bluuebunny/crossref_metadata_2025 huggingface dataset:
Insights into the role of d‐amino acid oxidase mutations in amyotrophic lateral sclerosis
Authors: Padhi Aditya K. , Hazra Saugata
Published: September 2018

Missense mutations in the coding region of d‐amino acid oxidase (DAO) have been found in patients suffering from amyotrophic lateral sclerosis (ALS). Mutations primarily impair the enzymatic activity of DAO and cause neurodegeneration due to an abnormal accumulation of d‐serine in the spinal cord. However, the structural and dynamic changes that lead to impaired enzymatic activity are not fully understood. We present here extensive molecular dynamics simulations of wild‐type, and all reported ALS‐associated DAO mutants to elucidate the plausible mechanisms of impaired enzymatic activity, a critical function needed for neuroprotection. Simulation results show that DAO mutations disrupt several key interactions with the active site residues and decrease the conformational flexibility of active site loop comprising 216 to 228 residues, necessary for substrate binding and product release. This conformational restriction of the active site loop in the mutants is mainly due to the distortion of critical salt bridge and hydrogen bond interactions compared with wild‐type. Furthermore, binding free energy calculations show that DAO mutants have a lower binding affinity toward cofactor flavin adenine dinucleotide and substrate imino‐serine than the wild‐type. A closer look at the cofactor and substrate interaction profiles further show that DAO mutants have lost several critical interactions with the neighboring residues as compared with wild‐type. Taken together, this study provides first‐hand explanation of crucial structural features that lead to the loss of enzymatic function in DAO mutants and highlights the need of further genomic scans of patients with ALS to map the association of novel DAO variants in ALS pathophysiology.
Spin State Energetics of VGen−/0 (n = 5–7) Clusters and New Assignments of the Anion Photoelectron Spectra
Authors: Tran Van Tan , Tran Quoc Tri
Published: September 2018

The geometrical structures, electron leading configurations, and relative energies of the low‐lying states of VGe
n−/0 (n = 5–7) clusters have been investigated with density functional theory and CASSCF/CASPT2 method. The pure GGA BP86 functional gave almost the same relative energy order for the low‐lying states as the CASPT2 method. At the BP86 and CASPT2 levels, the ground states of VGe
n−/0 (n = 5–7) clusters were proposed to be the 1A1 and 2A1 of A‐VGe5−/0, 3A″ and 2A″, 2A′ (2E2) of A‐VGe6−/0, and 1A′ and 2A′ of A‐VGe7−/0 isomers. The adiabatic and vertical detachment energies (ADEs and VDEs) of the detachments of one electron from several orbitals of the anionic ground states were reported at the CASPT2 level. The calculated ADEs and VDEs corresponded well with the experimental values as observed in the 266 nm anion photoelectron spectra. © 2018 Wiley Periodicals, Inc.
Modulation of specific cell cycle phases in human embryonic stem cells by lncRNA RNA decoys
Authors: Sahu Mousumi , Mallick Bibekanand
Published: September 2018

Recent studies have shown that long noncoding RNAs (lncRNAs) are crucial regulators of human embryonic stem cells (hESCs). However, modes of actions of lncRNAs in hESCs are not well illustrated. Here, we predicted a regulatory network in hESCs in which lncRNAs interact with TFs and thereby control the expressions of downstream targets of TFs. The predicted network is comprised of 2289 3‐motif subgraphs which are characterized by 3 nodes: (i) a lncRNA which is predicted to interact with (ii) a TF and (iii) a gene which is a target of TF and coexpressing with lncRNA. We performed functional annotation of the network by identifying hub nodes followed by pathway enrichment study, which unveiled an active G1‐S cell cycle phase transition‐specific subnetwork that encompasses 2 lncRNAs, MALAT1 and DANCR. Our analysis revealed that MALAT1 and DANCR might be playing key roles in G1‐S phase transition by acting as RNA decoy via interacting with crucial stemness maintaining TFs. We predicted that MALAT1 possibly compete with DNMT1 and CDCA7 genes to bind to E2F1 thereby interrupting repression of DNMT1 and activation of CDCA7 by E2F1 in hESCs, whereas DANCR possibly competes with IPO7 gene to bind to MYC thereby interrupting MYC‐mediated activation of IPO7 in hESCs. Both of these are conjectured to contribute to rapid G1‐S phase transition aiding in stemness maintenance of hESCs. This study presents a crucial TF target cross talks mediated by lncRNAs in hESCs regulating its properties which needs further investigation.
Influences of the North Atlantic Oscillation on extreme temperature during the cold period in China
Authors: Liu Xiaowan , Xu Zongxue , Peng Dingzhi , Wu Guocan
Published: September 2018

Extreme climate shifts were frequently recognized over the Eurasia land, and the atmospheric anomalies have been widely deemed as one of the potential causes for the shifts. In this study, the North Atlantic Oscillation (NAO) was initially assumed as the primary factor leading to changes in temperature extremes in China during the cold period. Then, influencing modes and mechanisms of the NAO on cold period extreme temperatures were both explored with a time lag estimation and a correlation analysis using a stream function and a zonal index. The results indicated that decadal variations in the NAO were the main cause for changes in wintertime extreme temperatures, especially after the turning point in the late 1990s, when the phase changed from positive to negative and extreme temperatures occurred with a significantly increasing tendency. Rossby waves derived from the west wind near the Mediterranean were also responsible for this phenomenon, and the “upstream effect” and group winds were potential pathways for Rossby wave train functions. These results could be a reference for influence and mechanism exploration between extreme climate and atmospheric circulation factors and could provide a new way of thinking for similar studies in the future.
Refractance window drying of fruits and vegetables: a review
Authors: Shende Deepika , Datta Ashis K
Published: September 2018

