bluuebunny/crossref_metadata_2025 huggingface dataset:
Programmed His Bundle Pacing
Authors: Jastrzębski Marek , Moskal Paweł , Bednarek Agnieszka , Kiełbasa Grzegorz , Vijayaraman Pugazhendhi , Czarnecka Danuta
Published: February 2019

Background:

During permanent nonselective His bundle (ns-HB) pacing, it is crucial to confirm HB capture/exclude that only right ventricle (RV) myocardial septal pacing is present. Because the effective refractory period (ERP) of the working myocardium is different than the ERP of the HB, we hypothesized that it should be possible to differentiate ns-HB capture from RV myocardial capture using programmed extrastimulus technique.

Methods:

In consecutive patients during HB pacemaker implantation, programmed HB pacing was delivered from the screwed-in HB pacing lead. Premature beats were introduced at 10-ms steps during intrinsic rhythm and also after a drive train of 600 ms. The longest coupling interval that resulted in an abrupt change of QRS morphology was considered equal to ERP of HB or RV myocardium.

Results:

Programmed HB pacing was performed from 50 different sites in 32 patients. In 34 of 36 cases of ns-HB pacing, the RV myocardial ERP was shorter than HB ERP (271.8±38 versus 353.0±30 ms;
P
<0.0001). Programmed HB pacing using a drive train resulted in a typical abrupt change of paced QRS morphology: from ns-HB to RV myocardial QRS (34 of 36 cases) or to selective HB QRS (2 of 36 cases). Programmed HB pacing delivered during native conduction resulted in obtaining selective HB QRS in 20 of 34 and RV myocardial QRS in 14 of 34 of the ns-HB cases. In RV myocardial–only pacing cases (false ns-HB pacing, n=14), such responses were not observed—the QRS morphology remained stable. Therefore, the programmed HB pacing correctly diagnosed all ns-HB cases and all RV myocardial pacing cases.

Conclusions:

A novel maneuver for the diagnosis of HB capture, based on the differences in ERP between HB and myocardium, was formulated, assessed, and found as diagnostically valuable. This method is unique in enabling to visualize selective HB QRS in patients with otherwise obligatory ns-HB pacing (RV myocardial capture threshold <HB capture threshold).
Simplified Echocardiography Screening Criteria for Diagnosing and Predicting Progression of Latent Rheumatic Heart Disease
Authors: Nunes Maria Carmo P. , Sable Craig , Nascimento Bruno R. , Lima Emilly Malveira de , da Silva Jose Luiz Padilha , Diamantino Adriana C. , Oliveira Kaciane K.B. , Okello Emmy , Aliku Twalib , Lwabi Peter , Colosimo Enrico Antonio , Ribeiro Antonio Luiz P. , Beaton Andrea Z.
Published: February 2019

Background:

The 2012 World Heart Federation Criteria are the current gold standard for the diagnosis of latent rheumatic heart disease (RHD). Because data and experience using these criteria have grown, there is opportunity to simplify and develop outcome prediction tools. We aimed to develop a simple echocardiographic score applicable for RHD screening with potential to predict disease progression.

Methods:

This study included 3 cohorts used for score derivation (n=9501), score validation (n=7312), and assessment of outcomes prediction (n=227). In the derivation cohort, variables independently associated with definite RHD were assigned point values proportional to their regression coefficients. The sum of these values was stratified into low (0–6), intermediate (7–9), and high (≥10) risk.

Results:

Five components were selected for score development, including mitral valve anterior leaflet thickening, excessive leaflet tip motion, and regurgitation jet length ≥2 cm, and aortic valve focal thickening and any regurgitation. The score showed optimal discrimination and calibration for RHD diagnosis in the derivation and validation cohorts (C statistic, 0.998 and 0.994, respectively), with good discrimination for predicting disease progression (C statistic, 0.811). Progression-free survival rate in the low-risk children at 1-, 2-, and 3-year follow-up was 100%, 100%, and 93%, respectively, compared with 90%, 60%, and 47% in high-risk group. The point-based score was strongly associated with disease progression (hazard ratio, 1.270; 95% CI, 1.188–1.358;
P
<0.001).

Conclusions:

This simplified score, based on components of the World Heart Federation criteria, is highly accurate to recognize definite RHD and provides the first tool for risk stratification, assigning children with latent RHD to low, intermediate, or high risk based on echocardiographic features at diagnosis.
Highland biodiversity of Fanniidae (Insecta, Diptera): fourteen new species from the Andes and Central America
Authors: GRISALES DIANA , DE CARVALHO CLAUDIO J. B.
Published: February 2019

