties of the Child Attachment Interview in Italian Context: A Focus on Normative and Specific Clinical Groups in School-Aged Children
Authors: Bizzi Fabiola , Shmueli-Goetz Yael , Castellano Rosetta , San Martini Pietro , Cavanna Donatella
Published: February 2020

While attachment assessments developed for infancy and adulthood are well established, no such gold standard measure exists for school years, where measures are not yet sufficiently robust. Nevertheless, the last decade has witnessed some progress in this field with the development of the Child Attachment Interview (CAI), a semistructured interview designed to access children’s mental representations of their attachment relationships. This study aimed to test the validity and reliability of the CAI for an Italian population, using a normative group and a clinical group of disruptive behavior disorder and somatic symptom disorder patients. A total sample of 311 Italian children (213 normative and 98 clinical) aged 8 to 15 years completed a battery of measures assessing attachment, verbal IQ, and symptomatology. The psychometric properties of the CAI alongside other children (Kerns Security Scale, Inventory of Parent and Peer Attachment) and parents (Adult Attachment Interview) attachment measures in normative sample, as well as the distribution of attachment patterns in normative and clinical samples, were examined. The results revealed the CAI to have adequate interrater and test–retest reliability, as well as discriminant, and convergent validity. Significant differences in the CAI’s distribution of attachment patterns for normative and specific clinical groups were found. Taken together, the findings show that the CAI Italian version is a reliable and valid measure for assessing attachment in school years and beyond.
Prospective College Students With Autism Spectrum Disorder: Parent Perspectives
Authors: Hillier Ashleigh , Ryan Joseph , Buckingham Abigail , Schena David , Queenan Alexa , Dottolo Andrea , Abreu Marlene
Published: February 2020

Young adults with autism spectrum disorder (ASD) are attending university in increasing numbers. While those with ASD may be very knowledgeable within their chosen field, a range of academic-related and nonacademic challenges may hinder their success including executive functioning challenges and interpersonal issues. The purpose of this study was to conduct a preliminary investigation into the perspective of parents of high schoolers with ASD regarding their son/daughters’ transition to college. Qualitative analysis of parent interviews examined the concerns and challenges they anticipated their son/daughter might experience in a university setting, as well as supports they are seeking as they consider postsecondary options. Prominent themes that emerged as areas of concern were social skills, executive functioning, academics, campus living, and support services. These findings highlight some key potential pitfalls for students with ASD which may be useful targets for prevention and remediation, as well as informing policy for colleges and universities as they consider cost-effective interventions to improve the academic success of students with ASD.
Supporting indigenous women missionaries An alternative paradigm for mission in the barrios of Tijuana
Authors: Barkman Linda , Barkman John
Published: February 2020

An alternative paradigm of mission that involves providing support to indigenous missionaries in situ, this case study exemplifies this method in action among the poorest of the poor in Obrero Segundo, a barrio in Tijuana, Mexico. The methodology includes supporting women with educational and/or living expense stipends in order to empower grassroots Christian ministry. Such support of indigenous women missionaries stands in sharp contrast to the two most prevalent mission paradigms in Tijuana, one of which is the “rich” US mission team who oversees long- and short-term missionary projects, and the other is the “successful” Mexican American who returns to Tijuana on weekends to run his church plant. But while there are real benefits in mission based on these paradigms, another paradigm is needed, one that addresses the specific needs and capabilities of the women already doing mission in their own neighborhoods and amongst their own people groups.
The effect of flow and pressure on the intraoxygenator flow path of different contemporary oxygenators: an in vitro trial
Authors: Hendrix Rik HJ , Yeung Alexander KS , Ganushchak Yuri M , Weerwind Patrick W
Published: February 2020

Introduction:

This study analyzed the effect of different flows and pressures on the intraoxygenator flow path in three contemporary oxygenators and its consequences for oxygen transfer efficiency.

Methods:

In an experimental setup, intraoxygenator flow path parameters were analyzed at post-oxygenator pressures of 150, 200, and 250 mm Hg and at flows ranging from 2 L/min to the oxygenators’ maximum permitted flow, with and without pulsatility. The oxygen gradient and the oxygen transfer per minute and per 100 mL blood were calculated using previously collected clinical data and compared with the flow path parameters.

Results:

Increasing pressure did not affect the flow path parameters, whereas pulsatile flow led to significantly increased dynamic oxygenator blood volumes. Increased flow resulted in decreased values of the flow path parameters in all oxygenators, indicating increased flow through short pathways in the oxygenator. In parallel, oxygen transfer/100 mL blood decreased in all oxygenators (average 2.5 ± 0.4 to 2.4 ± 0.3 mL/dL, p > 0.001) and the oxygen gradient increased from 229 ± 45 to 287 ± 29 mm Hg, p > 0.001, indicating decreased oxygen transfer efficiency. Oxygen transfer/min increased (101 ± 15 to 143 ± 20 mL/min/m2, p > 0.001), however, due to the increased flow through the oxygenator.

