bluuebunny/crossref_metadata_2025 huggingface dataset:
Primary health care performance: a scoping review of the current state of measurement in Africa
Authors: Bresick Graham , Christians Felicia , Makwero Martha , Besigye Innocent , Malope Sebaka , Dullie Luckson
Published: September 2019

Introduction

Countries with strong primary healthcare (PHC) report better health outcomes, fewer hospital admissions and lower expenditure. People-centred care that delivers essential elements of primary care (PC) leads to improved health outcomes and reduced costs and disparities. Such outcomes underscore the need for validated instruments that measure the extent to which essential, evidence-based features of PC are available and applied to users; and to ensure quality care and provider accountability.

Methods

A systematic scoping review method was used to identify peer-reviewed African studies and grey literature on PC performance measurement. The service delivery dimension in the Primary Healthcare Performance Initiative conceptual framework was used to identify key measurable components of PC.

Results

The review identified 19 African studies and reports that address measuring elements of PC performance. 13 studies included eight nationally validated performance measuring instruments. Of the eight, the South African and Malawian versions of Primary Care Assessment Tool measured service delivery comprehensively and involved PC user, provider and manager stakeholders.

Conclusion

40 years after Alma Ata and despite strong evidence for people-centred care, significant gaps remain regarding use of validated instruments to measure PC performance in Africa; few validated instruments have been used. Agreement on indicators, fit-for-purpose validated instruments and harmonising existing instruments is needed. Rigorous performance-based research is necessary to inform policy, resource allocation, practice and health worker training; and to ensure access to high quality care in a universal health coverage (UHC) system—research with potential to promote socially responsive, accountable PHC in the true spirit of the Alma Ata and Astana Declarations.
The influence of gender on immunisation: using an ecological framework to examine intersecting inequities and pathways to change
Authors: Feletto Marta , Sharkey Alyssa
Published: September 2019

There is still a substantial knowledge gap on how gender mediates child health in general, and child immunisation outcomes in particular. Similarly, implementation of interventions to mitigate gender inequities that hinder children from being vaccinated requires additional perspectives and research. We adopt an intersectional approach to gender and delve into the social ecology of implementation, to show how gender inequities and their connection with immunisation are grounded in the interplay between individual, household, community and system factors. We show how an ecological model can be used as an overarching framework to support more precise identification of the mechanisms causing gender inequity and their structural complexity, to identify suitable change agents and interventions that target the underlying causes of marginalisation, and to ensure outcomes are relevant within specific population groups.
Sedation versus general anaesthesia in endovascular therapy for anterior circulation acute ischaemic stroke: the multicentre randomised controlled AMETIS trial study protocol
Authors: Chabanne Russell , Fernandez-Canal Charlotte , Degos Vincent , Lukaszewicz Anne-Claire , Velly Lionel , Mrozek Segolene , Perrigault Pierre-François , Molliex Serge , Tavernier Benoit , Dahyot-Fizelier Claire , Verdonk Franck , Caumon Elodie , Masgrau Aurélie , Begard Marc , Chabert Emmanuel , Ferrier Anna , Jaber Samir , Bazin Jean-Etienne , Pereira Bruno , Futier Emmanuel
Published: September 2019

Introduction

Endovascular thrombectomy is the standard of care for anterior circulation acute ischaemic stroke (AIS) secondary to emergent large vessel occlusion in patients who qualify. General anaesthesia (GA) or conscious sedation (CS) is usually required to ensure patient comfort and avoid agitation and movement during thrombectomy. However, the question of whether the use of GA or CS might influence functional outcome remains debated. Indeed, conflicting results exist between observational studies with better outcomes associated with CS and small monocentric randomised controlled trials favouring GA. Therefore, we aim to evaluate the effect of CS versus GA on functional outcome and periprocedural complications in endovascular mechanical thrombectomy for anterior circulation AIS.

Methods and analysis

Anesthesia Management in Endovascular Therapy for Ischemic Stroke (AMETIS) trial is an investigator initiated, multicentre, prospective, randomised controlled, two-arm trial. AMETIS trial will randomise 270 patients with anterior circulation AIS in a 1:1 ratio, stratified by centre, National Institutes of Health Stroke Scale (≤15 or >15) and association of intravenous thrombolysis or not to receive either CS or GA. The primary outcome is a composite of functional independence at 3 months and absence of perioperative complication occurring by day 7 after endovascular therapy for anterior circulation AIS. Functional independence is defined as a modified Rankin Scale score of 0–2 by day 90. Perioperative complications are defined as intervention-associated arterial perforation or dissection, pneumonia or myocardial infarction or cardiogenic acute pulmonary oedema or malignant stroke evolution occurring by day 7.

Ethics and dissemination

The AMETIS trial was approved by an independent ethics committee. Study began in august 2017. Results will be published in an international peer-reviewed medical journal.

Trial registration number

NCT03229148.
Zinc concentration in preterm newborns at term age, a prospective observational study
Authors: Vázquez-Gomis Rosmari , Bosch-Gimenez Vicente , Juste-Ruiz Mercedes , Vázquez-Gomis Consuelo , Izquierdo-Fos Ignacio , Pastor-Rosado José
Published: September 2019

Objectives

To determine zinc concentrations and associated factors in a population of preterm newborns at term age.