In the neotropics, vegetation formations at high elevations are often unique, with their own characteristic vegetation because of unique and complex evolutionary histories. The complexity of the biogeographic and ecological structure of the fauna is demonstrated by the specialized fauna and flora occurring in these regions. Fanniidae (Diptera) is one of these specialized groups that became very diversified in the highlands. Currently, of the 91 species of Fanniidae in the Neotropical region, 43 (8 Euryomma, 35 Fannia) occur exclusively in Andean and Central American highlands. Here, we increase that highland diversity by describing 14 new species from 1000–4150 m.a.s.l. in the Andes and Central America: Fannia awa sp. nov., F. bari sp. nov., F. boruca sp. nov., F. bribri sp. nov., F. huetare sp. nov., F. humahuaca sp. nov., F. kabekwa sp. nov., F. palta sp. nov., F. polleti sp. nov., F. quillacingas sp. nov., F. teribi sp. nov., F. terraba sp. nov., F. tsachilas sp. nov. and F. yukpa sp. nov. We also provide an identification key for male specimens and diagnoses and descriptions of the species, along with photographs and illustrations of the male terminalia. New records and updated distributions are also provided for the Andean species.
Observations of Thermally Driven Circulations in the Pyrenees: Comparison of Detection Methods and Impact on Atmospheric Composition Measured at a Mountaintop
Authors: Hulin M. , Gheusi F. , Lothon M. , Pont V. , Lohou F. , Ramonet M. , Delmotte M. , Derrien S. , Athier G. , Meyerfeld Y. , Bezombes Y. , Augustin P. , Ravetta F.
Published: February 2019

The atmospheric composition measured at the Pic du Midi high-altitude observatory (2875 m MSL) in the French Pyrenees is frequently affected by upward transport of boundary layer air during anabatic circulations at different scales. The Pyrenean Platform for Observation of the Atmosphere (P2OA) includes two observatories located 28 km apart: at the Pic du Midi and at a low-altitude site (580 m MSL) located in the plain north of the mountain chain. From a 10-yr-long data series collected at P2OA, three different methods are used to detect thermally induced circulations. The methods are based on observations collected independently at three key locations in the plain–mountain circulation cell: within the altitude return flow above the plain, close to the surface in the plain, and at the mountaintop. The main aims are 1) to present and compare the three detection methods and 2) to evaluate the impact of thermally driven circulations on in situ air composition measurements at the Pic du Midi. The first method uses radar wind measurements at 3000 and 5000 m above the plain to detect the return flow of the plain–mountain circulation. The second, which is based on surface wind data from the plain site, reveals days during which surface thermally induced winds occur locally. The third method, which is based on surface data at the mountaintop, focuses on diurnal moisture cycles to rank days with decreasing anabatic influence. We then compare the three independent detection methods, discuss possible connections among thermal circulations at different scales and locations, and present an evaluation of their impact on in situ atmospheric composition measurements at Pic du Midi.
The Winter Concurrent Meridional Shift of the East Asian Jet Streams and the Associated Thermal Conditions
Authors: Zhang Yazhou , Yan Peiwen , Liao Zhijie , Huang Danqing , Zhang Yaocun
Published: February 2019

In this study, the concurrent meridional shift of the East Asian polar-front jet (EAPJ) and the East Asian subtropical jet (EASJ) and the associated thermal conditions have been investigated. The concurrent meridional shift is dominantly characterized by an out-of-phase shift of the two jets, as an equatorward shift of the EAPJ and a poleward shift of the EASJ, and vice versa. This shift is linked with the dipole surface air temperature (SAT) anomaly over the Eurasian continent and a La Niña–like sea surface temperature (SST) anomaly. Associated with the dipole SAT anomaly, the meridional temperature gradient (MTG) anomaly exhibits a tripole pattern from low to high latitudes over the Eurasian continent, as well as an enhanced maximum eddy growth rate and an anomalous divergence of Eliassen–Palm flux (E-P flux) over the regions between the EAPJ and EASJ. Additionally, the synoptic-scale transient eddy activities (STEA) significantly decrease over the high latitudes and enhance between the EAPJ and EASJ. All the anomalies would benefit the equatorward and poleward shift of the EAPJ and EASJ, respectively. The MTG, E-P flux and STEA anomalies are also indicated in that associated with the Niña-like SST anomaly. Particularly, the variations are evident in low latitudes. The pathway of the stationary Rossby wave activity flux anomalies shows an eastward Rossby wave packet propagation along the southern portion of the EAPJ is associated with the SAT anomaly and that along the northern portion of the EASJ is associated with the SST anomaly. The relative contributions of the two thermal conditions have emphasized the role of the dipole SAT anomaly, based on multilinear regression.
Migration Incorporation Regimes and Institutionalized Forms of Solidarity: Between Unconditional Institutional Solidarity and Welfare Chauvinism
Authors: Fernández G. G. Eva
Published: February 2019

Despite compelling literature, research has so far failed to provide substantive empirical evidence on the relationship between individual preferences on the inclusion of immigrants into institutionalized forms of solidarity and migration incorporation regimes. I argue that, apart from individual factors and welfare state generosity, citizenship models shape citizen’s attitudes on immigrant social rights. Concretely, I examine the effect of the civic and cultural dimensions of the models of citizenship relative to attitudes of unconditional institutional solidarity toward immigrants and welfare chauvinism. The results show that individual attitudes about welfare eligibility of migrants differ among sociodemographic characteristics, political economic orientations, and social depositions of deservingness but at the same time yield from the cultural barriers to the access of immigrants to the political community.
Vein Versus Prosthetic Graft for Femoropopliteal Bypass Above the Knee: A Systematic Review and Meta-Analysis of Randomized Controlled Trials
Authors: Sharrock Martin , Antoniou Stavros A. , Antoniou George A.
Published: February 2019