Fruit and vegetable drying to make leather, pestil or powder products is a challenging task. Traditional drying adversely affects the taste, colour, nutritional qualities and preservation of bioactive compounds due to high‐temperature exposure of the product. The substitute for traditional drying processes is consequently necessary to impart superior quality and preserve greater nutritional value in processed foods. Refractance window (RW) drying is a thin film drying system having high heat and mass transfer rates that speeds up the rate of drying. Polyester (Mylar), an infrared transparent plastic sheet transmits radiative heat to food during the RW drying process with higher drying rate, more retention of nutrients and low aroma and flavour loss. RW drying is reported to be affected by the thickness of puree or slices and temperature of drying, as thick samples need longer drying time, generate higher water activity, bring changes in colour parameters, experience higher effective diffusion coefficient (Deff) and result in lower solubility of powder. RW drying was compared with different drying processes and was observed to have more retention of nutrients and be more economical. RW dried samples were better in terms of colour and textural quality when compared with other traditional drying methods. © 2018 Society of Chemical Industry
Noninvasive detection of cancer spread to lymph nodes: A review of molecular imaging principles and protocols
Authors: Li Chengyue , Torres Veronica C. , Tichauer Kenneth M.
Published: September 2018

Identification of cancer spread to tumor‐draining lymph nodes offers critical information for guiding treatment in many cancer types. Current clinical methods of nodal staging are invasive and can have substantial negative side effects. Molecular imaging protocols have long been proposed as a less invasive means of nodal staging, having the potential to enable highly sensitive and specific evaluations. This review article summarizes the current status and future perspectives for molecular targeted nodal staging.
The effect of preoperative treatments on lymph node counts after total gastrectomy in esophagogastric adenocarcinoma
Authors: Li Ziyu , Li Shuangxi , Bu Zhaode , Zhang Lianhai , Wu Xiaojiang , Shan Fei , Jia Yongning , Ji Xin , Ji Jiafu
Published: September 2018

Objectives

This study aims to explore the effects of preoperative treatments on lymph nodes (LNs) counts after total gastrectomy with D2 lymphadenectomy in esophagogastric adenocarcinoma.

Methods

A retrospective analysis was performed for 446 patients with locally advanced esophagogastric adenocarcinoma. The patients were divided into three groups: surgery first (SF), preoperative chemotherapy (PCT), and preoperative chemoradiotherapy (PCRT). Clinical‐pathological data were analyzed.

Results

The case number in SF, PCT, and PCRT groups was 281, 109, and 56, respectively, and the median total LNs count was 32.0 (10.0‐102.0), 31.0 (12.0‐62.0), and 25.5 (10.0‐50.0), respectively, (P < 0.001). Univariate and multivariate analyses demonstrated the total LNs count was lower in PCRT than SF/PCT (P < 0.001), and had no correlation with tumor regression grades (TRGs). Subgroup comparison showed radiation target LNs count was lower in PCRT than SF/PCT (P < 0.001), and peritarget LNs count was lower in PCRT than SF (P = 0.002).

Conclusion

For esophagogastric adenocarcinoma, PCRT reduced total LNs count after total gastrectomy with D2 lymphadenectomy, whereas PCT did not. In the PCRT group, LNs count was lower in both radiation target and peritarget areas than in the SF group but only in radiation target area than in the PCT group. The correlation between TRGs and total LNs count remained unclear.
Advancements in imaging technology for microvascular free tissue transfer
Authors: Chang Eric I. , Chu Carrie K. , Chang Edward I.
Published: September 2018

The use of preoperative imaging has become routine for many reconstructive microsurgeons to help localize perforators for planning of microvascular free flaps. However, with advancements in imaging technology, perforator mapping represents only one potential benefit as virtual planning and medical modeling, and flap tissue perfusion are also rapidly becoming commonplace and the standard of care for many surgeons who perform high‐volume free flap reconstruction for the breast, head and neck, torso, and the extremities.
High stromal transforming growth factor β–induced expression is a novel marker of progression and poor prognosis in gastric cancer
Authors: Suzuki Masaki , Yokobori Takehiko , Gombodorj Navchaa , Yashiro Masakazu , Turtoi Andrei , Handa Tadashi , Ogata Kyoichi , Oyama Tetsunari , Shirabe Ken , Kuwano Hiroyuki
Published: September 2018

Background and Objectives

Transforming growth factor β‐induced (TGFBI) protein is a secreted extracellular matrix protein with conflicting roles in cancer, acting as a tumour suppressor and a promoter, which appears to be tissue specific. The role of TGFBI in gastric cancer (GC) remains unclear, which we aimed to investigate using the clinical samples as well as an in vitro coculture model of GC.

Methods

The clinical significance of TGFBI was assessed in 208 GC samples using immunohistochemistry. Molecular function of TGFBI in the GC cells was examined by small interfering RNA‐mediated TGFBI downregulation in the gastric fibroblasts cocultured with the GC cells.

Results

TGFBI expression was localised mainly in the cancer stroma and not in the noncancerous gastric tissue or the GC cells. High TGFBI expression was significantly associated with poor prognosis and cancer progression. Downregulation of TGFBI in the cocultured gastric fibroblasts inhibited the invasion and migration abilities of the GC cells.