Design

This analytical, descriptive, observational and prospective study was conducted in the neonatal unit of a tertiary hospital. Preterm newborn between gestational weeks 24 and 34 were included in the study. The patients were recruited close to the date of birth. Their clinical histories were collected, and the serum zinc concentrations (SZCs) at gestational weeks 37–41 were measured. This study aimed to measure SZC in a population of preterm newborns at term age, and analyse the anthropometric, clinical and nutritional parameters associated with a decrease in SZC.

Results

Overall, 83 preterm subjects were evaluated, including 44 (53%) female infants and 39 (47%) male infants. The median period of gestation was 31 (IQ25–IQ75: 29–33) weeks, and the mean weight at birth was 1.523±0.535 kg. The median SZC at term was 4.4 (IQ25–IQ75: 2.6–6.9) µmol/L. There were some variables associated with zinc concentrations like bronchopulmonary dysplasia (BPD), weight at birth, z-score of length at discharge, being small for gestational age and treatment with recombinant human erythropoietin, although the unique variable that was independent of the other variables in the multivariate analysis (p 0.01) was BPD. Preterm newborn with BPD had lower SZC at term age than those without (2.7 vs 4.9 µmol/L, p 0.005).

Conclusions

Zinc concentrations in this preterm population were low. BPD was significantly and negatively correlated with zinc concentrations.

Clinical trial registration

NCT03532555.
Human concentrations of uric acid scavenges adaptive and maladaptive reactive oxygen species in isolated rat hearts subjected to ischemic stress
Authors: Boardman Neoma T. , Falck Aleksander Tank , Lund Trine , Chu Xi , Martin-Armas Montserrat , Norvik Jon V. , Jenssen Trond G. , Ytrehus Kirsti
Published: September 2019

Uric acid is a purine degradation product but also an important antioxidant and reactive oxygen species (ROS) scavenger. Experimental settings that mimic myocardial ischemia–reperfusion have not included uric acid despite that it is always present in human extracellular fluid and plasma. We hypothesized that uric acid has an important role in myocardial ROS scavenging. Here, we tested the cardiac response to uric acid on infarct size following ischemia–reperfusion with and without exacerbated oxidative stress due to acute pressure overload and during preconditioning. We also examined mitochondrial respiration and ROS-induced mitochondrial permeability transition pore opening. Under exacerbated ROS stress induced by high-pressure perfusion, uric acid lowered oxidative stress and reduced infarct size. In contrast, uric acid blocked cardioprotection induced by ischemic preconditioning. However, this effect was reversed by probenecid, an inhibitor of cellular uptake of uric acid. In accordance, in intact cardiomyocytes, extracellular uric acid reduced the susceptibility of mitochondria towards opening of the permeability transition pore, suggesting that uric acid may prevent ischemia–reperfusion injury due to scavenging of maladaptive ROS. Moreover, as uric acid also scavenges adaptive ROS, this may interfere with preconditioning. Altogether, uric acid might be a confounder when translating preclinical experimental results into clinical treatment.
Comparative transcriptome profiling reveals the reprogramming of gene networks under arsenic stress in Indian mustard
Authors: Thakur Sapna , Choudhary Shruti , Dubey Preeti , Bhardwaj Pankaj
Published: September 2019

Arsenic is a widespread toxic metalloid that is classified as a class I carcinogen known to cause adverse health effects in humans. In the present study, we investigated arsenic accumulation potential and comparative gene expression in Indian mustard. The amount of arsenic accumulated in shoots varied in the range of 15.99–1138.70 mg/kg on a dry weight basis among five cultivars. Comparative expression analysis revealed 10 870 significantly differentially expressed genes mostly belonging to response to stress, metabolic processes, signal transduction, transporter activity, and transcription regulator activity to be up-regulated, while most of the genes involved in photosynthesis, developmental processes, and cell growth were found to be down-regulated in arsenic-treated tissues. Further, pathway analysis using the KEGG Automated Annotation server (KAAS) revealed a large-scale reprogramming of genes involved in genetic and environmental information processing pathways. Top pathways with maximum KEGG orthology hits included carbon metabolism (2.5%), biosynthesis of amino acids (2.1%), plant hormone signal transduction (1.4%), and glutathione metabolism (0.6%). A transcriptomic investigation to understand the arsenic accumulation and detoxification in Indian mustard will not only help to improve its phytoremediation efficiency but also add to the control measures required to check bioaccumulation of arsenic in the food chain.
On the Schrödinger spectrum of a hydrogen atom with electrostatic Bopp–Landé–Thomas–Podolsky interaction between electron and proton
Authors: Carley Holly K. , Kiessling Michael K.-H. , Perlick Volker
Published: September 2019