Conflicting evidence exists surrounding which conduit material is preferable in above-knee femoropopliteal bypass surgery. We performed a systemic review of electronic information sources to identify randomized controlled trials (RCTs) comparing vein versus prosthetic grafts in above-knee femoropopliteal bypasses. Eight RCTs reporting 1271 grafts (608 saphenous vein and 663 prosthetic) in 1132 patients were included. At 5 years, the vein group had significantly higher primary patency (odds ratio [OR]: 1.73, 95% confidence interval [CI]: 1.17-2.55, P = 0.006), primary assisted patency (OR: 4.02, 95% CI: 2.84-5.70, P < 0.0001), and secondary patency (OR: 1.83, 95% CI: 1.20-2.80, P = 0.005) rates compared with the prosthetic group. The vein group required significantly fewer reinterventions (OR: 0.33, 95% CI: 0.18-0.60, P = 0.0003). There was no significant difference in 30-day mortality (risk difference: −0.01, 95% CI: −0.02 to 0.01, P = 0.34), 30-day morbidity (OR: 1.58, 95% CI: 0.61-4.06, P = 0.35), major amputation (OR: 0.71, 95% CI: 0.43-1.18, P = 0.19), or overall survival (OR: 0.95, 95% CI: 0.70-1.30, P = 0.76) when comparing vein versus prosthetic grafts. Our analysis supports the use of the saphenous vein in above-knee femoropopliteal bypass grafting owing to its superiority in primary, primary assisted, and secondary patency rates and less need for reintervention when compared with prosthetic grafts.
Dual-energy X-ray computed tomography for void detection in fiber-reinforced composites
Authors: Suzuki Yasuhito , Cousins Dylan S , Dorgan John R , Stebner Aaron P , Kappes Branden B
Published: February 2019

Void detection in fiber-reinforced composites traditionally relies on precise density measurements before and after the physical removal of the polymer matrix; consequently, this method only provides data on the total volume of voids within the material without information about void sizes, shapes, and distributions. Despite advances in X-ray computed tomography, it is still challenging to quantitatively and convincingly characterize void content due to the complex X-ray physics of divergent, broad-spectrum laboratory X-ray sources. Here, we demonstrate that by using aligned high-energy and low-energy X-rays, dual-energy X-ray computed tomography provides high-quality images and phase-based segmentation that allows for clear distinction between air, polymer matrix, and reinforcing fibers. We verify the method on several fiber-reinforced composite samples: epoxy-glass fiber composites fabricated by vacuum-assisted resin transfer molding and by light resin transfer molding (light resin transfer molding), and a carbon fiber composite fabricated via vacuum-assisted resin transfer molding.
Black Women’s Struggles against Extractivism, Land Dispossession, and Marginalization in Colombia
Authors: Hernández Reyes Castriela Esther
Published: February 2019

The neocolonial turn toward extractivism intensifies the use of violence while fostering land dispossession, racism, and militarization of social life. Afro-Colombian women resist this process by using their subjectivities politically, strategically, discursively, and textually. An examination through the lens of black/decolonial feminism of the first national Mobilization for the Care of Life and Ancestral Territories, led by 40 black women from the Department of Cauca in 2014, shows that black women’s emotions and collective affections were driving forces that exhibited both their exclusions and their resistance. These feelings may be seen as catalysts through which their lived experiences are expressed and performed in the material world. Examination of this event suggests that a more radical analysis of black women’s historicity, subjectivities, and struggles is needed to better capture and understand experience-based epistemologies that challenge hegemonic forms of knowledge production.

El giro neocolonial hacia el extractivismo intensifica el uso de la violencia al tiempo que fomenta el despojo de tierras, el racismo y la militarización de la vida social. Las mujeres afrocolombianas se resisten a este proceso utilizando sus subjetividades políticas, estratégica, discursiva y textualmente. Un examen a través del feminismo negro/decolonial de la primera movilización nacional por el Cuidado de la Vida y los Territorios Ancestrales, liderada por 40 mujeres negras del Departamento del Cauca en 2014, revele que las emociones y los afectos colectivos de las mujeres negras fueron fuerzas impulsoras que exibian tanto sus exclusiones como sus formas de resistencia. Estos sentimientos pueden verse como catalizadores a través de los cuales sus experiencias vividas se expresan y realizan en el mundo material. El examen de este evento sugiere que se necesita un análisis más radical de la historicidad, las subjetividades y las luchas de las mujeres afrodescendientes para captar y comprender mejor las epistemologías basadas en la experiencia que desafían las formas hegemónicas de producción de conocimiento.
Copenhagen’s “Return to the Inner City” 1990-2010
Authors: Urban Florian
Published: February 2019

This article will present Copenhagen’s tortuous path from industrial decline to regeneration city, centering on the rebuilding of large waterfront areas in the Copenhagen Harbor such as Islands Brygge, Sluseholmen, and Frihavn, as well as on select developments in the central neighborhoods Nørrebro, Vesterbro, and Christianshavn. Focusing on architecture, it will show that Copenhagen’s “return to the inner city” was guided by the mutual influence of discourse, policy, and architectural design. This is evidenced by government documents and press clippings. The article will also show that in contrast to regeneration projects elsewhere, Copenhagen’s redevelopment yielded a comparatively socially mixed city with appealing public spaces and inventive architecture. This was facilitated by strong public authorities and by local and national politicians who upheld welfare state values and only to a small extent gave in to the market-oriented ideologies that influenced policy in other European countries at the time.
Design, modeling, and control of a horizontal magnetic micromanipulator
Authors: Ablay Günyaz , Böyük Mustafa , İçöz Kutay
Published: February 2019

