bluuebunny/crossref_metadata_2025 huggingface dataset:
Carfilzomib Weekly plus Melphalan and Prednisone in Newly Diagnosed Transplant-Ineligible Multiple Myeloma (IFM 2012-03): A Phase I Trial
Authors: Leleu Xavier , Fouquet Guillemette , Richez Valentine , Guidez Stéphanie , Duhamel Alain , Machuron François , Karlin Lionel , Kolb Brigitte , Tiab Mourad , Araujo Carla , Meuleman Nathalie , Malfuson Jean-Valère , Bourquard Pascal , Lenain Pascal , Roussel Murielle , Jaccard Arnaud , Pétillon Marie-Odile , Belhadj-Merzoug Karim , Lepeu Gérard , Chrétien Marie-Lorraine , Fontan Jean , Rodon Philippe , Schmitt Anna , Offner Fritz , Voillat Laurent , Cereja Sophie , Kuhnowski Frédérique , Rigaudeau Sophie , Decaux Olivier , Humbrecht-Kraut Catherine , Frayfer Jamile , Fitoussi Olivier , Roos-Weil Damien , Eisenmann Jean-Claude , Dorvaux Véronique , Voog Eric G. , Attal Michel , Moreau Philippe , Avet-Loiseau Hervé , Hulin Cyrille , Facon Thierry
Published: May 2019

Purpose:

Carfilzomib is a novel generation proteasome inhibitor. The Carmysap trial demonstrated that twice-weekly KMP (carfilzomib, melphalan, prednisone) might challenge the MPV (melphalan, prednisone, bortezomib) standard. We sought to study KMP weekly, allowing to increase carfilzomib's dose with maintained efficacy and improved safety profile.

Patients and Methods:

IFM2012-03, a phase I multicenter study of KMP weekly in elderly patients with newly diagnosed multiple myeloma (eNDMM), aimed to determine the MTD of carfilzomib. Carfilzomib was given intravenously at 36, 45, 56, and 70 mg/m2/day on days 1, 8, 15, and 22 with melphalan and prednisone, for nine 35-day induction cycles, followed by carfilzomib maintenance for 1 year. Three dose-limiting toxicities (DLT) determined MTD at the lower dose.

Results:

Thirty eNDMMs were treated, 6 per cohort at 36, 45, and 56 mg/m2 and 12 at 70 mg/m². There was one DLT at 36 mg/m2 (lymphopenia), one at 45 mg/m2 (lysis syndrome), two at 56 mg/m2 (cardiac insufficiency and febrile neutropenia), and two at 70 mg/m2 (vomiting and elevated liver enzymes). The safety profile was acceptable; however, specific attention must be paid to the risk of cardiovascular events, especially for elderly patients. The overall response rate was 93.3%, with 46.6% complete response.

Conclusions:

The MTD dose of carfilzomib was 70 mg/m2 in this KMP weekly study in eNDMM. Response rates, and especially CR rate, were remarkable in this population, and would benefit from being assessed in a larger-scale study. The IFM2012-03 study demonstrated that the MTD of carfilzomib weekly is 70 mg/m2 in eNDMM, and 56 mg/m2 for patients older than 75 years. Carfilzomib used weekly in combination has a good efficacy and safety profile in eNDMM.
NKT Cell–Driven Enhancement of Antitumor Immunity Induced by Clec9a-Targeted Tailorable Nanoemulsion
Authors: Lam Pui Yeng , Kobayashi Takumi , Soon Megan , Zeng Bijun , Dolcetti Riccardo , Leggatt Graham , Thomas Ranjeny , Mattarollo Stephen R.
Published: May 2019

Invariant natural killer T (iNKT) cells are a subset of lymphocytes with immune regulatory activity. Their ability to bridge the innate and adaptive immune systems has been studied using the glycolipid ligand α-galactosylceramide (αGC). To better harness the immune adjuvant properties of iNKT cells to enhance priming of antigen-specific CD8+ T cells, we encapsulated both αGC and antigen in a Clec9a-targeted nanoemulsion (TNE) to deliver these molecules to cross-presenting CD8+ dendritic cells (DC). We demonstrate that, even in the absence of exogenous glycolipid, iNKT cells supported the maturation of CD8α+ DCs to drive efficient cross-priming of antigen-specific CD8+ T cells upon delivery of Clec9a/OVA-TNE. The addition of αGC to the TNE (Clec9a/OVA/αGC) further enhanced activation of iNKT cells, NK cells, CD8α+ DCs, and polyfunctional CD8+ T cells. When tested therapeutically against HPVE7-expressing TC-1 tumors, long-term tumor suppression was achieved with a single administration of Clec9a/E7 peptide/αGC TNE. Antitumor activity was correlated with the recruitment of mature DCs, NK cells, and tumor-specific effector CD8+ T cells to the tumor-draining lymph node and tumor tissue. Thus, Clec9a-TNE codelivery of CD8+ T-cell epitopes with αGC induces alternative helper signals from activated iNKT cells, elicits innate (iNKT, NK) immunity, and enhances antitumor CD8+ T-cell responses for control of solid tumors.
CT-Quantified Adipose Tissue Distribution: Risk or Protective Factor for Complications after Rectal Cancer Surgery?
Authors: Nattenmüller Johanna , Böhm Jürgen , Bagdassarjan Astgik , Kulu Yakup , Gigic Biljana , Schneider Martin , Kauczor Hans-Ulrich , Ulrich Cornelia M. , Ulrich Alexis
Published: May 2019