The Schrödinger spectrum of a hydrogen atom, modeled as a two-body system consisting of a point electron and a point proton, changes when the usual Coulomb interaction between point particles is replaced with an interaction which results from a modification of Maxwell’s law of the electromagnetic vacuum. Empirical spectral data thereby impose bounds on the theoretical parameters involved in such modified vacuum laws. In the present paper the vacuum law proposed, in the 1940s, by Bopp, Landé–Thomas, and Podolsky (BLTP) is scrutinized in such a manner. The BLTP theory hypothesizes the existence of an electromagnetic length scale of nature — the Bopp length [Formula: see text] —, to the effect that the electrostatic pair interaction deviates significantly from Coulomb’s law only for distances much shorter than [Formula: see text]. Rigorous lower and upper bounds are constructed for the Schrödinger energy levels of the hydrogen atom, [Formula: see text], for all [Formula: see text] and [Formula: see text]. The energy levels [Formula: see text], [Formula: see text], and [Formula: see text] are also computed numerically and plotted versus [Formula: see text]. It is found that the BLTP theory predicts a nonrelativistic correction to the splitting of the Lyman-[Formula: see text] line in addition to its well-known relativistic fine-structure splitting. Under the assumption that this splitting does not go away in a relativistic calculation, it is argued that present-day precision measurements of the Lyman-[Formula: see text] line suggest that [Formula: see text] must be smaller than [Formula: see text]. Finite proton size effects are found not to modify this conclusion. As a consequence, the electrostatic field energy of an elementary point charge, although finite in BLTP electrodynamics, is much larger than the empirical rest mass ([Formula: see text]) of an electron. If, as assumed in all “renormalized theories” of the electron, the empirical rest mass of a physical electron is the sum of its bare rest mass and its electrostatic field energy, then in BLTP electrodynamics the electron has to be assigned a negative bare rest mass.
Phthalocyanine-corannulene conjugates: Synthesis, complexation studies with a pyridyl-functionalized C60 fullerene, and photophysical properties
Authors: Suanzes Juan A. , Chaurasia Sumit , Calderon Rafael M. Krick , Guldi Dirk M. , Bottari Giovanni , Torres Tomás
Published: September 2019

We report here the synthesis and characterization of some novel Zn(II)phthalocyanine (Pc)-corannulene conjugates and their complexation ability towards a pyridyl-functionalized C[Formula: see text] fullerene through metal-ligand supramolecular interactions. Steady-state and time-resolved photophysical studies carried out on these electron donor–acceptor (D–A) Zn(II)Pc-corannulene/C[Formula: see text] ensembles indicate the formation of photogenerated charge-separated species. Interestingly, a stabilization of the photoinduced charge-separated state is observed in the case of the D–A supramolecular complexes comprising the corannulene-substituted Zn(II)Pcs when compared to their non-corannulene functionalized Zn(II)Pc analogues. We rationalize this stabilizing effect of the charge-separated state exerted by the corannulene as a result of the increased [Formula: see text]-extension and augmented hydrophobicity of the Zn(II)Pc core by the covalently-linked polyaromatic hydrocarbon (PAH) fragment.
It Is an Equal Failing to Trust Everybody and to Trust Nobody
Authors: Huang Teng-Chieh , Zaeem Razieh Nokhbeh , Barber K. Suzanne
Published: September 2019

Social media are providing a huge amount of information, in scales never possible before. Sentiment analysis is a powerful tool that uses social media information to predict various target domains (e.g., the stock market). However, social media information may or may not come from trustworthy users. To utilize this information, a very first critical problem to solve is to filter credible and trustworthy information from contaminated data, advertisements, or scams. We investigate different aspects of a social media user to score his/her trustworthiness and credibility. Furthermore, we provide suggestions on how to improve trustworthiness on social media by analyzing the contribution of each trust score. We apply trust scores to filter the tweets related to the stock market as an example target domain. While social media sentiment analysis has been on the rise over the past decade, our trust filters enhance conventional sentiment analysis methods and provide more accurate prediction of the target domain, here, the stock market. We argue that while it is a failing to ignore the information social media provide, effectively trusting nobody, it is an equal failing to trust everybody on social media too: Our filters seek to identify whom to trust.
Machine Learning Methods for Reliable Resource Provisioning in Edge-Cloud Computing
Authors: Duc Thang Le , Leiva Rafael García , Casari Paolo , Östberg Per-Olov
Published: September 2019

Large-scale software systems are currently designed as distributed entities and deployed in cloud data centers. To overcome the limitations inherent to this type of deployment, applications are increasingly being supplemented with components instantiated closer to the edges of networks—a paradigm known as edge computing. The problem of how to efficiently orchestrate combined edge-cloud applications is, however, incompletely understood, and a wide range of techniques for resource and application management are currently in use.

This article investigates the problem of reliable resource provisioning in joint edge-cloud environments, and surveys technologies, mechanisms, and methods that can be used to improve the reliability of distributed applications in diverse and heterogeneous network environments. Due to the complexity of the problem, special emphasis is placed on solutions to the characterization, management, and control of complex distributed applications using machine learning approaches. The survey is structured around a decomposition of the reliable resource provisioning problem into three categories of techniques: workload characterization and prediction, component placement and system consolidation, and application elasticity and remediation. Survey results are presented along with a problem-oriented discussion of the state-of-the-art. A summary of identified challenges and an outline of future research directions are presented to conclude the article.
Computational Mining of Social Media to Curb Terrorism
Authors: Almoqbel Mashael , Xu Songhua
Published: September 2019

In the ever-connected social networking era, terrorists exploit social media platforms via sophisticated approaches. To curb these activities, a rich collection of computational methods was developed. This article surveys the use of social media by terrorists, followed by
a temporal classification framework
that overviews computational countermeasures at four major stages, including inception of an attack, immediately before an attack, onset of an attack, and after an attack. The literature surveyed was organized around the four temporal stages. The resulting survey is summarized in a table with the main technology used in each stage based on the time of the attack.
PAPP-A and the IGF system in atherosclerosis: what’s up, what’s down?
Authors: Steffensen Lasse B. , Conover Cheryl A. , Oxvig Claus
Published: September 2019