Conclusions

High stromal TGFBI expression might be a useful predictive marker for poor prognosis in GC patients. Furthermore, TGFBI in the cancer stromal cells is a promising target for GC treatment.
Early Predictors of the Long‐term Response to Therapy in Patients With Crohn Disease Derived From a Time‐Intensity Curve Analysis After Microbubble Contrast Agent Injection
Authors: Quaia Emilio , Gennari Antonio Giulio , Cova Maria Assunta
Published: September 2018

Objectives

The aim of this study was to identify early predictors of the long‐term response to therapy in patients with Crohn disease (CD) from time‐intensity curves obtained after microbubble injection.

Methods

One hundred fifteen consecutive patients with a proven diagnosis of CD involving the terminal ileal loop who were scheduled to begin pharmacologic therapy with biologics (infliximab or adalimumab) were scanned after sulfur hexafluoride–filled microbubble injection before the beginning and at the end of the sixth week of treatment. The absolute value and percentage change of each semiquantitative kinetic parameter (peak enhancement, time to peak enhancement, rise time, mean transit time, wash‐in and wash‐out rates, area under the curve [AUC] for the whole time‐intensity curve, AUC during wash‐in, AUC during wash‐out, and wash‐in perfusion index) as measured on the terminal ileal tract and adjacent reactive mesenteric fat were calculated from time‐intensity curves. Patients were followed for at least 24 months with redetermination of the Crohn Disease Activity Index and with at least 1 endoscopy within 18 weeks after the beginning of pharmacologic treatment. The absolute values and percentage changes of kinetic parameters were assessed as potential predictors of the therapeutic outcome by a logistic regression analysis.

Results

The study group included 66 male and 49 female patients (mean age ± SD, 45.76 ± 11 years). The pretreatment values and percentage changes of the peak enhancement, AUC, AUC during wash‐in, and AUC during wash‐out were found to be predictors (P < .05) of the long‐term therapeutic outcome.

Conclusions

The analysis of time‐intensity curves obtained after microbubble contrast agent injection provides early predictors of the long‐term therapeutic outcome in patients with CD.
New Method for Assessment of Levator Avulsion Injury: A Comparative Elastography Study
Authors: Maßlo Katharina , Möllers Mareike , de Murcia Kathrin Oelmeier , Klockenbusch Walter , Schmitz Ralf
Published: September 2018

Objective

The aim of this study was to introduce elastography as a new method for sonographic assessment of postpartum pelvic floor trauma.

Methods

We examined 86 postpartum primiparous women, of whom 43 had undergone primary caesarean section (group_CS) and 43 vaginal delivery (group_VD). In a puborectal‐symphysis plane, B‐mode and elastographic ultrasonography were used to evaluate pelvic floor trauma. The strain value of left and right puborectal muscle was assessed close to the symphysis (Trauma_Elastography). The strain ratio maximum of this measurement was stored (Trauma_Index).

Results

The elastographic evaluation revealed more trauma‐suspicious lesions than the B‐mode investigation (60.5% versus 39.5%; P < .001). The median Trauma_Index was higher in group_VD compared to group_CS (1.63 versus 1.18; P < .001).

Conclusion

Sonographic elastography assessment in a new examination plane shows postpartum trauma of the pelvic floor in women after vaginal delivery. This new method may help to identify women with a higher risk of postpartum pelvic floor disorders.
Sudden hearing loss after cialis (tadalafil) use: A unique case of cochlear hydrops
Authors: Wester Jacob L. , Ishiyama Gail , Karnezis Stellios , Ishiyama Akira
Published: September 2018

We discuss a unique case of sudden sensorineural hearing loss after Cialis (tadalafil) use, a phosphodiesterase 5 (PDE5) inhibitor, and the implication of ipsilateral cochlear hydrops seen on magnetic resonance imaging (MRI). We report a case of a 53‐year‐old male with unilateral low‐frequency sudden sensorineural hearing loss (SSNHL) after ingestion of tadalafil. The SSNHL occurred 1 day after ingestion and was associated with aural fullness and tinnitus. There were no symptoms of vertigo. He received oral prednisone immediately after the onset of hearing loss without improvement. Delayed intravenous contrast‐enhanced three‐dimensional Fluid‐attenuated inversion recovery MRI revealed ipsilateral dilation of the cochlear duct without any hydronic change in the vestibular system. Acetazolamide therapy was initiated, and his symptoms improved. A posttreatment audiogram revealed an increase in threshold of 15 dB. To the best of our knowledge, this is the first case of cochlear hydrops visualized on imaging after a PDE5 inhibitor induced SSNHL. Tadalafil and other PDE5 inhibitors have a known association with SSNHL. Despite several proposed mechanisms, there is inconclusive evidence of a causal relationship. Our presented case suggests that cochlear hydrops may be one possible mechanism of PDE5 inhibitor–associated SSNHL. MRI should be considered in the evaluation of such patients who do not respond to oral steroids as initial treatment. Laryngoscope, 2615–2618, 2018
Radiation and Second Primary Thyroid Cancer Following Index Head and Neck Cancer
Authors: Polednik Katherine M. , Simpson Matthew C. , Adjei Boakye Eric , Mohammed Kahee A. , J. Dombrowski John , Varvares Mark A. , Osazuwa‐Peters Nosayaba
Published: September 2018

Objectives/Hypothesis

Radiation is thought to increase risk of developing second primary thyroid cancer (SPTC). This study estimated the rate of SPTC following index head and neck cancer (HNC) and determined whether radiation treatment among HNC survivors increased SPTC risk.