Purpose: Obesity is associated with increased incidence and mortality in rectal cancer (RC). However, an obesity paradox in the sense of a protective effect of obesity is discussed controversially. We evaluated whether adipose tissue distribution has an impact on medical (MC) and surgical complications (SC) after RC surgery. Methods: A total of 296 RC patients underwent oncological surgery and multidetector CT with quantification of total (TAT), visceral (VAT), and subcutaneous adipose tissue (SAT). Logistic regressions on SC (anastomotic leakage [n = 26], wound infection [n = 58], bleeding [n = 12], abscess [n = 32], bladder dysfunction [n = 24], burst abdomen [n = 10]), and MC (pulmonary [n = 22], cardiac [n = 18], urinary tract infection [n = 9], sepsis [n = 5]) were performed. Results: High pelvicVAT was associated with reduced risk for overall SC (OR = 0.915, p = 0.012) and anastomotic leakage (OR = 0.587, p = 0.024, CI: 0.369/0.934). In contrast, CT-quantified obesity was associated with increased risk for wound infection, bladder dysfunction, burst abdomen, overall MC, and cardiac complications (ORs up to 1.423). BMI was not associated with any SC or MC. Conclusion: An obesity paradox with a protective effect of CT-quantified adipose tissue was confirmed for anastomotic leakage and overall SC. In contrast, high adipose tissue was associated with higher risk for other SC and MC. These results show a more complex influence of body composition on MC and SC. CT-quantified obesity is able to provide deeper insights to explain the obesity paradox beyond BMI.
Changes in Anticoagulant Utilization Among United States Nursing Home Residents With Atrial Fibrillation From 2011 to 2016
Authors: Alcusky Matthew , McManus David D. , Hume Anne L. , Fisher Marc , Tjia Jennifer , Lapane Kate L.
Published: May 2019

Background

Nursing home residents with atrial fibrillation are at high risk for ischemic stroke and bleeding events. The most recent national estimate (2004) indicated less than one third of this high‐risk population was anticoagulated. Whether direct‐acting oral anticoagulant (
DOAC
) use has disseminated into nursing homes and increased anticoagulant use is unknown.

Methods and Results

A repeated cross‐sectional design was used to estimate the point prevalence of oral anticoagulant use on July 1 and December 31 of calendar years 2011 to 2016 among Medicare fee‐for‐service beneficiaries with atrial fibrillation residing in long‐stay nursing homes. Nursing home residence was determined using Minimum Data Set 3.0 records. Medicare Part D claims for apixaban, dabigatran, edoxaban, rivaroxaban, and warfarin were identified and point prevalence was estimated by determining if the supply from the most recent dispensing covered each point prevalence date. A Cochran‐Armitage test was performed for linear trend in prevalence. On December 31, 2011, 42.3% of 33 959 residents (median age: 85; Q1 79, Q3 90) were treated with an oral anticoagulant, of whom 8.6% used
DOAC
s. The proportion receiving treatment increased to 47.8% of 37 787 residents as of December 31, 2016 (
P
<0.01); 48.2% of 18 054 treated residents received
DOAC
s. Demographic and clinical characteristics of residents using
DOAC
s and warfarin were similar in 2016. Half of the 8734
DOAC
users received standard dosages and most were treated with apixaban (54.4%) or rivaroxaban (35.8%) in 2016.

Conclusions

Increases in anticoagulant use among
US
nursing home residents with atrial fibrillation coincided with declining warfarin use and increasing
DOAC
use.
Taxonomic revision of the “mexicanus” group of the genus Vaejovis C. L. Koch, 1836 (Scorpiones: Vaejovidae)
Authors: GERARDO A. CONTRERAS-FÉLIX , OSCAR F. FRANCKE B.
Published: May 2019

Within the scorpion genus Vaejovis C.L. Koch, the “mexicanus” group is composed of species distributed in the mountains of México. This group presents taxonomic problems, because its characterization and the species included in the group have varied through the years. In the present work, we redefine this group based on several morphological characters, and we differentiate it from the other two species groups within the genus: “vorhiesi” and “nit dulus+nigrescens”. Additionally, five new species are described: Vaejovis ceboruco sp. nov., Vaejovis nanchititla sp. nov., Vaejovis santibagnezi sp. nov., Vaejovis talpa sp. nov. and Vaejovis tapalpa sp. nov; the males of three species are described for the first time (V. dugesi, V. nigrofemoratus and V. tesselatus); and the updated diagnosis for all species is included. Keys for the identification of males and females of the 30 species included in this group are given. Lastly, notes on the natural history and distribution of some species are provided, with maps of known distribution for all the species.
Compatibility of Y-Site Injection of Meropenem Trihydrate With 101 Other Injectable Drugs
Authors: Lessard Jean-Justin , Caron Elaine , Schérer Hugo , Forest Jean-Marc , Leclair Grégoire
Published: May 2019