Magnetic micromanipulators with a wide range of force generating capabilities are able to manipulate micron size particles for various applications and measurements. These magnetic particles can be coated with receptors to specifically bind to target biomolecules. In this work, a horizontal magnetic micromanipulator is designed, modeled and controlled for single micron size magnetic particle manipulations. A method is presented for dynamic modeling of magnetic micromanipulators. A feedback control method is designed that allows direct linearization of the system. It is shown that the proposed controller guarantees the stability of the closed-loop system, and yields zero steady-state error in a wide range of operation conditions. We show that the micromanipulator is able to generate a wide range of piconewton (pN) scale forces on a superparamagnetic particle for single molecule separation, and biosensor developments.
Robust fault estimation in the finite-frequency domain for multi-agent systems
Authors: Han Weixin , Wang Zhenhua , Shen Yi , Xie Wenbo
Published: February 2019

In this paper, a distributed fault estimation observer (DFEO) is designed for multi-agent systems in the finite-frequency domain. The DFEO consists of a network of local fault estimation observers corresponding to each agent. Here communication topology is described as a graph with loops. By using the generalized Kalman–Yakubovich–Popov lemma, the proposed DFEO is designed to avoid the overdesign problem generated by the entire-frequency domain. Furthermore, the design conditions for DFEO are formulated as linear matrix inequalities. Finally, compared with the [Formula: see text] approach in the entire-frequency domain, the proposed DFEO design approach shows better performance in numeral simulations of satellites attitude synchronization.
Book review: Kaveh Yazdani, India, Modernity and the Great Divergence: Mysore and Gujarat (17th to 19th C.)
Authors: Rothermund Dietmar
Published: February 2019

Kaveh Yazdani, India, Modernity and the Great Divergence: Mysore and Gujarat (17th to 19th C.), Brill, Leiden, 2017, 669 pp., US$246.
Book review: Saurabh Mishra, Beastly Encounters of the Raj: Livelihoods, Livestock and Veterinary Health in North India, 1790–1920
Authors: Chakrabarti Pratik
Published: February 2019

Saurabh Mishra, Beastly Encounters of the Raj: Livelihoods, Livestock and Veterinary Health in North India, 1790–1920, University of Manchester Press, Manchester, 2015, ix + 208 pp., Illustrated, £75.
Comparison of prognosis between emergency and scheduled hemodialysis
Authors: Bian Zhixiang , Gu Huiyi , Chen Peihua , Zhu Shijian
Published: February 2019

Background

The survival rate of patients undergoing hemodialysis and other renal replacement therapies has been extensively studied, but comparative studies of emergency and scheduled hemodialysis are limited.

Methods

This study included 312 patients who underwent emergency hemodialysis and 274 who received scheduled hemodialysis. We investigated the prognostic differences between these two groups of patients, including the short-term and long-term survival rates.

Results

The overall survival rate was significantly better among the patients in the scheduled hemodialysis group than emergency hemodialysis group. The mortality rate within 3 months of emergency hemodialysis was 4.8%, while that within 3 months of scheduled hemodialysis was 1.1%.

Conclusions

Significant differences were present between emergency and scheduled hemodialysis, especially the levels of serum creatinine and hemoglobin.
Transient Dean flow in a channel with suction/injection: A semi-analytical approach
Authors: Jha Basant K , Danjuma Yahaya J
Published: February 2019

The mathematical model responsible for fully developed laminar transient flow formation between the gaps of two stationary concentric porous tubes due to the imposition of azimuthal pressure gradient (Dean flow) is solved semi-analytically. The tubes walls are porous so that a radial flow can be superimposed. The solution of the momentum and continuity equations are obtained semi-analytically by using the combination of Laplace transform technique and a Laplace inversion method called Riemann sum approximation method. The solutions for skin friction at [Formula: see text] (outer surface of the inner porous tube) and [Formula: see text] (inner surface of the outer porous tube) are presented. The impact of suction/injection parameter and the ratio of the radii of the tubes are examined for the velocity profile and skin friction. Results show that the velocity profile decreases with increase in suction/injection parameter for various values of time, [Formula: see text] and at large value of time, ([Formula: see text]), the velocity and the skin friction attain a steady state.
The LAMB gait analysis protocol: Definition and experimental assessment of operator-related variability
Authors: Rabuffetti Marco , Marzegan Alberto , Crippa Alessandro , Carpinella Ilaria , Lencioni Tiziana , Castagna Anna , Ferrarin Maurizio
Published: February 2019

