bluuebunny/crossref_metadata_2025 huggingface dataset:
Submental island flap reconstruction for carcinoma of the oral cavity: Experience in 30 cases
Authors: Pradhan Pradeep , Samal Swagatika , Samal Dillip Kumar , Preetam Chappity , Parida Pradipta Kumar
Published: March 2019

Objective

The submental flap can be utilized for soft tissue reconstruction in oral cavity malignancies because due to its close approximation to the surgical site, fewer donor site morbidity and the cost effectiveness of the procedure.

Methods

A total of 30 patients with squamous cell carcinoma of the oral cavity were included in the study from July 2012 to August 2015 in a tertiary care referral hospital. Patients with clinical staging I/II/III (T1/T2/T3, N0) oral malignancy were included in the study. Patients with nodal metastasis irrespective of the stage of disease and patients with chronic medical illness/revision cases were excluded from the study. Submental island flap was utilized for the reconstruction of the soft tissue defect in each patient. Patients were followed at monthly interval till 6 months in the postoperative period.

Results

The buccal mucosa (12 patients), tongue (10 patients) and floor of mouth (8 patients) were the subsites in the oral cavity. Partial and complete skin necrosis was found in 4 and 2 patients respectively. Postoperative chemoradiation was required in 5 patients. None of the patients had loco regional recurrence till 6 months of follow‐up.

Conclusion

The submental island flap is considered to be the reliable option for the soft tissue reconstruction in oral cancer because of dependent vascular pedicle, less donor site morbidity and the lower cost compared to the free flaps, often preferred in patients with a lower socioeconomic condition.
Stone Sculpture Wear: Alteration/Fragmentation Processes and Their Impact on Carving Traces of Tenon Heads of Chavín de Huántar, Peru
Authors: González-Ramírez Andrea
Published: March 2019

The study of the stone sculpture production process is subject to the preservation and visibility of tool traces and surface finishes. In this article it is proposed that the parameters developed in conservation for the diagnosis of surface stone alteration processes can be used as descriptors to isolate the attributes of postproduction conditions and their influence on variation in the appearance of stonework traces. It shows how the application to a case study served to determine the alterations that contribute to the deterioration of carving traces, the selection of the best-preserved areas for recording, and the retrieval of information for increasing the sample number. The results of fracturing patterns caused by a stress sector in the sculpture body are shown. Certain sets of alterations occurred together, either affecting the integrity of the carving groove or increasing the texturing finish of the polished surface.
Simulator-based training for learning resuscitative transesophageal echocardiography
Authors: Chenkin Jordan , Hockmann Edgar , Jelic Tomislav
Published: March 2019

Objectives

Transesophageal echocardiography (TEE) is a relatively new resuscitation tool in the emergency department. Recent studies have demonstrated that it can impact diagnosis and management of critically ill patients. The objective of this study is to determine the effectiveness of a simulation-based curriculum for teaching emergency medicine residents a five-view TEE protocol.

Methods

Emergency medicine residents with previous ultrasound experience were invited to attend a 1-hour TEE training session. The training consisted of a didactic lecture followed by guided practice on a simulator. Performance was measured prior to training, after the training session, and by a transfer test 1 to 2 weeks after training. The primary outcome was the percentage of successful image generation using a scoring tool by two blinded reviewers.

Results

Twenty-two residents completed the study. The percentage of successful views increased from 44.5% (SD 27.9) at baseline to 98.6% (SD 3.5) after training (p < 0.001), and was 86.8% (SD 12.1) on transfer testing (p < 0.001).

Conclusion

A brief simulation-based teaching session was effective for teaching emergency medicine residents a five-view resuscitative TEE protocol. Future studies are needed to determine optimal methods for long-term skill retention.
First come, first served? Birth order effects on child height in South Africa
Authors: Bishwakarma Rajan , Villa Kira M.
Published: March 2019

We examine the birth order effects on health status for a sample of children aged 1–18 years in South Africa. Using a mother fixed-effects specification, we observe children's height-for-agez-score decreases with birth order. We investigate potential mechanisms underlying the birth order effect including those related to biology, parental preferences, and resource dilution. We also look at whether these effects are due to selection into families of different sizes. We find that the magnitude of the effect is larger in poorer and rural households and in larger families – suggesting that the birth order effect is largely due to resource dilution in economically constrained households.
Voter Response to Salient Judicial Decisions in Retention Elections
Authors: Harris Allison P.
Published: March 2019

Even at their most salient, judicial retention elections do not increase turnout on Election Day. However, those who vote often participate in judicial retention races at higher levels than usual following salient judicial decisions. I use a series of difference-in-differences analyses to estimate the effect of the Iowa Supreme Court’s legalization of same-sex marriage on the subsequent retention races. I find that retention race participation was higher than we would have otherwise expected after the decision. Scholars often cite the infrequence with which justices are removed as evidence of justices’ relative independence from voters in retention elections, but the overwhelming retention of these justices does not mean they are independent from voters. Increases in the number of ballots cast in these races is perhaps more important than increases in negative votes when it comes to judicial independence, because each vote is an evaluation of the justices, whether positive or negative.
Condemning or Condoning the Perpetrators? International Humanitarian Law and Attitudes Toward Wartime Violence
Authors: Wallace Geoffrey P. R.
Published: March 2019