Objective: The objective of the study was to establish the compatibility of injectable meropenem with 101 other drugs during Y-site administration. Methods: Meropenem (50 mg/mL, 10 mL) was combined with 101 undiluted injectable drugs (10 mL each) at room temperature. Each preparation was performed twice. The first sample underwent a visual evaluation and a particle count test by light obstruction immediately after mixing. These tests were repeated 4 hours after mixing using the second preparation. Incompatibility was defined as precipitation or other visual change (turbidity, crystal formation, gas formation, color change) or failure to meet United States Pharmacopeia (USP) <788> 1.B specifications at any time point. Results: A total of 83 of the 101 injectable drugs tested with meropenem were found to be compatible both visually and using the USP <788> particle counter. The gross incompatibility of the other 17 drugs was determined by visual observation. One mixture complied with the specifications, but showed an increase of temperature upon mixing and was removed from the study. Conclusion: Of the 101 drugs tested, 83 were found to be compatible while the remaining 17 were incompatible. One drug was removed from the study as its compatibility was unclear.
Effects of processing conditions on solidification characteristics and mechanical properties of in situ magnesium metal matrix composites derived from polysilazane precursor
Authors: Chelliah Nagaraj M , Pambannan Padaikathan , Surappa MK
Published: May 2019

Polymer-derived in situ magnesium metal matrix composites (P-MMMCs) were fabricated by injecting a liquid or cross-linked polysilazane precursor into molten magnesium by a stir-casting method at two different melt temperatures of 700 and 800℃. Microstructural analysis reveals that the composites fabricated at 700℃ exhibit uni-modal grain size distribution having more or less columnar-shaped grain morphology. On the contrary, bi-modal grain size distribution with predominantly dendritic grain morphology occurs in the Mg matrix composites fabricated at 800℃. Such difference in grain morphology can be associated with variation in the availability of heterogeneous nucleation sites, and direction of heat flux during solidification. All of the fabricated composites were investigated for their solidification characteristics, microstructural evolution, micro/nano-hardness and compression properties. This article discusses the correlation between the processing parameters, microstructural evolution and mechanical properties of the as-cast in situ composites fabricated by liquid metallurgical route. Polymer-injection followed by in situ pyrolysis holds the potential of revolutionary processing technologies for producing castings of metal matrix nanocomposites, for example by bubbling the organic liquid with a carrier gas, e.g. nitrogen, into the molten metal by a Bessemer-like process.
Mystical techniques, mental processes, and states of consciousness in Abraham Abulafia’s Kabbalah: A reassessment
Authors: Putzu Vadim
Published: May 2019

This article reevaluates the mystical techniques and experiences peculiar to Abraham Abulafia’s Kabbalah and attempts to offer an alternative approach to their dominant understanding, which largely depends on Moshe Idel’s work. Current scholars of Jewish mysticism have a habit of highlighting the “unique character” of Abulafia’s mystical practices while asserting that they cannot be compared with the induction techniques and the psychophysical phenomena typical of hypnosis. While generally agreeing with the scholars discussed that the hyperactivation of the mind found in Abulafian Kabbalah contrasts sharply with the mental relaxation attained through the mystical practices of other religious traditions, the present study takes issue with the current view of Abulafian Kabbalah’s relation to hypnotic procedures, processes, and states. This work addresses the issues present with the current view and offers a more inclusive model for interpreting Abulafia’s Kabbalah, drawing from psychiatrist Roland Fischer.
The influence of daily spiritual experiences and gender on subjective well-being over time in cancer survivors
Authors: Rudaz Myriam , Ledermann Thomas , Grzywacz Joseph G.
Published: May 2019

Cancer survivors are at risk for poor subjective well-being, but the potential beneficial effect of daily spiritual experiences is unknown. Using data from the second and third wave of the Midlife in the United States (MIDUS) study, we examined the extent to which daily spiritual experiences at baseline moderate the association between subjective well-being at baseline and approximately 10 years later in cancer survivors ( n = 288). Regression analyses, controlled for age, educational attainment, and religious/spiritual coping, showed that daily spiritual experiences moderated the association between life satisfaction at baseline and follow-up. Specifically, high spiritual experiences enhanced life satisfaction over time in cancer survivors with low life satisfaction at baseline. Also, daily spiritual experiences moderated the association between positive affect at baseline and follow-up, though this moderating effect was different for women and men. No moderating effect emerged for negative affect.
Leadership Acceptance Through the Lens of Social Identity Theory: A Case Study of Military Leadership in Afghanistan
Authors: Jansen Marenne Mei , Delahaij Roos
Published: May 2019

This study builds on the experiences of a Dutch reconnaissance platoon deployed in Afghanistan in which leadership was not accepted. Setup as a qualitative single case study, this article advances our understanding of how group dynamics and contextual factors might impact the acceptance of leadership. Rather than primarily focusing on the behavior of the leader, this article highlights the perspective of followers in the ranks. The study also offers empirical evidence for the potential of social identity theory as a framework within which to study leadership acceptance. The case shows that leadership acceptance is largely dependent on group processes rather than on the characteristics of leadership. Additionally, it points to the importance of contextual factors. Finally, it suggests that a lack of attention to in-group dynamics, and a lack of active entrepreneurship by the leader, can catalyze “in-group entrepreneurship.”
Is Gratitude Always Beneficial to Interpersonal Relationships? The Interplay of Grateful Disposition, Grateful Mood, and Grateful Expression Among Married Couples
Authors: Leong Joyce L. T. , Chen Sylvia Xiaohua , Fung Helene H. L. , Bond Michael Harris , Siu Nicolson Y. F. , Zhu Jay Yijie
Published: May 2019