Study Design

Retrospective data analysis.

Method

The Surveillance, Epidemiology, and End Results database (1975–2014) was queried for cases of index HNC (N = 127,563) that developed SPTC. Adjusted multivariable competing risk proportional hazards model tested risk of developing a SPTC following index HNC. Sensitivity analyses using proportional hazards models were also performed restricting data to patients who 1) received both radiation and chemotherapy and 2) radiation alone.

Results

Only 0.2% of index HNC survivors (n = 229) developed SPTC, yielding a rate of 26.1 per 100,000 person‐years. For every increasing year of age at diagnosis, patients were 3% less likely to develop an SPTC (adjusted hazard ratio [aHR] = 0.97, 95% CI: 0.96‐0.98). Males were also less likely to develop an SPTC (aHR = 0.73, 95% CI: 0.55‐0.96). Radiation (aHR = 0.92, 95% CI: 0.68‐1.25), surgery (aHR = 0.79, 95% CI: 0.56‐1.11), and chemotherapy (aHR = 1.13, 95% CI: 0.76‐1.69) were not significantly associated with developing SPTC. The sensitivity models also did not find an association between treatment and risk of SPTC.

Conclusions

Rate of developing SPTC following index HNC was very low, and previous exposure to radiation did not significantly increase risk in our study population. More studies are needed to understand the increasing incidence of thyroid cancer across the United States.

Level of Evidence

NA Laryngoscope, 129:1014–1020, 2019
Does Delaying Endoscopic Sinus Surgery Adversely Impact Quality‐of‐Life Outcomes?
Authors: Alt Jeremiah A. , Orlandi Richard R. , Mace Jess C. , Soler Zachary M. , Smith Timothy L.
Published: September 2018

Objectives

There is little consensus regarding the prognostic value of symptom duration in predicting clinical disease severity or quality‐of‐life (QOL) outcomes in patients with chronic rhinosinusitis (CRS). Our objectives were to: 1) determine if patients with longer symptom duration have worse preoperative disease severity and/or QOL, and 2) determine if delayed surgical intervention influences outcomes of endoscopic sinus surgery (ESS).

Methods

Patients diagnosed with CRS were prospectively enrolled into a multicenter cohort study and observed 14.7 (standard deviaton {SD} ± 4.8) months on average following primary ESS. Preoperative symptom duration was stratified into short‐term (< 12 months), middle‐term (12–60 months), and long‐term (> 60 months). Disease severity was assessed using endoscopy and computed tomography. Disease‐specific QOL was measured with the 22‐item Sinonasal Outcome Test (SNOT‐22) and Rhinosinusitis Disability Index. Adjusted bivariate and multivariate associations between symptom duration, disease severity, and QOL scores were evaluated.

Results

One hundred and thirteen patients met inclusion criteria with 35 patients lost to postoperative follow‐up. No significant differences in preoperative disease severity or QOL scores were reported between symptom duration subgroups. Participants in the long‐term symptom subgroup reported significantly greater mean postoperative improvement on SNOT‐22 total scores (n = 28; −36.3[± 22.2]) compared to both short‐term (n = 27; −23.4[SD ± 11.3]; P = 0.039) and middle‐term (n = 23; −23.5[SD ± 20.1]; P = 0.050) subgroups. Postoperative QOL improvements in the long‐term symptom subgroup remained significantly greater (P ≤ 0.036) after multivariate adjustment.

Conclusions

Symptom duration was not associated with mean preoperative disease severity or QOL. Patients with long‐term symptom duration reported the greatest mean postoperative QOL improvement, suggesting that delayed surgical intervention may not reduce QOL improvements following ESS.

Level of Evidence

2c Laryngoscope, 129:303–311, 2019
Narrow Band Imaging Endoscopy of the Nasopharynx for Malignancy: An Inter‐ and Intraobserver Study
Authors: Vlantis Alexander C. , Wong Eddy W. Y. , Ng Siu Kwan , Chan Jason Ying Kuen , Tong Michael C. F.
Published: September 2018

Objective

To assess interobserver agreement and intraobserver reproducibility when assessing the nasopharynx for malignancy under white light and narrow band imaging endoscopy because the decision to biopsy hinges on the examiner's perceived chance of malignancy.

Methods

An interobserver and intraobserver agreement study utilizing white light and narrow band endoscopic images of the nasopharynx. The setting was an academic referral hospital.

Participants were 156 adults with suspected nasopharyngeal carcinoma who underwent white light and narrow band imaging endoscopy and biopsy. Images of the nasopharynges were subsequently scored for malignancy by four otolaryngologists.

The nasopharynx was scored on 4‐point scales under white light and narrow band imaging endoscopy for the likelihood of malignancy or abnormality, respectively.

Results

Intraclass correlation coefficients for intraobserver agreement for nasopharyngeal malignancy for four observers under white light were 0.86, 0.89, 0.79 and 0.88 (mean 0.855), respectively; and under narrow band imaging they were 0.64, 0.68, 0.64, and 0.66 (mean 0.655), respectively (all P values < 0.001). The coefficient for interobserver reliability under white light was 0.79 (95% confidence interval [CI] 0.76–0.82; P < 0.001), which indicated strong agreement. The coefficient for interobserver reliability under narrow band imaging was 0.56 (95% CI 0.50–0.61; P < 0.001), which indicated moderate agreement.