What are the implications of international law for attitudes toward wartime violence? Existing research offers contrasting views on the ability of international legal principles to shape individual preferences, especially in difficult situations involving armed conflict. Employing cross-national survey evidence from several conflict and post-conflict countries, this article contributes to this debate by evaluating the relationship between individuals’ knowledge of the laws of war and attitudes toward wartime conduct. Findings show that exposure to international law is associated with a significant reduction in support for wartime abuses, though the results are stronger for prisoner treatment than for targeting civilians. Analysis further reveals that legal principles generate different expectations of conduct than alternative value systems that are rooted in strong moral foundations regarding the impermissibility of wartime abuses. The findings are relevant for understanding the relationship between international law and domestic actors, and how legal principles relate to the resort to violence.
Dissecting the paleocontinental and paleoenvironmental dynamics of the great Ordovician biodiversification
Authors: Franeck Franziska , Liow Lee Hsiang
Published: March 2019

The Ordovician was a time of drastic biological and geological change. Previous work has suggested that there was a dramatic increase in global diversity during this time, but also has indicated that regional dynamics and dynamics in specific environments might have been different. Here, we contrast two paleocontinents that have different geological histories through the Ordovician, namely Laurentia and Baltica. The first was situated close to the equator throughout the whole Ordovician, while the latter has traversed tens of latitudes during the same time. We predict that Baltica, which was under long-term environmental change, would show greater average and interval-to-interval origination and extinction rates than Laurentia. In addition, we are interested in the role of the environment in which taxa originated, specifically, the patterns of onshore–offshore dynamics of diversification, where onshore and offshore areas represent high-energy and low-energy environments, respectively. Here, we predict that high-energy environments might be more conducive for originations.

Our new analyses show that the global Ordovician spike in genus richness from the Dapingian to the Darriwilian Stage resulted from a very high origination rate at the Dapingian/Darriwilian boundary, while the extinction rate remained low. We found substantial interval-to-interval variation in the origination and extinction rates in Baltica and Laurentia, but the probabilities of origination and extinction are somewhat higher in Baltica than Laurentia. Onshore and offshore areas have largely indistinguishable origination and extinction rates, in contradiction to our predictions. The global spike in origination rates at the Dapingian/Darriwilian boundary is apparent in Baltica, Laurentia, and onshore and offshore areas, and abundant variability in diversification rates is apparent over other time intervals for these paleocontinents and paleoenvironments. This observation hints at global mechanisms for the spike in origination rates at the Dapingian/Darriwilian boundary but a domination of more regional and local mechanisms over other time intervals in the Ordovician.
Higher Summability and Discrete Weighted Muckenhoupt and Gehring Type Inequalities
Authors: Saker S. H. , Kubiaczyk I.
Published: March 2019

In this paper, we prove some reverse discrete inequalities with weights of Muckenhoupt and Gehring types and use them to prove some higher summability theorems on a higher weighted space $l_{w}^{p}({\open N})$ form summability on the weighted space $l_{w}^{q}({\open N})$ when p>q. The proofs are obtained by employing new discrete weighted Hardy's type inequalities and their converses for non-increasing sequences, which, for completeness, we prove in our special setting. To the best of the authors' knowledge, these higher summability results have not been considered before. Some numerical results will be given for illustration.
DEFEAT IN THE ARENA
Authors: Coleman Kathleen M.
Published: March 2019

Everybody in life wants to win. At its most basic, this must stem from the survival instinct: in a battle against predators, winning means survival; defeat means death. In a social context, however, obviously not everyonecanwin, and we have to learn to accommodate defeat, whether our own or that of others. Hence, in a competitive society, defeat presents a challenge. Usually, if an observer sympathizes with the defeated, there is an impulse to dress up the defeat in various guises; or, if the defeated party is scorned, the defeat is presented in the most humiliating terms possible. In a gladiatorial context, the attitudes of the observer, not to mention the gladiators themselves, are hard to recover. Recent work has focused on the ‘affective dispositions’ of the spectators, drawing analogies with modern combat sports. Yet, modern spectators do not have to decide whether the defeated party deserves to live or die, whereas, for a Roman spectator, defeat was to be calibrated on a scale of life and death. The ancient protagonists themselves will obviously share impulses with their modern equivalents, although, when the contest is potentially fatal, the drive to win must take on an urgency surpassing pure ambition. When a modern athlete dies on the sports field or in the boxing ring, it is an accident, however tragic, whereas a gladiator who lost a fight could suffer the penalty of losing his life as well. Defeat was in deadly earnest.
Latin Literature
Authors: Whitton Christopher
Published: March 2019

Nos ausi reserare… (‘We dare unbolt…’): a small but weighty beginning, with the new Loeb Ennius. It's nearly eighty years since E. H. Warmington finished his four-volume Remains of Old Latin (1935–40), combining the fragments of Ennius, Lucilius, Accius, and other pre-Sullan poetry in cheerful farrago with the Twelve Tables and a book of ‘archaic inscriptions’. The dry title notwithstanding, this was a flagship collection from a long-serving general editor of the Loeb Classical Library (1937–74): the scholarship was valiant, despite the slips so fully catalogued by unkinder reviewers, and the product has exerted wide influence as the go-to ‘accessible’ edition of so much important material – even if l'Année Philologique insists on calling its editor ‘Brian’ (his son: talk about tuer le père). Still, eighty years are a long time even in Classics, and an update could fairly be called overdue; happy news, then, that Harvard have commissioned Gesine Manuwald, another London professor, to oversee it. The new title is Fragmentary Republican Latin, more of a mouthful but a touch less downbeat; the remit is extended to include oratory and historiography; and the first instalment is a chunky Ennian diptych (one book for the Annals, one for the rest), jointly curated by Manuwald and Sander M. Goldberg.
Hylemorphism, rigid designators, and the disembodied ‘Jesus’: a call for clarification
Authors: TURNER JAMES T.
Published: March 2019