A growing body of research has documented positive outcomes of gratitude in personal and interpersonal domains. To uncover the dynamic process of gratitude and relational well-being, we examined the interplay of grateful disposition, grateful mood, and grateful expression in ongoing close relationships. Hong Kong Chinese couples ( n = 100) participated in a three-wave study across three consecutive weeks. Adopting the Actor–Partner Interdependence Model, we found that at Time 1, grateful disposition not only predicted one’s own grateful mood but also the perceived grateful mood of one’s spouse, both of which predicted marital satisfaction. At Time 2, the couples were randomly assigned to two conditions over 2 weeks: having one spouse keeping a private gratitude journal or overtly expressing gratitude to the other. Couples’ grateful mood increased at Time 3, indicating the effectiveness of both interventions. However, the resulting changes in marital satisfaction differed for the beneficiaries (enactors) and benefactors (targets), such that husbands who perceived their wife’s expressed gratitude as less sincere declined in their marital satisfaction. The results reveal the boundary conditions in evaluating expressions of gratitude and improvement of relationships and provide implications for social exchange and couple therapy.
Financial Inclusion, Health-Seeking Behavior, and Health Outcomes Among Older Adults in Ghana
Authors: Gyasi Razak M. , Adam Anokye M. , Phillips David R.
Published: May 2019

Purpose:

This study examines the associations between financial inclusion, health-seeking behavior, and health-related outcomes in older persons in Ghana.

Method:

Employing data from a 2016/2017 Aging, Health, Psychological Well-Being and Health-Seeking Behavior Study ( N = 1,200; mean age = 66.2 years [standard deviation = 11.9], we estimated regression models of self-rated health (SRH), psychological distress (PD), and health-care use (HCU) on a variable representing compositional characteristics of financial inclusion.

Results:

Multivariate logistic and generalized Poisson models showed that financial inclusion is positively associated with SRH (β = .104, standard error [ SE] = .033, p < .001) but inversely related to both PD (β = .038, SE = .032, p < .005) and HCU (β = −.006, SE = .009, p < .05) independent of other factors. However, after adjusting for socioeconomic and health-related factors, the associations were tempered and the effect of SRH decreased by 0.094 and PD increased by 0.065 points but HCU became statistically insignificant (β = −.020, SE = .0114, p > .05)

Conclusions:

Financial services inclusion profoundly appears to buffer against and retard health-related challenges in later life. Social and health policies targeted at improving the health outcomes of older people should include and build on the growing recognition of the importance of inclusive financial services and strategies.
Aortic and tricuspid valve infective endocarditis caused by Streptococcus suis
Authors: Miki Takao , Ohki Satoshi , Obayashi Tamiyuki , Yasuhara Kiyomitsu , Okonogi Shuichi , Umeno Tadashi
Published: May 2019

Streptococcus suis is a zoonotic pathogen that causes invasive infections in humans. We report a case of aortic and tricuspid valve infective endocarditis caused by Streptococcus suis, which required cardiac surgery. The patient was a 53-year-old man with high fever and general fatigue for one month. He had been a pig farmer for 30 years. His blood cultures were positive for Streptococcus suis, and transthoracic echocardiography revealed aortic and tricuspid regurgitation with mobile vegetations adhering to the tricuspid valve. We performed aortic valve neo-cuspidization using autologous pericardium, and tricuspid valve replacement using a biological valve.
Extracorporeal membrane oxygenation support in refractory perioperative anaphylactic shock to rocuronium: a report of two cases
Authors: Carelli Matheus , Seco Michael , Forrest Paul , Wilson Michael K , Vallely Michael P , Ramponi Fabio
Published: May 2019

In recent years, extracorporeal membrane oxygenation has become increasingly common in the treatment of in-hospital cardiac arrest in non-cardiac surgery patients. This includes cardiac arrest secondary to perioperative anaphylactic shock refractory to standard advanced life support protocols, which is a rare but catastrophic event associated with significant mortality. Neuromuscular blocking drugs are most commonly implicated in perioperative anaphylaxis, with rocuronium playing a major role. In this article, we report two cases of young and otherwise fit and well patients who experienced a perioperative arrest secondary to rocuronium anaphylaxis before elective surgery; both patients did not respond to conventional advanced life support, but survived neurologically intact after institution of urgent veno-arterial extracorporeal membrane oxygenation.
The Work of the International Commission of Jurists
Authors: MacDermot Niall
Published: May 2019

This is the third article in our series on organisations whose work brings them into the field of freedom of expression.
Immersion in the bureaucratic field: Methodological pathways
Authors: Hahonou Eric Komlavi , Martin Tomas Max
Published: May 2019

The introduction argues that while the legitimacy of bureaucracy as an object of inquiry is well established, little is generally said on the methodologies mobilized by ethnographers to study the bureaucratic field. The special issue is a contribution to fill this gap. The authors characterize bureaucracy as a mode of control by way of four dimensions—service, rule, violence, and secrecy—and propose three methodological pathways through which ethnographers may immerse in the bureaucratic field. The first pathway, “stages,” is concerned with the methodological reflections on accessing the bureaucratic stage and of being led in by bureaucrats as they perform their stage work. The second focuses on “techniques” and considers the implications of immersing oneself in a distinct technical landscape. The third pathway concerns the ethnographer’s positionality, drawing attention to the deep reflexivity and unstable ethics of bureaucracy ethnography. The authors invite bureaucracy ethnographers to pursue these pathways and to engage in a critical reflection on their fieldwork practices.
Visualizing the road network topology differences of Istanbul city
Authors: Erdem Umut , Cubukcu K. Mert
Published: May 2019