Conclusions

Intraobserver and interobserver agreement for nasopharyngeal malignancy was strong on white light endoscopy but only moderate on narrow band imaging endoscopy. Agreement may be improved by adopting a standard set of assessment guidelines, including an objective detailed morphological analysis under white light and vasculature analysis under narrow band imaging.

Level of Evidence

2a

Laryngoscope, 129:1374–1379, 2019
Enhanced Spin Hall Effect of Light in Spheres with Dual Symmetry
Authors: Gao Dongliang , Shi Ran , Miroshnichenko Andrey E. , Gao Lei
Published: September 2018

The spin–orbit interaction (SOI) of light is usually weak in dielectric particles and recently is enhanced in plasmonic structures. This Letter Article shows that strong SOI can arise in dielectric particles with dual symmetry, resulting in enhanced spin Hall effect of scattered light. It reveals the relationship between spin Hall shift and dual symmetry. The interference between electric and magnetic dipolar modes plays an important role in enhancing the spin Hall shift. Strong SOI is demonstrated by the optical singularity of the orbital angular momentum. The results can find potential applications in dielectric‐based photonic devices, such as optical sensing and manipulation of subwavelength nanoparticles.
Tuning of Structural Colors Like a Chameleon Enabled by Shape‐Memory Polymers
Authors: Schauer Senta , Baumberg Jeremy J. , Hölscher Hendrik , Smoukov Stoyan K.
Published: September 2018

Nature often uses structuring of materials for coloration rather than incorporating dye molecules, since single‐construction materials are capable of producing any vivid visible color in plants and insects. By precisely engineering features that diffract or scatter light, more recently, humans have created similarly intense non‐fading colors. Stretchable polymer opals have emerged as a single material which can dynamically shift across the whole visible spectrum using structural colors, by temporary stretching or compression. For energy efficiency and practical considerations, however, it is necessary to fix semi‐permanently desired colors without continuous stretching or application of other stimuli or energy. Here, a polymer opal incorporating a shape‐memory polymer embedded in its matrix can keep a particular color fixed without the application of external forces, yet can be reprogrammed to a different fixed color on demand. The influence of the material composition on its optical appearance, shape‐fixity, and shape recovery abilities in controlled stretch experiments is quantified. High‐speed printing‐compatible localized compression pattern imprinting is shown to generate stable but easily erasable color patterns. This opens up the potential for durable and energy‐efficient yet reusable and reconfigurable displays, wearables, or packaging and security labeling based on such polymeric film materials.
Patient‐ and Nutrition‐Derived Outcome Risk Assessment Score as a Predictor of Mortality in Critically Ill Surgical Patients: A Retrospective, Single‐Center Observational Study
Authors: Nakayama Anna , Canales Cecilia , Yeh D. Dante , Belcher Donna , McCarthy Caitlin M. , Quraishi Sadeq A.
Published: September 2018

Background

The Patient‐ And Nutrition‐Derived Outcome Risk Assessment (PANDORA) was recently validated for predicting mortality in hospitalized patients; however, its utility in the intensive care unit (ICU) remains unknown.

Methods

We investigated whether PANDORA is associated with 30, 90, and 180 day mortality in critically ill surgical patients by performing logistic regressions, controlling for age, sex, race, body mass index, macronutrient deficit, and length of stay. The area under the receiver operating characteristic curves (AUC) of PANDORA vs Acute Physiology and Chronic Health Evaluation (APACHE) II scores for mortality at each time point were also compared.

Results

312 patients comprised the analytic cohort. PANDORA was associated with mortality at 30 (OR 1.08; 95% CI 1.04–1.13; P < .001), 90 (OR 1.09; 95% CI 1.03–1.12; P < .001), and 180 days (OR 1.10; 95% CI 1.06–1.15; P < .001). PANDORA and APACHE II were comparable for mortality prediction at 30 (AUC: 0.69, 95% CI 0.62–0.76 vs 0.74, 95% CI 0.67–0.81; P = .29), 90 (AUC: 0.71, 95% CI 0.63–0.77 vs 0.74, 95% CI 0.67–0.80; P = .52), and 180 days (AUC: 0.73, 95% CI 0.67–0.79 vs 0.75, 95% CI 0.69–0.81; P = .66).

Conclusion

In surgical ICU patients, PANDORA was associated with mortality and was comparable with APACHE II for mortality prediction at 30, 90, and 180 days after initiation of care. Prospective studies are needed to assess whether nutrition support, stratified by PANDORA scores, can improve outcomes in surgical ICU patients.
Cytoplasmic p27Kip1 promotes tumorigenesis via suppression of RhoB activity
Authors: Calvayrac Olivier , Nowosad Ada , Cabantous Stéphanie , Lin Lin‐Po , Figarol Sarah , Jeannot Pauline , Serres Murielle P , Callot Caroline , Perchey Renaud T , Creff Justine , Taranchon‐Clermont Estelle , Rouquette Isabelle , Favre Gilles , Pradines Anne , Manenti Stephane , Mazieres Julien , Lee Huei , Besson Arnaud
Published: September 2018