Many in the Christian tradition affirm two things: (1) that Jesus Christ descended to Hades/Limbus Patrum on Holy Saturday and (2) that the human nature of Jesus is a hylemorphic compound, the unity of a human soul and prime matter. I argue that (1) and (2) are incompatible; for the name ‘Jesus’, ‘Christ’, and ‘Jesus Christ’ rigidly designates a human being. But, given a certain view of hylemorphism, the human being, Jesus, ceased to exist in the time between his death and resurrection. So, Jesus did not descend to Hades/Limbus Patrum, even if God the Son did.
Effect of local topographic heterogeneity on tree species assembly in an Acacia-dominated African savanna
Authors: Mutuku Paul Musili , Kenfack David
Published: March 2019

Stand structure and tree species diversity patterns were examined plot-wide and among four topographically defined habitats (plateau, cliff, low plain and depressions) in a 120-ha permanent plot in an Acacia-dominated savanna in Mpala Ranch, central Kenya. The four habitats were defined by clustering the 3000 quadrats of 20 × 20 m in the plot based on their altitude, slope and convexity. Structural and floristic differences among the four habitats were examined and species-habitat associations were tested for the 30 most abundant species using torus translation randomization tests. The plot included 113 337 trees in 62 species with diameter at knee height ≥ 2 cm (18.4 species ha−1), 41 genera and 23 families. Fabaceae with the genus Acacia were the dominant family, followed by Euphorbiaceae and Ebenaceae. Tree density and basal area were twice as high on low plain and depressions than on the plateau. Species richness was highest in the cliff and was seven times higher than in the adjacent plateau. Half of the species assessed showed significant positive associations with one habitat and 21 showed significant negative associations with at least one habitat. The variation in stand structure and tree species diversity within the Mpala plot shows that topography is among the important drivers of local species distribution and hence the maintenance of tree diversity in savannas.
Habitat filtering of six coexistingHeliconiaspecies in a lowland tropical rain forest in Amazonian Ecuador
Authors: Tokarz Elizabeth L. , Álvia Pablo , Valencia Renato , Queenborough Simon A.
Published: March 2019

Herbaceous plants are often under-studied in tropical forests, despite their high density and diversity, and little is known about the factors that influence their distribution at microscales. In a 25-ha plot in lowland Amazonian rain forest in Yasuní National Park, Ecuador, we censused six species ofHeliconia(Heliconiaceae) in a stratified random manner across three topographic habitat types. We observed distribution patterns consistent with habitat filtering. Overall, more individuals occurred in the valley (N = 979) and slope (N = 847) compared with the ridge (N = 571) habitat. At the species level,Heliconia stricta(N = 1135),H.spathocircinata(N = 309) andH.ortotricha(N = 36) all had higher abundance in the valley and slope than ridge. Further,H. vellerigera(N = 20) was completely absent from the ridge. Conversely,H. velutina(N = 903) was most common in the drier ridge habitat. The two most common species (H.strictaandH.velutina) had a reciprocal or negative co-occurrence pattern and occurred preferentially in valley versus ridge habitats. These results suggest that taxa within this family have different adaptations to the wetter valley versus the drier ridge and that habitat partitioning contributes to coexistence.
Advanced Rietveld refinement and SEM analysis of tobermorite in chemically diverse autoclaved aerated concrete
Authors: Schreiner J. , Goetz-Neunhoeffer F. , Neubauer J. , Volkmann S. , Bergold S. , Webler R. , Jansen D.
Published: March 2019

Changes of structural properties of tobermorite in autoclaved aerated concrete (AAC) for various compositions were characterized and the disadvantages of SEM analysis in this context are discussed. The influence of variations in the chemical composition of raw materials on lattice parameters, morphology and domain sizes of tobermorite was investigated by XRD and for comparison by SEM analysis. Particularly the effect of substitution by Al3+ and (SO4)2− in tobermorite structure was examined. The dimensions of coherently scattering domains were calculated based on the refinement of anisotropic peak broadening of tobermorite in XRD diffractograms using a Rietveld compatible approach. No effect of (SO4)2− on the domain sizes and lattice parameters of tobermorite could be observed. The amount of anhydrite detected by quantitative XRD analysis indicates that all of the available (SO4)2− is present as anhydrite. Lath-like shapes of domains and a larger c parameter are calculated whenever Al3+ is incorporated in a considerable amount. Formation of katoite can be observed very clearly in SEM micrographs whenever the amount of available Al3+ exceeds a distinct value in the dry mix. The effect of Al3+ and (SO4)2− on tobermorite morphology could not be observed clearly by SEM analysis in AAC samples.
An apple a day: an outbreak of cryptosporidiosis in Norway associated with self-pressed apple juice
Authors: Robertson L. J. , Temesgen T. T. , Tysnes K. R. , Eikås J. E.
Published: March 2019