This study aims at visualizing the spatial distribution of road network per person in the city of Istanbul, Turkey. As a world city, Istanbul connects two continents and has almost 15 million population. Therefore, the city has a tremendous road network consists of 713,634 edges and 242,545 nodes. The road network is mapped on an equal population distribution cartogram for displaying where the least and the most amount of roads per person exist. These feature graphs might help planners, geographers, decision makers etc. for improving their understandings regarding the network topology of the road network.
Rules of the Road: Compliance and Defiance among the Different Types of Cyclists
Authors: Chaloux Nick , El-Geneidy Ahmed
Published: May 2019

Although cycling has become a more attractive option to commuters in many North American cities recently, significant apprehension remains around its safety. Though risks experienced by cyclists are diverse, the idea that they are because of scofflaw cyclists—cyclists who regularly ignore the rules of the road—remains prevalent. Improving cycling safety requires countering this idea, and therefore an understanding of how different cyclists act under the existing rules. Using a survey of 1,329 cyclists in Montreal, Canada, this study generated a typology of cyclists based on cycling motivations and behaviors and conducted comparisons based on their responses to four cycling rule-breaking scenarios. Our study shows that all cyclist types contravene traffic laws in similar ways, and 0.6% of respondents consistently follow the traffic laws. Breaking the law was often considered the safest option by respondents, which reflects a disconnect between the safety goals of traffic laws and the reality on the streets based on the perspectives of different cyclist types. Although cyclist types may act similarly in response to existing laws, they still respond uniquely to policies aimed at increasing rule adherence. Targeted interventions aimed at educating young cyclists, improving dedicated infrastructure, and prioritizing cycling traffic could increase rule compliance across all types. Through our study, planners, policy makers, and law enforcement could improve cycling safety by better understanding the behavior and rationale taken by cyclists.
Analyzing Simulation-Based Active Traffic Management Impact on a Large-Scale Regional Network
Authors: Lee Minha , Xiong Chenfeng , Zhu Zheng , Zhou Weiyi , Zhang Lei
Published: May 2019

A vast number of real-time corridor management strategies have been introduced because the dynamics of traffic patterns and increased congestion result in challenging problems on road systems. Although these strategies can offer positive impacts on regional traffic, their evaluation tools are often limited to the scope of one specific corridor. To fill this gap, this study integrates a mesoscopic dynamic traffic assignment simulation model with an existing traffic-responsive ramp metering strategy. This integrated model is suitable for network-wide analysis and large-scale simulation of integrated corridor management strategies. The integrated modeling platform is demonstrated as a practice-ready tool. We present a case study that explores the benefits of metering control under various traffic conditions in a real-world network in Maryland. Both local and network-wide impacts are illustrated in the case study. This is one of the first attempts to simultaneously analyze network-wide traffic impacts and capture minute-by-minute demand–supply interactions under managed corridor strategies. The results indicate that ramp metering is beneficial even under non-recurrent traffic conditions at multiple spatial resolutions.
Use of Deep Learning for Automatic Detection of Cracks in Tunnels: Prototype-2 Developed in the 2017–2018 Time Period
Authors: Daneshgaran Fred , Zacheo Luca , Stasio Francesco Di , Mondin Marina
Published: May 2019

Cracks on the surfaces inside road tunnels are among the most critical problems in the management of such tunnels and, if not properly addressed, can have severe consequences in relation to safety and costs. Nowadays, the main techniques used for analysis of such surfaces make use of either human inspections or complex automated systems, which are, respectively, very time consuming and expensive, and/or difficult to implement. There is therefore great interest in a low-cost data-acquisition platform coupled with Artificial Intelligence-based automated crack detection system. This paper introduces a low-cost technique for road tunnel inspections based on a simple system that does not require complex preliminary work and can also be used in tunnels with a normal traffic flow. In particular, thanks to a second-generation data-acquisition system developed in the 2017–2018 academic year, a series of high-resolution pictures can be obtained and used in a pre-trained deep neural network able to identify the presence of cracks through the classification of the pictures. Thanks to deep learning techniques, it is possible to exploit the power of Inception-v4, a deep convolutional neural network provided by Google, which can be retrained for the specific purpose of crack detection. This kind of network has been trained with a pictures database generated using a second data-acquisition prototype developed during the 2017–2018 academic year.
Governance Capacity of the City of Niš, Serbia, in the Spatial Planning Process
Authors: Maksić Milica
Published: May 2019

The basic objective of this paper is to research the capacity of local-level governance in Serbia to transform spatial planning practices. The analysis was performed on the case study of the City of Niš, where besides the presence of formal planning instruments, new informal governance practices have emerged. The governance of spatial development was analyzed in relation to three ideal governance models: hierarchy, market, and network, and four planning models: the comprehensive planning model, the negotiative planning model, the neoliberal model, and the collaborative model. The strengths and weaknesses of the institutional and planning framework are defined, and recommendations for improvement are given.
Noninvasive Oxygenation Strategies in Immunocompromised Patients With Acute Hypoxemic Respiratory Failure: A Pairwise and Network Meta-Analysis of Randomized Controlled Trials
Authors: Zayed Yazan , Banifadel Momen , Barbarawi Mahmoud , Kheiri Babikir , Chahine Adam , Rashdan Laith , Haykal Tarek , Samji Varun , Armstrong Emily , Bachuwa Ghassan , Al-Sanouri Ibrahim , Seedahmed Elfateh , Hernandez Dawn-Alita
Published: May 2019

Introduction:

Acute hypoxemic respiratory failure (AHRF) is a leading cause of intensive care unit (ICU) admission among immunocompromised patients. Invasive mechanical ventilation is associated with increased morbidity and mortality.