The cell cycle inhibitor p27Kip1 is a tumor suppressor via the inhibition of CDK complexes in the nucleus. However, p27 also plays other functions in the cell and may acquire oncogenic roles when located in the cytoplasm. Activation of oncogenic pathways such as Ras or PI3K/AKT causes the relocalization of p27 in the cytoplasm, where it can promote tumorigenesis by unclear mechanisms. Here, we investigated how cytoplasmic p27 participates in the development of non‐small cell lung carcinomas. We provide molecular and genetic evidence that the oncogenic role of p27 is mediated, at least in part, by binding to and inhibiting the GTPase RhoB, which normally acts as a tumor suppressor in the lung. Genetically modified mice revealed that RhoB expression is preferentially lost in tumors in which p27 is absent and maintained in tumors expressing wild‐type p27 or p27CK–, a mutant that cannot inhibit CDKs. Moreover, although the absence of RhoB promoted tumorigenesis in p27−/− animals, it had no effect in p27CK– knock‐in mice, suggesting that cytoplasmic p27 may act as an oncogene, at least in part, by inhibiting the activity of RhoB. Finally, in a cohort of lung cancer patients, we identified a subset of tumors harboring cytoplasmic p27 in which RhoB expression is maintained and these characteristics were strongly associated with decreased patient survival. Thus, monitoring p27 localization and RhoB levels in non‐small cell lung carcinoma patients appears to be a powerful prognostic marker for these tumors. Copyright © 2018 Pathological Society of Great Britain and Ireland. Published by John Wiley & Sons, Ltd.
Urine biochemistry to predict long‐term outcomes in fetuses with posterior urethral valves
Authors: Dreux Sophie , Rosenblatt Jonathan , Moussy‐Durandy Amélie , Patin Franck , Favre Romain , Lortat‐Jacob Stephen , El Ghoneimi Alaa , Oury Jean‐François , Deschenes Georges , Ville Yves , Heidet Laurence , Muller Francoise
Published: September 2018

What's already known about this topic?

In fetuses with lower urinary tract obstruction, prenatal counseling with regard to long‐term renal function is an unmet challenge. The literature on the predictive value of fetal urine analysis is controversial.

What does this study add?

In a cohort of 89 children affected by posterior urethral valves, and who reached 10 years of age, multivariate analysis of fetal urinary markers predicted renal function with 93% sensitivity and 71% specificity.
Ultrathin Fe‐N‐C Nanosheets Coordinated Fe‐Doped CoNi Alloy Nanoparticles for Electrochemical Water Splitting
Authors: Zhang Qingran , Webster Richard F. , Cheong Soshan , Tilley Richard D. , Lu Xunyu , Amal Rose
Published: September 2018

The development of highly active and cost‐effective catalyst materials toward electrochemical water splitting is of great importance for converting and storing the intermittent solar energy in the form of hydrogen. Herein, for the first time, an ultrathin Fe and N‐co‐doped carbon nanosheet encapsulated Fe‐doped CoNi alloy nanoparticle (FeCoNi@FeNC) composite is obtained and applied as a bifunctional catalyst for hydrogen evolution reaction (HER) and oxygen evolution reaction (OER). This catalyst exhibits prominent catalytic performances for both HER and OER, which only requires overpotentials of 102 and 330 mV, respectively, to reach a current density of 10 mA cm−2 in alkaline media. The high catalytic activity is intrinsically associated with the presence of Fe in both nanosheets and nanoparticles, which has triggered the occurrence of coordinative effects between Fe‐N‐C and FeCoNi that are beneficial for HER and OER, as revealed by electrochemical techniques. In an overall water splitting electrolyzer, FeCoNi@FeNC is employed as both the cathode and anode catalysts, achieving 12 mA cm−2 at 1.63 V for a duration of more than 12 h.
Statistical inferences of extended concentration indices for directly standardized rates
Authors: Yu Mandi , Liu Benmei , Li Yan , Zou Zhaohui (Joe) , Breen Nancy
Published: September 2018

The relative concentration index (RCI) and the absolute concentration index (ACI) have been widely used for monitoring health disparities with ranked health determinants. The RCI has been extended to allow value judgments about inequality aversion by Pereira in 1998 and by Wagstaff in 2002. Previous studies of the extended RCI have focused on survey sample data. This paper adapts the extended RCI for use with directly standardized rates (DSRs) calculated from population‐based surveillance data. A Taylor series linearization (TL)–based variance estimator is developed and evaluated using simulations. A simulation‐based Monte Carlo (MC) variance estimator is also evaluated as a comparison. Following Wagstaff's approach in 1991, we extend the ACI for use with DSRs. In all simulations, both the TL and MC methods produce valid variance estimates. The TL variance estimator has a simple, closed form that is attractive to users without sophisticated programming skills. The TL and MC estimators have been incorporated into a beta version of the National Cancer Institute's Health Disparities Calculator, a free statistical software tool that enables the estimation of 11 commonly used summary measures of health disparities for DSRs.
Don’t Start with Europeans First. An Initiative for Extending Voting Rights Should also Promote Access to Citizenship for Third Country Nationals
Authors: Swoboda Hannes
Published: September 2018

I would support the idea of a citizens’ initiative proposing the extension to EU citizens of the right to vote in national elections in the member state of residence. At the same time, I do not share the view that we should ‘start with the Europeans first’. EU policy makers should encourage member states to facilitate access to national citizenship for third country nationals who are long term residents in a member state.
Voting Rights and Beyond…
Authors: Wilhelm Martin
Published: September 2018

As an activist NGO, we fully support this ECI, but not without emphasizing that, in the long-term, the European people must become a post-national and inclusive concept, overcoming the exclusion of third-country nationals.
Free Movement Emancipates, but What Freedom Is This?
Authors: Paskalev Vesco
Published: September 2018