In the autumn of 2018, an outbreak of cryptosporidiosis affected adult employees from the same company in Western Norway. The organism wasCryptosporidium parvum, GP60 subtype IIaA14G1R1. All those infected had drunk from the same container of self-pressed apple juice. Incubation period (1 week) and clinical signs were similar among those infected, although some experienced a more prolonged duration of symptoms (up to 2–3 weeks) than others. The infections resulted after consumption from only one of 40 containers of juice and not from any of the other containers. It seems that althoughCryptosporidiumoocysts were detected in a sample from another container, the contamination did not affect the whole batch. This is perhaps indicative of a restricted contamination event, either from contaminated ground in the orchard, or during collection of the fruit, or during processing. Although outbreaks of food-borne cryptosporidiosis have previously been associated with consumption of contaminated apple juice, most of the more recent outbreaks of food-borne cryptosporidiosis have been associated with salad vegetables or herbs. This outbreak, the first outside USA reported to be associated with apple juice, is a timely reminder that such juice is a suitable transmission vehicle forCryptosporidiumoocysts, and that appropriate hygienic measures are essential in the production of such juice, including artisanal (non-commercial) production.
Quantification Challenges for Atom Probe Tomography of Hydrogen and Deuterium in Zircaloy-4
Authors: Mouton Isabelle , Breen Andrew J. , Wang Siyang , Chang Yanhong , Szczepaniak Agnieszka , Kontis Paraskevas , Stephenson Leigh T. , Raabe Dierk , Herbig M. , Britton T. Ben , Gault Baptiste
Published: March 2019

Analysis and understanding of the role of hydrogen in metals is a significant challenge for the future of materials science, and this is a clear objective of recent work in the atom probe tomography (APT) community. Isotopic marking by deuteration has often been proposed as the preferred route to enable quantification of hydrogen by APT. Zircaloy-4 was charged electrochemically with hydrogen and deuterium under the same conditions to form large hydrides and deuterides. Our results from a Zr hydride and a Zr deuteride highlight the challenges associated with accurate quantification of hydrogen and deuterium, in particular associated with the overlap of peaks at a low mass-to-charge ratio and of hydrogen/deuterium containing molecular ions. We discuss possible ways to ensure that appropriate information is extracted from APT analysis of hydrogen in zirconium alloy systems that are important for nuclear power applications.
Microstructural Characterization of Sulfurization Effects in Cu(In,Ga)Se2 Thin Film Solar Cells
Authors: Aboulfadl Hisham , Keller Jan , Larsen Jes , Thuvander Mattias , Riekehr Lars , Edoff Marika , Platzer-Björkman Charlotte
Published: March 2019

Surface sulfurization of Cu(In,Ga)Se2 (CIGSe) absorbers is a commonly applied technique to improve the conversion efficiency of the corresponding solar cells, via increasing the bandgap towards the heterojunction. However, the resulting device performance is understood to be highly dependent on the thermodynamic stability of the chalcogenide structure at the upper region of the absorber. The present investigation provides a high-resolution chemical analysis, using energy dispersive X-ray spectrometry and laser-pulsed atom probe tomography, to determine the sulfur incorporation and chemical re-distribution in the absorber material. The post-sulfurization treatment was performed by exposing the CIGSe surface to elemental sulfur vapor for 20 min at 500°C. Two distinct sulfur-rich phases were found at the surface of the absorber exhibiting a layered structure showing In-rich and Ga-rich zones, respectively. Furthermore, sulfur atoms were found to segregate at the absorber grain boundaries showing concentrations up to ~7 at% with traces of diffusion outwards into the grain interior.
LOGARITHMIC COEFFICIENTS PROBLEMS IN FAMILIES RELATED TO STARLIKE AND CONVEX FUNCTIONS
Authors: PONNUSAMY SAMINATHAN , SHARMA NAVNEET LAL , WIRTHS KARL-JOACHIM
Published: March 2019

Let${\mathcal{S}}$be the family of analytic and univalent functions$f$in the unit disk$\mathbb{D}$with the normalization$f(0)=f^{\prime }(0)-1=0$, and let$\unicode[STIX]{x1D6FE}_{n}(f)=\unicode[STIX]{x1D6FE}_{n}$denote the logarithmic coefficients of$f\in {\mathcal{S}}$. In this paper we study bounds for the logarithmic coefficients for certain subfamilies of univalent functions. Also, we consider the families${\mathcal{F}}(c)$and${\mathcal{G}}(c)$of functions$f\in {\mathcal{S}}$defined by$$\begin{eqnarray}\text{Re}\biggl(1+{\displaystyle \frac{zf^{\prime \prime }(z)}{f^{\prime }(z)}}\biggr)>1-{\displaystyle \frac{c}{2}}\quad \text{and}\quad \text{Re}\biggl(1+{\displaystyle \frac{zf^{\prime \prime }(z)}{f^{\prime }(z)}}\biggr)<1+{\displaystyle \frac{c}{2}},\quad z\in \mathbb{D},\end{eqnarray}$$for some$c\in (0,3]$and$c\in (0,1]$, respectively. We obtain the sharp upper bound for$|\unicode[STIX]{x1D6FE}_{n}|$when$n=1,2,3$and$f$belongs to the classes${\mathcal{F}}(c)$and${\mathcal{G}}(c)$, respectively. The paper concludes with the following two conjectures:

∙

If$f\in {\mathcal{F}}(-1/2)$, then$|\unicode[STIX]{x1D6FE}_{n}|\leq 1/n(1-(1/2^{n+1}))$for$n\geq 1$, and$$\begin{eqnarray}\mathop{\sum }_{n=1}^{\infty }|\unicode[STIX]{x1D6FE}_{n}|^{2}\leq {\displaystyle \frac{\unicode[STIX]{x1D70B}^{2}}{6}}+{\displaystyle \frac{1}{4}}~\text{Li}_{2}\biggl({\displaystyle \frac{1}{4}}\biggr)-\text{Li}_{2}\biggl({\displaystyle \frac{1}{2}}\biggr),\end{eqnarray}$$where$\text{Li}_{2}(x)$denotes the dilogarithm function.