Objective:

To evaluate the efficacy of various oxygenation strategies including noninvasive ventilation (NIV), high-flow nasal cannula (HFNC), and conventional oxygen therapy in immunocompromised patients with AHRF.

Methods:

Electronic databases including PubMed, Embase, and the Cochrane Library were reviewed from inception to December 2018. We included all randomized controlled trials (RCTs) comparing different modalities of initial oxygenation strategies in immunocompromised patients with AHRF. Our primary outcome was the need for intubation and invasive mechanical ventilation while secondary outcomes were ICU acquired infections and short- and long-term mortality. Data were extracted separately and independently by 2 reviewers. We performed a Bayesian network meta-analysis to calculate odds ratio (OR) and Bayesian 95% credible intervals (CrIs).

Results:

Nine RCTs were included (1570 patients, mean age 61.1 ± 13.8 years with 64% male). Noninvasive ventilation was associated with a significantly reduced intubation rate compared with standard oxygen therapy (OR: 0.53; 95% CrI: 0.26-0.91). There were no significant reductions of intubation between NIV versus HFNC (OR: 0.83; 95% CrI: 0.35-2.11) or HFNC versus standard oxygen therapy (OR: 0.65; 95% CrI: 0.26-1.24). There were no significant differences between all groups regarding short-term (28-day or ICU) mortality or long-term (90-day or hospital) mortality or ICU-acquired infections ( P > 0.05).

Conclusion:

Among immunocompromised patients with AHRF, NIV was associated with a significant reduction of intubation compared with standard oxygen therapy. There were no significant differences among all oxygenation strategies regarding mortality and ICU-acquired infections.
An Oral History Interview With Leon Gross, PhD
Authors: Eden Aimee R.
Published: May 2019

One of the distinguishing and unique features of being an International Board Certified Lactation Consultant is successful completion of the International Board of Lactation Consultant Examiners examination, necessary for initial and ongoing certification. First offered in 1985, the exam content and scoring criteria have been developed using rigorous psychometric principles. While conducting my dissertation research about the professionalization of breastfeeding support (Eden, 2017), I interviewed Leon Gross, PhD, the psychometrician who oversaw the development of the first exam offered in 1985. He continued in this role through 2013. The interview excerpts below are from a taped interview conducted on March 27, 2011 in Rosslyn, Virginia (AE = Aimee Eden; LG = Leon Gross).
Comparison of Monoclonal Antibodies for Treatment of Uncontrolled Eosinophilic Asthma
Authors: Koski Renee R. , Grzegorczyk Kirsten M.
Published: May 2019

Objective

To summarize the current literature for Food and Drug Administration (FDA)-approved monoclonal antibodies used as add-on maintenance therapy in uncontrolled eosinophilic asthma.

Data Sources

PubMed was searched on December 17, 2018 using keywords: asthma, eosinophilic asthma, omalizumab, reslizumab, mepolizumab, benralizumab, and dupilumab.

Study Selection

Studies evaluating safety and efficacy of monoclonal antibodies for treatment of severe or eosinophilic asthma were included.

Results

Twenty-one randomized, double-blind, placebo-controlled trials evaluating the current FDA-approved monoclonal antibodies (omalizumab, mepolizumab, reslizumab, benralizumab, and dupilumab) for the treatment of uncontrolled eosinophilic asthma were included. The studies demonstrated clinically significant reductions in asthma exacerbations, symptoms, emergency room visits, eosinophil counts, and improvements in pulmonary function and asthma-related quality of life.

Conclusion

Five monoclonal antibodies are available for uncontrolled eosinophilic asthma. Choice depends on patient factors. Future studies should focus on cost-effectiveness of treatment, drug-drug comparisons, and long-term efficacy and safety.
Nonlinear semi-analytical nonlocal strain-gradient dynamic response investigation of phase-transition-induced transversely graded hierarchical viscoelastic nano/microplates
Authors: Shariyat M , Farrokhi F
Published: May 2019

A functionally graded Boltzmann hierarchical viscoelastic model with both stress- and strain-gradient nonlocalities is developed and implemented to extract results that are more precise than results of Eringen's nonlocal elasticity model. The available size-dependent vibration analyses of the nano/microplates have focused on the frequency analysis and even not the time-dependent transient vibration analyses. In the present research, the forced and transient responses of the microplates are studied comprehensively, for the first time, using a three-element standard solid viscoelastic model. The studied transversely symmetric graded viscoelastic microplate and the relevant function of the material properties variations contain notable hints as well. Furthermore, the resulting new sixth-order nonlocal strain gradient integrodifferential equations are solved by a special technique that includes an analytical spatial Navier series-type solution and a trapezoidal and Runge–Kutta integration schemes, in time domain. Finally, the influences of the stress- and strain-gradient nonlocality parameters and the viscoelasticity parameters on the dynamic behaviors of the viscoelastic FGM microplates are investigated in details. Results show that the effects of the strain gradient nonlocality on the viscodynamic results may be much remarkable than those of the length scale nonlocality, in microscales.
A precise prediction of the tooth root stresses for involute external gears with any fillet geometry under consideration of the exact meshing condition
Authors: Paucker Tobias , Otto Michael , Stahl Karsten
Published: May 2019