Gait analysis has demonstrated to efficaciously support clinical investigations. The patterns of the outcome variables (joint angles, moments and powers) are characterized by an intrinsic and extrinsic variability. Particularly, extrinsic variability is induced by operator-dependent differences in markers’ placement, with errors propagating non-linearly to alter outcome variable patterns. The aims of this study are (1) to consider a specific gait analysis protocol named LAMB and provide a description of its procedures, (2) to experimentally assess the between-operator and within-operator variability induced by operator-dependent marking of required anatomical landmarks and (3) to evidence how such inaccuracies propagates to the gait analysis kinematic and kinetic outcome variables. Six expert gait analysis operators performed LAMB anatomical landmarks marking on three healthy adult participants; moreover, one operator repeated three times the marking on one participant. The participants then performed a set of locomotor tasks including stair negotiation and heel- and toe-walking. An anatomical calibration approach let to register each marking and to compute, starting from one single raw data set, a set of outcome variables for each marking/operator. The between-operator variability of gait analysis outcome was assessed in terms of mean absolute variability to quantify offsets and minimal correlation coefficient to quantify patterns’ similarity. The results evidence average minimal correlation coefficient ranging from 0.857 for moments to 0.907 for angles and average mean absolute variability accounted for few degrees in angular variables (worst between-operator mean absolute variability is 7.3°), while dynamic variables mean absolute variability, relative to the variable range, was below 5% for moment and below 10% for powers. The variability indexes are comparable to those related to previously published protocols and are independent from the considered task, thus suggesting that the LAMB is a reliable protocol suitable for the analysis of different locomotor tasks.
Multifractal analysis of uterine electromyography signals to differentiate term and preterm conditions
Authors: Punitha N , Ramakrishnan S
Published: February 2019

In this study, an attempt has been made to identify the origin of multifractality in uterine electromyography signals and to differentiate term (gestational age > 37 weeks) and preterm (gestational age ≤ 37 weeks) conditions by multifractal detrended moving average technique. The signals obtained from a publicly available database, recorded from the abdominal surface during the second trimester, are used in this study. The signals are preprocessed and converted to shuffle and surrogate series to examine the source of multifractality. Multifractal detrended moving average algorithm is applied on all the signals. The presence of multifractality is verified using scaling exponents, and multifractal spectral features are extracted from the spectrum. The variation of multifractal features in term and preterm conditions is analyzed statistically using Student’s t-test. The results of scaling exponents show that the uterine electromyography or electrohysterography signals reveal multifractal characteristics in term and preterm conditions. Further investigation indicates the existence of long-range correlation as the primary source of multifractality. Among all extracted features, strength of multifractality, exponent index, and maximum and peak singularity exponents are statistically significant ( p < 0.05) in differentiating term and preterm conditions. The coefficient of variation is found to be lower for strength of multifractality and peak singularity exponent, which reveal that these features exhibit less inter-subject variance. Hence, it appears that multifractal analysis can aid in the diagnosis of preterm or term delivery of pregnant women.
European Criminal Law and the Dangerous Citizen
Authors: Mitsilegas Valsamis
Published: February 2019

This article will examine the impact of the Europeanization of punishment, and of criminal justice in general, on the focus of criminal law on dangerousness and on dangerous citizens, rather than on harm and facts. It argues that the EU criminal law is part of a growing global trend pushing towards preventive criminal justice, namely the exercise of state power in order to prevent future acts that are deemed to constitute security threats, which at EU level is problematic in terms of fundamental rights and citizenship rights. The article argues EU criminal law is contributing to three main shifts: a shift from an investigation of acts that have taken place due to an emphasis on suspicion, a shift from targeted action to generalized surveillance, or, underpinning both, a temporal shift from the past to the future. It develops this argument looking at administrative terrorist sanctions, criminalization of terrorist acts, mass surveillance and expulsion of convicted criminals.
Situational Awareness and Interpersonal Competence as Evaluator Competencies
Authors: Garcia Gabriela L. , Stevahn Laurie
Published: February 2019

This article reports research that examined the meaning of two broad evaluator competency domains. The first is situational awareness (SA) that focuses on understanding the unique contexts of evaluations and their users/stakeholders. The second is interpersonal competence (IC) that focuses on social skills needed for constructive interactions in conducting program evaluations. This research employed a qualitative design in which 13 experienced and skilled evaluators, purposively sought from varied professional contexts, participated in semistructured interviews that elicited thick descriptive narratives on what contributes to effective SA and IC in actual practice. Results revealed seven key factors pertinent to evaluator competence in these domains, plus the following three deeper dispositional elements underlying effective practice: (a) commitment to service, (b) humility as a learner, and (c) dedication to developing trust.
Development of an ultra short baseline–aided buoy for underwater targets localization
Authors: Fanelli Francesco , Monni Niccolò , Palma Nicola , Ridolfi Alessandro
Published: February 2019