∙

If$f\in {\mathcal{G}}(c)$, then$|\unicode[STIX]{x1D6FE}_{n}|\leq c/2n(n+1)$for$n\geq 1$.
Impact of the Presence of Embassies on Trade: Evidence from Turkey
Authors: Bagir Yusuf Kenan
Published: March 2019

This paper analyzes the impact of the presence of foreign missions on trade using Turkey's unique expansion in its foreign embassy network (39 new embassies in 8 years) as the source of variation in a panel data setting. A majority of the existing empirical studies use cross-sectional bilateral trade data due to lack of variation over time (Rose, 2007; Moons and Bergeijk, 2013). Employing a panel data analysis, this paper is able to address the endogeneity issues that are associated with a standard cross-sectional analysis. The dependent variable in the paper is the trade between Turkey and 190 countries for 2006 to 2016. The results indicate that presence of an embassy increases export value by 30% and this increase comes mainly from the volume effect. Categorizing goods by the Rauch (1999) classification shows that the increase in differentiated goods exports is the main driver of the export surge. The number of exporting firms increases by about 8%. There is no statistically significant impact on the exports of homogeneous goods. Replication of the analysis for imports suggests no impact on imports.
Resistance to very-long-chain fatty-acid (VLCFA)-inhibiting herbicides in multiple field-selected rigid ryegrass (Lolium rigidum) populations
Authors: Brunton David J. , Boutsalis Peter , Gill Gurjeet , Preston Christopher
Published: March 2019

Five populations of rigid ryegrass (Lolium rigidumGaudin) from fields across cropping regions in southern Australia were suspected of having resistance to thiocarbamates, chloroacetamides, and sulfonylisoxazoline herbicides. Resistant (R) populations 375-14, 198-15, 16.2, EP162, RAC1, and A18 and two susceptible (S) populations (SLR4 and VLR1) were included in a dose–response study. All suspected R populations expressed resistance to one or all herbicides (thiocarbamates, chloroacetamides, and pyroxasulfone). Population 198-15 exhibited the highest LD50to triallate (44.7-fold), prosulfocarb (45.7-fold),S-metolachlor (31.5-fold), and metazachlor (27.2-fold) compared with the S populations. Populations 198-15 and 375-14 were also resistant to pyroxasulfone (13.5- and 14.9-fold) compared with the S populations, as was population EP162. This study documents the first case of field-evolved resistance to thiocarbamate, chloroacetamide, and sulfonylisoxazoline herbicides inL. rigidum.
No association of 25-hydroxyvitamin D and parathormone levels with glucose homeostasis in type 2 diabetes – a study from Shillong, Meghalaya
Authors: Bora Kaustubh , Ruram Alice Abraham
Published: March 2019

Abstract. Background: Although inadequate vitamin D and altered parathyroid hormone (PTH) are implicated in deranged glucose metabolism and risk of future diabetes, their role in regulating glucose homeostasis in established cases of diabetes is unclear. We aimed to (i) evaluate vitamin D status, and (ii) determine if vitamin D and PTH were associated with parameters of glucose homeostasis in type 2 diabetes (T2D) patients from Meghalaya, India. Methods: We determined 25-hydroxyvitamin D (25-OH-D) and PTH concentrations in 251 T2D patients (not on insulin), and examined their associations with the following parameters of glucose homeostasis: fasting blood sugar (FBS), post-prandial blood sugar (PPBS), glycated hemoglobin (HbA1c), fasting insulin (FI), homeostasis model assessments of insulin resistance (HOMA-IR) and β-cell function (HOMA-β). Results: None of the patients had adequate vitamin D (mean 25-OH-D = 19.3 ng/mL); 47.8% patients were deficient (25-OH-D < 20 ng/mL), while 52.2% were insufficient (25-OH-D < 30 ng/mL) vitamin D. Significant ( P < 0.05) univariate associations were observed between: 25-OH-D and FI ( r = 0.14); 25-OH-D and HOMA-β ( r = 0.13); PTH and FI ( r = −0.18), and PTH and HOMA-β ( r = −0.11). However these associations disappeared after controlling for potential confounders. The 25-OH-D and PTH levels were not associated with any of the tested parameters of glucose homeostasis. Conclusion: There was widespread prevalence of vitamin D deficiency/insufficiency in our sample T2D patients. However, neither vitamin D nor PTH appeared to play a major role in influencing glucose homeostasis in this present selection of T2D cases.
Cluster‐Based Evaluation of Model Compensating Errors: A Case Study of Cloud Radiative Effect in the Southern Ocean
Authors: Schuddeboom Alex , Varma Vidya , McDonald Adrian J. , Morgenstern Olaf , Harvey Mike , Parsons Simon , Field Paul , Furtado Kalli
Published: March 2019