There is a darker side of freedom of movement. Notwithstanding its apparent emancipatory effect for the individual citizens, which may well outweigh what is lost in terms of non-participation, freedom of movement tends to decrease, rather than increase, republican freedom in Europe.
EU Citizens Should Have Voting Rights in National Elections, But in Which Country?
Authors: Bauböck Rainer
Published: September 2018

I will be happy if Philippe Cayla’s and Catriona Seth’s proposal for a European Citizens’ Initiative (ECI) on national voting rights for EU citizens is successful. But I will not sign it myself. I agree that there is a serious democratic deficit in the current regulation of voting rights. It is contrary to the spirit of EU law if EU citizens who take up residence in another member state lose fundamental rights as a consequence of exercising their right of free movement. And it seems particularly perverse that they retain their rights to vote in local and European Parliament elections but can lose the more significant franchise in national elections. The question is: which country should be responsible for letting them vote and under which conditions?
‘Feed them First, Then Ask Virtue of Them’: Broadening and Deepening Freedom of Movement
Authors: Sangiovanni Andrea
Published: September 2018

Given Ferrera’s insistence that EU citizenship should play a more ‘integrative role’, the criteria by which we should judge whether his proposals would be successful, assuming they were ever adopted, are explicitly functional. In my contribution I seek to ground them not in a functional-empirical analysis of what is most likely to inspire support for EU citizenship but in a broader conception of social justice. The two perspectives are not in direct competition, but they do depart from very different starting points.
EU Citizenship, Duties and Social Rights
Authors: Seeleib-Kaiser Martin
Published: September 2018

EU migrant citizens are often considered as outsiders, who access social benefits and services without having fulfilled their duties in the country of destination. As a group, however, EU migrant citizens are net contributors to the public purse in key destination countries. The current debate on duties of citizens within (con)federal jurisdictions has been rehearsed in different contexts, such as the North German Federation or the US, and the arguments are no different. EU citizenship must become an unconditional fundamental status, if it is to be meaningful.
Imagine: European Union Social Citizenship and Post-Marshallian Rights and Duties
Authors: Kostakopoulou Dora
Published: September 2018

Writing in 1959, Ortega y Gasset noted that ‘reality is not closed and reduced to the past and the present, but holds open the frontier of the future in which the real will be something that has yet to come into being.’ Ferrera and the other contributors in this forum have opened up a debate on the future of EU citizenship and argued for its ‘renovation’ in the light of rising Euroscepticism and nationalist centrifugalism in the member states. Ferrera shares Bauböck’s diagnosis that EU citizenship has not met its integrative potential. While renovation is not always innovation, Ferrera has laid down the path for innovative thinking about the (future) content of EU citizenship and for the introduction of ‘soft’ citizenship duties which would strengthen the ties that bind EU citizens. I am in favour of ‘soft’ as well as ‘hard’ EU citizenship duties and I argue here that EU citizenship is not, and cannot be, duty free.
Regaining the Trust of the Stay-at-Homes: Three Strategies
Authors: Van Parijs Philippe
Published: September 2018

At the heart of the current legitimacy crisis of the European Union lies the distrust of the stay-at-homes. There are three ways to address it: turning them all into movers; giving up free movement; developing a European Union that cares and protects.
EU Accession to the ECHR Requires Ensuring the Franchise for EU Citizens in National Elections
Authors: Duff Andrew
Published: September 2018

As rapporteur of the European Parliament on electoral reform, I strongly support the launching of this ECI, and will sign it. Wider legal and political action will surely be necessary at the EU level. And changes to both the primary and secondary law of the EU cannot be obstructed forever.
How to Enfranchise Second Country Nationals? Test the Options for Best Fit, Easiest Adoption and Lowest Costs
Authors: Owen David
Published: September 2018

The proposal of this ECI by Philippe Cayla and Catriona Seth is a welcome initiative addressing a problem that has already been highlighted by the European Commission, namely, that some ‘second country nationals’ (SCNs) lose their entitlement to vote in the national elections of their state of nationality without having acquired the right to vote at this level in their state of residence. This chapter critically considers a number of possible rules for resolving the legitimacy deficit identified. It tests them against three criteria: best fit, easiest adoption and lowest costs.
What’s in a People? Social Facts, Individual Choice, and the European Union
Authors: Kochenov Dimitry
Published: September 2018

Rainer Bauböck’s contribution struggles hard with a non-existing problem ignoring the fact that those who have little interest in the state of residence would obviously find it nonsensical to participate in the political life there. Knowing this leaves open the question whether it is worth superimposing the people’s judgment with a state-mandated one. If people are free, societal ties cannot depend on state mandated blessings.
Cash-for-Passports and the End of Citizenship
Authors: Spiro Peter J.
Published: September 2018

Investor citizenship programmes are becoming increasingly commonplace in state practice. What was once the province of outlier Caribbean microstates is gaining traction among more substantial states. Cash-for-passports, as Ayelet Shachar labels the phenomenon, clashes with our received understandings of citizenship as a marker of social solidarity in a Walzerian sense. The emerging market for citizenship literally commodifies the status.But where Shachar sees investor citizenship programmes as a threat to robust citizenship ties, I see them more as a manifestation of citizenship that is already being hollowed out. In the old world, investor citizenship programmes would have been inconceivable.Today, far from inconceivable, they are becoming an accepted element of strategic immigration policy.
Don’t Put the Baby in the Dirty Bathwater! A Rejoinder
Authors: Dumbrava Costica
Published: September 2018