Autonomous underwater vehicles localization and navigation are challenging due to the lack of Global Positioning System underwater: alternative techniques have then to be used in order to measure the position of the vehicle. To this aim, sensor fusion methods based on acoustic positioning systems are often exploited. This article faces the study and the improvement of the localization of an underwater target through an ultra short baseline–aided buoy built by the Mechatronics and Dynamic Modelling Laboratory of the University of Florence. Such a buoy relies on an ultra short baseline device for the localization and is aided by a proper sensor set in order to compensate variations in its pose. First, a study of the underwater localization based on the ultra short baseline technique is provided. The measurement errors entailed by the buoy motion are then analyzed and preliminarily compensated, exploiting linear least squares methods. Subsequently, filtering techniques are considered with the aim to further increase the accuracy of the ultra short baseline measurements. Due to the nonlinearities of the sensors characteristics, extended Kalman filter has been used, with different models for stationary and moving targets. The solutions proposed have been validated through experimental tests conducted with MArine Robotic Tool for Archaeology autonomous underwater vehicles built by the Mechatronics and Dynamic Modelling Laboratory. The results evidence an improved vehicle localization, suggesting interesting future developments concerning both mechanical and computational solutions.
Permanent Iodine-125 Seed Implantation for the Treatment of Nonresectable Retroperitoneal Malignant Tumors
Authors: Li Qingchun , Tian Yuan , Yang Dongyan , Liang Yun , Cheng Xianbin , Gai Baodong
Published: February 2019

Purpose:

This study aimed to investigate the outcomes of permanent Iodine-125 (125I) radiotherapy for patients with unresectable retroperitoneal malignant tumor.

Methods:

Twenty-six patients with retroperitoneal malignant tumors were implanted with 125I seeds under ultrasound guidance from June 2012 to June 2015. The patients were then followed up for 3 to 36 months after the implantation. During the follow-up, pain relief, control of tumor growth, over survival rate, and complications were evaluated.

Results:

Most of the patients (90%, 24/26) suffered from mild to severe pain before 125I seed treatment. After 1-month treatment, 16 patients had 100% pain relief, 4 patients had at least 50% pain relief, and 4 patients had no response, showing 83.3% of pain relief response. Results of computed tomography scan after 2-month 125I treatment indicated that 3 patients had complete remission in the tumor size, 20 patients had partial remission in tumor size, 2 patients were stable, and 1 patient had progressive disease, accounting for 88.4% response in tumor size remission. The median survival of the 26 patients was 11 months. The 1-year and 2-year overall survival rates were 46% and 27%, respectively. The median survival of the 5 patients with pancreatic cancer was 9.4 months. None of the patients had any severe complications.

Conclusions:

125I implantation could effectively relieve the pain in the patients with advanced primary or metastatic retroperitoneal malignant tumors and suppress local tumor progress.
Mindsets: A View From Two Eras
Authors: Dweck Carol S. , Yeager David S.
Published: February 2019

A growth mindset is the belief that human capacities are not fixed but can be developed over time, and mindset research examines the power of such beliefs to influence human behavior. This article offers two personal perspectives on mindset research across two eras. Given recent changes in the field, the authors represent different generations of researchers, each focusing on different issues and challenges, but both committed to “era-bridging” research. The first author traces mindset research from its systematic examination of how mindsets affect challenge seeking and resilience, through the ways in which mindsets influence the formation of judgments and stereotypes. The second author then describes how mindset research entered the era of field experiments and replication science, and how researchers worked to create reliable interventions to address underachievement—including a national experiment in the United States. The authors conclude that there is much more to learn but that the studies to date illustrate how an era-bridging program of research can continue to be generative and relevant to new generations of scholars.
Pattern of and reasons for antiretroviral therapy regimen change among adult HIV/AIDS patients at regional hospital in Eastern Ethiopia: A 10-year retrospective study
Authors: Sisay Mekonnen , Edessa Dumessa , Ayele Yohanes , Getachew Mesay
Published: February 2019

Objectives:

Despite the successes of treatment with antiretroviral therapy in reducing morbidity and mortality among HIV-infected patients, long-term sustainability of the initial regimen has become challenging. Therefore, this study is aimed to address pattern of and reasons for change of antiretroviral therapy regimens among HIV/AIDS patients at Jugel Hospital, Eastern Ethiopia.

Methods:

A retrospective cross-sectional study was conducted to review medical records of 220 patients who had been on treatment and experienced regimen change at least once from September 2006 to August 2016. Structured data abstraction format was customized from World Health Organization guideline. Data were entered in Epi-data version 3.1, and exported to and analyzed with Statistical Package for Social Sciences version 20. Following descriptive statistics, binary logistic regression was run to determine the association between selected variables and second-time regimen change.

Results:

The mean age of patients was 37.6 (±8.9) years and 62.3% of them were female. Majority of the patients were presented to the hospital with World Health Organization clinical stage III (59.1%) and CD4 count below 200 cells/mm3 (68.6%). The mean duration of stay on initial regimen was found to be 3.26 (±1.92) years. The average number of initial regimen changes per year was 22 (±11.28). In two-thirds (66.36%) of the patients, their initial regimen was changed to tenofovir disproxil fumarate–based alternatives. The most-frequent reason for initial regimen change was toxicity (32.3%). Among those who experienced the regimen change for the first time, the prevalence of second-time regimen change was found to be 18.18%. Patients who had been taking tuberculosis treatment along with antiretroviral therapy were more likely to get their regimen changed for the second-time compared to those who were not infected with tuberculosis (adjusted odds ratio: 3.40; 95% confidence interval: 1.87–6.47). Besides, patients who were on zidovudine-based (adjusted odds ratio: 0.26; 95% confidence interval: 0.33–0.47) and tenofovir disoproxil fumarate–based regimens (adjusted odds ratio: 0.03; 95% confidence interval: 0.01–0.12) were less likely to get their regimen changed for the second-time compared to those who were on stavudine-based regimens.