Pregnancy-associated plasma protein-A (PAPP-A) is a metalloproteinase with a well-established role in releasing bioactive insulin-like growth factor-1 (IGF-1) from IGF-binding protein-2, -4, and -5 by proteolytic processing of these. The IGF system has repeatedly been suggested to be involved in the pathology of atherosclerosis, and both PAPP-A and IGF-1 are proposed biomarkers and therapeutic targets for this disease. Several experimental approaches based on atherosclerosis mouse models have been undertaken to obtain causative and mechanistic insight to the role of these molecules in atherogenesis. However, reports seem conflicting. The literature suggests that PAPP-A is detrimental, while IGF-1 is beneficial. This raises important questions that need to be addressed. Here we summarize the various studies and discuss potential underlying explanations for this seemingly inconsistency with the objective of better understanding complexities and limitations when manipulating the IGF system in mouse models of atherosclerosis. A debate clarifying what’s up and what’s down is highly warranted going forward with the ultimate goal of improving atherosclerosis therapy by targeting the IGF system.
Neutrophil Extracellular Traps Drive Mitochondrial Homeostasis in Tumors to Augment Growth
Authors: Yazdani Hamza O. , Roy Eva , Comerci Alexander J. , van der Windt Dirk J. , Zhang Hongji , Huang Hai , Loughran Patricia , Shiva Sruti , Geller David A. , Bartlett David L. , Tsung Allan , Sheng Tai , Simmons Richard L. , Tohme Samer
Published: September 2019

Neutrophil infiltration and neutrophil extracellular traps (NET) in solid cancers are associated with poorer prognosis, but the mechanisms are incompletely understood. We hypothesized that NETs enhance mitochondrial function in tumor cells, providing extra energy for accelerated growth. Metastatic colorectal cancer tissue showed increased intratumoral NETs and supranormal preoperative serum MPO-DNA, a NET marker. Higher MPO-DNA correlated with shorter survival. In mice, subcutaneous tumor implants and hepatic metastases grew slowly in PAD4-KO mice, genetically incapable of NETosis. In parallel experiments, human cancer cell lines grew slower in nu/nu mice treated with DNAse, which disassembles NETs. PAD4-KO tumors manifested decreased proliferation, increased apoptosis, and increased evidence of oxidative stress. PAD4-KO tumors had decreased mitochondrial density, mitochondrial DNA, a lesser degree of ATP production, along with significantly decreased mitochondrial biogenesis proteins PGC1α, TFAM, and NRF-1. In vitro, cancer cells treated with NETs upregulated mitochondrial biogenesis-associated genes, increased mitochondrial density, increased ATP production, enhanced the percentage of cancer cells with reduced mitochondrial membrane potential, and increased the oxygen consumption rate. Furthermore, NETs increased cancer cells' expression of fission and fusion-associated proteins, DRP-1 and MFN-2, and mitophagy-linked proteins, PINK1 and Parkin. All of which were decreased in PAD4-KO tumors. Mechanistically, neutrophil elastase released from NETs activated TLR4 on cancer cells, leading to PGC1α upregulation, increased mitochondrial biogenesis, and accelerated growth. Taken together, NETs can directly alter the metabolic programming of cancer cells to increase tumor growth. NETs represent a promising therapeutic target to halt cancer progression.

Significance:

Neutrophils through the release of NETs facilitate the growth of stressed cancer cells by altering their bioenergetics, the inhibition of which induces cell death.
MUC1-C Activates the NuRD Complex to Drive Dedifferentiation of Triple-Negative Breast Cancer Cells
Authors: Hata Tsuyoshi , Rajabi Hasan , Takahashi Hidekazu , Yasumizu Yota , Li Wei , Jin Caining , Long Mark D. , Hu Qiang , Liu Song , Fushimi Atsushi , Yamashita Nami , Kui Ling , Hong Deli , Yamamoto Masaaki , Miyo Masaaki , Hiraki Masayuki , Maeda Takahiro , Suzuki Yozo , Samur Mehmet K. , Kufe Donald
Published: September 2019

The NuRD chromatin remodeling and deacetylation complex, which includes MTA1, MBD3, CHD4, and HDAC1 among other components, is of importance for development and cancer progression. The oncogenic mucin 1 (MUC1) C-terminal subunit (MUC1-C) protein activates EZH2 and BMI1 in the epigenetic reprogramming of triple-negative breast cancer (TNBC). However, there is no known link between MUC1-C and chromatin remodeling complexes. Here, we showed that MUC1-C binds directly to the MYC HLH-LZ domain and identified a previously unrecognized MUC1-C→MYC pathway that regulates the NuRD complex. MUC1-C/MYC complexes selectively activated the MTA1 and MBD3 genes and posttranscriptionally induced CHD4 expression in basal- but not luminal-type BC cells. In turn, MUC1-C formed complexes with these NuRD components on the ESR1 promoter. Downregulating MUC1-C decreased MTA1/MBD3/CHD4/HDAC1 occupancy and increased H3K27 acetylation on the ESR1 promoter, with induction of ESR1 expression and downstream estrogen response pathways. Targeting MUC1-C and these NuRD components also induced expression of FOXA1, GATA3, and other markers associated with the luminal phenotype. These findings support a model in which MUC1-C activates the NuRD complex to drive dedifferentiation and reprogramming of TNBC cells.

Significance:

MUC1-C directly interacts with MYC to activate the NuRD complex, mediating regulation of the estrogen receptor in triple-negative breast cancer cells.
A Comparison of Biopsy and Mucosal Swab Specimens for Examining the Microbiota of Upper Gastrointestinal Carcinoma
Authors: Liu An-Qi , Vogtmann Emily , Shao Dan-Tong , Abnet Christian C. , Dou Hao-Yu , Qin Yu , Su Zheng , Wei Wen-Qiang , Chen Wen
Published: September 2019

Background:

There is currently no optimal sampling method for upper gastrointestinal (UGI) tract microbiota. We compared biopsies and mucosal swab specimens for microbial sampling from patients with UGI carcinoma.