Conclusion:

Varying trans-membrane oxygenator pressures did not lead to changes in the intraoxygenator flow path, while an increased flow exhibited lower flow path parameters resulting in less efficient use of the gas exchange compartment. The latter was confirmed by a decrease in O2 transfer efficiency during higher blood flows.
Visualizing Aesthetics Across Two Centuries
Authors: Kranjec Alexander , Skov Martin
Published: February 2020

Empirical aesthetics is associated with two research questions: How the mind generally assigns value to sensory stimuli and how it responds specifically to art objects. Researchers have debated whether these phenomena share enough to warrant being collapsed into a single field. To ask how these particular questions came to be associated with aesthetics, we conducted Google Ngram analyses over a corpus of books spanning two centuries. Analyses trace the frequency of “big questions” about art and beauty, and how the term aesthetic appears relative to other concepts. Results indicate the 19th century was dominated by notions of beauty and an aesthetic sense. Questions about art and aesthetic experience become more frequent during the 20th century. Results are interpreted with respect to associated affective and evaluative concepts, art movements, and scientific debates. Understanding how aesthetics is used over time can cast light on the ways current work is being conceived and pursued.
Effect of CKD–MBD phenotype on health-related quality of life in patients receiving maintenance hemodialysis: A cross-sectional study
Authors: Luo Laimin , Chen Qinkai
Published: February 2020

Objective

This study aimed to investigate the factors influencing health-related quality of life (HRQoL) in patients with different chronic kidney disease–mineral and bone disorder (CKD–MBD) phenotypes.

Methods

Patients undergoing maintenance hemodialysis (MHD) at our center from 1 July to 31 August 2017 were enrolled. Patients who received hemodialysis for less than 3 months or displayed poor compliance, or those with incomplete clinical data were excluded. QoL was evaluated using the Kidney Disease Quality of Life–Short Form (KDQOL-SF™) 1.3 scale. The influential factors were stratified based on different CKB–MBD phenotypes.

Results

There were 296 patients enrolled. The serum intact parathyroid hormone (iPTH) concentration was 436.40 ± 490.99 pg/mL, serum calcium (Ca) concentration was 2.14 ±0.27 mmol/L, serum phosphorus (P) concentration was 1.81 ± 0.56 mmol/L, the kidney disease and dialysis-related QoL (KDTA) score was 57.07 ± 10.40, and the SF-36 score was 51.45 ± 17.62. Among patients with different CKD–MBD phenotypes, HRQoL was highest in the group with an iPTH concentration of 150 to 300 pg/mL, serum Ca concentration of <2.10 mmol/L, and serum P concentration of >1.78 mmol/L.

Conclusions

CKD−MBD phenotypes significantly affected HRQoL. Comprehensive management of serum iPTH, Ca, and P levels is important to improve QoL in patients receiving hemodialysis.
Heparin coated meta-organic framework co-delivering doxorubicin and quercetin for effective chemotherapy of lung carcinoma
Authors: Sun Xiaojun , Li Yongxing , Xu Liang , Shi Xinyu , Xu Mengmin , Tao Xuefang , Yang Guobiao
Published: February 2020

Objective

To develop and evaluate a drug delivery system (DDS) capable of targeting cancer cells while at the same time delivering two chemotherapeutic agents to overcome multidrug resistance (MDR).

Methods

This study developed a DDS composed of heparin (HA)-coated meta-organic framework (MOF) nanoparticles (HM) designed to deliver doxorubicin (Dox) and quercetin (Que). A range of in vitro and in vivo studies were conducted to determine the characteristics of the HM/Dox/Que nanoparticles, their ability to produce cytotoxic effects in Dox-resistant A549/Dox cells and target and treat solid tumours in a mouse xenograft model of human lung carcinoma.

Results

This study demonstrated that the HM/Dox/Que nanoparticles reduced cell viability, increased apoptosis, arrested cells in the G0/G1 phase of the cell cycle and reversed MDR in A549/Dox cells in vitro when compared with mono-drug delivery. In a mouse xenograft model of human lung carcinoma, the HM/Dox/Que nanoparticles targeted the tumours and reduced tumour growth as determined by tumour volume.