It is beyond dispute that any attempt to dislodge a deeply rooted and widespread institution such as ius sanguinis is bound to pose serious practical challenges. However, if one has compelling moral reasons for dismantling such an institution, one ought to work towards this end. Babies are born into a physical world and from actual bodies but they are not naturally born into families and citizenship. The latter are social conventions that demand our acceptance when they are justified and our courage to change and replace them when they are not. To my critics who worried that abolishing ius sanguinis amounts to throwing out the baby with the dirty bathwater I reply that we should not put the baby in the dirty bathwater in the first place.
Revocation of Citizenship of Terrorists: A Matter of Political Expediency
Authors: Hailbronner Kay
Published: September 2018

Revocation of citizenship means a substantial interference with individual rights. It can only be justified if tightly defined material conditions in accordance with the constitutional law of each country and its international commitments are fulfilled. Risk assessment and proof of an affiliation, assistance or membership in an international terrorist organisation will be essential elements in this procedure. Whether there is a practical value in revocation of citizenship for citizens engaged in international terrorism in addition to criminal and administrative sanctions is within the framework of law a matter of political expediency which may well lead to different results in different countries.
Human Rights for All Is Better than Citizenship Rights for Some
Authors: Kanstroom Daniel
Published: September 2018

The best way to avoid The calamities of the rightless for whom no law exists (Arendt) is not only to strengthen citizenship protections. That may well have the perverse consequences of, on the one hand, rendering citizenship ever harder to achieve, and on the other, relegating noncitizens to an increasingly rightless realm. We must do the harder, more basic work of defining and instantiating meaningful human rights protections for all people, regardless of status, or location. Focusing too specifically on the problem of deprivation of citizenship must not blind us ‘to the numerous small and not so small evils with which the road to hell is paved.’
Virtual Politics, Real Guns: On Cloud Community, Violence, and Human Rights
Authors: Blake Michael
Published: September 2018

My contribution does not intend not to defeat Orgad’s vision, but to outline significant worries about how we might make that vision real. Orgad does not want voluntary forms of transnational institution to take the place of states, but insists upon their validity and power as ‘state-like entities.’ It is this latter point with which I take issue. If these institutions are to become genuinely state-like, they must have some part in doing what it is that states do; and we must understand how they could do that sort of thing, and how we could move from where we are to where we might be. If, in contrast, these institutions are merely places for debate and for the creation of solidarity, then we have had them for a very long time indeed. It is then not clear what these tools provide us with except for scale and ease. Either way, I suggest, we have some work to do. Orgad’s vision is profoundly hopeful, while my own is not, and I genuinely hope I can be proven wrong.
Cloud Agoras: When Blockchain Technology Meets Arendt’s Virtual Public Spaces
Authors: Kostakopoulou Dora
Published: September 2018

The virtual public space of blockchain communities will make citizens think, engage and act more virtually. In other words, the virtual reality of cloud agoras will have an impact on institutions and the participants themselves; it will yield pressures for more open, transparent and accountable institutions and will result in more virtuous, that is, actively engaged, citizens. Whether cloud agoras will prove to be decisive public spaces and strong promoters of democratic processes that make wealth, power and privilege accountable or merely subaltern counter publics will depend on the intentions and actions of their participants. In other words, the answer to the question whether the virtual public space of global citizenship will have a decisive influence on global, regional and national public policy-making is not theoretical or scholarly; it will be a contextual one.
Reducing Healthcare Costs Using ACS NSQIP‐Driven Quality Improvement Projects: A Success Story from Sheikh Khalifa Medical City (SKMC)
Authors: Nimeri Abdelrahman A. , Bautista Jejomar , Philip Ruby
Published: September 2018

Introduction

Surgical complications increase hospital length of stay and costs and lead to poor patient experience. We aim to evaluate our complication rates over time and the financial impact of joining the adult multi‐specialty American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) at Sheikh Khalifa Medical City (SKMC).

Methods

Sheikh Khalifa Medical City is a Joint Commission International‐accredited ACS NSQIP member since 2009. For the purpose of quality improvement, we have established several task forces (2010–2014) to decrease high rates of venous thromboembolism (VTE), urinary tract infection (UTI), surgical site infection (SSI), unplanned intubation (UI), and ventilator more than 48 h (Vent > 48 h). Our aim is to evaluate our complication rates over time and calculate the cost savings from prevented occurrences in VTE, UTI, SSI, UI, and Vent > 48 h. Cost savings are calculated using the return on investment calculator from ACS NSQIP. In addition, the cost of joining and maintaining ACS NSQIP at SKMC is calculated to determine the total cost savings after subtracting these costs.

Results

During the study period, we performed 8842 cases (2009–2015) and our overall morbidity improved significantly from observed/expected (O/E) 1.61% to (O/E) 0.85%. We prevented 12 VTE cases (2011–2015), 56 UTI cases (2013–2015), 12 SSI cases (2013–2015), 4 UI cases (2014–2015), and 7 Vent > 48 h cases (2014–2015). The cost saving from all these four task forces was $1,680,000. The cost of joining and maintaining ACS NSQIP at SKMC since 2009 was $336,000. Hence, the total saving for SKMC was $1,344,000.

Conclusion

ACS NSQIP‐driven quality improvement projects have resulted in reduction in complications and healthcare costs at SKMC over a 6‐year period.