Conclusion:

The majority of the patients had their treatment regimen changed because of drug-related toxicities, treatment failure, and comorbid conditions. Some regimen changes might be attributable to failure of either hospital supply system or patient-related factors which would have been prevented considering limited number of treatment options. There must be consideration of risks and benefits prior to changing a particular regimen.
Meeting Geriatric Competencies: Are Internal Medicine Residency Programs in New Jersey Meeting Expectations for Quality Care in Older Adults
Authors: Sedhom Ramy , Sedhom Daniel , Barile David
Published: February 2019

There has long been recognition for improved education and training in aging and geriatrics. As the number of older individuals in the United States increases, with 20% being older than 65 years by 2030, it will become increasingly important for internists and medical subspecialty trainees to have proper training in the care of older adults. A survey was developed and administered to Internal Medicine Program Directors, to perform an educational needs assessment. The survey was administered during the beginning of the 2015 academic year via email. The survey assessed general program characteristics, details regarding required geriatric and palliative medicine teaching, opportunities for electives, barriers encountered at each training site, and future recommendations for improving the structure of resident education. Analysis of survey responses indicated that geriatric and palliative care education is lacking. Although all training programs provided some aspect of geriatric and palliative medicine training to internal medicine residents, only 27% of training programs had a formal curriculum in geriatric and palliative medicine. The majority had an informal curriculum. Very few programs reported using a multimodality approach; most used isolated experiences in either an inpatient or an outpatient setting. Although all residency directors believed curricular developments in geriatric and palliative medicine were important, very few have available faculty needed to facilitate curricular improvements. Almost all identified that they would use a restructured curriculum if it were readily available. Investment in developing content and a standardized curriculum in geriatric and palliative medicine would be very valuable and well received in New Jersey.
Using Professional Online Portfolios to Enhance Student Transition Into the Poststudent World
Authors: Watson McClain
Published: February 2019

Although most students have learned to succeed academically, by the time they enter our business communication courses, their time as students is almost over. This article describes the challenges facing “students who will soon stop being students” and introduces the professional online portfolio as a project which enables them to develop the confidence, the capacity, and a concrete platform with which to communicate with the world outside the black box of school.
Molecular Concepts Adaptive Assessment (MCAA) Characterizes Undergraduate Misconceptions about Molecular Emergence
Authors: Gauthier Andrea , Jantzen Stuart , McGill Gaël , Jenkinson Jodie
Published: February 2019

This paper discusses the results of two experiments assessing undergraduate students’ beliefs about the random nature of molecular environments. Experiment 1 involved the implementation of a pilot adaptive assessment ( n = 773) and focus group discussions with undergraduate students enrolled in first- through third-year biology courses; experiment 2 involved the distribution of the redesigned adaptive assessment to the same population of students in three consecutive years ( n = 1170). The overarching goal of the study was to provide a detailed characterization of learners’ perceptions and beliefs regarding molecular agency, environments, and diffusion and whether or not those beliefs change over time. Our results indicated that advanced learners hold as many misconceptions as novice learners and that confidence in their misconceptions increases as they advance through their undergraduate education. In particular, students’ understanding of random/Brownian motion is complex and highly contextual, suggesting that the way in which we teach biology does not adequately remediate students’ preconceived notions of molecular agency and may actually reinforce them.
Comparative Assessment of Clinical Benefit Using the ESMO-Magnitude of Clinical Benefit Scale Version 1.1 and the ASCO Value Framework Net Health Benefit Score
Authors: Cherny Nathan I. , de Vries Elisabeth G.E. , Dafni Urania , Garrett-Mayer Elizabeth , McKernin Shannon E. , Piccart Martine , Latino Nicola J. , Douillard Jean-Yves , Schnipper Lowell E. , Somerfield Mark R. , Bogaerts Jan , Karlis Dimitris , Zygoura Panagiota , Vervita Katerina , Pentheroudakis George , Tabernero Josep , Zielinski Christoph , Wollins Dana S. , Schilsky Richard L.
Published: February 2019

PURPOSE

To better understand the European Society for Medical Oncology-Magnitude of Clinical Benefit Scale version 1.1 (ESMO-MCBS v1.1) and the ASCO Value Framework Net Health Benefit score version 2 (ASCO-NHB v2), ESMO and ASCO collaborated to evaluate the concordance between the frameworks when used to assess clinical benefit attributable to new therapies.

METHODS

The 102 randomized controlled trials in the noncurative setting already evaluated in the field testing of ESMO-MCBS v1.1 were scored using ASCO-NHB v2 by its developers. Measures of agreement between the frameworks were calculated and receiver operating characteristic curves used to define thresholds for the ASCO-NHB v2 corresponding to ESMO-MCBS v1.1 categories. Studies with discordant scoring were identified and evaluated to understand the reasons for discordance.

RESULTS

The correlation of the 102 pairs of scores for studies in the noncurative setting is estimated to be 0.68 (Spearman’s rank correlation coefficient; overall survival, 0.71; progression-free survival, 0.67). Receiver operating characteristic curves identified thresholds for ASCO-NHB v2 for facilitating comparisons with ESMO-MCBS v1.1 categories. After applying pragmatic threshold scores of 40 or less (ASCO-NHB v2) and 2 or less (ESMO-MCBS v1.1) for low benefit and 45 or greater (ASCO-NHB v2) and 4 to 5 (ESMO-MCBS v1.1) for substantial benefit, 37 discordant studies were identified. Major factors that contributed to discordance were different approaches to evaluation of relative and absolute gain for overall survival and progression-free survival, crediting tail of the curve gains, and assessing toxicity.