Methods:

A total of 67 patients with esophageal squamous cell carcinoma (ESCC) and 36 patients with gastric cardia adenocarcinoma (GCA) were recruited in the Linxian Cancer Hospital (Henan, China). Sterile biopsies and swabs were used to collect paired samples from the resection specimens from carcinoma and adjacent normal tissue. Data from 16S rRNA gene sequencing were processed using QIIME2 to evaluate differences in alpha and beta diversity and taxonomic relative abundances between specimen types.

Results:

Alpha diversity was not significantly different between swab specimens and biopsies, both for ESCC and GCA. Paired specimens were correlated for both sample types from ESCC (ρ > 0.6, P < 0.001) but not GCA (ρ < 0.4, P > 0.05). For beta diversity, distinct clustering by sampling method was not observed for adjacent normal or tumor tissue from ESCC or GCA. There was a high correlation for weighted UniFrac and Bray–Curtis distance only in ESCC paired specimens (ρ > 0.6, P = 0.001). The 10 dominant bacterial genera were similar between swab and biopsy specimens. However, higher levels of Veillonella (P = 0.0002) and Streptococcus (P = 0.0002) were detected in ESCC adjacent normal and GCA carcinoma swabs, respectively, compared with the biopsies.

Conclusions:

Mucosal swab specimens and biopsies could yield similar microbial profiles from ESCC but not GCA. Both can be used to characterize UGI microbiota; one sampling method should be selected for future studies.

Impact:

This study provides insight for planning microbiota collections from the UGI tract.
Metformin and Aging: A Review
Authors: Glossmann Hartmut H. , Lutz Oliver M.D.
Published: September 2019

Metformin is sometimes proposed to be an “anti-aging” drug, based on preclinical experiments with lower-order organisms and numerous retrospective data on beneficial health outcomes for type 2 diabetics. Large prospective, placebo-controlled trials are planned, in pilot stage or running, to find a new use (or indication) for an aging population. As one of the metformin trials has “frailty” as its endpoint, similar to a trial with a plant-derived senolytic, the latter class of novel anti-aging drugs is briefly discussed. Concerns exist not only for vitamin B12 and B6 deficiencies, but also about whether there are adverse effects of metformin on individuals who try to remain healthy by maintaining cardiovascular fitness via exercise.
The Activated Clotting Time Paradox
Authors: Pacchioni Andrea , Ferro Jayme , Pesarini Gabriele , Mantovani Riccardo , Mugnolo Antonio , Bellamoli Michele , Penzo Carlo , Marchese Giuseppe , Benedetto Daniela , Turri Riccardo , Fede Alfredo , Benfari Giovanni , Saccà Salvatore , Ribichini Flavio , Versaci Francesco , Reimers Bernhard
Published: September 2019

Background:

Radial artery occlusion (RAO) is a thrombotic complication of transradial catheterization that can lead to permanent occlusion of the radial artery. Sheath-vessel diameter ratio, postprocedure compression time, occlusive hemostasis, and insufficient anticoagulation are all predictors of RAO. However, excessive anticoagulation can lead to longer time to achieve complete hemostasis and less patent hemostasis rate. This study was designed to assess the relationship among residual anticoagulation at the end of a percutaneous coronary procedure and the risk of RAO.

Methods:

Eight hundred thirty-seven patients undergoing transradial catheterization were enrolled. Activated clotting time (ACT) was measured before sheath removal. Patients were divided into 3 groups according to ACT values (ACT <150 s, ACT between 150 and 249 s, ACT >250 s), patent hemostasis with reverse Barbeau test was attempted in all patients, and compression device removed as soon as possible. Within 24 hours, patency of radial artery was checked by Doppler using reverse Barbeau technique.

Results:

Incidence of RAO was higher for the extreme ACT values. Patent hemostasis were less frequently obtained and time to hemostasis significantly longer for increasing ACT values (
P
=0.004 for trend and <0.0001 for trend, respectively). At logistic regression analysis, ACT values <150 s were an independent predictor of RAO (odds ratio, 3.53; 95% IC, 1.677–7.43;
P
=0.001) while adjusted probability for RAO confirmed U-shaped relationship with ACT values.

Conclusions:

The level of anticoagulation is strongly related to incidence of RAO and should be measured objectively by ACT.

Clinical Trial Registration:

URL:
https://www.clinicaltrials.gov
. Unique identifier: NCT02762344.
Direct Assessment of Health Utilities Using the Standard Gamble Among Patients With Primary Intracerebral Hemorrhage
Authors: Slaughter Kristen B. , Meyer Ellie G. , Bambhroliya Arvind B. , Meeks Jennifer R. , Ahmed Wamda , Bowry Ritvij , Behrouz Reza , Mir Osman , Begley Charles , Tyson Jon E. , Miller Charles , Warach Steven , Grotta James C. , McCullough Louise D. , Savitz Sean I. , Vahidy Farhaan S.
Published: September 2019

Background:

Standard gamble (SG) directly measures patients’ valuation of their health state. We compare in-hospital and day-90 SG utilities (SGU) among intracerebral hemorrhage patients and report a 3-way association between SGU, EuroQoL-5 dimension, and modified Rankin Scale at day 90.