An environmentally friendly design of gearboxes means to increase the utilization of material steadily. This leads to in many ways optimized constructions, which require an exact prediction of occurring stresses under given load-carrying capacity to guarantee sufficient endurance. This paper shows a very precise method to calculate the occurring tooth root stress for involute, external gearings with any form of fillets within a few seconds. A two-dimensional Boundary–Element–Model is used to receive the notch stresses of the fillets which are linked to a high quality analytical tooth contact analysis to consider the exact relations of the gear meshing. The introduced model also allows a calculation of the occurring tension and compression stresses along the whole fillet for different meshing positions. This paper shows the optimization potential by using the described method in comparison to a standard approach.
Motion planning of spacecraft with obstacle avoidance under low uncertainty using the improved equal-collision-probability-curve and improved linear quadratic regulator strategy
Authors: Yi Wang , Xiaoqian Chen , Yuzhu Bai , Lu Cao , Xiaozhou Zhu
Published: May 2019

In terms of the motion planning problem of spacecraft proximity operations with obstacle avoidance under low uncertainty, the improved equal-collision-probability-curve and improved linear quadratic regulator (IECPC-ILQR) strategy is proposed. Firstly, the novel function of the IECPC algorithm is developed to generate the avoidance control impulse. Subsequently, the ILQR is designed to track the reference trajectory. Furthermore, combining the improved ECPC algorithm with the ILQR controller, the composite controller of the IECPC-ILQR strategy is obtained and is implemented on the chaser spacecraft. Compared with the traditional ECPC algorithm, the IECPC-ILQR strategy can avoid collision in the presence of low uncertainty. Furthermore, the proposed avoidance strategy can obtain higher control precision while requiring the same fuel. Finally, numerical simulations verify the effectiveness of the proposed IECPC-ILQR strategy.
Total resolution of ocular Kaposi sarcoma with different treatment approaches – a case series and review of literature
Authors: Yeak Justin , Iqbal Tajunisah , Zahari Mimiwati , Ismail Fazliana
Published: May 2019

Kaposi sarcoma (KS) is an angioproliferative disease that can vary from low-grade to aggressive and lethal multicentric vascular lesions, which can involve various locations, commonly mucocutaneous, lymph nodes, and visceral organs. It can also involve unusual sites such as the eye, central or peripheral nervous system, larynx, and many other anatomical sites. We describe three cases of ocular KS, which resolved completely following different treatment modalities. All three cases were known HIV-positive individuals with low CD4 cell counts. Case 1 received pegylated doxorubicin, case 2 received local radiotherapy, and case 3 received only highly active antiretroviral therapy (HAART). All three cases responded well to their respective therapy. Ocular KS is generally responsive to treatment. Initiation of HAART can achieve a remarkable response. In large or resistant cases, other treatment modalities can be considered to achieve resolution of lesions.
Slowly progressive fatal PML-IRIS following antiretroviral initiation at CD4+ nadir of 350 cells/mm3 despite CD4+ cell count rise to 900 cells/mm3
Authors: Sandhu Mani Ratnesh , Rutledge Ronnye , Grant Matthew , Mahajan Amit , Spudich Serena
Published: May 2019

AIDS-related progressive multifocal leukoencephalopathy (PML)-immune reconstitution inflammatory syndrome (IRIS) is a central nervous system inflammatory syndrome where immune response to John Cunningham (JC) virus antigen following antiretroviral therapy (ART) causes breakdown of the blood–brain barrier. We report a unique case of PML-IRIS, which presented with dystonic choreoathetosis after initiation of ART at a CD4+ cell count of 350 cells/mm3. This report shows continuous progression of the disease over a period of two years, despite robust immune reconstitution. The worsening of neurological symptoms, persistent positivity of JC virus in CSF, and progressive inflammatory picture on MR scans in the setting of a CD4+ cell count of 900 cells/mm3 highlight a different variant of PML-IRIS, and challenge the role of CD4+ cell count in diagnosing opportunistic infections in HIV/AIDS patients.
The diagnostic accuracies of the 2012 SLICC criteria and the proposed EULAR/ACR criteria for systemic lupus erythematosus classification are comparable
Authors: Dahlström Ö , Sjöwall C
Published: May 2019

In a joint effort, the European League Against Rheumatism (EULAR) and the American College of Rheumatology (ACR) recently proposed new criteria for the classification of systemic lupus erythematosus (SLE) with the overarching goal to identify potential participants for clinical studies. Herein, we present the first independent evaluation of these criteria in comparison with older classification grounds using an adult Scandinavian study population of confirmed SLE cases and individuals with SLE-mimicking conditions. We included 56 confirmed SLE cases meeting the 1982 ACR criteria (ACR-82) and/or the Fries “diagnostic principle” (antinuclear antibodies on at least one occasion plus involvement of at least two defined organ systems) and 55 controls with possible systemic autoimmune disease, including the presence of any SLE-related autoantibody. The proposed EULAR/ACR criteria showed a diagnostic sensitivity of 93% (95% confidence interval (CI), 0.83–0.98) compared with 83% (95% CI, 0.72–0.91) for the updated ACR criteria from 1997. The diagnostic accuracy of all tested classification grounds was fairly similar, achieving approximately 85%. However, the disease specificity of the EULAR/ACR criteria reached only 73% (95% CI, 0.59–0.83), which was comparable with the 2012 Systemic Lupus International Collaborating Clinics (SLICC) criteria, 75% (95% CI, 0.61–0.85), but clearly lower than for ACR-82, 94% (95% CI, 0.83–0.99). In this first independent evaluation of a limited number of cases, we found comparable results with respect to diagnostic sensitivity, specificity and accuracy regarding the SLICC-12 and the proposed EULAR/ACR classification criteria. However, their specificity for SLE appeared to be lower compared with ACR-82.
The Power of Reiki: Feasibility and Efficacy of Reducing Pain in Children With Cancer Undergoing Hematopoietic Stem Cell Transplantation
Authors: Zucchetti Giulia , Candela Filippo , Bottigelli Cristina , Campione Gabriela , Parrinello Annalisa , Piu Paola , Vassallo Elena , Fagioli Franca
Published: May 2019