CONCLUSION

The agreement between the frameworks was higher than observed in other studies that sought to compare them. The factors that contributed to discordant scores suggest potential approaches to improve convergence between the scales.
Vascular Cognitive Impairment
Authors: Graff-Radford Jonathan
Published: February 2019

PURPOSE OF REVIEW

This article provides an overview of vascular cognitive impairment; discusses its epidemiology, subtypes, and associations with other neurodegenerative diseases; and reviews the diagnostic evaluation and management of these disorders.

RECENT FINDINGS

Cerebrovascular disease is a common cause of dementia and frequently coexists with neurodegenerative causes. The heterogeneity of mechanisms leading to vascular cognitive impairment makes developing unifying clinical and research criteria difficult. Recognizing the neuroimaging hallmarks of different forms of vascular cognitive impairment can allow for individualized treatment and management. In individuals with mild vascular cognitive impairment, aerobic exercise appears to be a promising treatment but requires further investigation.

Vascular cognitive impairment can be caused by several mechanisms. While treating vascular risk factors is rational to prevent worsening of cognitive impairment, well-designed studies are needed to demonstrate efficacy.
Early-onset Alzheimer Disease and Its Variants
Authors: Mendez Mario F.
Published: February 2019

PURPOSE OF REVIEW

Early-onset Alzheimer disease (AD) is defined as having an age of onset younger than 65 years. While early-onset AD is often overshadowed by the more common late-onset AD, recognition of the differences between early- and late-onset AD is important for clinicians.

RECENT FINDINGS

Early-onset AD comprises about 5% to 6% of cases of AD and includes a substantial percentage of phenotypic variants that differ from the usual amnestic presentation of typical AD. Characteristics of early-onset AD in comparison to late-onset AD include a larger genetic predisposition (familial mutations and summed polygenic risk), more aggressive course, more frequent delay in diagnosis, higher prevalence of traumatic brain injury, less memory impairment and greater involvement of other cognitive domains on presentation, and greater psychosocial difficulties. Neuroimaging features of early-onset AD in comparison to late-onset AD include greater frequency of hippocampal sparing and posterior neocortical atrophy, increased tau burden, and greater connectomic changes affecting frontoparietal networks rather than the default mode network.

Early-onset AD differs substantially from late-onset AD, with different phenotypic presentations, greater genetic predisposition, and differences in neuropathologic burden and topography. Early-onset AD more often presents with nonamnestic phenotypic variants that spare the hippocampi and with greater tau burden in posterior neocortices. The early-onset AD phenotypic variants involve different neural networks than typical AD. The management of early-onset AD is similar to that of late-onset AD but with special emphasis on targeting specific cognitive areas and more age-appropriate psychosocial support and education.
Primary Progressive Aphasias and Apraxia of Speech
Authors: Botha Hugo , Josephs Keith A.
Published: February 2019

PURPOSE OF REVIEW

This article reviews two of the primary progressive aphasias (PPAs), disorders characterized by the early and predominant impairment of language, and primary progressive apraxia of speech, a degenerative motor speech disorder that is closely related to PPA. An outline of the history and controversy surrounding how these disorders are classified is provided before the article focuses on each disorder’s clinical and imaging features.

RECENT FINDINGS

Over the past decade, the classification of degenerative speech and language disorders has been refined. Clinical, imaging, and pathologic evidence suggests that primary progressive apraxia of speech is a distinct degenerative disorder. Furthermore, multiple lines of evidence have highlighted issues with nonfluent/agrammatic variant PPA, which complicates the diagnosis, prognosis, and study of this disorder. Semantic variant PPA, while not without controversy, remains one of the most well-defined disorders, with good clinicopathologic correlation.

Accurate classification and diagnosis of these degenerative speech and language disorders is crucial in clinical practice and ongoing research efforts. For nonfluent/agrammatic variant PPA, the authors suggest emphasizing agrammatism as the core inclusion criterion and taking care not to include patients with isolated or predominant apraxia of speech. Isolated apraxia of speech can be the manifestation of a degenerative disease and, based on the different prognosis, should be recognized as distinct from PPA. Finally, it is important to recognize that some patients with semantic dementia, despite sharing the same pathologic associations, may not meet criteria for PPA.
Mechanisms of Notch signaling: a simple logic deployed in time and space
Authors: Henrique Domingos , Schweisguth François
Published: February 2019

Most cells in our body communicate during development and throughout life via Notch receptors and their ligands. Notch receptors relay information from the cell surface to the genome via a very simple mechanism, yet Notch plays multiple roles in development and disease. Recent studies suggest that this versatility in Notch function may not necessarily arise from complex and context-dependent integration of Notch signaling with other developmental signals, but instead arises, in part, from signaling dynamics. Here, we review recent findings on the core Notch signaling mechanism and discuss how spatial-temporal dynamics contribute to Notch signaling output.