Methods and Results:

Patients with intracerebral hemorrhage underwent in-hospital and day-90 assessments for the modified Rankin Scale, EuroQoL-5 dimension, and SG. SG provides patients a choice between their current health state and a hypothetical treatment with varying chances of either perfect health or a painless death. Higher SGU (scale, 0–1) indicates lower risk tolerance and thus higher valuation of the current health state. Logistic regression was used to estimate the likelihood of low SGU (≤0.6), and Wilcoxon paired signed-rank test compared in-hospital and day-90 SGU. In-hospital and day-90 SG was obtained from 381 and 280 patients, respectively, including 236 paired observations. Median (interquartile range) in-hospital and day-90 SGUs were 0.85 (0.40–0.98) and 0.98 (0.75–1.00;
P
<0.001). In-hospital SGUs were lower with advancing age (
P
=0.007), higher National Institutes of Health Stroke Scale, and intracerebral hemorrhage scores (
P
<0.001). Proxy-based assessments resulted in lower SGUs; median difference (95% CI), −0.2 (−0.33 to −0.07). After adjustment, higher National Institutes of Health Stroke Scale and proxy assessments were independently associated with lower SGU, along with an effect modification of age by race. Day-90 SGU and modified Rankin Scale were significantly correlated; however, SGUs were higher than the EuroQoL-5 dimension utilities at higher modified Rankin Scale levels.

Conclusions:

Divergence between directly (SGU) and indirectly (EuroQoL-5 dimension) assessed utilities at high levels of functional disability warrant careful prognostication of intracerebral hemorrhage outcomes and should be considered in designing early end-of-life care discussions with families and patients.
Biomarkers in Cardiovascular Disease: The Dilemma of Racial Differences
Authors: Suzuki Toru , Israr Muhammad Zubair , Salzano Andrea
Published: September 2019

See Article
Hackler et al
Association Between Intravenous Thrombolysis and Anaphylaxis Among Medicare Beneficiaries With Acute Ischemic Stroke
Authors: Lerario Mackenzie P. , Grotta James C. , Merkler Alexander E. , Omran Setareh Salehi , Chen Monica L. , Parikh Neal S. , Yaghi Shadi , Murthy Santosh , Navi Babak B. , Kamel Hooman
Published: September 2019

Background and Purpose—

Allergic reactions, including anaphylaxis, can sometimes occur after intravenous thrombolysis in patients with acute ischemic stroke. However, it remains unclear whether patients with stroke who receive thrombolytic agents face a higher risk of anaphylaxis than those who do not receive thrombolytics.

Methods—

We performed a retrospective cohort study using inpatient and outpatient claims between 2008 and 2015 from a nationally representative 5% sample of Medicare beneficiaries. We included patients who were ≥65 years old and hospitalized with acute ischemic stroke, defined by validated
International Classification of Diseases, Ninth Revision, Clinical Modification
diagnosis codes. Our exposure was treated with an intravenous thrombolytic agent during the index hospitalization (
International Classification of Diseases, Ninth Revision, Clinical Modification
code 99.10). Our primary outcome was anaphylaxis, defined using an accepted
International Classification of Diseases, Ninth Revision, Clinical Modification
code algorithm (989.5, 995.0-4, 995.6x, E905, E905.3, E905.5, or E905.8-9). A secondary outcome was anaphylactic shock (995.0 or 995.6x). Multiple logistic regression was used to evaluate the association between intravenous thrombolysis and anaphylaxis after adjustment for demographics, vascular risk factors, the Charlson comorbidity index, exposure to intravenous contrast dye, treatment with mechanical thrombectomy, and history of allergic reactions.

Results—

Among 66 989 patients with stroke, the 3176 (4.7%) who underwent intravenous thrombolysis more often had atrial fibrillation (47.7% versus 37.4%) and more often received intravenous contrast dye (44.3% versus 21.9%) but were otherwise similar in terms of demographics and comorbidities. Anaphylaxis developed in 17 (0.54%; 95% CI, 0.31%–0.86%) patients who received intravenous thrombolysis versus 45 (0.07%; 95% CI, 0.05%–0.09%) who did not. After adjustment for demographics, comorbidities, contrast dye, mechanical thrombectomy, and history of allergies, there was a significant association between receipt of intravenous thrombolysis and anaphylaxis (odds ratio, 7.8; 95% CI, 4.3–13.9). We found a similar association for anaphylactic shock.

Conclusions—

Although a rare occurrence, the risk of anaphylaxis among patients with acute ischemic stroke was significantly higher among those who received intravenous thrombolysis.
Two “Mothers” in 5 Ezra 2:1-32
Authors: Bergren Theodore A.
Published: September 2019

The early Christian apocryphon 5 Ezra (2 Esdras) 2:1-32 describes two distinct but unidentified “mothers.” The first (2:1-7) is desolate, forlorn, and consigned to “destruction”; the second (2:15-32) is encouraged, glorified, and triumphant.

It is generally recognized that the first “mother” represents the city of Jerusalem, “Mother Jerusalem.” The identity of and literary/thematic inspiration(s) behind the second “mother,” however, are uncertain.

The main thesis of this paper is that the “mother” in 2:15-32 represents the Christian church, “Mother Church.” The primary evidence for this identification is the remarkable thematic and verbal parallels between 5 Ezra’s descriptions of the “mother” and the characterizations of “Mother Church” in the writings of Cyprian.

Furthermore, the writings of Zeno of Verona and Lactantius contain lists of Christian ecclesiastical “works of mercy” that are close to 5 Ezra 2:20-22.