Purpose: Reiki is a growing complementary therapy in pediatric oncology that needs evidence to become more credible among the health community. A within-subject design experiment was conducted to pilot testing the feasibility and efficacy of Reiki to provide pain relief among pediatric patients undergoing hematopoietic stem cell transplantation (HSCT). Method: Pediatric patients undergoing HSCT during the inpatient phase in the Stem Cell Transplantation Unit were eligible to participate to the pilot study. Short and medium effects were assessed investigating the increase or decrease of patient’s pain during three specific time periods (“delta”) of the day: morning of the Reiki session versus assessment before Reiki session (within subjects control period), assessment before Reiki session versus assessment after Reiki session (within subjects experimental period) and assessment after Reiki session versus morning the day after Reiki session (within subject follow-up period). The long-term effects were verified comparing the pain evolution in the day of the Reiki session with the following rest day. Results: The effect of 88 Reiki therapy sessions in nine patients (Mage = 12; Female = 61%) was analyzed following a short, medium, and long-term perspective. Repeated-measures analysis of variance revealed a significant difference among the three periods ( F = 17,17 p < .0001): A decrease of the pain occurred in the experimental period in short and medium term, while in the follow-up period, the pain level remained stable. Conclusions: This study demonstrates the feasibility of using Reiki therapy in pediatric cancer patients undergoing HSCT. Furthermore, these findings evidence that trained pediatric oncology nurses can insert Reiki into their clinical practice as a valid instrument for diminishing suffering from cancer in childhood.
Barriers to Cervical Cancer Screening and Treatment in the Dominican Republic: Perspectives of Focus Group Participants in the Santo Domingo Area
Authors: Liebermann Erica J. , VanDevanter Nancy , Shirazian Taraneh , Frías Gúzman Natalia , Niles Mimi , Healton Cheryl , Ompad Danielle
Published: May 2019

Introduction: Cervical cancer is the second leading cause of cancer death among women in the Dominican Republic, and high rates persist despite existing Pap smear screening programs. The purpose of this study was to explore Dominican women’s knowledge and attitudes regarding human papillomavirus (HPV) and cervical cancer, cervical cancer screening practices, and perceived barriers and facilitators to early detection of cervical cancer. Method: Six focus groups ( N = 64) were conducted in Spanish in urban, suburban, and rural locations, in private and public school settings, community and workplace settings, in or near Santo Domingo, as part of a larger study on barriers and facilitators to HPV vaccine implementation. Audio recordings were transcribed verbatim and translated from Spanish to English. Qualitative data analysis used inductive and deductive approaches. Results: Knowledge regarding HPV and cervical cancer varied across groups, but all agreed there was significant stigma and fear regarding HPV. Most women reported having Pap screening at least yearly. Follow-up of abnormal Pap testing was less consistent, with cost and uncertainty about provider recommendations identified as barriers. Discussion: Broader examination of provider-level and health system barriers and facilitators to cervical cancer prevention in the Dominican Republic is essential, in order to inform interventions to improve the effectiveness of cervical cancer screening and treatment programs and reduce preventable deaths.
Integrating Technology for Students with Emotional and Behavioral Disorders to Promote Engagement
Authors: Hirsch Shanna E. , Alves Kat D. , Dunn Michelle
Published: May 2019

Students with emotional and behavioral disorders (EBD) often struggle with behavior and can display academically challenging behavior in the classroom. Therefore, teachers should consider implementing evidence-based strategies that promote desirable behavioral and academic outcomes. This article focuses on how general and special educators can use technology to deliver two evidence-based classroom management practices: (a) opportunities to respond and (b) behavior-specific praise.
Synaptotagmins: Beyond Presynaptic Neurotransmitter Release
Authors: Wu Xuanang , Hu Shaoqin , Kang Xinjiang , Wang Changhe
Published: May 2019

Synaptotagmins (Syts) are well-established primary Ca2+ sensors to initiate presynaptic neurotransmitter release. They also play critical roles in the docking, priming, and fusion steps of exocytosis, as well as the tightly coupled exo-endocytosis, in presynapses. A recent study by Awasthi and others (2019) shows that Syt3 Ca2+-dependently modulates the postsynaptic receptor endocytosis and thereby promotes the long-term depression (LTD) and the decay of long-term potentiation (LTP). This work highlights the importance of Syt3 in modulating long-term synaptic plasticity and, importantly, extends the function of Syt proteins from presynaptic neurotransmitter release to a new promising postsynaptic receptor internalization.