Conclusion

The use of HM/Dox/Que nanoparticles might be a viable alternative to traditional chemotherapy of lung carcinoma.
The phenomenon of concealed conduction in a case of His bundle pacing (HBP)
Authors: Sun Shuai , Zhang Hong , Liu Xing-Peng
Published: February 2020

The phenomenon of concealed conduction in His bundle pacing (HBP) has rarely been reported. We report here a patient who had 2: 1 atrioventricular block and complete left bundle branch block was used because of HBP. The patient developed continuous right bundle branch block after the operation. After excluding mechanical damage, we speculate that the mechanism of right bundle branch block in this case was due to concealed conduction.
Relationship between use of screws and acetabular cup stability in total hip arthroplasty: a meta-analysis
Authors: Fei Chen , Wang Peng-Fei , Wei Wei , Qu Shuang-Wei , Yang Kun , Li Zhi , Zhuang Yan , Zhang Bin-Fei , Zhang Kun
Published: February 2020

Objective

The relationship between the use of screws and acetabular cup stability in total hip arthroplasty (THA) remains controversial. We evaluated cup stability in THA with and without the use of screws.

Methods

We performed a systematic literature search to identify studies on cup stability relative to the use of screws in patients undergoing THA before October 2018. Methodological quality assessment and data collection were performed by two individual reviewers. Meta-analysis was performed using Review Manager version 5.3.5.

Results

We included seven trials involving 1402 patients (1469 THAs): 767 patients (809 THAs) with screws and 635 patients (660 THAs) without screws. The findings of meta-analysis indicated that uncemented acetabular component fixation with the use of additional screws was not correlated with migration of the cup, migration on roentgen stereophotogrammetry, or reoperation after THA. Moreover, operation time was not significantly different according to whether screws were used. There was no relationship between use of additional screws and osteoporosis or Harris Hip Score; however, THA with or without the use of screws might be related to bone sclerosis in the C1 region.

Conclusion

Currently, limited evidence shows that the use of screws during THA may not improve cup stability.
Inhibition of phosphodiesterase suppresses allergic lung inflammation by regulating MCP-1 in an OVA-induced asthma murine model with co-exposure to lipopolysaccharide
Authors: Lee Chang Doo , Choi Won Seok , Choi Yong Geon , Kang Hyun Sik , Lee Wang Tae , Kim Hong Jo , Lee Ji-Yun
Published: February 2020

Objective

Asthma is a chronic inflammatory disease that can lead to severe problems with the respiratory system. This study aimed to evaluate the suppression of allergic airway inflammation of an asthma murine model by 3-isobutyl-1-methylxanthine (IBMX), which is a non-specific cyclic nucleotide phosphodiesterase (PDE) inhibitor.

Methods

Allergic lung inflammation was evoked by ovalbumin (OVA) alone or co-exposure with lipopolysaccharide (LPS) in a murine asthma model.

Results

Compared with the OVA alone-treated control, co-exposure with LPS significantly enhanced allergic inflammatory responses in airway hyperresponsiveness and pathologic changes of the asthmatic mouse lung. Specifically, LPS enhanced allergic asthma through the increase of monocyte chemoattractant protein (MCP)-1 release. However, IBMX significantly suppressed specific airway resistance and tidal volume, the infiltration of eosinophils and mast cells into the lung, the levels of serum immunoglobulin (Ig)E and IgG1, and the release of Th2 cytokines (interleukin (IL)-4, IL-13, and MCP-1). IBMX attenuated the aggravation of inflammation by inhibiting MCP-1, and inhibited the infiltration of eosinophils and the production of Th2 cell-associated inflammatory mediators.

Conclusion

These results demonstrate the therapeutic potential of targeting the regulation of PDE activity in an aggravated chronic allergic asthmatic response after bacterial infection.
Finite element analysis of a new plate for Pauwels type III femoral neck fractures
Authors: Wang Gang , Tang Yong , Wu Xuhua , Yang Huilin
Published: February 2020

Background

A new plate for the treatment of Pauwels type III femoral neck fractures was developed, and its biomechanical stability was analyzed by the finite element method.

Method

Using 3-matic and UG-NX software, we constructed models of Pauwels type III femoral neck fractures with angles of 50°, 60°, and 70°. Moreover, a new femoral neck plate (NFNP) fixation model and a Pauwels screw fixation model were developed. Under axial loads of 1400 N and 2100 N, von Mises stress (VMS) distribution on the screws, peak VMS, displacement between fracture fragments, and model principal strains in cancellous bone were recorded.

Result

The peak VMS of internal fixation in the two models was mostly located near the fracture line, and the screw closest to the femoral calcar experienced maximum stress. With a Pauwels angle of 50°, 60°, and 70°, the peak VMS values of the new plates were lower than in the Pauwels screw. The displacement of fracture fragments in the NFNP was smaller than in the Pauwels screw, and peak VMS values of cancellous bone in the NFNP were lower than in the Pauwels screw.

Conclusion

The newly developed plate provided excellent biomechanical stability for Pauwels type III femoral neck fractures.