Model evaluation is difficult and generally relies on analysis that can mask compensating errors. This paper defines new metrics, using clusters generated from a machine learning algorithm, to estimate mean and compensating errors in different model runs. As a test case, we investigate the Southern Ocean shortwave radiative bias using clusters derived by applying self‐organizing maps to satellite data. In particular, the effects of changing cloud phase parameterizations in the MetOffice Unified Model are examined. Differences in cluster properties show that the regional radiative biases are substantially different than the global bias, with two distinct regions identified within the Southern Ocean, each with a different signed bias. Changing cloud phase parameterizations can reduce errors at higher latitudes but increase errors at lower latitudes of the Southern Ocean. Ranking the parameterizations often shows a contrast in mean and compensating errors, notably in all cases large compensating errors remain.
Quantification of Energetic Electron Precipitation Driven by Plume Whistler Mode Waves, Plasmaspheric Hiss, and Exohiss
Authors: Li W. , Shen X.‐C. , Ma Q. , Capannolo L. , Shi R. , Redmon R. J. , Rodriguez J. V. , Reeves G. D. , Kletzing C. A. , Kurth W. S. , Hospodarsky G. B.
Published: March 2019

Whistler mode waves are important for precipitating energetic electrons into Earth's upper atmosphere, while the quantitative effect of each type of whistler mode wave on electron precipitation is not well understood. In this letter, we evaluate energetic electron precipitation driven by three types of whistler mode waves: plume whistler mode waves, plasmaspheric hiss, and exohiss observed outside the plasmapause. By quantitatively analyzing three conjunction events between Van Allen Probes and POES/MetOp satellites, together with quasi‐linear calculation, we found that plume whistler mode waves are most effective in pitch angle scattering loss, particularly for the electrons from tens to hundreds of keV. Our new finding provides the first direct evidence of effective pitch angle scattering driven by plume whistler mode waves and is critical for understanding energetic electron loss process in the inner magnetosphere. We suggest the effect of plume whistler mode waves be accurately incorporated into future radiation belt modeling.
Impacts of Tropical Indian and Atlantic Ocean Warming on the Occurrence of the 2017/2018 La Niña
Authors: Zhang Chao , Luo Jing‐Jia , Li Shuanglin
Published: March 2019

The occurrence of the 2017/2018 La Niña, following a weak‐to‐neutral La Niña in boreal winter 2016/2017, was surprising. Based on observational records and multiple linear regression analysis for the Pacific zonal wind tendency (dU/dt), this study investigates possible reasons why the La Niña condition suddenly happened in late 2017. Similar to previous four double‐peaked La Niña events (1983–1985, 1998–2000, 2007–2009, and 2010–2012), we find that the multiyearly persistent easterly anomaly in the central equatorial Pacific is a key condition to the development of the second La Niña. The occurrence of the 2017/2018 La Niña results from large warm sea surface temperature (SST) anomalies in the tropical Indian and Atlantic Oceans that act to force the persistent easterly anomaly in the Pacific via modifying the Walker Circulations. About 24% of the variance of the Pacific dU/dt can be statistically explained by the tropical Indian Ocean and Atlantic SST anomalies.
Submarine Moraines in Southeast Greenland Fjords Reveal Contrasting Outlet‐Glacier Behavior since the Last Glacial Maximum
Authors: Batchelor C. L. , Dowdeswell J. A. , Rignot E. , Millan R.
Published: March 2019

Knowledge of the past behavior of the outlet glaciers of Southeast (SE) Greenland is necessary to understand and model spatial differences in the response of the Greenland Ice Sheet (GIS) to climatic changes. Here we use bathymetric data to map the distribution of more than 50 major moraines in SE Greenland fjords. Inner‐fjord moraines are widespread along the SE Greenland margin, occurring in 65% of the surveyed fjords. We identify, for the first time, nine midfjord moraines that span the approximately 150‐km‐long eastern margin of the Julianehåb Ice Cap. In contrast, midfjord moraines are generally absent from the deeper and wider fjords of the SE GIS. The variable distribution of midfjord moraines along the SE Greenland margin reveals contrasting behavior of the SE GIS and the eastern Julianehåb Ice Cap during the last deglaciation, which probably reflects differences in fjord geometry and exposure to ocean heat.
eSCCIP: A Psychosocial eHealth Intervention for Parents of Children With Cancer
Authors: Canter Kimberly S. , Deatrick Janet A. , Hilgart Michelle M. , Myers Jeffrey , Vega Gabriela , Ritterband Lee M. , Kazak Anne E.
Published: March 2019

Objective: eHealth interventions may facilitate the dissemination of evidence-based psychosocial interventions to families of children with chronic illnesses, including cancer. This article describes a 4-phase, mixed-methods, user-centered approach to the design and evaluation of a novel psychosocial intervention for parents of children with cancer (Electronic Surviving Cancer Competently Intervention Program [eSCCIP]), adapted from an in-person intervention (Surviving Cancer Competently Intervention Program). Method: Development of eSCCIP involved a multidisciplinary design team of content and eHealth experts. Iterative Think Aloud testing and beta testing with parents of children with cancer was also completed. Results: An intensive, user-centered development and evaluation process was utilized to develop an eHealth intervention for parents of children with cancer. Initial testers rated eSCCIP favorably on questionnaires evaluating user experience and perceptions, and provided positive feedback and suggestions for additional improvement through qualitative interviews. Conclusions: Initial results suggest that eSCCIP may be an acceptable, feasible, and usable intervention for parents of children with cancer. eSCCIP is now ready for a larger pilot evaluation of usability, feasibility, and impact on target outcomes, including the reduction of anxiety and posttraumatic stress syndrome (PTSS) and improvements in family functioning.