Our findings suggest that 5 Ezra is a post-250 Latin composition of North African origin.
The Rule of Law under Pressure: Russia and the European Human Rights System
Authors: Kahn Jeffrey
Published: September 2019

This article is based on a keynote address given at the 10th Annual Conference on the Development of Russian Law held at the Faculty of Law, University of Helsinki, on 20–21 November 2017, by Professor Marianna Muravyeva. The article, which reflects political developments at the time of its delivery, explores the origins and consequences of the decision to accept Russia’s application for membership in the Council of Europe.
Unpacking Recipes and Communicating Experience: The Ervarenissen of Simon Eikelenberg (1663-1738) and the Art of Painting
Authors: Hagendijk Thijs
Published: September 2019

This article argues that in the early modern period, epistemic genres were transformed to suit new purposes. Modelled on the experimental essay form used by proponents of the New Sciences, the Dutch polymath and painter Simon Eikelenberg (1663-1738) wrote down ervarenissen to document how painting materials such as varnishes were prepared. Recipes have been identified as the ubiquitous vehicles for written know-how in the early modern period, yet authors continuously searched for new ways to unpack the ineffable dimensions of know-how in text. This article explores the ervarenissen as an alternative communicative strategy. Eikelenberg appropriated the experimental essay to create expressive instructions. He emphasized the specificity and idiosyncrasy of an act of making, tried to establish a sympathetic relationship with his readers, and showed how vulnerability, failure and improvisation belong to the workshop.
Rhamphomyia Meigen of the Canadian Arctic Archipelago, Greenland and Iceland (Diptera: Empididae)
Authors: SINCLAIR BRADLEY J. , VAJDA ÉLODIE A. , SAIGUSA TOYOHEI , SHAMSHEV IGOR V. , WHEELER TERRY A.
Published: September 2019

Rhamphomyia of the Canadian Arctic Archipelago, Greenland and Iceland, comprising 23 species, including five new species, are revised: R. (Ctenempis) albopilosa Coquillett, R. (Dasyrhamphomyia) erinacioides Malloch, R. (Dasyrhamphomyia) hovgaardii Holmgren, R. (Dasyrhamphomyia) leptidiformis Frey, R. (Dasyrhamphomyia) nigrita Zetterstedt, R. (Eorhamphomyia) shewelli Sinclair, Vajda, Saigusa & Shamshev sp. nov., R. (Pararhamphomyia) diversipennis Becker, R. (Pararhamphomyia) filicauda Henriksen & Lundbeck, R. (Pararhamphomyia) frigida Sinclair, Vajda, Saigusa & Shamshev sp. nov., R. (Pararhamphomyia) helleni Frey, R. (Pararhamphomyia) hilariformis Frey, R. (Pararhamphomyia) hoeli Frey, R. (Pararhamphomyia) kjellmanii Holmgren, R. (Pararhamphomyia) lymaniana Sinclair, Vajda, Saigusa & Shamshev sp. nov., R. (Pararhamphomyia) omissinervis Becker, R. (Pararhamphomyia) petervajdai Sinclair, Vajda, Saigusa & Shamshev sp. nov., R. (Pararhamphomyia) septentrionalis Sinclair, Vajda, Saigusa & Shamshev sp. nov., R. (Pararhamphomyia) simplex Zetterstedt, R. (Pararhamphomyia) ursinella Melander, R. herschelli Malloch, R. hirtula Zetterstedt, R. laevigata Loew, R. setosa Coquillett. The following six new synonyms are proposed: R. calvimontis Cockerell, 1916 and R. wuorentausi Frey, 1922 = R. albopilosa Coquillett, 1900; R. fridolini Frey, 1950 = R. laevigata Loew, 1861; R. hirticula Collin, 1937 = R. setosa Coquillett, 1895; R. uralensis Becker, 1915 = R. kjellmanii Holmgren, 1880; R. zaitzevi Becker, 1915 = R. hovgaardii Holmgren, 1880. Lectotypes are designated for the following species: R. diversipennis Becker, R. filicauda Henriksen & Lundbeck, R. helleni Frey, R. herschelli Malloch, R. hirticula Collin, R. hoeli Frey, R. leptidiformis Frey, R. omissinervis Becker, R. setosa Coquillett, R. uralensis Becker, R. wuorentausi Frey, R. zaitzevi Becker. A neotype is designated for R. laevigata Loew. Keys to male and female species of Rhamphomyia and distribution maps of this region are provided. DNA barcode data are presented for 16 species of arctic Rhamphomyia.
The Effect of Drifter GPS Errors on Estimates of Submesoscale Vorticity
Authors: Spydell Matthew S. , Feddersen Falk , Macmahan Jamie
Published: September 2019