Implications for Impact Statement

eHealth interventions have great promise in delivering needed psychosocial support to parents and caregivers of children with cancer. This article describes the development of eSCCIP, an eHealth adaptation of an in-person intervention. Think Aloud methods and beta testing of eSCCIP indicate that this eHealth intervention may be an acceptable option for delivery of psychosocial care to parents of children with cancer.
Feasibility and Acceptability of an Online Problem-Solving Therapy Intervention for Adolescent and Young Adult Brain Tumor Survivors
Authors: Moscato Emily L. , Miley Aimee E. , LeBlond Elizabeth I. , King Jessica A. , Raj Stacey P. , Narad Megan E. , Platt Amber , Thompson Aimee N. , Baum Katherine T. , Salloum Ralph , Wade Shari L.
Published: March 2019

Objective: To describe the preliminary feasibility and acceptability of a web-based, problem-solving intervention for adolescent and young adult pediatric brain tumor survivors. Methods: With feedback from survivors and stakeholders, we created “A Survivor’s Journey” by modifying an existing problem-solving intervention for traumatic brain injury. Survivors (ages 13–25) were recruited from a pediatric survivorship clinic and were eligible if they had self or caregiver-reported psychosocial difficulties. A Survivor’s Journey has four core sessions (i.e., introduction, problem-solving, positive thinking, memory) and up to seven supplemental sessions. Each session involved web content and videoconferencing with a doctoral-level therapist. We analyzed postintervention data related to feasibility (i.e., enrollment and completion rates), as well as survivor’s ratings of satisfaction and usability of the intervention. Results: Nineteen survivors ( M age = 17.57), half of eligible participants, agreed to participate, and 95% of those enrolled completed at least the core sessions. Overall, survivors rated the intervention favorably on usability and satisfaction. Survivors who had borderline to impaired IQ or who were treated with cranial radiation reported higher satisfaction, suggesting that the intervention is appealing even for high-risk groups. Conclusions: Online problem-solving therapy could be a promising therapeutic approach for survivors of pediatric brain tumor, given the relatively high satisfaction and usability ratings. However, improving enrollment and examining treatment efficacy should be addressed in future work.

Implications for Impact Statement

Survivors of pediatric brain tumor may have late effects from their cancer and its treatment including difficulties with learning, anxiety, or depression. Results from our pilot study suggest that a problem-solving intervention delivered online is both feasible and acceptable to adolescent and young adult survivors. Providing psychosocial services online may be a promising avenue for accessible, evidence-based care for this population.
Iterative Development of a Tailored mHealth Intervention for Adolescent and Young Adult Survivors of Childhood Cancer
Authors: Schwartz Lisa A. , Psihogios Alexandra M. , Henry-Moss Dare , Daniel Lauren C. , Ver Hoeve Elizabeth S. , Velazquez-Martin Blanca , Butler Eliana , Hobbie Wendy L. , Buchanan Lunsford Natasha , Sabatino Susan A. , Barakat Lamia P. , Ginsberg Jill P. , Fleisher Linda , Deatrick Janet A. , Jacobs Linda A. , O’Hagan Bridget , Anderson Lindsay , Fredericks Emily , Amaral Sandra , Dowshen Nadia , Houston Keisha , Vachani Carolyn , Hampshire Margaret K. , Metz James M. , Hill-Kayser Christine E. , Szalda Dava
Published: March 2019

Objective: Methods for developing mobile health (mHealth) interventions are not well described. To guide the development of future mHealth interventions, we describe the application of the agile science framework to iteratively develop an mHealth intervention for adolescent and young adult (AYA) survivors of childhood cancer. Method: We created the AYA STEPS mobile app (AYA Self-management via Texting, Education, and Plans for Survivorship) by modifying and integrating 2 existing programs: an online survivorship care plan (SCP) generator and a text messaging self-management intervention for AYA off treatment. The iterative development process involved 3 stages of agile science: (1) formative work, (2) obtaining feedback about the first AYA STEPS prototype, and (3) pilot testing and finalization of a prototype. We determined preferences of AYA stakeholders as well as discovered and addressed technology problems prior to beginning a subsequent randomized controlled trial. Results: AYA survivors reported that the app and the embedded tailored messages related to their health and SCP were easy to use and generally satisfying and beneficial. Usage data supported that AYA were engaged in the app. Technology glitches were discovered in the pilot and addressed. Conclusion: The iterative development of AYA STEPS was essential for creating a consistent and acceptable end user experience. This study serves as one example of how behavioral scientists may apply agile science to their own mHealth research.

Implications for Impact Statement

This study describes the development of a new mHealth intervention for a vulnerable population with unmet needs—AYA childhood cancer survivors—in three iterative stages informed by an agile science framework. The methods are generalizable to future mHealth intervention development in pediatric psychology.
Online Cognitive-Behavioral Group Intervention for Adolescents With Chronic Illness: A Pilot Study
Authors: Douma Miriam , Joosten Mala M. H. , Scholten Linde , Maurice-Stam Heleen , Grootenhuis Martha A.
Published: March 2019

Objective: To assess feasibility and explore preliminary effectiveness of an online cognitive-behavioral group intervention (Op Koers Online) to prevent and/or reduce psychosocial problems by teaching use of active coping skills to adolescents (ages 12 to 18) with chronic illness. Method: Adolescents who signed up for the chat intervention were asked to complete online questionnaires at baseline and postintervention (after 8 weeks). Feasibility was evaluated based on attendance (missed sessions, dropout rate and homework completion), technological issues and with an evaluation questionnaire. Preliminary effectiveness was evaluated with standardized questionnaires: Op Koers Online Questionnaire (disease-related coping skills), Youth Self-Report (emotional and behavioral functioning), Pediatric Quality of Life Inventory (Health-Related Quality of Life [HRQoL]). Mean scale scores postintervention were compared with baseline with paired-samples t tests. Effect sizes were calculated. Results: In total, 33 adolescents participated in the intervention, 29 adolescents completed the questionnaires at baseline. Regarding postintervention questionnaires, 25 adolescents completed the evaluation questionnaires and 23 adolescents completed all questionnaires postintervention. Dropout rate was 6%. In 1 session (2%), there were technological issues that caused the session to stop. Participants’ overall satisfaction was high. Regarding effectiveness, participants improved significantly in the use of total coping skills and the coping skills “information seeking and giving” and “social competence” after the intervention compared with baseline. Participants also reported significantly fewer withdrawn/depressed behavior and scored significantly better on emotional and psychosocial HRQoL after following the intervention. Conclusions: This pilot study indicates that Op Koers Online is feasible and potentially effective. Further research (a randomized controlled trial) is needed to establish the effects of the intervention.

Implications for Impact Statement

This study evaluates the feasibility and preliminary effectiveness of a new and unique Internet-delivered intervention for adolescents with chronic illness: Op Koers Online. The findings indicate that this intervention is feasible (based on good attendance, limited technological issues and positive overall evaluation of the intervention) and show preliminary effectiveness (based on improvements in disease-related coping skills and psychosocial functioning). In conclusion: Op Koers Online is a promising intervention. Our findings emphasize the growing evidence for Internet-based interventions and their suitability for adolescents. The importance of teaching adolescents how to use active coping skills with cognitive-behavioral therapy techniques is also highlighted.
Stretchable, self-healing, transient macromolecular elastomeric gel for wearable electronics
Authors: Hao Mingming , Li Lianhui , Wang Shuqi , Sun Fuqin , Bai Yuanyuan , Cao Zhiguang , Qu Chunyan , Zhang Ting
Published: March 2019

Flexible and stretchable electronics are emerging in mainstream technologies and represent promising directions for future lifestyles. Multifunctional stretchable materials with a self-healing ability to resist mechanical damage are highly desirable but remain challenging to create. Here, we report a stretchable macromolecular elastomeric gel with the unique abilities of not only self-healing but also transient properties at room temperature. By inserting small molecule glycerol into hydroxyethylcellulose (HEC), forming a glycerol/hydroxyethylcellulose (GHEC) macromolecular elastomeric gel, dynamic hydrogen bonds occur between the HEC chain and the guest small glycerol molecules, which endows the GHEC with an excellent stretchability (304%) and a self-healing ability under ambient conditions. Additionally, the GHEC elastomeric gel is completely water-soluble, and its degradation rate can be tuned by adjusting the HEC molecular weight and the ratio of the HEC to glycerol. We demonstrate several flexible and stretchable electronics devices, such as self-healing conductors, transient transistors, and electronic skins for robots based on the GHEC elastomeric gel to illustrate its multiple functions.
A microfluidic platform for continuous monitoring of dopamine homeostasis in dopaminergic cells
Authors: Yu Yue , de Campos Richard P. S. , Hong Seolim , Krastev Dimitar L. , Sadanand Siddharth , Leung Yen , Wheeler Aaron R.
Published: March 2019

Homeostasis of dopamine, a classical neurotransmitter, is a key indicator of neuronal health. Dysfunction in the regulation of dopamine is implicated in a long list of neurological disorders, including addiction, depression, and neurodegeneration. The existing methods used to evaluate dopamine homeostasis in vitro are inconvenient and do not allow for continuous non-destructive measurement. In response to this challenge, we introduce an integrated microfluidic system that combines dopaminergic cell culture and differentiation with electroanalytical measurements of extracellular dopamine in real-time at any point during an assay. We used the system to examine the behavior of differentiated SH-SY5Y cells upon exposure to four dopamine transporter ant/agonists (cocaine, ketamine, epigallocatechin gallate, and amphetamine) and study their pharmacokinetics. The IC50 values of cocaine, ketamine, and epigallocatechin gallate were determined to be (average ± standard deviation) 3.7 ± 1.1 µM, 51.4 ± 17.9 µM, and 2.6 ± 0.8 µM, respectively. Furthermore, we used the new system to study amphetamine-mediated dopamine release to probe the related phenomena of dopamine transporter-mediated reverse-transport and dopamine release from vesicles. We propose that this platform, which is the first platform to simultaneously evaluate uptake and release, could be useful to screen for drugs and other agents that target dopaminergic neurons and the function of the dopamine transporter. More broadly, this platform should be adaptable for any application that could benefit from high-temporal resolution electroanalysis combined with multi-day cell culture using small numbers of cells.