Differential kinematic flow properties (DKP), such as vertical vorticity, have been estimated from surface drifters. However, previous DKP error estimates were a posteriori and did not include correlated errors across drifters. To accurately estimate submesoscale (≤1 km) DKPs from drifters, errors must be better understood. Here, the a priori vorticity standard error is derived that depends upon the number of drifters in the cluster, the drifter cluster major and minor axes lengths, the instrument velocity error, and the cross-drifter error correlation. Two stationary GPS experiments, with zero vorticity, were performed at separations of O(101–103) m to understand vorticity error and test the derivation using 1 Hz position differences and Doppler shift velocities. Vorticity errors of ±5f (where f is the local Coriolis parameter)were found for ≈40 m separations. The frequency-dependent velocity variances and GPS-to-GPS correlations are quantified. Vorticity estimated with a “blended” velocity has reduced error. The stationary vorticity error can be well predicted given velocity error, correlation, and minor axis length. Vorticity error analysis is applied to submesoscale-sampling in situ GPS drifters near Point Sal, California. The derivation predicts when large high-frequency vorticity fluctuations (indicating noise) occur. Previously, cluster area or ellipticity were used as criteria to distinguish error. We show that the drifter cluster minor axis (narrowness) is a key time-dependent factor affecting vorticity error, and even for velocity errors <0.004 m s−1, the vorticity error exceeds ±5f when cluster minor axis <50 m. These results will aid submesoscale drifter deployment planning.
Bias Correction of Tropical Cyclone Parameters in the ECMWF Ensemble Prediction System in Australia
Authors: Aijaz Saima , Kepert Jeffrey D. , Ye Hua , Huang Zhendong , Hawksford Alister
Published: September 2019

Global ensemble prediction systems have considerable ability to predict tropical cyclone (TC) formation and subsequent evolution. However, because of their relatively coarse resolution, their predictions of intensity and structure are biased. The biases arise mainly from underestimated intensities and enlarged radii, in particular the radius of maximum winds. This paper describes a method to reduce this limitation by bias correcting TCs in the ECMWF Ensemble Prediction System (ECMWF-EPS) for a region northwest of Australia. A bias-corrected TC system will provide more accurate forecasts of TC-generated wind and waves to the oil and gas industry, which operates a large number of offshore facilities in the region. It will also enable improvements in response decisions for weather sensitive operations that affect downtime and safety risks. The bias-correction technique uses a multivariate linear regression method to bias correct storm intensity and structure. Special strategies are used to maintain ensemble spread after bias correction and to predict the radius of maximum winds using a climatological relationship based on wind intensity and storm latitude. The system was trained on the Australian best track TC data and the ECMWF-EPS TC data from two cyclone seasons. The system inserts corrected vortices into the original surface wind and pressure fields, which are then used to estimate wind exceedance probabilities, and to drive a wave model. The bias-corrected system has shown an overall skill improvement over the uncorrected ECMWF-EPS for all TC intensity and structure parameters with the most significant gains for the maximum wind speed prediction. The system has been operational at the Australian Bureau of Meteorology since November 2016.
Average Gaps and Oaxaca–Blinder Decompositions: A Cautionary Tale about Regression Estimates of Racial Differences in Labor Market Outcomes
Authors: Słoczyński Tymon
Published: September 2019

Using a recent result from the program evaluation literature, the author demonstrates that the interpretation of regression estimates of between-group differences in wages and other economic outcomes depends on the relative sizes of subpopulations under study. When the disadvantaged group is small, regression estimates are similar to the average loss for disadvantaged individuals. When this group is a numerical majority, regression estimates are similar to the average gain for advantaged individuals. The author analyzes racial test score gaps using ECLS-K data and racial wage gaps using CPS, NLSY79, and NSW data, and shows that the interpretation of regression estimates varies substantially across data sets. Methodologically, he develops a new version of the Oaxaca–Blinder decomposition, in which the unexplained component recovers a parameter referred to as the average outcome gap. Under additional assumptions, this estimand is equivalent to the average treatment effect. Finally, the author reinterprets the Reimers, Cotton, and Fortin decompositions in the context of the program evaluation literature, with attention to the limitations of these approaches.
Assessing the structural, mechanical and dispersible characteristics of flushable nonwovens
Authors: Atasağun Hande G , Bhat Gajanan S
Published: September 2019

Flushable wipes have become popular among consumers who worry about environmental problems the world confronts today. However, whether these wipes have a positive effect on environmental protection is contradictory because of the lack of government regulations and legal obligations. Starting from this point, in this study, we characterized commercially available flushable products, which were manufactured from various raw materials by different production methods, in order to understand the relationship between their structure and performance properties. The results showed that production technology had a significant effect on the structural, mechanical, and dispersible properties of nonwovens. The disintegration percentage of nonwovens was inversely related to their wet strength. The findings of this study will be helpful in the design of new flushable nonwovens for improved wet strength and dispersibility performance.
Navigating Vertical Transfer Online: Access to and Usefulness of Transfer Information on Community College Websites
Authors: Schudde Lauren , Bradley Dwuana , Absher Caitlin
Published: September 2019

Objective: To transfer, students often must navigate complex and imperfect information about credit transfer, bureaucratic hurdles, and conflicting degree requirements. This study examined how administrators and transfer personnel think about institutional online transfer resources and examined community colleges’ online transfer information. Methods: For a sample of 20 Texas community colleges, we spoke to key transfer personnel about the information provided to students and reviewed college websites, assessing the ease of access and usefulness of online transfer information. We used a qualitative case study approach to triangulate findings from our data sources. Results: Approximately two thirds of colleges in the sample fell below the highest standard on our rubric for either ease of access or usefulness, indicating room for improvement at most institutions. Many personnel recognized the strengths and limitations of their college’s online information, though several were ambivalent about the need for improving online information, arguing that online information is not as promising an intervention as face-to-face advising. Conclusion/Contributions: Our research illustrates the need for colleges to develop and update their online information intentionally, determining which information students need to transfer (including transfer guides for partner programs/colleges) and how students might search for that information, and ensuring that necessary transfer information is available and up to date. The framework provided by our website review approach, coupled with a proposed rubric to assess ease of access and usefulness of transfer information, may guide institutions in their evaluation of their online transfer information.